Current Nutrition Reports

, Volume 3, Issue 1, pp 35–42 | Cite as

Dietary Patterns May Sustain Weight Loss among Adults

  • Linda C. Tapsell
  • Elizabeth P. Neale
  • Deborah J. Nolan-Clark
Dietary Patterns and Behavior (LM Steffen, Section Editor)


Sustainable weight loss requires a shift in eating behaviour maintained over a long time period. Research in this area focuses on dietary patterns based on cuisines that emphasise intakes of common core foods or those that target specific nutrients, such as fat. This review examined the literature to identify evidence on dietary patterns that may be effective for sustained weight loss. Medline, Pubmed, Scopus, and ScienceDirect were searched for relevant literature, and 14 trials were reviewed. Overall, Mediterranean, vegetarian, and low-fat dietary patterns were associated with sustained weight loss under energy-restricted conditions. Evidence to support the efficacy of the Mediterranean diet for sustained weight loss without an energy deficit was inconsistent. Core foods emphasised in dietary patterns associated with weight loss included fruit, vegetables, nuts, legumes, whole grains, and olive oil. Further research involving matched behavioural interventions is required to conclusively identify dietary patterns most conducive to sustained weight loss.


Dietary patterns Weight loss Mediterranean diet Low-fat Vegetarian Vegan Prudent Dietary scores Nutrient density Humans Adults 


Compliance with Ethics Guidelines

Conflict of Interest

Linda C. Tapsell has served on the Science Advisory Committee of McCormick Science Institute, will receive royalties from Oxford University Press for work on a nutrition textbook, and has received reimbursement for travel/accommodations/meeting expenses from the California Walnut Commission.

Elizabeth P. Neale has received financial support through a grant from Pork CRC, has received compensation from Safcol Australia for service as a consultant, and has received payment for manuscript preparation from Pork CRC.

Deborah J. Nolan-Clark has received financial support through a grant from Pork CRC, has received compensation from Safcol Australia for service as a consultant, and has received payment for manuscript preparation from Pork CRC.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of particular importance

