Grants Institution: American Associates Ben Gurion University of the Negev Principle Investigator: Iris Shai, Ph.D., R.D. Category: Diet, Obesity, Diabetes, Cardiovascular/Heart Disease Study Name: "Dietary Intervention - Randomized Controlled Trial (DIRECT):" - PART1 August 2004 "Dietary Intervention - Randomized Controlled Trial (DIRECT): PART 2: Measurements of Carotid Plaque Volume by Three-Dimensional Ultrasound" - November 2004 The following summary reports the results of PART 1 only. Summary: This study compared the efficacy and safety of three weight-loss diets; 1) low-fat, restricted calorie, 2) Mediterranean, restricted-calorie and 3) low-carbohydrate, non-restricted calorie. Over a two year period, 322 moderately obese participants were randomly assigned to one of the diets. Among the 36 participants with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than the low-fat diet. Participants on the low-carbohydrate diet had better clinical and cardiovascular markers relative to the other two diets. Although the low-carbohydrate diet group had no limit placed on number of calories consumed, their consumption was only marginally different then the other two diets that had caloric restrictions in place. This study shows that Mediterranean and low-carbohydrate diets may be better alternatives to low-fat diets for managing obesity, diabetes and cardiovascular disease. The more favorable effects on lipids with the low-carbohydrate diet and on glycemic control with the Mediterranean diet suggest that personal preferences/lifestyle and metabolic considerations might determine the individualized tailoring of dietary interventions. Status: Completed Results: Published in The New England Journal of Medicine, Vol. 359, No.3, 2008 The Dr. Robert C. and Veronica Atkins Foundation c/o National Philanthropic Trust, 165 Township Line Road, Suite 150, Jenkintown, PA 19046-3593