What Is the Green Mediterranean Diet and Why Is It Different?

The Mediterranean diet is recommended by many health professionals for its balanced and health-focused approach. Packed with vegetables, fruits, whole grains, fatty fish, olive oil, and recommendations for limiting red meat and highly processed foods, it’s linked to numerous potential health benefits like supporting heart health, glycemic control, and brain health.

But what about the green Mediterranean diet? How is it different, and is it even better? While not as widely known as the traditional Mediterranean diet, early research on the green Med diet is promising. Let’s take a closer look at what sets the greener diet apart and whether it’s worth the switch.

What exactly is the green Mediterranean diet?

“We call it an enhanced Mediterranean diet,” says Edwina Rich, MS, RDN, CDN, LDN, president of Rich Nutrition Consulting Group and former Director of Clinical Nutrition Services at NYU Langone Health in New York City. It combines two healthy eating styles into one, Rich explains.

The plant-forward approach builds on the original Mediterranean diet by encouraging more greens, including mankai duckweed, an aquatic green containing high-quality protein and vitamin B12, and incorporating green tea. The diet recommendations also minimize or eliminate the intake of red or highly processed foods and meats.

Both green tea and mankai contain polyphenols — naturally occurring compounds known for their antioxidant properties that help to protect cells from oxidative damage. Currently, researchers theorize that the additional polyphenols and fiber in the green Mediterranean diet may amplify the suggested health benefits, potentially offering a greater impact on the prevention of some non-communicable diseases long-term, like high blood pressure, heart disease, and liver disease.

Mediterranean diet vs. green Mediterranean diet

The Mediterranean diet isn’t just a way of eating, but a lifestyle that emphasizes whole, nutrient-dense foods with vibrant colors, bold flavors, and nutritionally balanced meals. Rooted in the cuisines of Greece and Southern Italy, it prioritizes fruits and vegetables, whole grains like brown rice and oats, nuts, and extra virgin olive oil. The diet also includes fatty fish and moderate amounts of poultry and dairy and recommends limiting red meat and highly processed foods.

The green Mediterranean diet takes this foundation and gives it a plant-based perspective, incorporating more plants, plant proteins, and green tea to pack in even more diverse nutrients and other compounds into the daily diet.

In 2022, this diet was included as part of the Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT-PLUS) to examine the effects of different diets on health. The study suggested that the green Mediterranean diet, supplemented with mankai duckweed, green tea, and sometimes walnuts, may have neuroprotective effects in the long term.

Type	Foundation	Main proteins	Food limitations	Unique qualities
Mediterranean diet	High intake of extra virgin olive oil, vegetables including leafy greens, fruits, grains, nuts, and beans	Omega-3 fatty fish with moderate amounts of poultry and dairy	Limited amounts of red meat (special occasions), highly processed meats, and highly processed sweets	Rich in monounsaturated fats and essential omega-3 fats
Green Mediterranean diet	Similar to the traditional Mediterranean diet, but with higher amounts of plant-based foods and plant proteins, along with regular consumption of green tea	Plant proteins like mankai duckweed, legumes, nuts, and seeds	Limited amounts of no red meat, highly processed meat, refined grains, or other highly processed foods	High emphasis on polyphenols with the addition of mankai duckweed and green tea

What to eat on the green Med diet: a food focus

The green Med diet is packed with a variety of nutrient-rich foods.

Foods to limit

The green Mediterranean diet limits many of the same foods as the traditional Mediterranean diet. But as a plant-based diet, you should eat less poultry, fish, eggs, and dairy. The diet also significantly restricts red meat and highly processed, unhealthy meat.

Certain food limitations of the green Med diet are also in line with the general dietary guidelines for a healthy diet. For example, regular excessive consumption of red and highly processed meat is associated with an increased risk of certain chronic diseases, gastrointestinal issues, and all-cause mortality. Meanwhile, excessive intake of added sugar is associated with an increased risk of overweight and obesity, among others.

Green Mediterranean diet meal ideas

Knowing what to eat is one thing, but putting it all together? I’m well aware of the struggle. Working as a registered dietitian for more than 25 years, meal plans are one of the most common requests I get from clients. It helps answer the most distressing question: what’s for dinner?

To get you started on the green Mediterranean diet, I put together a downloadable 7-day meal plan filled with vibrant colors, wholesome ingredients, and healthful meals.

As the Clinical Nutrition Director at NYU Langone Health, Rich added several green Mediterranean-style meals to the menu, including a spinach frittata with feta cheese in the inpatient room service menu and a whole-wheat pita pizza with tomatoes and spinach for the inpatient pediatric menu. For staff and visitors, grilled romaine lettuce was featured on the salad bar.

Potential health benefits of the green Med diet

Is going green that much better for your health? Early research seems to suggest that the green Mediterranean diet may potentially enhance certain proposed benefits to health that come with the traditional Mediterranean diet. While there’s still more to learn, the plant-forward approach may benefit heart health, support weight loss, play a role in lowering fat in the liver, and contribute to longevity.

Heart health

The green Med diet may take heart-healthy eating to the next level. According to a 2021 study in BMJ Heart, part of the DIRECT-PLUS clinical trial, results from this study showed that the green Med diet outperformed both the traditional Med diet and the basic healthy diet in potentially benefiting the heart.

Participants following the green Mediterranean diet had a reduction in the ‘bad’ cholesterol (low-density lipoprotein or LDL) and blood pressure levels. Further, their 10-year cardiovascular disease risk dropped by 3.7%, compared to 2.3% in the original Mediterranean group.

It’s theorized that the polyphenols in the greener diet plan may intensify the overall health benefits. However, the health claims are based on small, short-term studies made up of mostly middle-aged men from a small region of the world, so the benefits may not apply to all.

