As the fascination with a low-fat diet fades into history, along with VHS tapes and New Kids on the Block, three diets are getting more attention – the Mediterranean diet, Low-Carb and Paleo. Is one superior compared to the other two?
Unfortunately, no one has performed a solid research study comparing these three diets. Personally, Vanessa and I lean toward Low-Carb and Paleo over the Mediterranean Diet for reasons I’ll explain below. First, a little overview on each.
The Mediterranean Diet
Of the three styles of eating, the Mediterranean diet has received the most research attention. However, a significant amount of the research has been observational research, or population-based studies. Researchers look at groups of people or populations who are identified as mainly eating a certain way, look at their health outcomes and compare them to other groups.
Observations are only the first step of the scientific method—a good place to start, but never the place to end. These studies don’t exist to generate health advice, but to spark hypotheses that can be tested and replicated in a controlled setting so we can figure out what’s really going on. Trying to find “proof” in an observational study is like trying to make a penguin lactate. It just ain’t happening… ever. Mark Sisson
With the Mediterranean diet, a large part of the problem lies in the fact that there is no clear definition of what makes up the diet.
Part of the popularity comes from the health and longevity of people living near the Mediterranean. Their diet is often characterized as consisting of more olive oil, legumes, vegetables, fruit, unrefined grains and fish. They also tend to eat less meat and drink more wine. Does that mean these food choices make them healthy, or are they a generally healthier people who happen to eat this way? My assumption is the latter.
Often overlooked is the fact that in some areas of the Mediterranean, foods are cooked in lard, butter and sheep’s tail fat. Don’t tell that to the average nutritionist who thinks saturated fat is bad.
To further complicate things, the entire lifestyle of those in the Mediterranean is significantly different than those living in modern day America. People are far more active, have less stress, take more breaks during the day and have much stronger relationships than we do. It’s possible their health could be maintained by eating a diet of only meat, lard and wine while living the same lifestyle. We just don’t know.
Research on a more standardized Mediterranean diet has shown that it lowers body weight and improves lipid and glucose levels compared to the Standard American Diet (SAD). No surprise there, since refined grains and sugars are reduced. If I had to choose between the SAD and the Mediterranean Diet, I'd recommend the latter without hesitation.
Low-Carb
For the average person, the food choices in a Low-Carb diet seem more obvious than in a Mediterranean diet. Reduction in carbohydrates is at the core of what makes a Low-Carb diet “low-carb.”
Since starch is significantly limited, gluten-containing grains are significantly reduced or even eliminated from the diet. As such, it wipes out a common allergen often found in the diet of those following a Mediterranean diet.
At its core, Low-Carb diets limit and/or reduce total carbohydrate intake, although there isn't any one consensus on how many grams of carbohydrates per day is considered low-carb. Some experts say it is 50 g per day or less while others go as high as 150 g per day.
Reducing carbohydrates helps maintain healthier blood sugar levels, which also reduces insulin secretion and triglyceride formation.
I’ve only come across a couple studies that compare Low-Carb to the Mediterranean diet. In those studies, participants lost more weight on the Low-Carb diet than on the Mediterranean diet. They also saw a more significant drop in triglyceride levels and glucose. However, since HDL and LDL cholesterol levels both tend to rise on a Low-Carb diet and drop on the Mediterranean diet, researchers claim the Mediterranean diet lowers heart disease risk more. I disagree, since I don’t believe LDL cholesterol is the major culprit in the development of heart disease, but instead inflammation.
To look more at the Low-Carb research, be sure to check out my blog post What Do 18 Studies Say About Low-Carb Diets? The 18 studies I’ve included are randomized, controlled trials. This means groups are divided up and given specific dietary advice. They’re then followed over time and the results are compared at the end. While no study can say with 100% certainty that the findings are the final word, this is as close to showing cause and effect as research is able to do.
These are some of the research proven health benefits and advantages of Low-Carb diets:
- Greater weight loss and fat loss than reduced-calorie, low-fat diets, even when those following a Low-Carb diet are allowed to eat as many total calories as they choose
- Improved lipid parameters, specifically increased HDL levels and a reduced total cholesterol to HDL ratio
- Reduced blood sugar
- Reduced triglycerides
- Reduced blood pressure
- Reduced visceral (belly) fat
Paleo
Although the Paleo diet is based on eating the way humans did tens to hundreds of thousands of years ago, it’s just recently become popular. Within the Paleo diet culture, there is a range of opinions about the amount of carbohydrates people should consume. That said, there is little argument about where those carbohydrates should come from. Most carbohydrates in the Paleo diet come from root vegetables such as potatoes, yams and squash, or from fruit. If you’re looking for a more comprehensive list, check out this post from Diane Sanfilippo author of the best-selling book Practical Paleo.
Root-based starches are pretty filling, so even those who follow a Paleo diet without counting carbs will probably eat a lot less carbohydrates than the SAD diet and perhaps even the Mediterranean diet.
The bulk of the Paleo diet is made up of non-starchy vegetables, animal proteins, nuts, seeds and animal fats. At its core, you can ask “would this have been available to eat 100,000 years ago?” If the answer is no, you probably wouldn’t eat it when following Paleo. However, becoming overly dogmatic about it can cause one to miss out on some foods and supplements that can further promote health, which wouldn’t have been available earlier in human history.
Paleo is limited in vegetable oils and grains and many Paleo followers eliminate dairy. It eliminates a lot of problematic foods, which can lead to a large number of health benefits without even considering the macronutrients.
I’ve come across a couple studies comparing Paleo to Mediterranean. One study showed that the Paleo diet is more satisfying, which is critical to long-term adherence to a particular eating style.[1] Another study showed the Paleo diet improved glucose tolerance better than the Mediterranean diet.[2]
Which One is Best?
If I were asked which style of eating is best, I’d first think of what I’d recommend to my friends or family, who I care most about. Any of the three are better than eating the Standard American Diet, so if someone is more likely to follow one way of eating over the others, that’s the one I’d recommend.
Based on the hundreds of research articles and books I’ve read, I personally lean toward a combination of Low-Carb and Paleo. Here’s why.
The Paleo diet helps to clearly eliminate problematic foods such as grains, vegetable oils, sugar and most, if not all dairy. In doing so, many of the foods that cause digestive problems and inflammation, which is at the core of virtually every disease process, are wiped out of the diet. But that doesn’t mean I, nor most of the people I know, would benefit from eating sweet potatoes three times per day. Most people I know aren’t that active, which is why I lean toward a lower-carb, higher-protein Paleo plan.
In my tenacious pursuit of optimal health, I’m always looking for nutrition, exercise and lifestyle choices that provide the greatest benefits. From what I’ve read and reviewed, a lower-carb Paleo style of eating seems to be the best. As for the Mediterranean diet, it’s better than a low-fat diet or a SAD, but its lower emphasis on increased protein, and its inclusion of grains and higher-carb foods make it less appealing than the other two styles of eating.
What about you? What do you think? Leave a comment and share your thoughts below.
