Green Mediterranean diet × Liver-fat reduction from Mankai or green tea alone

Required evidence, verification status and materials actually read
Item	AVerification status	BReading scope	CReview item	DCurrent findings	EWhy unverified	FRequired materials and conditions	GFurther research
1	Partly verified	Full text not readStored summary read	N01 · Evidence conditionSelected isolated-component question and original gradeRequired	The selected existing record is liver-fat reduction from Mankai or green tea alone, grade ?, with a note that individual component effects were not separated. Subclaim score, status and axes are absent and are not filled with parent C with 46 points. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Separate subclaim score, status, axes and direct isolated-component effects are absent from the original material. Review of existing content remains incomplete.	Mankai or green-tea wording, note and grade, and the parent dietary verdict	Record updates distinguishing isolated-component and bundled-diet questions. This is a proposal; no new investigation, calculation or trial is conducted here.
2	Partly verified	Full text not readStored summary read	N02 · Evidence conditionBoundary between the bundled diet and component attributionRequired	The original text records results for a package of foods and meat restriction. Its overall descriptions of Mankai, green tea, walnuts and meat restriction are not transferred into efficacy of any one component. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Direct comparisons changing only Mankai or green tea, component-specific effects and interactions are not linked. Review of existing content remains incomplete.	Simultaneously changed components, factor separation and isolated comparisons	Propose follow-up research separating component attribution from the bundled pattern. No product or diet instructions are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
3	Partly verified	Full text not readStored summary read	N03 · Evidence conditionPhysical activity common to all three groupsRequired	The original account allocated 294 participants to healthy-diet guidance, MED and green-MED, all undertaking a physical-activity program. Activity is not recast as unique to green-MED or as an isolated-component effect. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Activity specifications, group implementation, contact and actual exposure by period are unverified. Review of existing content remains incomplete.	Common exposures in all groups and actual implementation	Propose follow-up material distinguishing common exposures from dietary differences. Exercise instructions are not written. This is a proposal; no new investigation, calculation or trial is conducted here.
4	Partly verified	Full text not readStored summary read	N04 · Evidence conditionWalnuts common to both MED groupsRequired	The study condition that both MED groups received 28 g/day walnuts is preserved. The green-MED versus conventional-MED difference is not explained as a walnut-only effect or as walnuts added only in green-MED. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Actual walnut adherence, correspondence with other foods and isolated comparisons are unverified. Review of existing content remains incomplete.	Common and different food exposures by group	Propose follow-up material disclosing common foods and different components. No intake guidance is provided. This is a proposal; no new investigation, calculation or trial is conducted here.
5	Partly verified	Full text not readStored summary read	N05 · Evidence conditionStudy exposures added in green-MEDRequired	Green-MED jointly added 3-4 cups/day green tea, 100 g/day frozen Mankai and greater restriction of red and processed meat. These figures are study conditions, not individual products, recommended amounts or doses establishing isolated efficacy. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Actual adherence, component and product specifications, meat-restriction amounts and individual exposures are unverified. Review of existing content remains incomplete.	Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures	Propose follow-up material separating planned from actual component exposures. No dose or energy conversions are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
6	Unverified	Full text not readStored summary read	N06 · Evidence conditionDirect material for Mankai aloneRequired	The current stored summary concerns the DIRECT-PLUS bundled pattern. Direct liver-fat trials of Mankai alone are not linked in the preserved citation list, and the bundled-group -38.9% is not used as an isolated effect. S01	Information currently required is unverified in the stored summary. Mankai-only trials, formulations, exposure, direct comparisons, effects, CIs and denominators are not linked. Review of existing content remains incomplete.	Isolated formulation, comparator, population, outcome and denominators	Propose follow-up research separating the isolated-component study specification. No hypothetical reports or effects are created. This is a proposal; no new investigation, calculation or trial is conducted here.
7	Unverified	Full text not readStored summary read	N07 · Evidence conditionDirect material for green tea aloneRequired	The current stored summary concerns a bundled diet including green tea. Direct liver-fat trials of green tea alone are not linked, and bundled results are not recast as green-tea treatment of fatty liver. S01	Information currently required is unverified in the stored summary. Green-tea-only trials, formulations, components, exposure, comparisons, effects, CIs and denominators are not linked. Review of existing content remains incomplete.	Isolated formulation, comparator, population, outcome and denominators	Propose follow-up research distinguishing isolated components from bundled diets. No intake or treatment instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.
8	Partly verified	Full text not readStored summary read	N08 · Evidence conditionActual population of the parent trialRequired	The original text describes 294 adults with abdominal obesity or dyslipidemia. Findings are not extended into isolated-component efficacy in selected liver-disease patients or everyone. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Age, sex, baseline liver fat and disease, recruitment and group allocation and analysis denominators are unverified. Review of existing content remains incomplete.	Abdominal obesity or dyslipidemia, eligibility and denominators	Propose follow-up material distinguishing populations and application boundaries for isolated and bundled questions. This is a proposal; no new investigation, calculation or trial is conducted here.
9	Partly verified	Full text not readStored summary read	N09 · Evidence conditionDifferent conventional-MED and healthy-diet-guidance contrastsRequired	The parent classification fields identify healthy-diet guidance as the comparator, while weight-adjusted P=.035 describes green-MED versus conventional MED. Effects, P values and comparator exposures from different contrasts are not mixed. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact contrast-specific estimates, denominators and correspondence of whole diets and contact are unverified. Review of existing content remains incomplete.	Three-group exposures, denominators and comparison specifications	Propose follow-up material with disclosed comparator-specific study specifications. This is a proposal; no new investigation, calculation or trial is conducted here.