Further, while polyphenols may be playing a key role in the results of these studies, the specific mechanisms behind how they support cardiovascular health are still uncertain. Additionally, while the 3.7% drop in heart disease risk may be statistically significant, it may not lead to dramatic changes in health outcomes for most people if other lifestyle factors aren’t addressed.

Weight loss

The BMJ Heart study also found the green Med diet may support weight loss, with participants losing more than 12 pounds in six months versus about 10 pounds on the traditional Med diet and about 3 pounds on the basic healthy diet plan.

The green Mediterranean diet may also help with reducing visceral fat, the belly fat that is generally associated with an increased risk of certain chronic health conditions like heart disease, type 2 diabetes, and metabolic syndrome.

A 2022 study published in BMC Medicine looked at the 18-month weight data from the DIRECT-PLUS clinical trial and found that the green Med diet group lost more than 14% of their visceral fat, compared to about 5% on the basic healthy diet and 6% on the traditional Mediterranean diet.

However, while food choices play a role in supporting weight management, many factors influence weight, like total daily calorie intake, physical activity, sleep, and stress. The Mediterranean diet, green or traditional, isn’t automatically low in calories, so weight loss outcomes may depend a lot more on the implementation of the overall dietary and lifestyle plan than the composition of the diet alone.

Liver health

Non-alcoholic fatty liver disease (NAFLD) is the accumulation of fat in the liver not related to alcohol consumption. It affects nearly 25% of the world’s population and may contribute to the development of many chronic health conditions like type 2 diabetes and cardiovascular disease.

It’s been suggested that the polyphenol-enriched Mediterranean diet may reduce fat accumulation in the liver and lower the risk of NAFLD by as much as 50% by supporting gut health, which may influence how the liver metabolizes fat and carbs.

However, NAFLD is a complex and multifactorial disease linked to obesity, insulin resistance, and imbalance of the gut microbiome, which means that the complexity of the condition may require a multifactorial lifestyle and dietary approach.

While the particular study shows an association between the green Med diet and a reduction in liver fat, it does not establish a direct cause-and-effect relationship. Improvements may be influenced not only by dietary choices but also by additional factors, such as increased physical activity.

Longevity

Rich in antioxidants and plant-based proteins, the green Mediterranean diet may also support healthy aging. Eating a greener diet is proposed to help reduce the risk of certain chronic diseases that may potentially shorten lifespan and support brain health while you age by playing a role in inflammation and oxidative stress reduction.

A 2024 study published in The American Journal of Clinical Nutrition suggests that the green Med diet may contribute to a more “youthful” brain by balancing blood sugar levels and delivering antioxidant compounds.

Again, while the results of these studies are promising, the evidence is preliminary and based more on association than direct cause and effect. While antioxidants and plant foods are linked to reduced inflammation and oxidative stress, it’s unclear how they influence the aging process.

Further, many factors affect aging, including genetics, environment, and lifestyle. Diet is only one piece of the puzzle.

Potential considerations of the green Mediterranean diet

The green Mediterranean diet earns high marks for its proposed health benefits, blending the nutrient-rich plant foods and proteins with the heart-healthy principles of the Mediterranean diet. However, there are a few main considerations to keep in mind if planning to shift to such a dietary pattern, including:

• Limited intake of animal-based proteins and dairy foods
• Potential lack of omega-3 fatty acids
• Need of careful planning and preparation
• Aquatic supplements not safe for everyone
• Not suitable for folks following a low potassium diet

One key guideline is that the diet encourages limiting red meat intake. Though most health organizations recommend reducing the intake of red and highly processed foods, shifting completely away from animal-based foods, including chicken and fish, may not be appealing to all.

Dietary guidelines suggest that, from a nutritional perspective, a healthy diet may include a moderation of animal-based products such as dairy, eggs, fish, and lean meat, which all provide nutrients important for overall health.

When shifting to a plant-based diet, it is important to carefully plan the daily meals to meet the body’s needs in order to avoid potential nutritional gaps for certain nutrients such as protein, iron, calcium, and vitamin B12 that are commonly found in dairy, eggs, lean meat, and other animal-based foods.

Moreover, the classical Mediterranean diet emphasizes fatty fish, which contains omega-3 fatty acids, which may play a vital role in its proposed benefits. The green Mediterranean diet recommends walnuts as a source of omega-3 fats.

However, the omega-3 fats in walnuts come in a different form, which the body needs to convert into more easily accessible fatty acids. With that being said, while walnuts are a source of healthy fats and omega-3s, they are not a direct substitute for fatty fish. This means that in order to meet the body’s needs, a combination of different plant-based sources, careful meal composition considerations, and, in some cases, additional supplementation may be required to meet the body’s needs daily.

The diet also includes a special edible aquatic plant not readily available at every grocery store and not right for all budgets. Allergic reactions are also a potential concern with aquatic plants and may not be recommended for everyone. Additionally, mankai duckweed is high in potassium and not recommended for individuals on a low-potassium diet to manage health conditions like kidney disease.

The green Med diet also recommends consuming 3–4 cups of green tea daily. Though packed with polyphenols, green tea contains caffeine and may not benefit those sensitive to the stimulant.

With that being said, while the green Med diet may have beneficial properties to health, especially focusing on higher inclusion of plant-based foods, it should be adapted and approached with careful planning, flexibility, and individual considerations to meet individual needs.

Final word

The green Mediterranean diet is considered an enhanced version of the traditional Mediterranean diet aimed at potentially amplifying suggested health benefits. It’s a promising eating style, but we still need more scientific knowledge on it and it may not work for all.