BUFFALO, N.Y., Nov. 29, 2022 /PRNewswire/ — Circuit Clinical—one of the nation’s fastest growing integrated research organizations—has expanded their presence in the Hudson Valley region through a partnership with Middletown Medical, a top tier, multi-specialty physician group, increasing access to clinical research as a care option to an additional 100,000 patients that Middletown Medical serves. This partnership will bring trials to a more diverse patient population—comprised of approximately 50{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} non-white individuals.
Middletown Medical Logo
The breadth of Middletown Medical’s primary and specialty care, combined with Circuit’s commitment to improving patient access and inclusion in clinical trials, will bring new care opportunities to Middletown’s patients through the provider relationships they already trust – further positioning the region as a destination for medical research and advancements. This partnership will initially include 11 Principal Investigators, participating in specialties such as, but not limited to, cardiology, rheumatology, neurology, gastroenterology, and family medicine.
“Patient care is a top priority for Middletown Medical and we are committed to providing any and all opportunities to our physicians and the communities they serve,” said Dr Rajan Gulati, President of Middletown Medical.
Middletown Medical and Circuit Clinical are committed to reducing the burden on patients who opt in for research participation. Along with localizing patient care within the Middletown Medical physicians’ offices, Circuit’s approach to transforming the patient journey includes hybrid care options through telemedicine, fully decentralized trial solutions, as well as trialjourney.com—an award-winning patient experience platform for finding trials and leaving site ratings and reviews to improve the experience of participating in clinical trials. This variety of care options can help eliminate traditional care obstacles that have created a burden for patients to participate in clinical research. Furthermore, patient participation in research will serve to benefit both individuals and communities, including offering extra care visits without co-pays, strengthening the patient-provider relationship, and often leading to improved health outcomes through a better and more personal care experience.
This collaboration was made possible through strategic partnerships with Labcorp—a leading global life sciences company that provides vital information to help doctors, hospitals, pharmaceutical companies, researchers, and patients make clear and confident decisions—as well as Medidata—a Dassault Systems company that is powering smarter treatments and healthier people with the world’s most trusted platform for clinical development, commercial, and real-world data.
“We are beyond excited to expand our national research network through amazing partnerships like this one with Middletown Medical,” said Irfan Khan, MD, CEO of Circuit Clinical. “Together we can empower patients to engage with clinical trials as a care option. The combined efforts of Circuit Clinical and our strategic partners, Labcorp and Medidata, allow us to make partnerships like this with Middletown Medical not only a reality, but as optimal and innovative as possible.”
About Middletown Medical
Middletown Medical is a multi-specialty physicians’ group dedicated to providing patients with top quality, comprehensive care in a warm and caring environment which delivers care to over 100,000 patients throughout Orange, Sullivan, and Ulster counties in New York state. Please access Middletownmedical.com to learn more about their doctors and the expansive scope of services provided.
About Circuit Clinical
Circuit Clinical®, one of the fastest-growing integrated research organizations in the USA, is dedicated to empowering patients to choose clinical research as a care option. Circuit is committed to transforming the experience for physicians and their patients of finding, choosing, and participating in clinical research. The company delivers clinical research services and an award-winning patient engagement platform, trialjourney.com. Learn more at circuitclinical.com and follow along for updates and announcements on LinkedIn.
For additional questions or inquiries, please contact the following:
Circuit Clinical
Candice Kent VP of Marketing and Communications [email protected]
Middletown Medical
Darcy Shepard CEO, Middletown Medical [email protected]
David Goldhill is the chief executive of SesameCare.com, a digital marketplace for discounted health services.
The United States spends twice as much per person as other wealthy countries on health care. This fact is well-known, and when it is mentioned, people often point out that the governments of other developed countries leverage purchasing power to drive cheaper, more universal care. So why doesn’t the United States do the same thing?
Because we can’t. In fact, the do-what-everyone-else-does option is uniquely unavailable to us.
