The 'green' Mediterranean diet: New twist on an old favorite

The Mediterranean diet has been touted as a common-sense approach to preventing chronic disease and dementia.^[] With a focus on whole foods and fresh produce, legumes, healthy fats, and seafood, it’s no wonder this diet is well-liked by both patients and healthcare providers.

Researchers recently explored what happens when patients take this diet to a new level by adding a little extra “green.” The results may have you rethinking the traditional Mediterranean diet.

A brainy upgrade

A 2024 study in the American Journal of Clinical Nutrition tested the effects of a standard Mediterranean diet vs what they called a green Mediterranean diet.^[] Both groups consumed 28 grams of walnuts per day and restricted total calories to 1,500–1,800 for men and 1,200–1,400 for women. They also received physical activity guidelines and a free gym membership. 

@palmgrenacu BEWARE ⬇️ You’re familiar with the anti-inflammatory diet and Mediterranean diet being one of the most healthiest diets you can be on 😁 Especially when you’re in pain. This is key 🔑 and I am recommending it to my patients all the time. But there’s one food in the diet that is often overlooked and might be costing you 😬 The wilted green is imperative if you’re going to be on an anti-inflammatory diet or Mediterranean diet. This side dish is often served with protein. And takes your diet to another level. Make sure to eat it at least once a day to get the maximum benefits. WILTED GREENS RECIPE 🥬  Bunch of dandelion leaves  Olive oil Lemon Take a big pot and fill it with water. Place on stove over medium heat. Add dandelion leaves to pot. Cover and bring to a rolling boil. Once it boils, lower it to simmer for 45 minutes. When cooked to a deep, dark green, remove dandelion leaves from water . Drizzle olive oil over it and squeeze fresh lemon juice over it. Enjoy warm. 😋  #antiinflammatoryrecipes #mediterraneandiet #mediterraneanfood #greekfood #healthyrecipes #healthygreens #oakparkil ♬ original sound - Lynn Palmgren | Acupuncturist

In accordance with the standard Mediterranean diet, participants were instructed to avoid simple carbohydrates, eat plenty of fruits and vegetables, and replace beef and lamb with fish and poultry. However, the green version of the diet added three to four cups of green tea throughout the day, plus a high-polyphenol green shake at dinner. 

The green shake was made from a form of cultivated duckweed called Mankai. Along with the catechins in green tea, participants in the green group received over 200 polyphenols through the Manaki drink, which is particularly high in antioxidants, especially derivatives of luteolin and apigenin.^[]

Real-world results: Brain health

Participants in this study underwent an MRI at baseline, and then at 18 months of following their prescribed diet. Ultimately, greater consumption of greenery was associated with younger brain age.^[]

“I think what the article confirms is what we’ve known so long about brain health,” Christina Prather, MD, FACP, Director of the Division of Geriatrics and Palliative Medicine and associate professor at George Washington University, tells MDLinx. “Nutrition matters. What we put in our body affects brain health.”

Dr. Prather has seen the impact of diet on her patients first-hand. “I often see people come in with under-controlled diabetes or high sugar intake. Correcting those issues really impacts how they feel and their own perceived cognitive performance,” she explains. 

Cancer prevention

Brain health isn't the only thing greens are good for: These foods, rich in polyphenols and other bioactive compounds, have demonstrated promising anticancer properties, attributable in part to their potent antioxidant and anti-inflammatory effects.^[] Polyphenols contribute to cellular defense mechanisms and promote homeostasis under oxidative stress. These compounds are metabolized into bioactive forms within the gut, where they exhibit systemic benefits, including the modulation of carcinogenic pathways.

In the clinic

Although the green Mediterranean diet may offer additional benefits, Dr. Prather admits that some patients aren’t quite ready for that extra step. “The majority of people are trying to move towards a plant-based diet or Mediterranean diet, and we work towards eliminating alcohol, getting more sleep, engaging in physical activity, and getting more vegetables in their diet. For people who are already doing those things, adding green drinks into the diet is a bonus,” she says. 

“We know that health comes from the ground—many of our medications for various conditions stem from what the earth has given us, and to write off a potential benefit from our environment is short-sighted," Dr. Prather continues. "It’s exciting to see reinforcement that there’s added benefit to adding more greens.” 

“As clinicians, we have to be able to go to that next level and help people make the jump into action,” she says. “It’s a message we all need to get behind.”