The effect of green Mediterranean diet on cardiometabolic risk; a randomised controlled trial
Open Access
- 23 November 2020
- Vol. 107 (13), 1054-1061
- https://doi.org/10.1136/heartjnl-2020-317802
Abstract
Background A Mediterranean diet is favourable for cardiometabolic risk. Objective To examine the residual effect of a green Mediterranean diet, further enriched with green plant-based foods and lower meat intake, on cardiometabolic risk. Methods For the DIRECT-PLUS parallel, randomised clinical trial we assigned individuals with abdominal obesity/dyslipidaemia 1:1:1 into three diet groups: healthy dietary guidance (HDG), Mediterranean and green Mediterranean diet, all combined with physical activity. The Mediterranean diets were equally energy restricted and included 28 g/day walnuts. The green Mediterranean diet further included green tea (3–4 cups/day) and a Wolffia globosa (Mankai strain; 100 g/day frozen cubes) plant-based protein shake, which partially substituted animal protein. We examined the effect of the 6-month dietary induction weight loss phase on cardiometabolic state. Results Participants (n=294; age 51 years; body mass index 31.3 kg/m2; waist circumference 109.7 cm; 88% men; 10 year Framingham risk score 4.7%) had a 6-month retention rate of 98.3%. Both Mediterranean diets achieved similar weight loss ((green Mediterranean −6.2 kg; Mediterranean −5.4 kg) vs the HDG group −1.5 kg; p=0.073, HDG−1.4%; pConclusions The green MED diet, supplemented with walnuts, green tea and Mankai and lower in meat/poultry, may amplify the beneficial cardiometabolic effects of Mediterranean diet. Trial registration number This study is registered under ClinicalTrials.gov Identifier no NCT03020186.Keywords
Funding Information
- Israel Ministry of Science and Technology (3-13604)
- Israel Ministry of Health (87472511)
- California Walnuts Commission
- Deutsche Forschungsgemeinschaft (SFB 1052)
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