Intermittent fasting, often referred to time-restricted eating, has become the latest diet craze not only for weight loss but also for enhancing health. Everyone from well-known celebrities to everyday, average people are trying intermittent fasting and claiming it is successful.
In a study on intermittent fasting published in the prestigious journal JAMA Internal Medicine on September 28, 2020, researchers questioned, “What is the effect of time-restricted eating on weight loss and metabolic health in patients with overweight and obesity?” The researchers’ findings acknowledge, “In this prospective randomized clinical trial that included 116 adults with overweight or obesity, time-restricted eating was associated with a modest decrease (1.17%) in weight that was not significantly different from the decrease in the control group (0.75%).” Meaning that during the three-month study on a daily 16-hour-fast (eating all their meals between noon and 8:00 pm), participants only lost 2 to 3 pounds, slightly better than their control group. The most concerning finding of the study was that 65 percent of weight loss from the fasting group was not fat, but from lean body mass and muscle. A healthy weight loss comes from a diet that enhances body fat loss, not muscle and lean body mass. Having more muscle increases metabolism and helps you burn more calories over a 24-hour period.
A new published study in the March 2, 2021 Journal Cell Reports concluded that every-other-day fasting makes it more difficult to lose belly fat and deep visceral abdominal fat. Increasing abdominal fat is strongly linked to increased incidence of type 2 diabetes and cardiovascular disease.
This new study was done in mice and not humans, because their physiology is similar but mice have a much faster metabolism. This is important because it allowed the researchers to use advanced instrumentation, examining tissues and measuring changes carefully and more precisely in the body much more easily.
The results of the study found that when mice fasted and went into starving or “preservation mode,” the mice stored more abdominal visceral and subcutaneous fat rather than burning it for energy! This type of metabolic adaptation may make intermittent fasting a less desirable diet for weight loss and for optimal health! Even though the study was done using mice, the researchers feel similar effects are most likely to occur in humans and that intermittent fasting is ineffective for burning belly fat – and they acknowledge that the other diets may be found to be more effective and successful.
For the fourth consecutive year, U.S. News & World Report ranked the Mediterranean diet as the #1 Best Overall Diet. The article says, “Research suggests that the diet can ward off chronic diseases and improve longevity.” The Mediterranean Diet was also tied as #1 for the easiest diet to follow: the best diet for diabetes; best heart-healthy diet, and best plant-based diet too. These results were based on a panel of 23 experts, and 41 diets based the scientific literature. The expert panel consisted of the country’s top nutrition experts and physicians specializing in weight loss, diabetes, and cardiovascular disease. I have been an advocate of the Mediterranean diet for over 25 years.
A breakthrough, long-term diet study was published in the American Heart Association journal Circulation on measuring abdominal and body fat! This diet study used magnetic resonance imaging (MRI) technology for the first time, measuring changes in body and organ fat during 18 months on a Mediterranean/low-carb diet, with and without moderate physical exercise. MRI is a diagnostic technique that produces computerized images of organs and internal body tissues using a magnetic field and radio waves. This is the best approach to date for measuring body fat, compared to weighing people as a result of diet and exercise. The scale, skinfold calipers or underwater weighing are not giving you the whole picture!
The aforementioned research was conducted between Ben-Gurion University of the Negev and Harvard University; the research group was led by Drs. Iris Shai, Yftach Gepner, Ilan Shelaf and Dan Schwarzfuchs from Ben-Gurion University. Dr. Meir Stampfer was also a lead author for the study, and is from the prestigious Harvard University. Dr. Stampfer is a well-known authority on nutrition and obesity. The study analyzed the implementation of positive dietary changes and how this could help in reducing body fat, particularly visceral (abdominal) body fat.
The Mediterranean low-carb diet was significantly superior to low-fat diet in decreasing fat storage, including visceral (deep abdominal) liver and heart fat. High visceral fat has been shown to increase metabolic syndrome, inflammation, cardiovascular disease and diabetes. Losing deep subcutaneous visceral fat, as well as haptic (liver) fat, was associated with improved insulin sensitivity and improved lipid profile.
The low-carb Mediterranean diet was more effective than a low-fat diet in eliminating fat storage, especially abdominal fat! Previous studies have shown that a low-carb Mediterranean diet may be an effective alternative to low-fat diets. It has a more favorable effect on lipids (with low-carb diet) and glycemic control (with Mediterranean diet).
In a groundbreaking, two-year dietary intervention study published in the New England Journal of Medicine, researchers found that the Mediterranean and low-carb diet was an effective alternative to weight loss. It appears to be just as safe, metabolically healthier and more effective compared to a low-fat diet. Consumption of monounsaturated fats (extra-virgin olive oil and nuts) is thought to improve insulin sensitivity, which may explain the favorable effect on blood glucose and insulin levels. Research has shown that nut consumption can enhance weight loss and weight gain (N Engl J Med, 2008).
