Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet)

Circulation. 2018 Mar 13;137(11):1103-1113. doi: 10.1161/CIRCULATIONAHA.117.030088. Epub 2018 Feb 26.


Background: Only a few randomized dietary intervention studies that investigated the effects of lacto-ovo vegetarian diet (Vd) in clinically healthy omnivorous subjects are available.

Methods: We randomly assigned to overweight omnivores with a low-to-moderate cardiovascular risk profile a low-calorie Vd compared with a low-calorie Mediterranean diet (MD), each lasting 3 months, with a crossover design. The primary outcome was the difference in body weight, body mass index, and fat mass changes between the 2 groups. Secondary outcomes were differences in circulating cardiovascular disease risk parameters changes between the 2 groups.

Results: One hundred eighteen subjects (mean age: 51.1 years, females: 78%) were enrolled. The total participation rate at the end of the study was 84.7%. No differences between the 2 diets in body weight were observed, as reported by similar and significant reductions obtained by both Vd (-1.88 kg) and MD (-1.77 kg). Similar results were observed for body mass index and fat mass. In contrast, significant differences between the 2 interventions were obtained for low-density lipoprotein cholesterol, triglycerides, and vitamin B12 levels. The difference between the Vd and MD groups, in terms of end-of-diet values, was recorded at 9.10 mg/dL for low-density lipoprotein cholesterol (P=0.01), 12.70 mg/dL for triglycerides (P<0.01), and 32.32 pg/mL for vitamin B12 (P<0.01). Finally, no significant difference was found between Vd and MD interventions in oxidative stress markers and inflammatory cytokines, except for interleukin-17, which improved only in the MD group. Forty-six participants during the Vd period and 35 during the MD period reached the target values for ≥1 cardiovascular risk factor.

Conclusions: Both Vd and MD were effective in reducing body weight, body mass index, and fat mass, with no significant differences between them. However, Vd was more effective in reducing low-density lipoprotein cholesterol levels, whereas MD led to a greater reduction in triglyceride levels.

Clinical trial registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02641834.

Keywords: Mediterranean; cardiovascular disease; diet; vegetarian.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adiposity
  • Adult
  • Aged
  • Body Mass Index
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol, LDL / blood
  • Cross-Over Studies
  • Diet, Healthy*
  • Diet, Mediterranean*
  • Diet, Vegetarian*
  • Energy Intake*
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Nutritive Value
  • Obesity / blood
  • Obesity / complications
  • Obesity / diet therapy*
  • Obesity / physiopathology
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Triglycerides / blood
  • Weight Loss*
  • Young Adult


  • Cholesterol, LDL
  • Triglycerides

Associated data

  • ClinicalTrials.gov/NCT02641834