The world’s other health-care systems survive only because they receive a massive and ongoing, but hidden, subsidy courtesy of the inefficient U.S. system. Two unique features of our arrangement — the absence of price controls and the profit drive of doctors and hospitals — allow other countries to transfer the risk and cost of medical innovation to Americans.
And unlike in any other industry, once Americans have borne the costs of lifesaving breakthroughs as well as incremental improvements in tools and techniques, these can be used elsewhere at little extra cost. American exorbitance allows other nations to offer price-controlled universal care with none of the decline in quality, technology or productivity that would otherwise result from central planning.
A similar complaint has been made about the country’s defense alliance: U.S. allies ride free on American defense spending. Health care, indeed, is a kind of second NATO.
The United States can’t lower its costs by doing what other countries do, because what others do depends on our unique system remaining as is. Our only hope is to put in place more sensible economic structures that could introduce the competition that’s necessary to bring prices down.
The size of the U.S. health-care system is almost impossible to overstate. With barely four percent of the world’s population, the United States accounts for almost half of the world’s $8 trillion health-care economy. England’s National Health Service is tiny by comparison — barely bigger than U.S. Veterans Affairs health system funding. Canada’s total spending is comparable to the revenue of a single American company, United Health. Free-market star Singapore spends only as much as New Jersey’s Medicaid program.
The world’s top 10 spenders in pharmaceutical products
In 2020, the United States spent more on pharmaceutical products than all other nine spenders in the ranking combined.
All other top 9
countries combined
Notes: Prices are reported at the ex-manufacturer level (price when sold from manufacturer to wholesaler or direct to pharmacies). * Hospital market only. **Pharmacy market only.
The world’s top 10 spenders in pharmaceutical products
In 2020, the United States spent more on pharmaceutical products than all other nine spenders in the ranking combined.
All other top 9 countries combined
Notes: Prices are reported at the ex-manufacturer level (price when sold from manufacturer to wholesaler or direct to pharmacies). * Hospital market only. **Pharmacy market only.
The world’s top 10 spenders in pharmaceutical products
In 2020, the United States spent more on pharmaceutical products than all other nine spenders in the ranking combined.
All other top 9 countries combined
Notes: Prices are reported at the ex-manufacturer level (price when sold from manufacturer to wholesaler or direct to pharmacies). * Hospital market only. **Pharmacy market only.
This is why all health-care innovators — makers of drugs, devices, diagnostics, medical software — share the same business plan: Make money in the United States and take whatever scraps you can get in the other markets.
The pharmaceutical industry earns almost 50 percent of its worldwide revenue here, as do medical information-technology firms. Device makers earn 40 percent of their money in the United States. And this understates things, because U.S. revenue is generated from higher prices, so margins are greater. If the United States accounts for half of a company’s revenue, it probably contributes at least 75 percent of its profits.
America’s domination might not seem obvious. After all, high-tech health care exists everywhere in the world. Even in emerging economies, brilliant researchers, great universities and advanced companies perform cutting-edge research. Many have close relationships with their countries’ health-care systems, and some innovations are introduced in other nations. But the profit opportunity — the reason to invest — is always generated in the United States.
Consider the well-known miracle drug Gleevec. Before it came along in 2001, less than 30 percent of patients diagnosed with chronic myelogenous leukemia survived at least five years; today, 90 percent do.
Gleevec is also a poster drug for American dysfunction. Novartis steadily raised its price in the United States — even after its patent expired — to eventually reaching more than $123,000 per year in 2020. Yet, in Canada, Gleevec was priced at $38,000. A generic version in India now costs just $400.
Drugmakers and their opponents argue over the “fair” returns on innovation that companies need to maintain their incentive to invest in new medicines. Critics point to the share of pharma’s profits that come from barely legal anticompetitive behavior or from drugs created with heavy public support — such as the U.S. government’s $12 billion investment in coronavirus vaccines.
But enormous returns on a few blockbuster drugs compensate for drugmakers’ many unsuccessful products. That’s the business model, and these big, “unfair” returns are available only in the United States.
