Real-World Comparison of Paleo, Mediterranean, and Intermittent Fasting Diets for Weight Loss

New Zealand researchers didn’t find much difference in outcomes between the three diets: intermittent fasting, Mediterranean, or paleo.

I don’t have the full article so know few details about the diets. For instance, there are many different intermitting fasting diets: which one did they use?

250 overweight adults chose which diet they wanted to follow for 12 months. Participants got a 30-minute educational session on their chosen diet and then were set loose. They may also have chosen “standard exercise” or high-intensity interval training.

From the report abstract:


Although 54.4% chose IF [intermittent fasting], 27.2% Mediterranean, and 18.4% Paleo diets originally, only 54% (IF), 57% (Mediterranean), and 35% (Paleo) participants were still following their chosen diet at 12 mo (self-reported). At 12 mo, weight loss was -4.0 kg (95% CI: -5.1, -2.8 kg) in IF, -2.8 kg (-4.4, -1.2 kg) in Mediterranean, and -1.8 kg (-4.0, 0.5 kg) in Paleo participants. Sensitivity analyses showed that, due to substantial dropout, these may be overestimated by ≤1.2 kg, whereas diet adherence increased mean weight loss by 1.1, 1.8, and 0.3 kg, respectively. Reduced systolic blood pressure was observed with IF (-4.9 mm Hg;  -7.2, -2.6 mm Hg) and Mediterranean (-5.9 mm Hg; -9.0, -2.7 mm Hg) diets, and reduced glycated hemoglobin with the Mediterranean diet (-0.8 mmol/mol; -1.2, -0.4 mmol/mol). However, the between-group differences in most outcomes were not significant and these comparisons may be confounded due to the nonrandomized design.


Small differences in metabolic outcomes were apparent in participants following self-selected diets without intensive ongoing dietary support, even though dietary adherence declined rapidly. However, results should be interpreted with caution given the exploratory nature of analyses.

Source: Intermittent fasting, Paleolithic, or Mediterranean diets in the real world: exploratory secondary analyses of a weight-loss trial that included ch… – PubMed – NCBI

I probably won’t bother to read the full report. You’re welcome to it for $35 USD. The abstract doesn’t convince me it’s worth my time and money.

Steve Parker, M.D.

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