As individuals age, the propensity to accumulate visceral fat in the abdominal region while simultaneously losing muscle mass becomes increasingly prevalent. This shift in body composition has been closely associated with metabolic syndrome, a cluster of symptoms that raises the risk of cardiovascular disease and type 2 diabetes. However, a recent study, published in JAMA Network Open on October 18, 2023, suggests that adopting a low-calorie version of the Mediterranean diet alongside increased physical activity could counteract these undesirable changes.
The research, which is part of the ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) study in Spain, has been designed to evaluate the Mediterranean diet’s effectiveness in preventing cardiovascular disease. The study involves middle-aged and older individuals who have overweight or obesity and are diagnosed with metabolic syndrome, a condition characterized by obesity, high blood pressure, elevated blood triglycerides, low levels of HDL (“good”) cholesterol, and insulin resistance.
The focus of the current report is a subgroup of 1,521 participants who underwent body composition assessments using dual-energy X-ray absorptiometry (DXA scans) at various points during the study. These participants were randomly divided into two groups.
The intervention group followed a reduced-energy Mediterranean diet, reducing their calorie intake by 30%, while simultaneously increasing their physical activity. In contrast, the control group adhered to a Mediterranean diet but without calorie restrictions or enhanced physical activity.
Analysis of the data revealed “clinically meaningful” alterations in body composition among the group that consumed fewer calories and exercised more. They exhibited notable improvements, including a 5% or greater reduction in total fat mass, total lean mass, and visceral fat mass, particularly at the one-year mark.
The research team’s conclusion points to the efficacy of a reduced-energy Mediterranean diet in conjunction with increased physical activity as a means to counteract age-related shifts in body composition.
When asked about the study’s findings, Dr. David Seres, Professor of Medicine at the Institute of Human Nutrition at Columbia University Medical Center, who was not involved in the study, commented that the results were not surprising and emphasized the importance of structured weight loss programs that incorporate reduced calorie diets and exercise. Nevertheless, he highlighted a potential issue with the study’s post hoc analysis, suggesting that it might introduce bias and advising the replication of results in new trials.
The Mediterranean diet’s efficacy lies in its emphasis on whole, healthy foods, including vegetables, fruits, legumes, whole grains, olive oil, fish, nuts, seeds, herbs, and spices. To adapt this diet for fat loss, individuals can reduce portion sizes, limit the consumption of calorie-dense foods like oils, and cut down on refined sugar. Maintaining a balanced plate, which includes a variety of food groups like vegetables, fruits, protein, carbohydrates, and healthy fats, is crucial.
To further lower calorie intake, registered dietitian Avery Zenker recommends concentrating on whole, minimally processed foods, and incorporating fiber-rich options such as fruits, vegetables, legumes, whole grains, nuts, and seeds. She advises adopting a gradual approach, focusing on adding nutrient-rich, lower-calorie foods to replace higher-calorie options.
Practicing portion control, especially with calorie-dense items like nuts, seeds, and olive oil, and embracing mindful eating to understand hunger and satiety cues are also key recommendations. Enhancing meals with generous use of herbs and spices, which provide flavor and antioxidants with minimal calories, is another effective strategy.
Zenker suggests meal planning to ensure access to healthy options at all times, along with maintaining proper hydration. Lastly, preparing for setbacks and having a contingency plan can enhance consistency and confidence in maintaining a Mediterranean diet for weight loss.
In conclusion, age-related changes in body composition, such as increased visceral fat and decreased muscle mass, can elevate the risk of cardiovascular disease and diabetes. However, the study indicates that a low-calorie Mediterranean diet, in combination with increased physical activity, can mitigate these effects. The Mediterranean diet’s flexible and balanced approach, emphasizing whole foods and reduced calorie consumption, makes it a promising choice for those seeking to shed unwanted pounds.