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

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

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Departments of Experimental and Clinical Medicine (F.S., M.D., G.P., R.M., A.M.G., A.S., A.C.)
Clinical Nutrition Unit (F.S., A.C.).
Don Carlo Gnocchi Foundation Italy, Onlus Istituto di Ricerca e Cura a Carattere Scientifico, Florence, Italy (F.S.).
Departments of Experimental and Clinical Medicine (F.S., M.D., G.P., R.M., A.M.G., A.S., A.C.).
Central Laboratory (F.C.).
Atherothrombotic Unit (A.M.G., A.S., R.M.), Careggi University Hospital, Florence, Italy.
Clinical and Experimental Biomedical Sciences (M.B., C.F.), University of Florence, Italy.



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


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.


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.


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.


URL: Unique identifier: NCT02641834.


Mediterranean; cardiovascular disease; diet; vegetarian

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