Which is Healthier: Being a Vegetarian or Eating a Mediterranean Diet?

Danny Kim for TIME By JAMIE DUCHARME February 26, 2018 The Mediterranean diet is consistently heralded as one of the most healthful eating styles. It’s heavy on produce, nuts, whole grains, olive oil and lean protein, and light on red meat, processed foods and refined sugars. But a new study finds that vegetarian diets may be just as good at keeping your heart healthy, according to a study published in the journal Circulation. For the study, a group of Italian researchers recruited 100 overweight but healthy adults with low-to-moderate cardiovascular risk profiles. Half the group started on a Mediterranean diet, while the other started on a lacto-ovo-vegetarian diet, which eliminates meat and fish but includes eggs and dairy. After three months, they switched. During and after both phases of the study, everyone had regular health screenings. Both diets, the researchers found, were good for people’s heart health — but in different ways. The vegetarian diet led to a more substantial drop in the “bad” LDL cholesterol that contributes to plaque build-up in the arteries, which is a risk factor for heart attack and stroke. The Mediterranean diet, meanwhile, led to a greater drop in triglycerides, which at elevated levels can be a risk factor for the same conditions. “We were able to show that if a person follows for three months … either a lacto-ovo or a Mediterranean diet, they are both beneficial for reducing cardiovascular risk factors,” says study author Francesco Sofi, an associate professor of food science and clinical nutrition at the University of Florence in Italy. The researchers also found that both diets led to modest decreases in body weight and body fat. On each plan, people lost an average of four pounds overall, three of them from fat. The findings aren’t entirely shocking since, as an accompanying editorial notes, the two eating styles have plenty of overlap. They’re both heavy on whole grains, produce, legumes and nuts, though vegetarians tended to make up for lost meat and fish with extra beans, nuts, eggs and dairy products, according to the study. Still, the eating plans are different enough to underscore the fact that there’s no such thing as a universal “best” diet, and that there are plenty of ways to achieve good health through food. “We have now two options in terms of the prevention of cardiovascular and also other diseases,” Sofi says. “They are both quite equally beneficial.” ORIGINAL RESEARCH ARTICLE Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet) Francesco Sofi, Monica Dinu, Giuditta Pagliai, Francesca Cesari, Anna Maria Gori, Alice Sereni, Matteo Becatti, Claudia Fiorillo, Rossella Marcucci, Alessandro Casini Download PDF https://doi.org/10.1161/CIRCULATIONAHA.117.030088 Circulation. 2018;CIRCULATIONAHA.117.030088 Originally published February 26, 2018 Article Supplemental Materials Info & Metrics eLetters Abstract Background—Only a few randomized dietary intervention studies that investigated the effects of lacto-ovo vegetarian diet (VD) in clinically healthy omnivorous subjects are available. Methods—We randomly assigned to overweight omnivores with a low-to-moderate cardiovascular risk profile a low-calorie VD compared with a low-calorie Mediterranean diet (MD), each lasting 3 months, with a crossover design. The primary outcome was the difference in body weight, body mass index, and fat mass changes between the 2 groups. Secondary outcomes were differences in circulating cardiovascular disease risk parameters changes between the 2 groups. Results—One hundred eighteen subjects (mean age: 51.1 years, females: 78%) were enrolled. The total participation rate at the end of the study was 84.7%. No differences between the 2 diets in body weight were observed, as reported by similar and significant reductions obtained by both VD (‒1.88 kg) and MD (‒1.77 kg). Similar results were observed for body mass index and fat mass. In contrast, significant differences between the 2 interventions were obtained for low-density lipoprotein cholesterol, triglycerides, and vitamin B12 levels. The difference between the VD and MD groups, in terms of end-of-diet values, was recorded at 9.10 mg/dL for low-density lipoprotein cholesterol (P=0.01), 12.70 mg/dL for triglycerides (P<0.01), and 32.32 pg/mL for vitamin B12 (P<0.01). Finally, no significant difference was found between VD and MD interventions in oxidative stress markers and inflammatory cytokines, except for interleukin-17, which improved only in the MD group. Forty-six participants during the VD period and 35 during the MD period reached the target values for ≥1 cardiovascular risk factor. Conclusions—Both VD and MD were effective in reducing body weight, body mass index, and fat mass, with no significant differences between them. However, VD was more effective in reducing low-density lipoprotein cholesterol levels, whereas MD led to a greater reduction in triglyceride levels. Clinical Trial Registration—URL: https://www.clinicaltrials.gov. Unique identifier: NCT02641834. Medit