Mediterranean Diet

Green-Mediterranean Diet Reduces Two Times Amount of Visceral Adipose Tissue Compared to Mediterranean Diet Alone

Jessica Ganga

A green-Mediterranean (MED) diet that is enriched with plant-based polyphenols reduces visceral adipose tissue—fat that is around internal organs, according to a new study.

The MED diet is a great source of polyphenols—a category of plant compounds that offers various health benefits. But the green-MED diet is twice fortified in dietary polyphenols and is lower in red and/or processed meat. In a randomized controlled study, the researchers set out to determine how the green-MED diet would impact visceral adipose tissue.

In total, 294 individuals participated in the randomized controlled study that took place during an 18-month period. Participants were split among three groups: (1) healthy dietary guidelines (HDG), (2) MED diet, or (3) green-MED diet. In both MED groups, participants consumed 28 g/ day of walnuts and 440 mg/day of polyphenols. Further, the green-MED group consumed three to four cups of green tea, duckweed plant green shake (100 g frozen cubes/day), 800 mg/day of polyphenols, and had a reduced meat intake.

Using MRI to quantify the abdominal adipose tissues, the researchers found that there was double the visceral adipose tissue loss in the green-MED dieters (14.1%) compared to participants in the other two groups (MED = 6.0%, HDG, 4.2%). The researchers saw a similar weight loss and waist circumference in both the MED and green-MED groups.

The authors noted several limitations including the low proportion of women involved in the study. The different visceral adipose tissue proportions at baseline across all three groups limited the general findings for women. Further, the researchers could not identify the exact components responsible for the dietary effects, as the regimens were compared in the study, not the specific nutrient intake.

“A green-MED diet enriched with polyphenols and decreased red meat consumption might serve as an improved version of the MED diet for targeted [visceral adipose tissue] reduction,” the researchers concluded. “Future studies are needed to explore the exact mechanisms of specific polyphenol-rich foods on visceral adiposity.”


Zelicha H, Kloting N, Kaplan A, et al. The effect of high-polyphenol Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized control trial. BMC Med. Published online September 30, 2022. doi:10.1186/s12916-022-02525-8