If the world’s largest health economy limited drug companies to “fair” returns — as other countries try to — then few new drugs would be created. The United States doesn’t pay $123,000 a year for Gleevec despite Canada paying only $38,000; Canada can pay $38,000 only because the United States pays $140,000.
And while pharmaceuticals might be the most obvious area in which the U.S. economy drives innovation, the $3.5 trillion we spend on care other than drugs makes an even greater contribution to world health-care advances.
In 2000, Intuitive Surgical Systems introduced the first commercially successful robotic surgery system. The company’s da Vinci robots carry $2 million price tags plus costly service contracts. In the first 20 years, 6,000 of the robots were sold worldwide, and American hospitals purchased roughly two-thirds of them.
Why? In the United States, the prices charged by hospitals and doctors are unrestricted. American physicians earn roughly two to three times as much as their counterparts in western Europe. Hospitals charge two to five times as much for their services.
The obvious, if rarely asked, question is: Why doesn’t competition bring U.S. health-care prices down? The answer: America’s stagnant third-party payment system allows hospitals and doctors to avoid competing on price. Instead, they compete on innovation. This is why hospitals advertise advanced, high-tech cancer therapies; surgeons build reputations for cutting-edge procedures; and even your family physician must invest to keep up.
Right now, we’re stuck. We want what every other country has. American reformers believe we’re just one clever policy tweak away from getting it — perhaps by instituting accountable care or “value-based” care.
But the only way to lower U.S. health-care costs is to rethink the system’s top-down policy structures that rely on huge, centralized payers.
What’s needed is a way to separate the safety net function that insurance provides from consumer decision-making. If insurance covered only major and unanticipated health problems, a consumer economy could drive competition in the rest of the system. This would give doctors and hospitals an economic incentive to bundle services, enhance efficiency, reduce waste and offer genuinely “value-driven” care.
In this century, the world has seen the democratization of many services considered “too complicated” for consumers — computers, finance, international travel, furniture construction, you name it. All this happened because people had enough control over their own spending to drive competition among innovators. It’s how industry managed to put supercomputer power in everyone’s pocket, while reducing price by 99 percent.
Until the same kind of competition is introduced in health care, the U.S. system will continue to subsidize the world — and cost us a fortune.
The Arena Media Brands, LLC and its partners may receive compensation for links to products and services on this website. The Sports Illustrated editorial team is not involved in the creation of this content.
Cyber Monday deals are here and they’re some of the best offering from retailers during the shopping season. You won’t find these kind of deals again until next year. From Amazon and Walmart to Samsung and Spanx, it’s time to put a cap on your holiday shopping list.
From tech and fitness to outdoors and home goods, we’re sourcing the biggest and best Cyber Monday deals happening now. Be sure to check back for more updates throughout the day, deals are ending Monday, Nov. 28.
From Roombas and Apple devices to heated blankets and home goods, Amazon is showcasing some major deals now through Cyber Monday. You’ll find a slew of Cyber Monday Deals and lightning deals happening now. If you’re looking for shopping inspiration, be sure to check out the Amazon gift guides for some of the most popular sellers.
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In a recent article published in BMJ, researchers proposed the tools and frameworks of mechanistic evidence, sometimes known as evidence-based medicine (EBM)+ combined with traditional EBM, might help overcome the highly protracted coronavirus disease 2019 (COVID-19) pandemic.
EBM+ encompasses conceptual tools and quality frameworks from various fields, including complexity science, engineering, and the social sciences, and a more pluralist approach to fetch ‘high-quality’ mechanistic evidence.
Background
Traditional methods, such as randomized controlled trials (RCTs) and meta-analyses, contributed significantly to the science of COVID-19. However, these methods have historically answered simple, focused questions in a stable context, such as those about biomedicine. They have significant limitations when extended to complex situations. In this case, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel pathogen, led to chaos across multiple sectors, medical, social, economic, and political dimensions in a fast-changing global context.
