Trial reportBMC medicine2022
The effect of high-polyphenol Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial.
Trial report in BMC medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 47 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Green-MED Diet Via the Gut-fat-brain Axis; DIRECT-PLUS
The Effect of Wolffia Globosa (Mankai) on Glycemic Control Among Patients With Type 2 Diabetes; A 3-month Randomized Controlled Pilot Trial
Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Sustained visceral fat loss is associated with attenuated brain atrophy and improved cognitive function in late midlife.Nature communications · 2026Pooled it
- Effect of Polyphenol Supplementation on Adiposity: A Systematic Review of Randomized Clinical Trials.Current nutrition reports · 2025Pooled it
- Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on Future Cancer Risk.International journal of molecular sciences · 2023Pooled it
- Lifestyle-Induced Visceral Fat Loss as a Key Target for Durable Cardiometabolic Health: MRI-Assessed 5- and 10-Year Follow-Up After 2 Clinical Trials.Circulation · 2026Trial
- Phenolic-rich extruded BRS 305 sorghum-based beverage improves fecal and blood metabolites, oxidative balance and cardiometabolic markers in adults with excess body weight: a single-blind, randomized, placebo-controlled study.European journal of nutrition · 2026Trial
- Effects of 12-Week Sorghum Consumption on Visceral Fat Area and Metabolic Parameters in Japanese Adults: An Exploratory Single-Arm Trial.Nutrients · 2026Trial
- The connection between nutrition education, behavior, and body composition in women following the Mediterranean diet: a sustainable approach.BMC women's health · 2026Trial
- How effective is rejoining a long-term weight loss program? The 5- and 10-year MRI-assessed Follow Interventions Trial (FIT) project.BMC medicine · 2026Trial
- Effects of the MIND diet on cardiometabolic health and novel anthropometric measures in women with type 2 diabetes and insomnia: a randomized controlled trial.Nutrition journal · 2025Trial
- Metabolic Dysfunction-Associated Steatotic Liver Disease Is Linked to Environmental Sustainability: The Role of the Mediterranean Diet.Nutrients · 2025Trial
- Non-invasive vestibular nerve stimulation (VeNS) reduces visceral adipose tissue: results of a randomised controlled trial.Scientific reports · 2025Trial
- Trial
- Impact of a Mediterranean-Inspired Diet on Cardiovascular Disease Risk Factors: A Randomized Clinical Trial.Nutrients · 2024Trial
- An Energy-Reduced Mediterranean Diet, Physical Activity, and Body Composition: An Interim Subgroup Analysis of the PREDIMED-Plus Randomized Clinical Trial.JAMA network open · 2023Trial
- The effect of polyphenols on DNA methylation-assessed biological age attenuation: the DIRECT PLUS randomized controlled trial.BMC medicine · 2023Trial
- Trial
- Beyond GLP-1 Agonists: Plant-Derived Bioactive Compounds as Adjunctive Strategies for Obesity Management.Nutrients · 2026Review
- Optimal visceral adipose tissue thresholds that minimize risk for osteoporosis and/or diabetes in midlife women.Journal of the Endocrine Society · 2026Article
- Development of the Asian Mediterranean Diet and its sensory acceptability in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).BMC nutrition · 2026Article
- Global Research Trends in Dietary Polyphenols for Preventing Non-Communicable Chronic Diseases: A Bibliometric Study.Food science & nutrition · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 7 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMediterranean (MED) diet is a rich source of polyphenols, which benefit adiposity by several mechanisms. We explored the effect of the green-MED diet, twice fortified in dietary polyphenols and lower in red/processed meat, on visceral adipose tissue (VAT).
methodsIn the 18-month Dietary Intervention Randomized Controlled Trial PoLyphenols UnproceSsed (DIRECT-PLUS) weight-loss trial, 294 participants were randomized to (A) healthy dietary guidelines (HDG), (B) MED, or (C) green-MED diets, all combined with physical activity. Both isocaloric MED groups consumed 28 g/day of walnuts (+ 440 mg/day polyphenols). The green-MED group further consumed green tea (3-4 cups/day) and Wolffia globosa (duckweed strain) plant green shake (100 g frozen cubes/day) (+ 800mg/day polyphenols) and reduced red meat intake. We used magnetic resonance imaging (MRI) to quantify the abdominal adipose tissues.
resultsParticipants (age = 51 years; 88% men; body mass index = 31.2 kg/m
conclusionsA green-MED diet, enriched with plant-based polyphenols and lower in red/processed meat, may be a potent intervention to promote visceral adiposity regression.
trial registrationClinicalTrials.gov , NCT03020186.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.