A quick one today. I will take a brief look at a recent study in the American Journal of Clinical Nutrition examined Intermittent Fasting (IF), Paleolithic diet (PD) or Mediterranean diets (MD) and compared results of weight-loss and other biomarkers of health and disease.

Methods were as follows:

  • Subjects (250 overweight, otherwise healthy adults chose the diet protocol they were to follow (tools in the toolbox) and attended an individualized dietary education session (30 mins) on their chosen protocol. 3-day intake records, weight, body composition, blood pressure, physical activity (0, 6 & 12 mo) and blood indexes (0 and 12 mo) were assessed.

  • Subjects chose which diet protocol to follow for the year. Choices were made as follows: Initially – 54.4% – IF, 27.2% – MD & 18.4% – PD; Of these the following were still following their original choice at 12 mo: 54% – IF, 57% – MD & 35% – PD.

The significant outcomes after 12 mo were as follows:

  • Weight loss: -4.0 kg IF, -2.8 kg MD & -1.8 kg PD.

  • Due to substantial drop out – these results might be over-estimated by ≦1.2 kg.

  • Adherence to the chosen diet increased mean weight loss by 1.1, 1.8 & 0.3 kg, respectively.

  • Glycated Hemoglobin (A1C) (mmol/mol): -0.8 in MD, however, between group differences in most outcomes NOT significant.

My 2 Cents:

There is a motivational bias inherent in this study, which is mentioned and estimated for effect, but cannot really be accurately, practically measured. It is that the clients are choosing their preferred diet protocol and that the individuals who completed the trial, possibly had pre-existing motivation above normal vs. those that dropped out. Although, this is obvious to say, it could have been partially captured with a simple psychology/belief test/survey at baseline. Then the effect of these values could have been better quantified and (at least) statistically controlled for.

The rest of the findings are more or less what I would expect. All the plans are reasonable and relatively well balanced in terms of intake of nutrient-dense foods in their approach.
All produced significant improvements in weight reduction and non-significantly improved some metabolic markers that were measured.

However, the biggest difference was the adherence rate. These were in descending order MD, IF & PD. MD & IF had very similar adherence rates (57 vs. 54%, respectively), while PD was lower at 35%. This could be due to 2 main factors. 1) Mainstream medical acceptance and promotion of the MD and denouncing of “alternative diets” (i.e. PD and even IF) could have confounded the adherence rates; 2) The higher dietary restrictions present in the PD also likely played a role in the lower adherence rate to this protocol.


So, my conclusion is this. As long as you are otherwise healthy and trying to prevent metabolic and other health problems rather than treating them, any of these diets and other are all fine for achieving the goal of weight loss, body composition improvement and improvement of biomarkers of health and disease over the long term.

The most important predictor of success is whether or not you will adhere to the diet or not. A diet/lifestyle change does you no good if you don’t stick to it. Given this, one could argue that it’s important that you choose a diet and lifestyle plan that you will be able to stick with.  I’ve already written about the benefits of IF and how much easier it is, in my opinion, to stick with (here).

That’s all for today.

If you are looking to make changes, be sure to subscribe to my site for more useful info and check out my store (here) and contact me if you want help choosing a diet and lifestyle plan that will give you the best odds of success.

Cheers and see you next time!

Dan T


Michelle R Jospe, Melyssa Roy, Rachel C Brown, Jillian J Haszard, Kim Meredith-Jones, Louise J Fangupo, Hamish Osborne, Elizabeth A Fleming, Rachael W Taylor, Intermittent fasting, Paleolithic, or Mediterranean diets in the real world: exploratory secondary analyses of a weight-loss trial that included choice of diet and exercise, The American Journal of Clinical Nutrition, , nqz330, https://doi.org/10.1093/ajcn/nqz330