People who strictly follow the Mediterranean diet tend to have a lower body mass index (BMI), which is a measure of the proportion of weight to height and waist circumference – according to a large population study led by Simona Bertoli from the Nutritional Research Center in Milan, Italy. The Mediterranean diet is high in fish, seafood, antioxidant-rich vegetables, red wine and berries rich in polyphenols, beans, lentils, nuts, legumes and extra-virgin-olive oil (EVOO) that are rich in healthy monounsaturated and polyunsaturated fats and low in saturated fats. Extra-virgin olive contains a polyphenol called oleuropein and can increase brown fat thermogenesis.
Brown fat is a special kind of fat cell that generates heat and helps regulate bodyweight and energy expenditure. The body has two forms of fat – white fat and brown fat. Brown fat burns calories. The more brown fat you have, the more calories you burn. The capability of harnessing one’s one brown fat for fat burning is revolutionary! The ability to get lean by producing extra brown fat and enhancing and activating existing brown fat represents a promising way to burn fat. Several landmark discoveries and approaches to this are being explored at major research centers and universities worldwide, with great excitement. Brown fat research is a hot topic today!
©Published by Advanced Research Media, Inc. 2021
©Reprinted with permission from Advanced Research Media, Inc.
1. Proteomics analysis of adipose depots after intermittent fasting reveals visceral fat preservation mechanisms. Dylan J. Harney, Michelle Cielesh, Renee Chu, Kristen C. Cooke, David E. James, Jacqueline Stöckli, Mark Larance. CELL REPORTS: 2 March 2021 https://s100.copyright.com/AppDispatchServlet?publisherName=ELS&contentID=S2211124721001182&orderBeanReset=true
2. Lowe DA, Wu N, Rohdin-Bibby L, Moore AH, Kelly N, Liu YE, Philip E, Vittinghoff E, Heymsfield SB, Olgin JE, Shepherd JA, Weiss EJ. Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity: The TREAT Randomized Clinical Trial. JAMA Intern Med. 2020 Nov 1;180(11):1491-1499. doi: 10.1001/jamainternmed.2020.4153. PMID: 32986097; PMCID: PMC7522780.
3. U.S. News Reveals Best Diet Rankings for 2021. January 4, 2021. US News & World Report. https://www.usnews.com/info/blogs/press-room/articles/2021-01-04/us-news-reveals-best-diet-rankings-for-2021
4. Olive oil may lower heart disease risk. American Heart Association News. March 5, 2020. https://www.heart.org/en/news/2020/03/05/olive-oil-may-lower-heart-disease-risk
5. Olive Oil Consumption and Cardiovascular Risk in U.S. Adults. Journal of the American College of Cardiology. Marta Guasch-Ferré, Gang Liu, Yanping Li, Laura Sampson, JoAnn E. Manson, Jordi Salas-Salvadó, Miguel A. Martínez-González, Meir J. Stampfer, Walter C. Willett, Qi Sun, Frank B. Hu. Journal of the American College of Cardiology. April 2020. https://doi.org/10.1016/j.jacc.2020.02.036
6. Razquin C, Martinez-Gonzalez MA. A Traditional Mediterranean Diet Effectively Reduces Inflammation and Improves Cardiovascular Health. Nutrients. 2019;11(8):1842. Published 2019 Aug 9. doi:10.3390/nu11081842
7. Fish Consumption in Healthy Adults Is Associated with Decreased Circulating Biomarkers of Endothelial Dysfunction and Inflammation during a 6-Year Follow-Up. Bas C. T. van Bussel, Ronald M. A. Henry, Casper G. Schalkwijk, Isabel Ferreira, Edith J. M. Feskens, Martinette T. Streppel, Yvo M. Smulders, Jos W. R. Twisk, Coen D. A. Stehouwer. The Journal of Nutrition, Volume 141, Issue 9, September 2011, Pages 1719-1725, https://doi.org/10.3945/jn.111.139733
8. Ratih Wirapuspita Wisnuwardani, Stefaan De Henauw, Marika Ferrari, Maria Forsner, Frédéric Gottrand, Inge Huybrechts, Antonios G Kafatos, Mathilde Kersting, Viktoria Knaze, Yannis Manios, Ascensión Marcos, Dénes Molnár, Joseph A Rothwell, Azahara Iris Rupérez, Augustin Scalbert, Kurt Widhalm, Luis A Moreno, Nathalie Michels, Total Polyphenol Intake Is Inversely Associated with a Pro/Anti-Inflammatory Biomarker Ratio in European Adolescents of the HELENA Study, The Journal of Nutrition, nxaa064, https://doi.org/10.1093/jn/nxaa064
9. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. Nutrition Journal, 2008, Volume 7, Number 1, Page 1. Joaquín Pérez-Guisado, Andrés Muñoz-Serrano, Ángeles Alonso-Moraga
10. Long-term successful weight loss with a combination biphasic ketogenic Mediterranean diet and Mediterranean diet maintenance protocol. Paoli, A., Bianco, A., Grimaldi, K. A., Lodi, A., & Bosco, G. (2013). Nutrients, 5 (12), 5205-17. doi:10.3390/nu5125205
11. Effect of ketogenic Mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and diet compliance in Italian council employees. Paoli, A., Cenci, L., & Grimaldi, K. A. (2011). Nutrition journal, 10, 112. doi:10.1186/1475-2891-10-112
12. Mediterranean Diet Reduces Risk of Incident Stroke in a Population With Varying Cardiovascular Disease Risk Profiles. Paterson, K. E., Myint, P. K., Jennings, A., Bain, L., Lentjes, M., Khaw, K. T., & Welch, A. A. (Oct 2018). Stroke, 49 (10), 2415-2420. Advance online publication. doi:10.1161/STROKEAHA.117.020258
13. Ahmad S, Moorthy MV, Demler OV, et al. Assessment of Risk Factors and Biomarkers Associated With Risk of Cardiovascular Disease Among Women Consuming a Mediterranean Diet. JAMA Netw Open. Dec. 7, 2018;1(8):e185708. doi:10.1001/jamanetworkopen.2018.5708
14. Marialaura Bonaccio, Augusto Di Castelnuovo, Simona Costanzo, Mariarosaria Persichillo, Amalia De Curtis, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello. Interaction between Mediterranean diet and statins on mortality risk in patients with cardiovascular disease: Findings from the Moli-sani Study. International Journal of Cardiology, 2018; DOI: 10.1016/j.ijcard.2018.11.117
15. Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools: The CENTRAL MRI Randomized Controlled Trial. Yftach Gepner, Ilan Shelef, Dan Schwarzfuchs, Hila Zelicha, Lilac Tene, Anat Yaskolka Meir, Gal Tsaban, Noa Cohen, Nitzan Bril, Michal Rein, Dana Serfaty, Shira Kenigsbuch, Oded Komy, Arik Wolak, Yoash Chassidim, Rachel Golan, Hilla Avni-Hassid, Avital Bilitzky, Benjamin Sarusi, Eyal Goshen, Elad Shemesh, Yaakov Henkin, Michael Stumvoll, Matthias Blüher, Joachim Thiery, Uta Ceglarek, Assaf Rudich, Meir J. Stampfer and Iris Shai. Circulation 2017;CIRCULATION AHA.117.030501, 2017.
16. Zong, G., Li, Y., Wanders, A.J., Alssema, M., Zock, P.L., Willett, W.C., Hu, F.B., Sun, Q. Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies BMJ. 2016;355:i5796.
17. Wiley. Fish consumption may prolong life. ScienceDaily, 18 July 2018. www.sciencedaily.com/releases/2018/07/180718082138.htm
18. Zhang, P. Zhuang, W. He, J. N. Chen, W. Q. Wang, N. D. Freedman, C. C. Abnet, J. B. Wang, J. J. Jiao. Association of fish and long-chain omega-3 fatty acids intakes with total and cause-specific mortality: prospective analysis of 421 309 individuals. Journal of Internal Medicine, 2018; DOI: 10.1111/joim.12786
19. Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association Frank M. Sacks, MD, FAHA, Chair, Alice H. Lichtenstein, DSc, FAHA, Jason H.Y. Wu, PhD, MSc, Lawrence J. Appel, MD, MPH, FAHA, Mark A. Creager, MD, FAHA, Penny M. Kris-Etherton, PhD, RD, FAHA, Michael Miller, MD, FAHA, Eric B. Rimm, ScD, FAHA, Lawrence L. Rudel, PhD, FAHA, Jennifer G. Robinson, MD, MPH, FAHA, Vice Chair, Neil J. Stone, MD, FAHA, and Linda V. Van Horn, PhD, RD, FAHA, Vice Chair On behalf of the American Heart Association.
20. Mediterranean Diet Reduces Risk of Incident Stroke in a Population With Varying Cardiovascular Disease Risk Profiles. Paterson, K. E., Myint, P.K., Jennings, A., Bain, L., Lentjes, M., Khaw, K.T., & Welch, A.A. (Oct 2018). Stroke, 49 (10), 2415-2420. Advance online publication. doi:10.1161/STROKEAHA.117.020258
21. Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults: The Attica study. Journal of the American College of Cardiology. 2004. https://doi.org/10.1016/j.jacc.2004.03.039.
