Mediterranean Diet Versus Very Low Calorie Ketogenic Diet Effects Of Reaching 5 Body Weight Loss On Body Composition In Subjects With Overweight And With Obesity—A Cohort Study

This study examined two popular weight loss approaches - the Mediterranean diet and a very low-calorie ketogenic diet (VLCKD) - to see how quickly they help people lose 5% of their body weight and how they affect body composition. Researchers followed 268 people with overweight or obesity for up to three months, randomly assigning them to follow either diet until they achieved the 5% weight loss target.

The ketogenic diet worked much faster, helping people reach their 5% weight loss goal in just one month, while the Mediterranean diet took the full three months. However, speed wasn't everything - the diets affected body composition differently. Both approaches successfully reduced overall body weight and fat mass, but the Mediterranean diet proved superior in several important ways: it led to greater reductions in waist circumference and fat mass, while better preserving muscle mass (fat-free mass) and maintaining healthy hydration levels.

These findings suggest that while ketogenic diets may offer quicker initial results, the Mediterranean diet may provide more favorable long-term body composition changes. The preservation of muscle mass is particularly important for metabolic health, as muscle tissue burns more calories at rest and supports healthy aging. The greater reduction in waist circumference with the Mediterranean diet is also significant, since abdominal fat is closely linked to increased risks of diabetes and heart disease.

For clinical practice, this research supports offering patients options based on their goals and preferences - ketogenic approaches for those seeking rapid initial results, and Mediterranean patterns for those prioritizing sustainable body composition improvements and muscle preservation.