The Mediterranean diet – which focuses on whole grains and lentils, fish, olive oil, nuts, vegetables, fruits, some dairy products and poultry and a minimum of red meat – has been described as “the most healthful diet” in the world. Along with healthful food choices, the diet also stresses the importance of exercising and eating as a family group as much as possible. 

Based on the nutrition of people from southern Italy, Crete and Greece, it has traditionally been adopted by many Israelis, even if they were not born here, but too many younger residents have become addicted to cheap junk and fast food. 

The Mediterranean diet has become popular because those who follow it have a low rate of obesity, cardiovascular illnesses, type-2 diabetes and other chronic disease.  show low rate of heart disease, chronic disease, and obesity. 

But the diet, according to researchers at Ben-Gurion University (BGU) of the Negev in Beersheba, can be improve on. A “green Mediterranean diet” containing even more plant matter and very little red meat or poultry could be even better for cardiovascular and metabolic health than the traditional version of the Mediterranean diet – at least in men. 

BGU’s Dr. Gal Tsaban and Prof. Iris Shai, who conducted the study, just published their findings online in the journal Heart under the title: The effect of green Mediterranean diet on cardiometabolic risk; a randomized controlled trial.” 

The researchers wanted to find out whether an ultra-green version of this diet that is higher in green plant-protein based food sources and even lower in red meat intake might be even better for health and for dropping the “bad cholesterol” (LDL), which is usually challenging to accomplish by diet. They randomly divided 294 sedentary and moderately abdominally obese people (with a body-mass index, or BMI, of 31) with an average age of 51 into three dietary groups. 

The first group received guidance on boosting physical activity and basic guidelines for achieving a healthy diet. The second received the same physical activity guidance and advice on following a calorie-restricted (1,500 to 1,800 calories daily) for men and 1200–1400 kcal/ day for women) traditional Mediterranean diet. 

This diet was low in simple carbohydrates, rich in vegetables, with poultry and fish replacing red meat. It included 28 grams per day of walnuts. The third group received physical activity guidance and advice on following a similar calorie-restricted green version of the Mediterranean diet (“green Med”). This included 28 grams per day of walnuts, avoidance of red/processed meat and higher quantities of plant matter, in addition to three to four cups per day of green tea and 100 grams of frozen cubes of Wolffia globosa duckweed (Mankai, cultivated strain, rich in polyphenols and phytosterols) taken as a green plant-based protein shake, which partially substituted animal protein. 

After six months, the effect of each of the diets on weight loss and on cardiovascular and metabolic risk factors was assessed. Those on both types of Mediterranean diet lost more weight – the “green Med” 6.2 kg; regular Mediterranean diet 5.4 kg; and an ordinary healthful diet 1.5 kg. Waist circumference – an indicator of a potentially harmful midriff bulge – shrank by an average of 8.6 centimeters among those on the “green Med” diet compared with 6.8 cm for those on the ordinary Mediterranean diet and 4.3 cm for those on the ordinary healthful diet. 

The “green Med” diet group resulted in larger declines in ‘bad’ low-density cholesterol of 6.1 mg/dl, a reduction of nearly four percent. The equivalent figures were 2.3 mg/dl (nearly one percent) for those in the Mediterranean diet group, and null (0.2 mg/dl) for those in the healthful- diet group. Similarly, other cardiovascular and metabolic risk factors improved more among those on the “green Med” diet, including drops in diastolic blood pressure, insulin resistance and an important marker of inflammation called C-reactive protein, which has a key role in artery hardening. The ratio of ‘good’ to ‘bad’ cholesterol also increased. 

These changes resulted in a substantial nearly two-fold fall in the 10-year Framingham Risk Score – a calculation used to predict the likelihood of serious heart disease over the next decade – among those on the “green Med” diet. The researchers caution that their sample included just 35 women. 

“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 Tsaban and Shai. “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.”