Tsaban G, Meir AY, Zelicha H, et al. - Findings demonstrate that insulin sensitivity recovery and visceral-adipose-tissue (VAT) regression beyond weight-loss may be reflected by diet-induced fasting-ghrelin-levels (FGL) elevation, especially in men. A greater FGL elevation was observed with a green-MED(Mediterranean) diet.

• In this secondary analysis of a clinical trial, individuals with abdominal-obesity/dyslipidemia were randomly assigned to one of three diets: healthy-dietary-guidelines (HDG), Mediterranean diet (MED), or green-MED diet, all combined with physical activity.

• Among 294 participants, unfavorable cardiometabolic parameters were evident in relation to lower FGL.

• An increase in FGL by 1.3%, 5.4%, and 10.5% in HDG, MED, and green-MED groups, respectively, was noted following 18-months of moderate and similar weight loss among the MED-groups.

• In gender-stratified analysis, similar changes were seen in men only.

• Men showed an association of FGL _18-month elevation with favorable alterations in insulin resistance profile and VAT regression, post-adjustment for relative weight-loss.

• Insulin resistance and VAT continued to be inversely associated with FGL elevation, beyond which was explained by weight-loss.