Mediterranean diet and weight loss: meta-analysis of randomized controlled trials.
BACKGROUND
The epidemiological evidence supporting a causal link between Mediterranean diets and body weight is contrasting. We evaluated the effect of Mediterranean diets on body weight in randomized controlled trials (RCTs) using a meta-analysis.


METHODS
We searched English and non-English publications in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from inception to January, 2010. Two evaluators independently selected and reviewed eligible studies. Sixteen randomized controlled trials, with 19 arms and 3,436 participants (1,848 assigned to a Mediterranean diet and 1,588 assigned to a control diet) were included.


RESULTS
In a random-effects meta-analysis of all 19 arms, the Mediterranean diet group had a significant effect on weight [mean difference between Mediterranean diet and control diet, -1.75 kg; 95% confidence interval (CI), -2.86 to -0.64 kg] and body mass index (mean difference, -0.57 kg/m², -0.93 to -0.21 kg/m²). The effect of Mediterranean diet on body weight was greater in association with energy restriction (mean difference, -3.88 kg, -6.54 to -1.21 kg), increased physical activity (-4.01 kg, -5.79 to -2.23 kg), and follow up longer than 6 months (-2.69 kg, -3.99 to -1.38 kg). No study reported significant weight gain with a Mediterranean diet.


CONCLUSIONS
Mediterranean diet may be a useful tool to reduce body weight, especially when the Mediterranean diet is energy-restricted, associated with physical activity, and more than 6 months in length. Mediterranean diet does not cause weight gain, which removes the objection to its relatively high fat content. These results may be useful for helping people to lose weight.
Esposito
Katherine
K
Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy. katherine.esposito@unina2.it
Kastorini
Christina-Maria
CM
Panagiotakos
Demosthenes B
DB
Giugliano
Dario
D
D000328:Adult; D000368:Aged; D000465:Algorithms; D038441:Diet, Mediterranean; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D015431:Weight Loss / Q000502:physiology*