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New research suggests that eating a low-calorie version of the Mediterranean diet can help people lose body fat and lower their risk of cardiovascular disease. FG Trade/Getty Images
  • As people age, they tend to gain belly fat while also losing muscle.
  • These changes in body composition are linked with metabolic syndrome.
  • However, a reduced-energy Mediterranean diet and increased activity may mitigate this.
  • A Mediterranean-style diet emphasizes a variety of healthy whole foods.
  • Watching portion sizes and limiting higher-calorie foods can help with fat loss.

As we age, we become more prone to having belly fat, also known as “visceral fat,” buried deep within our abdomens.

It is also known that we tend to lose muscle mass as we grow older.

These changes in body composition are associated with a range of health concerns, including cardiovascular disease and type 2 diabetes, according to the authors of a new study just published in JAMA Network Open.

However, they report that a combination of an energy-reduced Mediterranean diet and physical activity appears to mitigate these effects.

The October 18, 2023 study found that middle-aged and older adults with overweight or obesity and metabolic syndrome lost visceral fat and showed a greater reduction in the percentage of total fat during the course of the study.

They also had delayed loss of lean body mass.

The Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) study, which is still ongoing, is a randomized clinical trial with the intent of testing how the Mediterranean diet fares in the prevention of cardiovascular disease.

The Spanish study includes middle-aged and older women and men who are categorized as either living with overweight or obesity and also have metabolic syndrome, a clustering of symptoms including obesity, high blood pressure, high blood triglycerides, low HDL (“good”) cholesterol, and insulin resistance.

The current report deals with a subgroup of study participants including 1,521 people who had their body composition determined via dual-energy X-ray absorptiometry (DXA scans) at three points during the study.

These individuals were randomly assigned to one of two groups.

The intervention group consumed an energy-reduced Mediterranean diet which restricted their calorie intake by 30%. They also increased their physical activity.

The control group ate a Mediterranean diet as well but with no restrictions on quantity. Nor did they increase their activity level.

Upon analysis of the data, the researchers found “clinically meaningful” changes in body composition in the people who ate fewer calories and became more active.

They were more likely to see improvements of 5% or more in total fat mass, total lean mass, and visceral fat mass at follow-up, especially at the one-year point.

The team of scientists concluded that a reduced-energy Mediterranean diet in combination with increased physical activity appears to negate some of the changes in body composition seen with aging.

Dr. David Seres, Professor of Medicine at the Institute of Human Nutrition at Columbia University Medical Center, who was not involved in the study, said, “The study findings are not that surprising, and reinforce that a structured program of a reduced calorie diet and exercise seems to work better for weight loss than casual counseling.”

However, he noted that there were a few issues with the study.

“Importantly, the way they analyzed the findings was what is called post hoc,” he said, “meaning they decided what was important after the fact.

“This means they run the risk of inducing bias,” Seres explained. “It is less scientifically rigorous.”

The ALS Therapy Development Institute suggests that it is important to repeat the results of post-hoc analyses in new trials in order to confirm them.

While the authors do not explicitly acknowledge this potential issue, they do note that follow-up is needed to confirm how people’s health will be affected in the long term.

Registered Dietitian Avery Zenker explained that an energy-reduced Mediterranean diet is simply a diet that is lower in calories than a typical Mediterranean diet.

“Calories are a measure of energy, so an energy-reduced diet is a calorie-reduced diet,” she said. “The most common reason for an intentionally calorie-reduced diet is for weight loss.”

Zenker went on the relate that a Mediterranean diet is a style of eating known for its health benefits. It has been shown to reduce the risk of both heart disease and diabetes.

“It’s not a strict diet, but more so a lifestyle,” she added, noting that it consists of a variety of vegetables, fruits, legumes, whole grains, olive oil, fish, nuts, seeds, herbs, and spices.

People who follow this way of eating can make it lower in calories, according to Zenker, by reducing portion sizes, consuming fewer higher-calorie foods like oil, and limiting their intake of refined sugar.

Eating a balanced plate — including vegetables, fruits, protein, carbohydrates, and healthy fats — is also important, she said.

Additionally, she suggests focusing on whole foods. “Minimal processing of foods isn’t usually a concern,” she added, “but reducing processed or ultra-processed foods is encouraged.

“For example, choose whole fruits more often than fruit juice, and whole grains more often than refined grains,” said Zenker.

Related to this, she recommends eating plenty of fiber because it can help us feel satisfied with increasing our intake of calories. “Fiber is found in most of the plant foods on a Mediterranean diet, including, fruit, vegetables, legumes, whole grains, and nuts and seeds,” she explained.

Zenker further advises starting simply and focusing on adding rather than subtracting.

“Adding lower calorie, nutrient-rich foods can help reduce overall calories by replacing higher calorie foods,” she said. They are also high in fiber and water, which can help you feel satiated.

To help with keeping your calorie intake low, Zenker recommends practicing portion control, especially with higher-calorie foods like nuts, seeds, and olive oil.

“When choosing these foods, measuring with volume or weight-based measurements can help with portion management,” she said.

It is also helpful to practice mindful eating in order to get in tune with your hunger and satiety cues, according to Zenker.

To keep your meals flavorful, she suggests using herbs and spices generously. “Herbs and spices provide flavor to meals while adding nutrients like antioxidants, and negligible calories,” she explained.

Zenker also pointed to meal planning as a way to ensure that you always have healthy options on hand.

She advises having “go-to meals” that you know you can make and enjoy on those days when you just don’t know what to cook.

Zenker additionally recommends drinking plenty of water throughout the day. “Sometimes, our bodies confuse thirst with hunger,” she stated. “Water can also help us feel satiated since it takes up space in the stomach.”

Finally, Zenker suggests planning for setbacks. “Having a backup plan for when situations don’t go as ideally planned is a great way to remain confident and stay consistent,” she concluded.

As we grow older, it’s not uncommon for us to grow rounder around our midsection while also losing muscle mass.

However, these changes in body composition are linked with a greater risk for cardiovascular disease and diabetes.

A new study has found that a reduced-energy Mediterranean diet combined with increased physical activity can help mitigate these age-related changes.

The Mediterranean diet is a lifestyle that emphasizes the consumption of vegetables, fruits, legumes, whole grains, olive oil, fish, nuts, seeds, herbs, and spices.

This diet can be adapted for fat loss by reducing portion sizes and eating fewer higher-calorie, nutrient-poor foods.