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Fat that builds up in the pancreas is one of the lesser-known risk factors for diabetes and metabolic syndrome, but it turns out it can be targeted directly through what's on the plate.

A new international study led by Ben-Gurion University of the Negev, published in The American Journal of Clinical Nutrition, shows how a precise dietary change can draw fat out of the pancreas, the organ that regulates blood sugar and insulin secretion. The study was carried out during the DIRECT-PLUS trial and followed about 300 participants who underwent advanced abdominal MRI scans over 18 months.

A green Mediterranean (Green-MED) diet produced a 14% reduction in the fat stored inside the pancreas, compared with just 0.8% in the group following standard dietary guidelines. Specifically, a direct association was observed between the amount consumed and the magnitude of pancreatic fat reduction: Participants who consumed more than three servings of Mankai per week or more than 5.5 servings of walnuts per week had significantly greater reductions in pancreatic fat than those with lower intakes.

Unlike liver fat or abdominal (visceral) fat, pancreatic fat has no agreed clinical threshold yet, but its buildup causes local lipotoxicity. One of the study's key advances was using MRI to separate the clearance of pancreatic fat from the preservation of functional pancreatic volume. This distinction matters clinically: Obesity enlarges the pancreas through fat infiltration, while diabetes and aging shrink it through beta-cell death.

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