From dearmedia.com
If you’ve ever scrolled through wellness TikTok and wondered whether going vegan or adopting a Mediterranean diet is the more intelligent choice, you’re not alone. On a recent Ask Me Anything episode of Art of Being Well, host Dr. Will Cole breaks down the findings of a new head-to-head study and shared his clinical perspective—giving the kind of context that helps you choose what serves your body and your goals.
The listener’s question lands squarely on the debate: “Dr. Cole, I recently saw a new study on weight loss that showed a low-fat vegan diet lost more weight than a Mediterranean diet. What are your thoughts on this?”
What Dr. Cole provided wasn’t a direct answer, but a nuanced commentary on the benefits of both diets.
The study in question
Cole points to a recent trial that was published in this summer. The study Cole references was published in Frontiers in Nutrition this summer by the Physicians Committee for Responsible Medicine, a plant-based advocacy group. The randomized crossover trial followed 62 participants through two 16-week phases: first a low-fat vegan diet with no animal products, then a Mediterranean approach that reintroduced fish, moderate amounts of dairy, lean white meats, and at least 50 grams of olive oil a day.
The headline result everyone’s sharing
Here’s why the study made waves. Cole notes, “Participants lost an average of 13 pounds in the low-fat vegan diet, primarily from reduced body fat and visceral fat, while no significant weight change was observed in the Mediterranean diet.”
The paper also tracked markers beyond the scale. According to the study, the vegan diet significantly reduced dietary acid load—a measure of how much acid or alkaline effect foods have on the body based on their protein, potassium, phosphorus, calcium, and magnesium content. Foods high in protein like meat, cheese, and eggs increase acid production, while fruits and vegetables increase alkaline compounds. The study also found the vegan diet lowered advanced glycation end products, which are harmful compounds formed when proteins or fats combine with sugars, particularly during high-temperature cooking methods like grilled and frying. In contrast, the study found that the Mediterranean diet saw no significant decrease in dietary acid production.
Mediterranean still had a bright spot: “The one advantage that the Mediterranean diet had was blood pressure. Blood pressures significantly saw a decrease with the Mediterranean diet, not so much with the low-fat vegan diet.”
The fine print that actually matters
Cole flags why you shouldn’t crown an all-time winner off one trial. “Limitations of the study include 62 people, sixteen weeks each, [and] self-reported data,” he notes. In other words, it wasn’t a fully controlled feeding study—participants “just had to follow guidelines.”
He also wonders about calories and macros. “I would be interested in looking at the caloric intake,” he opines. “There’s excellent data around fasting mimicking diets.” Cole suggests that limiting your caloric intake, regardless of preferred diet, will have a more profound effect on weight loss.
The “vegan honeymoon” and what Cole recommends instead
If you’ve ever experienced a period of feeling amazing for a few months on a vegan diet and then stalled, you’ll appreciate this nuance. Cole notes, “That’s the vegan honeymoon period. We actually have patients that will say that ‘I went vegan, and I felt so good for three months, and then I crashed.’”
So, what’s the move? Cole allows a strategic, time-boxed approach: “Would it be beneficial for people to do blocks of sixteen weeks or four weeks or whatever, of this sort of vegan things where you’re modulating their immune system?” He quickly adds, “[Because of the] significant pitfalls long term, I am not advocating a strict low-fat vegan diet.”
Cole himself points out that neither he nor anyone on his team is vegan, and neither does he recommend it as a long-term diet plan.
Why the “acid load” metric isn’t the whole story
Current Western diets typically produce a high dietary acid load due to large amounts of animal protein and processed foods, which some research suggests may contribute to low-grade metabolic acidosis. However, Cole doesn’t love reducing nutrition to a single score. He notes that dietary acid load gets “used by plant-based vegan advocates.” Still, he warns, “correlation doesn’t necessarily equate with causation.” The body “highly regulates blood pH,” so urinary acidity changes don’t mean your blood turns acidic. “To be so reductive and say it’s just down to acid-forming food or base-forming food is oversimplifying clinical nutrition,” he says.
So—vegan or Mediterranean?
If your goal is short-term weight loss, Cole acknowledges the study’s finding that a low-fat vegan phase can make a significant difference—fast. Participants lost an average of 13 pounds on a vegan diet, according to the study. In the short term, it can deliver that “initial chutzpah,” Cole remarks.
If you’re prioritizing cardiometabolic markers like blood pressure, Mediterranean showed an edge: “Blood pressures significantly saw a decrease with Mediterranean.”
Where Cole lands is pragmatic and personalized. He’s open to “pulsed cyclical” vegan windows while being clear about “significant pitfalls long term,” and he resists one‑size‑fits‑all dogma. Or as his team puts it, when the dust settles, “We should do [an] experiment” and compare notes, because real-life results beat tribalism every time.
The bottom line is that if you want a rapid reset, a short vegan phase may be beneficial. If you wish to sustain a day-to-day eating with heart-healthy bona fides, the Mediterranean diet holds steady. And if you want something that sticks, follow Cole’s lead—test, learn, and cycle what works for your body.
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