SARS-CoV-2 has proved tenacious and shifting. While RCTs and meta-analyses of RCTs remarkably estimated the efficacy of COVID-19 drugs and vaccines, some scholars argue that tackling some of its aspects critically required mechanistic evidence. COVID-19 led to complex situations where multiple variables interacted dynamically with high uncertainty.
Decisions had to be taken in days (urgently), not years, and the consequences of not acting would have been catastrophic (threatening). In such situations, dismissing mechanistic evidence and overvaluing poorly designed or irrelevant RCT findings cost thousands of lives. Overall, the COVID-19 pandemic presented an epistemic opportunity to understand, debate, and embrace EBM+.
About the study
In the present study, researchers argued that while the hierarchy of evidence that places mechanistic evidence at the bottom and meta-analyses of RCTs at the top is a useful heuristic, but inapplicable to all circumstances. There should be enough guidance to apply hierarchy flexibly depending on the nature of the research question and the extent of complexity involved.
Indeed, RCTs are not a panacea; thus, systemic reviews are crucial to interpret primary evidence along with modifications of the hierarchy of evidence to answer contemporary policy questions pertaining to SARS-CoV-2.
Further, the researchers suggested modifications to the hierarchy of evidence for mechanistic evidence. They emphasized combining evidence of mechanisms with probabilistic evidence from clinical trials and non-randomized studies, both comparative and observational, to make a strong case for causality. It’s because a plausible mechanism confirms or denies the stability of the causal relationship across settings.
This exercise could ensure that public health interventions would work as they involve both the upstream causes and the ’causes’ through which interventions might act. For instance, COVID-19 causes included family structures and their interactions, economic and cultural variations, etc., and attitudes, beliefs, capabilities, and personal resources determined whether public health measures worked. Furthermore, the researchers argued that mechanistic evidence is inherently explanatory.
Early in the pandemic, COVID-19 scientific research was prematurely fixed and constrained to a population-intervention (or exposure)-comparison-outcome (PICO) format that narrowed predefined outcomes and suppressed scientific imagination. Such studies estimated infections in the mask wearer(s) in statistical terms. Still, they failed to account for unique patterns of SARS-CoV-2 spread (e.g., overdispersion, indoor predominance), all of which could have pointed at its predominantly airborne transmission.
An RCT randomized 6,024 people advised wearing masks outside the home. Its results showed infection with SARS-CoV-2 in 42 and 53 people (1.8{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} and 2.1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}) of the intervention and control arms, respectively, i.e., statistically insignificant. However, EMB supporters argue and evidenced that wearing masks in public does not substantially reduce infection.
The Cochrane Database of Systematic Reviews encouraged policy-makers to adopt the precautionary principle based on the findings of this flawed study because of the urgency of the situation. However, an EBM approach would have accounted for studies elucidating the mechanism(s) by which masking might work. For instance, evidence from:
i) real-world case studies and mathematical modeling studies supporting airborne route of transmission of SARS-CoV-2
ii) Engineering studies showing the filtration properties of different masks
iii) Psychological and socio-cultural evidence of whether people wear masks
Delivering public health interventions and ensuring they are implemented, for instance, face masking, is a complex phenomenon. It has multiple components acting interdependently and individually at multiple levels. Masks could be homemade or produced to formal technical standards. People may mask as socially expected, organisationally required, or legally mandated.
Overall, its adequate implementation is complex in real-world settings for multiple social and behavioral reasons. Thus, complex systems require a new paradigm with designs that could capture dynamic change(s), simultaneously accommodating non-linearity and embracing uncertainty. In support of structural evidence, the researchers discussed how engineering designs account for physical and technical properties and capabilities, social needs, and assessment of impact with the example of personal protective equipment (PPEs).
The use and impact of PPEs are influenced by the quality of indoor air. Yet, an RCT comparing these products with less effective protection to ‘prove’ their value in protecting against chemical contamination in a lead smelter makes no sense. All required is robust certification systems, standards, and workplace usage protocols for PPEs. Currently used PPEs have already proven a boon against occupational hazards for millions of healthcare workers worldwide.
