About 25% to 30% of people in the USA and Europe are affected by NAFLD. Problems like cardiovascular risk, type 2 diabetes, microbial imbalance, decreased gut microbiome diversity and insulin resistance can occur due to excessive fat (5% or higher) in the liver. The only intervention available for this is losing weight and reducing alcohol consumption.
Lead researcher and epidemiologist Prof. Iris Shai states that his research team and other groups have worked over the past 20 years to prove that the Mediterranean diet is the healthiest through rigorous randomized long-term trials. "Now, we have refined that diet and discovered elements that can make dramatic changes to hepatic fat and other key health factors," he says.
Direct-Plus, the clinical trial conducted by Prof Shai and his team, is the first to test an develop a new green Mediterranean diet. This diet is rich in vegetables, includes daily intake of walnuts (28g), and less processed and red meat. It is filled with green components that are high in polyphenols - three to four cups of green tea a day and 100g of a Mankai green shake that is high in minerals, B12, bioavailable protein, iron, vitamins, and polyphenols.
The trial was 18 months long and started in Israel, 2017, with 297 workers that had abdominal obesity were divided into three groups - green MED diet, Mediterranean diet and healthy dietary regimen. The participants were also given a physical exercise regimen along with free gym membership. The exact proportion of excess intrahepatic fat before and after the trial was checked through MRI scans.
Findings showed that though every diet led to a reduction in liver fat, greatest reduction of hepatic fat (39% lesser than before) was a result of the green MED diet. Comparatively, the traditional Mediterranean diet showed a 20% reduction and the healthy dietary guidelines showed only 12% reduction.
The green MED diet also led to a remarkable reduction in fatty liver. Prevalence of NAFLD dropped to 31.5% from a baseline rate of 62% in the green MED group. Reductions were also seen in the other two groups - 47.9% in the Mediterranean group and 54.8% in the healthy dietary regimen group.
Researchers observed that the effect of polyphenols and reduction of red meats seem to play an important role in reducing IHP and liver fat.