The Mediterranean Diet Goes Even More Green

For example, US News and World Reports released the annual list of top diets and ranked the Mediterranean diet as the number one overall dietary pattern, characterizing it as being “The not-so-surprising secret is an active lifestyle, weight control, and a diet low in red meat, sugar, and saturated fat and high in produce, nuts and other healthful foods”.

Even the USDA Dietary Guidelines 2020-2025 promote the MED diet as one of three recommended dietary patterns. Despite guidelines, research, and the obvious effects of not eating healthy, most people do not follow healthy eating habits. 

Nutrition-related statistics from the USDA estimate that about 74% of adults and 40% of children are overweight or obese, heart disease is a leading cause of death with over 18.2 million adults having coronary artery disease, 45% of adults have hypertension, 11% of adults have diabetes and 35% of adults have prediabetes with 90% of those adults also being overweight/obese, and 5% of people will be diagnosed with colorectal cancer at some point in their lives, among a long list of other staggering stats. Keep in mind that for most people, nutrition is a modifiable risk factor for all of these conditions.

Mediterranean diets are rich in plant-based foods and are linked to a lower risk of heart disease, stroke, and diabetes; it is believed that its impact is related to higher dietary intake of polyphenols, phytosterols, healthy fats, fiber, and a lower intake of animal-based protein. A typical MED diet includes plenty of fruits, veggies, nuts, seeds, olive oil, eggs, fish, poultry, and limited dairy products. Benefits of this diet include lower weight, lower cholesterol, more energy, healthier hearts, and extended longevity, among others.

Enter the new kid on the block: trying to make the MED diet even more effective, a team of researchers developed the Green-MED diet containing even more plant-based foods and very little red meat or poultry, and then they conducted a randomized controlled trial to examine whether it was more effective in further reversing cardiometabolic risks such as fatty deposits in the liver than can lead to non-alcoholic fatty liver disease which left untreated can cause cirrhosis and death. The diet was investigated in 294 participants with abdominal obesity or significant cholesterol disorders over an 18 month period, their findings have been reported in BMJ Journals Heart. 

All participants were advised to participate in an exercise program, and they were randomly placed into three diet groups: the healthy dietary group, the MED diet group, and the Green-MED diet group. The MED diet was rich in vegetables and walnuts as well as replacing beef and lamb with poultry and fish. The Green-MED diet also included walnuts and was further enriched with green plant-based foods adding 3-4 cups a day of green tea and replaced dinner with a green shake featuring frozen cubes of Manki to lower meat intake. 

90% of the participants were retained in the study, over the course of 19 months the prevalence of NAFLD decreased to 55% in the healthy dietary group, decreased to 48% in the MED group, and decreased to 31% in the Green-MED diet group. Those in the Green-MED group had close to double the amount of fat loss in the liver which was related to the green shake and the number of walnuts ingested along with the greater reduction in red and processed meats causing a greater drop in liver fat stores, according to the researchers.

“We examined the effect of the six-month dietary induction weight loss phase on the cardiometabolic state.” 

“Both Mediterranean diets achieved similar weight loss the HDG group, but the green Mediterranean group had a greater reduction in waist circumference (−8.6 cm) than the Mediterranean and HDG groups.”

“Within six months the green Mediterranean group achieved greater decrease in low-density lipoprotein cholesterol and a lower diastolic blood pressure reading.”

Following a Mediterranean-style diet is documented as being favorable for cardiometabolic risk. The group of researchers in this study concluded that “The Green-MED diet, supplemented with walnuts, green tea, and Mankai and lower in meat/poultry, may amplify the beneficial cardiometabolic effect of Mediterranean diet.”

Removing animal-based foods and replacing them with polyphenol-rich plant-based foods is suggested to help maximize the already healthy Mediterranean diet, which was done by adding the chlorophyll-rich Mankai green shakes in the Green-MED diet group. However, Mankai can be hard to find in Western cultures. You might be able to find them in the freezer section at a health food store as frozen cubes, similar to those used in the study. 

Globally, poor diet and lifestyle habits have made conditions such as NAFLD become a serious issue, but especially in Western societies. Research, such as this one, is showing that making better lifestyle choices and dietary changes can make a significant positive advance in health. Moreover, the closer the dietary change is to being a whole food primarily plant-based diet, the better odds one will have in avoiding chronic diseases and an improved healthspan in the oncoming years. 

“Education and encouragement to follow a green Med dietary pattern in conjunction with physical activity has the potential to be a major contributor to public health as it may improve balancing of cardiovascular risk factors, eventually preventing cardiovascular morbidity and mortality,” said Dr. Gal Tsaban and Professor Iris Shai of Ben-Gurion University who conducted the study.

“Our findings suggest that additional restriction of meat intake with a parallel boost in plant-based, protein- high-polyphenols rich foods such as walnuts, green tea and Mankai, may further benefit the cardiometabolic state and reduce cardiovascular risk, beyond the known beneficial effects of the traditional Mediterranean diet.”