Professor Susan Michie, an adviser to UK’s Scientific Advisory Group on Emergencies, proposed the capability-opportunity-motivation-behavior model. This model helped explain why people prefer or do not prefer wearing a mask. In some cases, they may lack key knowledge (e.g., they may not know whether cloth masks are as effective as surgical masks) or may physically not want to because they are not a good fit. Likewise, they might lack motivation (e.g., conscious beliefs) or opportunity (e.g., employer bans masks). Nevertheless, not exploring these wider influences might produce misleading findings by experimental studies.
Conclusions
In the present study, the authors emphasized more on other sources of evidence, especially mechanistic evidence, to manage the complex and fast-changing COVID-19 pandemic. As the debate regarding EBM+ continues, they hope to contribute further articles on how an EBM+ approach could enhance contribution to pandemic science.
Share on PinterestWhat makes us feel alert — or less so — in the morning? Image credit: Grant Faint/Getty Images.
Individuals tend to experience different levels of alertness from one day to another, while also differing from other individuals in their average daily alertness levels.
A recent longitudinal study suggests that the prior night’s sleep profile, physical activity during the previous day, and the nutritional composition of breakfast were linked to the daily variation in a person’s morning alertness levels.
The study also found that non-genetic factors, including mood, sleep quality, age, and daily food intake frequency, predicted differences in morning alertness among individuals.
The study reported a modest effect of genetic factors on daily alertness, suggesting that interventions to modify non-genetic factors could help improve daily alertness levels.
Impaired alertness immediately after waking and over the course of the day can adversely impact cognitive and motor performance and increase safety risks.
A recent study published in Nature Communications suggests that various modifiable lifestyle factors, such as sleep quality and duration, may have a larger impact on morning alertness levels than genetic factors.
These results suggest that interventions undertaken at the individual and societal level targeting these non-genetic factors could help alleviate the negative consequences associated with impaired alertness.
Sleep inertia refers to the phase of impaired alertness and performance that occurs between sleep and wakefulness, and it can last between a few minutes to several hours after waking up.
Although it is a common phenomenon, it can have a profound impact on the productivity and safety of individuals.
Specifically, sleep inertia can impact the safety of workers in hazardous occupations or impair decision-making by emergency service personnel, including healthcare workers and firefighters, which can influence the safety of others.
Likewise, reduced alertness over the course of the day due to inadequate sleep is associated with lower productivity and an increased risk of traffic accidents.
However, there is limited scientific evidence on the factors that influence the levels of alertness after waking up.
In the present study, the researchers assessed the factors associated with daily variation in morning alertness in the same individual.
They also examined the role of genetic versus non-genetic factors in influencing differences in average morning alertness levels among individuals.
The researchers first examined the impact of four prespecifiedfactors on the day-to-day variation in alertness observed within the same individual.
They assessed the impact of the previous night’s sleep profile, physical activity on the previous day, the nutritional composition of breakfast, and post-breakfast blood sugar levels on morning alertness. Participants recorded their dietary intake and alertness on the ZOE study app, through the study. The study was funded by ZOE Ltd.
To examine the impact of these factors, the researchers used data collected over a 2-week period from 833 individuals aged 18–65 years. The participants had to wear a wristwatch accelerometer throughout the entire study period to facilitate the collection of data on their sleep profile and physical activity levels.
For the evaluation of morning alertness levels, the participants recorded the levels of their alertness on an app on a scale of 0–100. They reported their first alertness rating at the start of breakfast and then intermittently over the subsequent 3 hours.
Based on each participant’s baseline sleeping profile, the researchers found an association between sleep duration and sleep timing with morning alertness levels.
Specifically, when a participant slept longer than usual or woke up later than their usual time, they were more likely to show higher levels of alertness the next morning.
Higher levels of physical activity during the previous day were also associated with increased morning alertness.
