Fasting mimicking diet cycles versus a Mediterranean diet and cardiometabolic risk in overweight and obese hypertensive subjects: a randomized clinical trial

In this single-center randomized trial, adults with hypertension and excess weight or obesity were assigned to four months of a continuous Mediterranean diet or to four monthly 5-day cycles of a Fasting Mimicking Diet (FMD), with researchers measuring blood vessel function (reactive hyperemia index and arterial compliance) and a range of cardiometabolic risk factors.

The authors reported that both diets produced comparable decreases in weight, waist circumference, BMI, body fat and cholesterol, and both improved a cardiac-risk test score. FMD, but not the Mediterranean diet, decreased reactive hyperemia index compared with baseline, a change the authors note can reflect either impaired or rejuvenated blood vessel lining and interpret as the latter; FMD also reduced HbA1c and IGF-1; the Mediterranean diet decreased glucose, insulin resistance and HDL cholesterol. At the end of the intervention, none of the measures differed significantly between the two groups. During the three-month follow-up, the Mediterranean diet group lost lean body mass while the FMD group did not.

The authors describe the two diets as producing comparable cardiometabolic benefit overall, with different individual markers moving for each. This is a single-center trial in adults with hypertension and excess weight, so the results may not apply to other groups.