March 16, 2021

The Green Mediterranean Diet and Liver Health

Amy Myrdal Miller, MS, RDN, FAND

About the author

Amy Myrdal Miller is a registered dietitian nutritionist (RDN) who has focused her professional work on promoting food and lifestyle choices that promote good health. She is the founder of Farmer’s Daughter Consulting, an agriculture, food, and culinary communications firm. Clients include Hinoman USA. A farmer’s daughter from North Dakota, today she and her husband live near Sacramento, CA, with their two super naughty cats Violet Grey and Schroeder, a.k.a., the Kittens with Mittens.

The Green Mediterranean Diet and Liver Health

When was the last time you thought about your liver and how it’s doing? Now may be a great time to consider ways you can improve your health and the health of your liver by adopting a Green Mediterranean diet.

 

Medical experts estimate one out of four people in the world have non-alcoholic fatty liver disease (NAFLD), a condition in which fat accumulates in the liver and affects how it functions. Left untreated, NAFLD can lead to inflammation in the liver, cirrhosis, liver tumors, and ultimately liver failure.

 

A lean liver, one where little or no fat is stored in the tissue, is a healthy liver. A lean liver functions well, doing all the things livers do, which are many. In fact, the liver is involved in more than 500 vital functions, including aiding in digestion, regulating blood clotting, removing bacteria from the blood steam, and making immune factors that help the immune system function well.

 

Doctor scan order non-invasive imaging technology scans to determine if a person’s liver may be affected by NAFLD, but there are other clues, including elevated liver enzymes (AST and ALT), low levels of folate in the blood, insulin resistance (measured in various ways including the hemoglobin A1c test), and a type 2 diabetes diagnosis. Men and women are equally affected by NAFLD.

A recently published study showed that you can reduce the amount of fat in the liver through weight loss and dietary changes. The study, conducted in Israel, tested three dietary protocols:

1. Participants in the Healthy Diet Group received advice on how to adopt a healthy diet and were encouraged to engage in regular physical activity.

2. Participants in the Mediterranean Diet group were given specific advice on how to adopt a lower calorie Mediterranean diet, rich in vegetables with poultry and fish replacing red meat. These participants were also given an ounce of walnuts every day and encouraged to engage in regular physical activity.

3. Participants in the Green Mediterranean Diet group followed the same protocol as the Med Diet group, but they were also asked to drink 3-4 cups of green tea each day and consume 100 grams (about 3 ounces or 3 cubes) of Mankai each day, incorporate into a green shake as a replacement for their evening meal.

Participants in both Mediterranean diet groups lost weight and reduced the amount of fat in their livers, but people in the Green Mediterranean Diet reduced the amount off at in their livers by twice as much as those in the Mediterranean Diet group.

There searchers also noted the people in the Green Mediterranean Diet group who ate the most folate-rich foods had the greatest reductions of fat in their lives. Folate is a vitamin found in many plant foods, including walnuts and Mankai and other green leafy vegetables, but Mankai is an especially rich source of folate. One serving (85 grams or 3 cubes) contains 60% of the Daily Value.

If you want to see the images of two study participants’ livers showing their scans at baseline and after 12% weight loss and 18 months, see below. The darker blue scans on the bottom indicate healthier, leaner liver tissue. The scans on the left for the study participant in the Green Mediterranean Diet show his liver contains less than 1% fat (96%reduction from baseline) compared to the Mediterranean Diet participant’s liver with 8.39% fat (40% reduction from baseline).

Fatty Liver Scans
Yaskolka Meir A, Rinott E, Tsaban G, et alEffect of green-Mediterranean diet on intrahepatic fat: the DIRECT PLUS randomised controlled trialGut Published Online First: 18 January 2021. doi: 10.1136/gutjnl-2020-323106

 

Researchers also noted that participants in the Green Med group also had the highest blood polyphenol levels. Polyphenols are naturally occurring compounds in plants; some polyphenols may provide benefits to the health of the liver, including reducing how much fat is stored in the liver. Researchers focused in on phenols found in walnuts, green tea, and Mankai. (this recent blog post provides more information about phenols in Mankai and other foods.)

 

Finally, researchers suspect that the reduced intake of red meat also provided benefits to people in both Mediterranean diet groups, but it’s possible the real “secret” is that benefits came from the greater amount of plant-based foods that contain folate, phenols, and other beneficial nutrients versus the reduction or elimination of red meat. More research is needed in this area.

 

No matter what your motivation is for improving your health, adding Mankai to your daily diet provides benefits. It’s a versatile ingredient that can add important nutrients to any day part of meal part. Check out the Mankai recipe collection for more inspiration!