Only physical activity levels during the 10 most active hours of the previous day were positively correlated with morning alertness levels.
Conversely, physical activity during the nighttime was associated with lower morning alertness.
The researchers then examined the impact of the macronutrient composition of breakfast on morning alertness. They provided calorie-matched standardized breakfasts of varying nutritional compositions, including high carbohydrate, high protein, and high fiber meals to each participant, which were consumed on different days.
The researchers compared the participants’ alertness levels after the consumption of each of these meals with that after a reference meal that provided moderate levels of carbohydrates and proteins.
Among the different standardized meals provided to the participants, consumption of a high carbohydrate breakfast was associated with higher levels of morning alertness than the reference meal.
In contrast, the high protein breakfast was linked to lower alertness levels than the reference meal.
The researchers also examined how the changes in blood glucose (sugar) levels after the consumption of breakfast influenced morning alertness levels.
Independent of breakfast composition, a lower blood glycemic load, a measure of the impact of food intake on blood glucose levels, after breakfast was associated with greater morning alertness.
Notably, these four factors influenced morning alertness levels independently of each other.
Jeff Kahn, CEO and co-founder of energy and sleep tracker subscription app Rise Science, who was not involved in this study, commented on the findings, telling Medical News Today that:
“The study helps to show that positive health and wellbeing outcomes, in this case, greater alertness, can be achieved through a variety of levers. The four independently impactful inputs they cite — longer than normal sleep duration, prior daytime exercise, carb-rich but still macronutrient-diverse breakfast composition, and a lower glycemic response in the hours following breakfast consumption are discrete tools in our performance toolbox that we can use and benefit from, even if we’re unable to achieve all four at all times.”
While these factors explained the day-to-day differences in morning alertness within the same individual, the authors were also interested in factors that could explain why certain participants had higher average alertness levels than others.
To put it differently, the researchers were interested in genetic and/ or lifestyle factors that could influence an individual’s characteristic or average daytime alertness levels.
The researchers found that positive mood, older age, lower frequency of eating during the day, and better sleep quality were predictors of an individual’s average daily alertness levels.
The present study consisted of both twins and genetically unrelated adults. This allowed the researchers to examine the extent to which genetic factors could influence daily alertness levels in twins.
The researchers found that genetic factors had a small impact on an individual’s alertness levels, suggesting a more significant impact of lifestyle factors that are amenable to modification.
Dr. Andrew McHill, a sleep researcher at Oregon Health & Science University, not involved in this study, commented that “[u]nique to this current study is the wide-ranging predictors that were collected — sleep, diet, and activity — and the ability to tease apart these behaviors versus genetic influences by use of the twin study.”
“Using this type of analysis allows for a more accurate assessment of potentially modifiable behaviors to improve next-day alertness. This is not only exciting for potential individual and society targets to improve safety and health, but also for the research community as it provides further testable hypotheses for future examinations to identify what exact mechanisms are causing these observed changes in alertness,” he added.
The researchers acknowledged that their study had a few limitations. For instance, the morning alertness levels in the study were based on self-reports and could be susceptible to bias.
The study also did not account for differences in light exposure during the morning, a factor known to significantly enhance alertness.
The researchers further noted that all standardized breakfasts consisted of carbohydrates, protein, and fat and only varied in the levels of these macronutrients.
They cautioned that these results should not be taken at face value and lead to the adoption of meals composed only of carbohydrates for breakfast.
Summary: A modified version of the Mediterranean diet called the green Mediterranean diet, which consists of enriched dietary polyphenols such as green tea, walnuts, and duckweed, and decreased red meats, reduced more visceral fat than the traditional Mediterranean diet or a traditional diet plan.
Source: Ben-Gurion University of the Negev
The green Mediterranean diet (MED) significantly reduces visceral adipose tissue, a type of fat around internal organs that is much more dangerous than the extra “tire” around your waist.
