Evidence map›Paper›PMID 38034010›Full record

Trial reportFrontiers in endocrinology2023

Long-term green-Mediterranean diet may favor fasting morning cortisol stress hormone; the DIRECT-PLUS clinical trial.

Liav Alufer, Gal Tsaban, Ehud Rinott, Alon Kaplan, Anat Yaskolka Meir, Hila Zelicha, Uta Ceglarek, Berend Isermann, Matthias Blüher, Michael Stumvoll and 2 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Frontiers in endocrinology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03020186 (Effects of Green-MED Diet Via the Gut-fat-brain Axis; DIRECT-PLUS), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03020186 nacompletednot on this map

Effects of Green-MED Diet Via the Gut-fat-brain Axis; DIRECT-PLUS

TypeinterventionalSponsorBen-Gurion University of the NegevRan2017 to 2019Enrolled294ConditionsAbdominal Obesity Metabolic SyndromeArmsPhysical activity, Physical activity+ MED diet, Physical activity+green MED diet
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
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  4. Review
  5. Article
  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 3 countries.

Liav Alufer *Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Gal Tsaban *Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Ehud RinottDepartment of Medicine, Hebrew University and Hadassah Medical Center, Jerusalem, Israel.
Alon KaplanFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Anat Yaskolka MeirFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Hila ZelichaFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Uta CeglarekDepartment of Medicine, University of Leipzig, Leipzig, Germany.
Berend IsermannDepartment of Medicine, University of Leipzig, Leipzig, Germany.
Matthias BlüherDepartment of Medicine, University of Leipzig, Leipzig, Germany.
Michael StumvollDepartment of Medicine, University of Leipzig, Leipzig, Germany.
Meir J StampferDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Iris ShaiFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Ben-Gurion University of the Negev · ILHarvard University · USLeipzig University · DEHadassah Medical Center · ILHelmholtz Zentrum München · DEUniversity Hospital Leipzig · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Fasting morning cortisol (FMC) stress hormone levels, are suggested to reflect increased cardiometabolic risk. Acute response to weight loss diet could elevate FMC. Richer Polyphenols and lower carbohydrates diets could favor FMC levels. We aimed to explore the effect of long-term high polyphenol Mediterranean diet (green-MED) on FMC and its relation to metabolic health. Methods: We randomized 294 participants into one of three dietary interventions for 18-months: healthy dietary guidelines (HDG), Mediterranean (MED) diet, and Green-MED diet. Both MED diets were similarly hypocaloric and lower in carbohydrates and included walnuts (28 g/day). The high-polyphenols/low-meat Green-MED group further included green tea (3-4 cups/day) and a Wolffia-globosa Mankai plant 1-cup green shakeFMC was obtained between 07:00-07:30AM at baseline, six, and eighteen-months. Results: Participants (age=51.1years, 88% men) had a mean BMI of 31.3kg/m Conclusion: Long-term adherence to MED diets, and mainly green-MED/high polyphenols diet, may lower FMC, stress hormone, levels,. Lifestyle-induced FMC decrease may have potential benefits related to cardiometabolic health, irrespective of weight loss. Clinical trial registration: ClinicalTrials.gov, identifier NCT03020186.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Diet, MediterraneanC-Reactive ProteinFastingFemaleGlycated HemoglobinHumansHydrocortisoneMaleMiddle AgedTestosteroneThyrotropinWeight LossC-Reactive ProteinGlycated HemoglobinHydrocortisoneTestosteroneThyrotropincardiometabolic healthfasting plasma cortisolinsulin resistancelifestyle interventionmediterranean dietweight loss

Identifiers

PMID38034010
PMCPMC10682947
OpenAlexW4388655590

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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 OpenQuestion graph.