“Better” cigarettes (those with less nicotine and toxic chemicals like benzo(a)pyrenes) still promote lung cancer. “Better” monounsaturated fats like olive oil may still lead to diseased arteries. When scientists fed a monounsaturated fat–rich diet to monkeys for five years, the monkeys developed extensive atherosclerotic plaques in their coronary arteries. (1)
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A 2010 study in Diabetes, Obesity and Metabolism assigned 259 overweight diabetics to one of three diets: a low-carb Mediterranean diet, a traditional Mediterranean diet or a diet based on recommendations from the American Diabetes Association. All groups were told to exercise 30 to 45 minutes at least three times per week. After a year, all groups lost weight; the traditional group lost an average of about 16 pounds while the ADA group dropped 17 pounds and the low-carb group lost 22 pounds.
In 2014, a group of three Brazilian researchers assessed the available literature on low-carbohydrate diets in a meta-analysis. They specifically looked at trials that compared a very-low carbohydrate ketogenic diet (VLCKD) that contained no more than 50 grams of carbohydrates per day against a conventional, low-fat diet with less than 30% of calories from fat. Ultimately, they included 13 studies that lasted 12 months or more and collectively contained 1577 subjects with 787 randomized to a low-fat diet group and 790 to a VLCKD group.
Keep in mind, too, that all oils are a mixture of saturated, monounsaturated, and polyunsaturated acids (though they’re usually called by the name of the fatty acid that is most abundant). Olive oil is about 14% saturated fat, so if you’re pouring olive oil into your skillets and food every day, you’re likely consuming significantly more artery-clogging saturated fat than you realized.
Now, if you had looked only at the blood lipids of the monkeys eating the monounsaturated-fat-rich diet in this study, you’d have thought they would have ended up with cleaner arteries than those that ate more saturated fat. Compared to monkeys fed the diet high in saturated fat, the monkeys fed the monounsaturated-fat-rich diet had lower LDL bad cholesterol levels and higher HDL good cholesterol levels (similar to what happens in studies with humans). And compared to monkeys fed a diet high in polyunsaturated fats, the monkeys fed the high-mono diet had HDLs that were nearly twice as high (again, just like humans).
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Yet it’s an incredibly well-rounded way to lose weight that ditches gimmicks and doesn’t require calorie or macronutrient counting as other diets do. And with the emphasis on healthy fat, it’s satisfying, too. That said, the 2019 U.S. News & World Report Best Diets ranked the Mediterranean diet as No. 1 for Best Diets Overall and it ranks 17 in their list of Best Weight-Loss Diets. (3) The reviewers note that it’s not a slam dunk, and all depends on how you eat. Even healthy diets like the Mediterranean aren’t free-for-all eating plans.
SOURCES: Environmental Nutrition, June 2003; May 2004; February 2005. The Journal of Pediatrics, July 1995. Journal of the American Dietetic Association, February 1997. Journal of the American Dietetic Association, July 1997. Journal of the American Medical Association, 2004; 292. Food Chemistry, May 2004, vol 85; issue 3. American Journal of Clinical Nutrition January 2005. FDA News, Nov. 1, 2004. The Olive Oil Source web site.