Letter by Koh Regarding Article, “Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet)”
Authors: Kwang Kon Koh
Journal: Circulation (2018)

Sofi et al 1 report that both a low-calorie lacto-ovo vegetarian diet and a low-calorie Mediterranean diet were effective in reducing body weight, body mass index, and fat mass, with no significant differences between them.However, a vegetarian diet was more effective in reducing low-density lipoprotein cholesterol levels, whereas a Mediterranean diet led to a greater reduction in triglyceride levels.Obesity is currently 1 of the greatest public health issues worldwide.It is clear that obesity is an established risk factor for the development of cardiovascular diseases such as hypertension, diabetes mellitus, coronary heart disease, and heart failure.In addition, multiple biological mechanisms linking obesity and cardiovascular disease events have been identified. 2Therefore, how to control body weight is a hot issue nowadays.People have been interested in types of diet and exercise.Recently, in a 12-month weight loss diet study, there was no significant difference in weight change between a healthy low-fat diet versus a healthy low-carbohydrate diet, and neither genotype pattern nor baseline insulin secretion was associated with the dietary effects on weight loss.In the context of these 2 common weight loss diet approaches, neither of the 2 hypothesized predisposing factors was helpful in identifying which diet was better for whom. 3f interest, improving adherence to healthy dietary patterns could attenuate the genetic association with weight gain.Moreover, the beneficial effect of improved diet quality on weight management was particularly pronounced in people at high genetic risk for obesity. 4Systematic review and meta-analysis of randomized, controlled trials using random effects, estimating risk ratios, and mean differences observed that weight-reducing diets, usually low in fat and saturated fat, with or without exercise advice or programs, may reduce premature all-cause mortality in adults with obesity. 5However, no study has assessed the interactions between changes in these diet quality scores and genetic predisposition to obesity in relation to long-term changes in body mass index and body weight.Cardiometabolic syndrome consisting of obesity, dyslipidemia of high triglycerides or low high-density lipoprotein cholesterol, prehypertension, and prediabetes showing fasting glucose >100 mg/dL are major risk factor for cardiovascular diseases such as hypertension, diabetes mellitus, coronary heart disease, and heart failure as well as cancer, congenital malformations, and dementia.Obesity is the most important factor among others and also can be controlled by diet and exercise.Indeed, exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes mellitus. 2lthough it is clear that there is a strong link between obesity and the incidence of various clinical outcomes, whether reducing weight gain should be the primary target at the clinical level remains debated.It has rather been suggested that targeting key