The Mediterranean diet is an eating pattern emphasizing plant-based foods , healthy unsaturated fats , lean proteins , and whole grains , while limiting red meat , added sugars , and processed foods . Research highlights that the Mediterranean diet and its variants have been associated with a wide range of health benefits, including improvements in cardiometabolic health . The Green Mediterranean (Green-MED) diet is a modified version that places even greater emphasis on plant-based foods, particularly those rich in polyphenols and plant-based protein . Now, the results of an international clinical intervention study suggest that the dietary plan could influence gene function and may help compensate for certain inherited genetic alterations in folate metabolism. The findings, published in Clinical Nutrition , show that the Green-MED diet increased folate levels , a B vitamin involved in DNA regulation and cellular health. Additionally, it was also linked to improvements in several markers of cardiometabolic health.
The Mediterranean diet is an eating pattern emphasizing plant-based foods , healthy unsaturated fats , lean proteins , and whole grains , while limiting red meat , added sugars , and processed foods .
Research highlights that the Mediterranean diet and its variants have been associated with a wide range of health benefits, including improvements in cardiometabolic health .
The Green Mediterranean (Green-MED) diet is a modified version that places even greater emphasis on plant-based foods, particularly those rich in polyphenols and plant-based protein .
Now, the results of an international clinical intervention study suggest that the dietary plan could influence gene function and may help compensate for certain inherited genetic alterations in folate metabolism.
The findings, published in Clinical Nutrition , show that the Green-MED diet increased folate levels , a B vitamin involved in DNA regulation and cellular health. Additionally, it was also linked to improvements in several markers of cardiometabolic health.
The findings are based on data from the DIRECT-PLUS randomized controlled trial , which investigated whether a more plant-focused, polyphenol-rich version of the Mediterranean diet could improve metabolic health and body-fat distribution better than standard healthy dietary plans.
The investigators found that people following the Green-MED diet had significantly higher blood folate levels than those in comparative groups following either a traditional Mediterranean diet or standard healthy dietary recommendations.
Notably, higher folate concentrations were associated with improvements in several health measures, including:
Folate plays a central role in a vital biochemical network known as one-carbon metabolism . This describes a series of biochemical reactions that help cells build and repair DNA and provide the methyl groups used to regulate gene activity without altering the underlying genetic code.
“When this pathway functions efficiently, it supports cardiovascular and metabolic health. In contrast, impaired folate metabolism has been associated with elevated homocysteine, endothelial dysfunction, inflammation, and increased cardiometabolic risk,” Şebnem Ünlüişler , MSc, Genetic Engineer at London Regenerative Institute, explained to Medical News Today .
“This study reinforces that overall dietary patterns matter more than individual nutrients,” she said. “Rather than focusing only on folate supplementation, the findings suggest that a green Mediterranean diet can improve folate status and support key metabolic pathways by combining nutrient-rich foods with bioactive plant compounds.”
“For both clinicians and the general public, this is another reminder that dietary quality can have measurable biological effects beyond basic nutrition.” — Şebnem Ünlüişler, MSc
In the study, the researchers were particularly interested in a common genetic variant in the MTHFR gene, rs1801133, which affects roughly 10-15% of individuals worldwide .
People who inherit two copies of the higher-risk version of this variant, referred to as the TT genotype or C677T variation, often have reduced activity of an enzyme necessary for efficient folate metabolism. Evidence suggests that the MTHFR enzyme works at about 30% of its normal capacity in those with the TT genotype.
This can increase a person’s risk for cardiovascular and metabolic conditions, such as hypertension , heart attack , and metabolic dysfunction-associated steatotic liver disease (MASLD) .
Additionally, this genotype can lead to elevated homocysteine levels , which are linked to a higher risk of several age-related health issues, such as Alzheimer’s disease and osteoporosis .
In the study, participants consumed a daily shake containing the aquatic plant mankai (Wolffia globosa), also known as duckweed. Mankai contains protein, fiber, minerals, essential amino acids, and naturally occurring folate.
Those carrying the TT genotype who consumed little mankai experienced an increase in cardiovascular risk scores over time. In contrast, those who closely followed the mankai-enriched Green-MED diet showed a substantial reduction in cardiovascular risk scores.