Paleo, Fasting and Mediterranean Diets All Offer Weight Loss and Health Improvements

Just about everyone would really love to know which diet is best. Which nutritional style offers the best path to weight loss and management and better health? Now, the good folks at the University of Otago have done the heavy lifting and found the answer to the question “What diet is the right one for me?”

Really, they came up with three answers. It turns out that the Paleo diet, the Mediterranean diet and Intermittent Fasting all offer weight loss and health benefits for adults who use them. Sticking to any of them, however, seems to be a problem. The Otago researchers noted a significant reduction in compliance over the one-year period of the study.

The researchers chose a form of Intermittent Fasting for the study wherein dieters limited their intake to approximately 25 percent of their normal caloric intake on two days a week of their choosing. This averaged 600 calories for the guys and 500 calories for the women. This led to slightly more weight loss than either the Paleo or Mediterranean diets. The Mediterranean diet, however, improved blood sugar levels best.

Overall weight loss results were modest, according to co-lead author Dr. Melyssa Roy, Research Fellow in the Department of Medicine. The 250 participants averaged between 4 1/2 and 9 pounds lost over the year. The fasting and Mediterranean diet groups also saw significant improvements in blood pressure.

Unlike clinical studies which take place in highly controlled environments, this study required a healthy dose of real life to get results that could be applied to actual people living actual lives. To that end, those participating in the study chose which diet they were going to use. They got no ongoing support from a dietitian (just like in the real world!) According to Dr. Roy, this study and it’s evidence show that the Mediterranean, Paleo or Intermittent Fasting diets can be “healthful, beneficial ways to eat.”

“This work supports the idea that there isn’t a single ‘right’ diet — there are a range of options that may suit different people and be effective. In this study, people were given dietary guidelines at the start and then continued with their diets in the real world while living normally. About half of the participants were still following their diets after a year and had experienced improvements in markers of health.

“Like the Mediterranean diet, intermittent fasting and paleo diets can also be valid healthy eating approaches — the best diet is the one that includes healthy foods and suits the individual.”


Just to clear up any confusion, the Mediterranean diet doesn’t require you to move to Italy, Greece or some other sun-soaked Mediterranean locale (although I bet you’d get better stress-management results!) It does require reduction of red meat consumption to once a week (or less,) along with moderate amounts of chicken, eggs, dairy and fish. The diet also stresses consumption of vegetables, fruits, legumes, nuts, seeds, whole-grain breads and olive oil (of course!)

The study used a modified, less restrictive version of the Paleo (short for Paleolithic) diet. Paleo diet purists will typically exclude all dairy, grains and legumes and emphasize less-processed foods like fruits and vegetables, animal proteins, nuts, extra-virgin olive oil and coconut products like coconut oil. For the study, Paleo eaters were permitted some dairy and a maximum of one serving per day of legumes and grain-based foods.

The Mediterranean diet was the easiest to stick to, according to Dr. Michelle Jospe, co-lead author and Postdoctoral Felllow in the University of Otago Department of Medicine.

“Our participants could follow the diet’s guidelines more closely than the fasting and paleo diets and were more likely to stay with it after the year, as our retention rates showed.”

Diet distribution among the 250 participants broke down to 54 percent fasting, 27 percent Mediterranean diet and 18 percent Paleo. At the end of the 12 months, 57 percent of those starting with the Mediterranean diet were still adhering to it. 54 percent of fasters were still fasting and only 35 percent of the Paleo eaters were still, um, “Paleo-ing.”

Let’s face it, most diets fail. People either quit on their diets or end up regaining the weight within a year or two. I won’t even waste your time citing the hundreds of studies that back that up. You know people in your own life, maybe it was even you, who have failed on diets. So retention rates of 35 to 57 percent are pretty solid, I’d say.

But was the weight loss worth the effort. You be the judge. After 12 months, those who chose fasting had lost about 9 pounds, those on the Mediterranean diet had lost about 6.2 pounds and the Paleo folks had lost about 4 pounds. Not exactly earth-shaking weight loss.

However, there are other factors to consider. The fasting and Mediterranean dieters reduced their systolic blood pressure and the Mediterranean dieters saw their blood sugar lowered as well.

I’ve written before about the importance of sustainability in choosing a diet or eating plan. Dr. Jospe backs that up, noting that those who were still following their chosen diet plan at 12 months continued to lose weight.

She thinks these outcomes are important to the many thousands of people who follow diets they’ve chosen themselves and have little supervision or professional help. If sustainability and satisfaction with their chosen way of eating are the focus, better health outcomes are more realistic and can be expected to last.

Science backs up the idea of happiness, satisfaction and sustainable health outcomes over quick fixes, rapid transformations and all the rest of the crap in the fitness and nutrition “industry?” Who would have thought that would happen?

Me. I did, along with every other person in my field who thinks past the instant gratification and quick buck. Get sustainable, get results and get a happier, longer life. Isn’t that the point of changing health habits in the first place?

Keep the faith and keep after it!

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Journal Reference – Michelle R Jospe, Melyssa Roy, et al., 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, 2019

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