The Green Mediterranean Diet Reduces Twice as Much Visceral Fat as the Mediterranean Diet and 10% More Than a Healthy Diet

Summary: A modified version of the Mediterranean diet, called the green Mediterranean diet, consisting of enriched dietary polyphenols such as green tea, walnuts, and duckweed, and reduced red meats, reduced more visceral fat than either the traditional Mediterranean diet or a traditional diet plan.

Source: Ben-Gurion University of the Negev

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

The green Mediterranean diet was compared with a Mediterranean diet and a healthy diet in DIRECT PLUS, a large-scale clinical interventional trial. Subsequent analysis found that the green Med diet reduced visceral fat by 14%, the Med diet by 7%, and the healthy diet by 4.5%.

Study published BMC Medicine.

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

Research Prof. Conducted by Iris Shai. Professor Emerita from Ben-Gurion University of the Negev, Israel, Harvard School of Public Health, and Professor Emeritus from the University of Leipzig, Germany, doctoral student Dr. Along with Hila Zelicha and her Italian, German and American colleagues.

The DIRECT-PLUS trial research team was the first to come up with 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 their daily intake of walnuts (28 grams), participants consumed 3-4 cups of green tea per day and 100 grams (frozen cubes) of duckweed green shakes per day. The aquatic green plant duckweed is high in bioavailable protein, iron, B12, vitamins, minerals and polyphenols, and substituted meat intake.

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This represents a cup of green tea.
In addition to their daily intake of walnuts (28 grams), participants consumed 3-4 cups of green tea per day and 100 grams (frozen cubes) of duckweed green shakes per day. Image is in the public domain

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

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

“A healthy lifestyle is a strong foundation for any weight loss program. From the results of our experiment, we learned that the quality of food is no less important than the number of calories consumed, and that the goal today is to understand the mechanisms of various nutrients, positive and negative, such as polyphenols. “As empty carbohydrates and processed red meat, it’s on fat cell differentiation and the rate at which they accumulate in the viscera,” says Shai.

“A 14% reduction in visceral fat is a stunning achievement for making simple changes to your diet and lifestyle. Weight loss is an important goal only if it comes with impressive results in reducing fat tissue,” says Dr. Hila Zelicha.

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

None of the funders were involved in any aspect of the design, conduct or analysis of the study and had no access to study results prior to publication.

About this diet and fat reduction research news

Author: Ehud Zion Waldoks
Source: Ben-Gurion University of the Negev
Communication: Ehud Zion Waldoks – Ben-Gurion University of the Negev
Picture: Image is in the public domain

Original research: Open Access.
“Effect of high polyphenol Mediterranean diet on visceral adiposity: DIRECT PLUS randomized controlled trial” by Hila Zelicha et al. BMC Medicine

see also

This shows a tomato salad


Effect of high polyphenol Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial.


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


In the 18-month Dietary Intervention Randomized Controlled Trial PoLifenols Untreated (DIRECT-PLUS) weight loss study, 294 participants were randomized to (A) healthy eating guidelines (HDG), (B) MED, or (C) green-MED diets, all combined with physical activity . Both isocaloric MED groups consumed 28 g/day walnuts (+ 440 mg/day polyphenol). The Green-MED group also includes green tea (3-4 cups per day) and Wolffia globosa (duckweed strain) herb green shake (100 g frozen cubes/day) (+ 800mg/day polyphenols) and reduced red meat intake. We used magnetic resonance imaging (MRI) to measure abdominal fat tissues.

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Participants (age = 51; 88% male; body mass index = 31.2 kg/m)2; 29% VAT) had a retention rate of 89.8% and 79.3% completed eligible MRIs. Both MED diets resulted in similar loss of middle weight (MED: − 2.7%, green-MED: − 3.9%) and waist circumference (MED: − 4.7%, green-MED: − 5.7%). while those on the green MED diet doubled VAT loss (HDG: – 4.2%, MED: – 6.0%, green-MED: – 14.1%; p < 0.05, independent of age, gender, waist circumference or weight loss). Green tea, walnuts and more dietary consumption Wolffia globosa; lower red meat intake; higher total plasma polyphenols (mainly hippuric acid) and high urine urolithin A polyphenol was associated with significantly greater VAT loss (p < 0.05, multivariate models).


A green MED diet enriched with plant-based polyphenols and lower in red/processed meat may be a potent intervention to promote visceral adiposity regression.

trial registration, NCT03020186


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