The green Mediterranean diet was pitted against the Mediterranean diet and a healthy diet in a large-scale clinical interventional trial- the DIRECT PLUS. Subsequent analysis found that the green Med diet reduced visceral fat by 14{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}, the Med diet by 7{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} and the healthy diet by 4.5{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}.
The study was published in BMC Medicine.
Reducing visceral fat is considered the true goal of weight loss as it is a more important indicator than a person’s weight or the circumference of their waist. Visceral fat aggregates over time between organs and produces hormones and poisons linked to heart disease, diabetes, dementia and premature death.
The research was led by Prof. Iris Shaiof Ben-Gurion University of the Negev, Israel, an adjunct Professor from the Harvard School of Public Health, and an Honorary Professor, University of Leipzig, Germany, together with her doctoral student Dr. Hila Zelicha and Italian, German, and American colleagues.
The DIRECT-PLUS trial research team was the first to introduce the concept of the green-Mediterranean diet. This modified MED diet is further enriched with dietary polyphenols and lower in red/processed meat than the traditional healthy MED diet. On top of a daily intake of walnuts (28 grams), the participants consumed 3-4 cups of green tea/day and 100 grams (frozen cubes) of duckweed green shake/day. The aquatic green plant duckweed is high in bioavailable protein, iron, B12, vitamins, minerals, and polyphenols and substituted meat intake.
On top of a daily intake of walnuts (28 grams), the participants consumed 3-4 cups of green tea/day and 100 grams (frozen cubes) of duckweed green shake/day. Image is in the public domain
The team has shown in previous studies that the green MED diet has a variety of salutary effects ranging from the microbiome to age-related degenerative diseases.
Two hundred and ninety four participants took part in the 18-month long trial.
“A healthy lifestyle is a strong basis for any weight loss program. We learned from the results of our experiment that the quality of food is no less important than the number of calories consumed and the goal today is to understand the mechanisms of various nutrients, for example, positive ones such as the polyphenols, and negative ones such as empty carbohydrates and processed red meat, on the pace of fat cell differentiation and their aggregation in the viscera,” says Prof. Shai.
“A 14{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} reduction in visceral fat is a dramatic achievement for making simple changes to your diet and lifestyle. Weight loss is an important goal only if it is accompanied by impressive results in reducing adipose tissue,” notes Dr. Hila Zelicha.
Funding: This work was funded by grants from the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – Project number 209933838- SFB 1052; the Rosetrees trust (grant A2623); Israel Ministry of Health grant 87472511; Israel Ministry of Science and Technology grant 3-13604; and the California Walnuts Commission.
None of the funding providers was involved in any stage of the design, conduct, or analysis of the study and they had no access to the study results before publication.
About this diet and fat reduction research news
Author: Ehud Zion Waldoks Source: Ben-Gurion University of the Negev Contact: Ehud Zion Waldoks – Ben-Gurion University of the Negev Image: The image is in the public domain
The effect of high-polyphenol Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial
Background
Mediterranean (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).
Methods
In 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.
Results
Participants (age = 51 years; 88{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} men; body mass index = 31.2 kg/m2; 29{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} VAT) had an 89.8{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} retention rate and 79.3{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} completed eligible MRIs. While both MED diets reached similar moderate weight (MED: − 2.7{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}, green-MED: − 3.9{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}) and waist circumference (MED: − 4.7{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}, green-MED: − 5.7{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}) loss, the green-MED dieters doubled the VAT loss (HDG: − 4.2{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}, MED: − 6.0{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}, green-MED: − 14.1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}; p < 0.05, independent of age, sex, waist circumference, or weight loss). Higher dietary consumption of green tea, walnuts, and Wolffia globosa; lower red meat intake; higher total plasma polyphenols (mainly hippuric acid), and elevated urine urolithin A polyphenol were significantly related to greater VAT loss (p < 0.05, multivariate models).
Conclusions
A green-MED diet, enriched with plant-based polyphenols and lower in red/processed meat, may be a potent intervention to promote visceral adiposity regression.
