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The Green Mediterranean Diet Reduces Visceral Fat Twice As Much As The Mediterranean Diet And 10% More Than A Healthy Diet – Neuroscience News

Summary: A modified version of the Mediterranean diet called the Green Mediterranean Diet, which consists of fortified dietary polyphenols such as green tea, nuts and duckweed, and a decrease in red meats, reduced more visceral fat than the traditional Mediterranean diet or a traditional diet.

Source: Ben Gurion University of the Negev

The Green Mediterranean Diet (MED) dramatically reduces visceral adipose tissue, a type of fat around internal organs that is far more dangerous than the extra “tire” around your waist.

The Green Mediterranean Diet was pitted against the Mediterranean diet and healthy eating in a large-scale interventional clinical trial – the DIRECT PLUS. Further analysis found that the Green Med diet reduced visceral fat by 14%, the Med diet by 7%, and the healthy diet by 4.5%.

The study was published in BMC Medicine.

Reducing visceral fat is considered the true goal of weight loss because it is a more important indicator than a person’s weight or waist circumference. Visceral fat aggregates over time between organs and produces hormones and poisons linked to heart disease, diabetes, dementia and premature death.

The research was led by Professor Iris Shai from Ben-Gurion University of the Negev, Israel, assistant professor at the Harvard School of Public Health and honorary professor at the University of Leipzig, Germany, with her doctoral student, Dr. Hila Zelicha, and colleagues from Italy, Germany and Americans.

The DIRECT-PLUS trial research team was the first to introduce the concept of the green-Mediterranean diet. This modified MED diet is further enriched with dietary polyphenols and contains less red/processed meat than the traditional healthy MED diet. In addition to daily consumption of nuts (28 grams), participants consumed 3-4 cups of green tea/day and 100 grams (frozen cubes) of green duckweed shake/day. The aquatic green plant duckweed is rich in bioavailable protein, iron, B12, vitamins, minerals, polyphenols and a meat substitute.

This shows a cup of green tea
In addition to daily consumption of nuts (28 grams), participants consumed 3-4 cups of green tea/day and 100 grams (frozen cubes) of green duckweed shake/day. Image is in public domain

The team has shown in previous studies that the MED Green Diet has a variety of beneficial effects ranging from microbiome to age-related degenerative diseases.

Two hundred and ninety-four participants took part in the 18-month trial.

“A healthy lifestyle is a solid foundation for any weight loss program. We have learned from the results of our experiment that the quality of food is no less important than the number of calories consumed and the goal today is to understand the mechanisms of various nutrients, for example, positives such as polyphenols , and the negatives such as empty carbohydrates and processed red meat, on the rate of fat cell differentiation and aggregation in the viscera,” says Professor Shai.

“A 14% reduction in visceral fat is a dramatic achievement for making simple changes to your diet and lifestyle. Weight loss is only an important goal if it is accompanied by impressive results in weight loss. reduction of adipose tissue,” notes Dr. Hila Zelicha.

Funding: This work was supported by grants from the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – Project number 209933838 – SFB 1052; the Rosetrees Trust (grant A2623); Israel Ministry of Health Grant 87472511; Grant 3-13604 from the Israeli Ministry of Science and Technology; and the California Walnut Commission.

None of the funders was involved at any stage of the design, conduct or analysis of the study and they did not have access to the study results prior to publication.

About This Diet and Fat Reduction Research News

Author: Ehud Zion Waldocks
Source: Ben Gurion University of the Negev
Contact: Ehud Zion Waldoks – Ben Gurion University of the Negev
Image: Image is in public domain

Original research: Free access.
“The effect of the polyphenol-rich Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial” by Hila Zelicha et al. BMC Medicine

See also

This shows a thermometer


The effect of the polyphenol-rich Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial


The Mediterranean diet (MED) is a rich source of polyphenols, which benefit adiposity through several mechanisms. We explored the effect of the green-MED diet, twice enriched in dietary polyphenols and lower in red/processed meat, on visceral adipose tissue (VAT).


In the 18-month Dietary Intervention Randomized Controlled Trial PoLyphenols UnproceSsed (DIRECT-PLUS) weight loss trial, 294 participants were randomized to (A) healthy eating guidelines (HDG), (B) MED or (C) green-MED diets combined with physical activity. The two isocaloric MED groups consumed 28 g/day of nuts (+ 440 mg/day of polyphenols). The green-MED group also consumed green tea (3 to 4 cups/day) and Wolffia globosa (strain of duckweed) vegetable green shake (100g of frozen cubes/day) (+ 800mg/day of polyphenols) and reduced consumption of red meat. We used magnetic resonance imaging (MRI) to quantify abdominal fatty tissue.


Participants (age = 51 years; 88% male; body mass index = 31.2 kg/m2; 29% VAT) had a retention rate of 89.8% and 79.3% completed eligible MRIs. While both MED diets achieved moderate weight loss (MED: −2.7%, green-MED: −3.9%) and waist circumference (MED: −4.7%, green-MED: − 5.7%), the green-MED schemes doubled the VAT loss (HDG: − 4.2%, MED: − 6.0%, green-MED: − 14.1%; p < 0.05, regardless of age, sex, waist circumference or weight loss). Higher dietary intake of green tea, nuts and Wolffia globosa; reduced consumption of red meat; higher total plasma polyphenols (mainly hippuric acid), and elevated urine urolithin A polyphenols were significantly related to greater TVA loss (p < 0.05, multivariate models).


A green-MED diet, enriched with plant-derived polyphenols and low in red/processed meat, can be a powerful intervention to promote the regression of visceral adiposity.

Trial registration, NCT03020186

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