The surprising results of a head-to-head study of Mediterranean, Paleo, and intermittent fasting

Most healthy eating plans work under perfect conditions. You just follow the guidelines, and then voila! A trimmer, healthier you!

Reality is not so kind. Two studies of real-world eaters shed light on which healthy eating strategies actually work in the real world.

Skip Paleo. A study in the American Journal of Clinical Nutrition followed 250 people for a year with minimal professional support, allowing them to opt into a Mediterranean food plan, intermittent fasting (two days a week of eating 500-600 calories), or a Paleo plan with a bit of dairy, legumes, and grains. At the end of a year, the Paleo plan had by far the lowest adherence, with just a third sticking to it, and the lowest weight loss, at 4.6 pounds. The Paleo eaters also showed no improvements in blood pressure or blood sugar levels.
Intermittent fasting works best. It’s maintainable: 54% of people were still fasting twice a week after a whole year, losing an average of 11.2 pounds, and showing lowered blood pressure.
 Mediterranean is also a smart choice. Take note: The Mediterranean eaters had the highest adherence rate, at 57%, and lost an average of 10.1 pounds, with improvements in both blood pressure and blood sugar levels.
You will not eat healthfully at a restaurant. A study in the Journal of Nutrition of 35,000 people over a 13-year period found that if you walk into a restaurant, your chances of adhering to your healthy eating plan are zero. Specifically, just 0.1% of restaurant meals were of ideal nutritional and dietary quality—and the 1 in 1,000 is probably not gonna be you. On average, Americans get over 20% of their calories from eating out.