Research

Energy balance

An energy-reduced Mediterranean diet combined with behavioral support and physical activity promotes significantly greater adherence and improvement in cardiovascular risk factors compared to an energy-unrestricted Mediterranean diet in patients with metabolic syndrome.

For individuals with metabolic syndrome, simply following a Mediterranean diet is not enough for optimal metabolic health; you must actively reduce caloric intake (by about 600 calories a day) and increase physical activity. The key to success is not just the food list, but the behavioral support and structured guidance (like monthly coaching) that helps you stick to the reduced calorie target.

StrongSupportsVERY_HIGH confidence
an intervention that encouraged an energy-reduced Mediterranean diet and physical activity, compared with advice to follow an energy-unrestricted Mediterranean diet, resulted in a significantly greater increase in diet adherence after 12 months.
Carmen Sayón-Orea et al. · JAMA · 2019

Why this rating

Large-scale (n=6874), multi-center, randomized controlled trial with high follow-up (96%).

Source

Effect of a Nutritional and Behavioral Intervention on Energy-Reduced Mediterranean Diet Adherence Among Patients With Metabolic Syndrome

Carmen Sayón-Orea et al. · JAMA · 2019

DOI 10.1001/jama.2019.14630

rct · n=6874Cited 176×
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DOI resolved against Crossref · corpus check 2026-06-10

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