  1. 1.
    Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360(9):859–73. doi: 10.1056/NEJMoa0804748.PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Pasanisi F, Contaldo F, de Simone G, Mancini M. Benefits of sustained moderate weight loss in obesity. Nutr Metab Cardiovasc Dis. 2001;11(6):401–6.PubMedGoogle Scholar
  3. 3.
    Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13(1):3–9. doi: 10.1097/00041433-200202000-00002.PubMedCrossRefGoogle Scholar
  4. 4.
    Kant AK. Dietary patterns and health outcomes. J Am Diet Assoc. 2004;104(4):615–35. doi: 10.1016/j.jada.2004.01.010.PubMedCrossRefGoogle Scholar
  5. 5.••
    Estruch R, Ros E, Salas-Salvadó J, Covas M-I, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90. doi: 10.1056/NEJMoa1200303. This study provides the primary results of the PREDIMED study, which evaluated the health outcomes of the Mediterranean dietary pattern.PubMedCrossRefGoogle Scholar
  6. 6.
    McManus K, Antinoro L, Sacks F. A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes. 2001;25(10):1503–11. doi: 10.1038/sj.ijo.0801796.CrossRefGoogle Scholar
  7. 7.
    Vincent-Baudry S, Defoort C, Gerber M, Bernard M-C, Verger P, Helal O, et al. The Medi-RIVAGE study: reduction of cardiovascular disease risk factors after a 3-mo intervention with a Mediterranean-type diet or a low-fat diet. Am J Clin Nutr. 2005;82(5):964–71.PubMedGoogle Scholar
  8. 8.
    Stendell-Hollis NR, Thompson PA, West JL, Wertheim BC, Thomson CA. A comparison of Mediterranean-style and MyPyramid diets on weight loss and inflammatory biomarkers in postpartum breastfeeding women. J Womens Health. 2013;22(1):48–57. doi: 10.1089/jwh.2012.3707.CrossRefGoogle Scholar
  9. 9.
    Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Weight loss with a low-carbohydrate, mediterranean, or low-fat diet. N Engl J Med. 2008;359(3):229–41. doi: 10.1056/NEJMoa0708681.PubMedCrossRefGoogle Scholar
  10. 10.
    Schwarzfuchs D, Golan R, Shai I. Four-year follow-up after two-year dietary interventions. N Engl J Med. 2012;367(14):1373–4.PubMedCrossRefGoogle Scholar
  11. 11.
    Estruch R, Martínez-González MA, Corella D, Salas-Salvadó J, Ruiz-Gutiérrez V, Covas MI, et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. 2006;145(1):1–11. doi: 10.7326/0003-4819-145-1-200607040-00004.PubMedCrossRefGoogle Scholar
  12. 12.
    Razquin C, Martinez JA, Martinez-Gonzalez MA, Mitjavila MT, Estruch R, Marti A. A 3 years follow-up of a Mediterranean diet rich in virgin olive oil is associated with high plasma antioxidant capacity and reduced body weight gain. Eur J Clin Nutr. 2009;63(12):1387–93. doi: 10.1038/ejcn.2009.106.PubMedCrossRefGoogle Scholar
  13. 13.
    Toobert DJ, Glasgow RE, Strycker LA, Barrera M, Radcliffe JL, Wander RC, et al. Biologic and quality-of-life outcomes from the Mediterranean lifestyle program: a randomized clinical trial. Diabetes Care. 2003;26(8):2288–93. doi: 10.2337/diacare.26.8.2288.PubMedCrossRefGoogle Scholar
  14. 14.
    Esposito K, Marfella R, Ciotola M, et al. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA. 2004;292(12):1440–6. doi: 10.1001/jama.292.12.1440.PubMedCrossRefGoogle Scholar
  15. 15.
    Esposito K, Di Palo C, Maiorino MI, Petrizzo M, Bellastella G, Siniscalchi I, et al. Long-term effect of mediterranean-style diet and calorie restriction on biomarkers of longevity and oxidative stress in overweight men. Cardiol Res Pract. 2011. doi: 10.4061/2011/293916.PubMedCentralGoogle Scholar
  16. 16.
    Barnard ND, Cohen J, Jenkins DJA, Turner-McGrievy G, Gloede L, Jaster B, et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006;29(8):1777–83. doi: 10.2337/dc06-0606.PubMedCrossRefGoogle Scholar
  17. 17.
    Kahleova H, Matoulek M, Malinska H, Oliyarnik O, Kazdova L, Neskudla T, et al. Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with type 2 diabetes. Diabet Med. 2011;28(5):549–59. doi: 10.1111/j.1464-5491.2010.03209.x.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Carty CL, Kooperberg C, Neuhouser ML, Tinker L, Howard B, Wactawski-Wende J, et al. Low-fat dietary pattern and change in body-composition traits in the Women’s Health Initiative Dietary Modification Trial. Am J Clin Nutr. 2011;93(3):516–24. doi: 10.3945/ajcn.110.006395.PubMedCrossRefGoogle Scholar
  19. 19.
    Howard BV, Manson JE, Stefanick ML, et al. Low-fat dietary pattern and weight change over 7 years: The women’s health initiative dietary modification trial. JAMA. 2006;295(1):39–49. doi: 10.1001/jama.295.1.39.PubMedCrossRefGoogle Scholar
  20. 20.
    Martínez-González MA, García-Arellano A, Toledo E, Salas-Salvadó J, Buil-Cosiales P, Corella D, et al. A 14-Item Mediterranean Diet Assessment Tool and Obesity Indexes among high-risk subjects: The PREDIMED Trial. PLoS ONE. 2012;7(8):e43134. doi: 10.1371/journal.pone.0043134.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Mendez MA, Popkin BM, Jakszyn P, Berenguer A, Tormo MJ, Sanchéz MJ, et al. Adherence to a Mediterranean diet is associated with reduced 3-year incidence of obesity. J Nutr. 2006;136(11):2934–8.PubMedGoogle Scholar
  22. 22.
    Grafenauer SJ, Tapsell LC, Beck EJ, Batterham MJ. Baseline dietary patterns are a significant consideration in correcting dietary exposure for weight loss. Eur J Clin Nutr. 2013;67(4):330–6. doi: 10.1038/ejcn.2013.26.PubMedCrossRefGoogle Scholar
  23. 23.
    Lassale C, Fezeu L, Andreeva VA, Hercberg S, Kengne AP, Czernichow S, et al. Association between dietary scores and 13-year weight change and obesity risk in a French prospective cohort. Int J Obes. 2012;36(11):1455–62. doi: 10.1038/ijo.2011.264.CrossRefGoogle Scholar
  24. 24.
    Rumawas ME, Dwyer JT, Mckeown NM, Meigs JB, Rogers G, Jacques PF. The development of the Mediterranean-style Dietary Pattern Score and its application to the american diet in the Framingham Offspring Cohort. J Nutr. 2009;139(6):1150–6. doi: 10.3945/jn.108.103424.PubMedCrossRefGoogle Scholar
  25. 25.•
    Tapsell LC, Dunning A, Warensjo E, Lyons-Wall P, Dehlsen K. Effects of vegetable consumption on weight loss: a review of the evidence with implications for design of randomised controlled trials. Crit Rev Food Sci Nutr. 2013. doi: 10.1080/10408398.2011.642029. This recent review highlights the impact of study design on trial outcomes.Google Scholar
  26. 26.
    Vergnaud A-C, Norat T, Romaguera D, Mouw T, May AM, Romieu I, et al. Fruit and vegetable consumption and prospective weight change in participants of the European Prospective Investigation into Cancer and Nutrition–Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home, and Obesity study. Am J Clin Nutr. 2012;95(1):184–93. doi: 10.3945/ajcn.111.019968.PubMedCrossRefGoogle Scholar
  27. 27.••
    Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men. N Engl J Med. 2011;364(25):2392–404. This prospective analysis (which used data from a number of cohort studies) identified key foods associated with weight gain over time.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Linda C. Tapsell
    • 1
  • Elizabeth P. Neale
    • 2
  • Deborah J. Nolan-Clark
    • 2
  1. 1.Smart Foods Centre, School of Medicine, IHMRIUniversity of WollongongWollongongAustralia
  2. 2.Landmark Nutrition Pty LtdWollongongAustralia

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