22. Teresa T Fung, Marjorie L McCullough, PK Newby, JoAnn E Manson, James B Meigs, Nader Rifai, Walter C Willett, Frank B Hu, Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction, The American Journal of Clinical Nutrition, Volume 82, Issue 1, July 2005, Pages 163-173, https://doi.org/10.1093/ajcn/82.1.163
23. Estruch R, Martínez-González MA, Corella D, et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial [published correction appears in Ann Intern Med. 2018 Aug 21;169(4):270-271]. Ann Intern Med. 2006;145(1):1-11. doi:10.7326/0003-4819-145-1-200607040-00004
24. Schwingshackl L, Christoph M, Hoffmann G. Effects of Olive Oil on Markers of Inflammation and Endothelial Function-A Systematic Review and Meta-Analysis. Nutrients. 2015;7(9):7651-7675. Published 2015 Sep 11. doi:10.3390/nu7095356
25. Medina-Remón A, Casas R, Tressserra-Rimbau A, et al. Polyphenol intake from a Mediterranean diet decreases inflammatory biomarkers related to atherosclerosis: a substudy of the PREDIMED trial. Br J Clin Pharmacol. 2017;83(1):114-128. doi:10.1111/bcp.12986
26. Sureda A, Bibiloni MDM, Julibert A, et al. Adherence to the Mediterranean Diet and Inflammatory Markers. Nutrients. 2018;10(1):62. Published 2018 Jan 10. doi:10.3390/nu10010062
27. Ruiz-Canela M, Estruch R, Corella D, Salas-Salvadó J, Martínez-González MA. Association of Mediterranean diet with peripheral artery disease: the PREDIMED randomized trial [published correction appears in JAMA. 2018 Dec 4;320(21):2272]. JAMA. 2014;311(4):415-417. doi:10.1001/jama.2013.280618
28. Martínez-González MA, Salas-Salvadó J, Estruch R, et al. Benefits of the Mediterranean Diet: Insights From the PREDIMED Study. Prog Cardiovasc Dis. 2015;58(1):50-60. doi:10.1016/j.pcad.2015.04.003
29. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. Ramón Estruch, Emilio Ros, Jordi Salas-Salvadó, et al. The New England Journal of Medicine. Massachusetts Medical Society. Apr 4, 2013 https://www.nejm.org/doi/full/10.1056/NEJMoa1200303
30. Anti-inflammatory Therapy with Canakinumab for Atherosclerotic Disease
31. Anti-inflammatory Therapy with Canakinumab for Atherosclerotic Disease. Paul M Ridker, Brendan M. Everett, Tom Thuren. The New England Journal of Medicine, Sep 21, 2017 https://www.nejm.org/doi/full/10.1056/NEJMoa1707914
32. Baker ME, DeCesare KN, Johnson A, Kress KS, Inman CL, Weiss EP. Short-Term Mediterranean Diet Improves Endurance Exercise Performance: A Randomized-Sequence Crossover Trial. J Am Coll Nutr. 2019 Sep-Oct;38(7):597-605. doi: 10.1080/07315724.2019.1568322. Epub 2019 Feb 13. PMID: 30758261.
33. David S Ludwig, Stephanie L Dickinson, Beate Henschel, Cara B Ebbeling, David B Allison, Do Lower-Carbohydrate Diets Increase Total Energy Expenditure? An Updated and Reanalyzed Meta-Analysis of 29 Controlled-Feeding Studies, The Journal of Nutrition, nxaa350, https://doi.org/10.1093/jn/nxaa350
354. Oleuropein, a Phenolic Compound in Extra Virgin Olive Oil, Increases Uncoupling Protein 1 Content in Brown Adipose Tissue and Enhances Noradrenaline and Adrenaline Secretions in Rats, Journal of Nutritional Science and Vitaminology, Released November 11, 2008 Yuriko Oi-Kano, Teruo Kawada, Tatsuo Watanabe, Fumihiro Koyama, Kenichi Watanabe, Reijirou Senbongi, Kazuo Iwai
35. Oleuropein aglycone enhances UCP1 expression in brown adipose tissue in high-fat diet induced by obese rats by activating beta-adrenergic signaling. Yuriko Oi-Kano, Teruo Kawada, Tatsuo Watanabe, Fumihiro Koyama, Kenichi Watanabe, Reijirou Senbongi, Kazuo Iwai, J Nutrit Biochemistry, 2/2017, 209-218
36. The influence of the type of dietary fat on postprandial fat oxidation rates: monounsaturated (olive oil) vs. saturated fat (cream). LS Piers, KZ Walker, RM Stoney, MJ Soares and K O’Dea. International Journal of Obesity (2002) 26, 814-821 (2002)
37. The effect of dietary oleic, linoleic, and linolenic acids on fat oxidation and energy expenditure in healthy men. Jones, Peter J.H. et al. Metabolism – Clinical and Experimental, Volume 57, Issue 9, 1198-1203
38. Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study. European Journal of Nutrition, 2017, Page 1 Heinz Freisling, Hwayoung Noh, Nadia Slimani