10	Partly verified	Full text not readStored summary read	N10 · Evidence conditionIntrahepatic-fat MRS and isolated-component resultsRequired	S01 describes 18-month change in intrahepatic fat by proton MRS. Imaging findings are not transferred into direct clinical treatment results for Mankai or green tea alone, or into other MRI-PDFF trials. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. MRS acquisition, reading, location, units, eligibility criteria and isolated-comparison findings are unverified. Review of existing content remains incomplete.	Proton-MRS definitions, units, time points and directness	Propose follow-up material separating measurement methods from component attribution. This is a proposal; no new investigation, calculation or trial is conducted here.
11	Partly verified	Full text not readStored summary read	N11 · Evidence conditionProportional reductions and absolute or between-group effectsRequired	Green-MED -38.9%, MED -19.6% and HDG -12.2% are original proportional intrahepatic-fat reductions. They are not recast as absolute percentage points, isolated-component effects, between-group differences or CIs, or new relative or absolute calculations. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Group original values, variances, exact comparative effects and CIs, within-person calculations and denominators are unverified. Review of existing content remains incomplete.	Group proportional changes, denominators and estimates	Propose follow-up material separating units and scope of reported estimates. No new calculations are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
12	Partly verified	Full text not readStored summary read	N12 · Evidence conditionWeight-adjusted P values and causal component attributionRequired	Weight-adjusted green-MED versus MED P=.035 and similar weight-loss wording concern a bundled-diet comparison. Possibilities beyond weight change do not establish causal effects of Mankai or green tea alone. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact adjusted models, coefficients and CIs, weight-analysis denominators and separate mediation or component effects are unverified. Review of existing content remains incomplete.	Adjusted models, contrasts, weight changes and effects	Propose follow-up research separating weight change from component attribution. This is a proposal; no new investigation, calculation or trial is conducted here.
13	Partly verified	Full text not readStored summary read	N13 · Evidence conditionHistorical wording of a small standardized effectRequired	The parent text describes a small standardized effect versus conventional MED. No new standardized values or CIs, isolated-component magnitudes or grades are created from that wording. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact standardized estimates, variances, specifications, CIs and relevance thresholds are unverified. Review of existing content remains incomplete.	Original standardized estimates, denominators and interpretation specifications	Propose follow-up records separating reported effects from the historical scope of verdict interpretation. This is a proposal; no new investigation, calculation or trial is conducted here.
14	Partly verified	Full text not readStored summary read	N14 · Evidence conditionRetention and eligible MRS have different denominatorsRequired	The original 294 randomized participants, 89.8% retention at 18 months and 78% eligible follow-up MRS are preserved separately. The original 22% without eligible MRS is not recast as 22% trial attrition or exact participant counts. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Group retention, MRS eligibility and missingness, reasons, and selected and analysis denominators are unverified. Review of existing content remains incomplete.	Randomization, retention, imaging eligibility and group missingness	Propose follow-up material distinguishing retention from imaging-analysis eligibility. No new count or rate calculations are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
15	Unverified	Full text not readStored summary read	N15 · Evidence conditionMissing imaging, analysis populations and sensitivity analysesRequired	Imaging missingness reflected in 78% eligible MRS is recorded as a limitation of the parent verdict. It is not used as proof that everyone completed imaging or as ITT evidence for an isolated-component effect. S01	Information currently required is unverified in the stored summary. ITT or PP, imaging-missingness handling, imputation, sensitivity analyses and baseline associations are unverified. Review of existing content remains incomplete.	Missing-data handling, ITT or PP, selection and estimate stability	Propose follow-up material distinguishing missingness from analysis specifications. This is a proposal; no new investigation, calculation or trial is conducted here.
16	Partly verified	Full text not readStored summary read	N16 · Evidence conditionRandomization and assessment maskingRequired	The original S01 design is a three-arm 18-month randomized lifestyle trial. The design label does not establish allocation concealment or participant, imaging-reader or analyst masking. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Sequence generation, concealment, reading and analysis masking, and group contact and expectations are unverified. Review of existing content remains incomplete.	Allocation, concealment, MRS reading, contact and expectations	Propose follow-up material disclosing lifestyle exposures and imaging-assessment conditions. This is a proposal; no new investigation, calculation or trial is conducted here.
17	Unverified	Full text not readStored summary read	N17 · Evidence conditionActual diets, activity and other concurrent exposuresRequired	Activity common to all three groups, walnuts common to both MED groups and added green-MED components are recorded as originally described. This is not interpreted as a trial isolating components without actual adherence or concurrent-management differences. S01	Information currently required is unverified in the stored summary. Group energy intake, whole diets, activity, medications, management and individual adherence are unverified. Review of existing content remains incomplete.	Food, weight, activity and management adherence material	Propose follow-up material distinguishing common from different exposures. No diet or weight-management instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.
18	Partly verified	Full text not readStored summary read	N18 · Evidence conditionRegistration identifier and access to actual plansRequired	The original evidence and citation lists identify NCT03020186. The identifier and historical parent registration verification do not establish current registration reading or isolated-component plans before recruitment. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Recruitment and registration timing, protocol, SAP, outcome and component hierarchy, and changes remain unread. Review of existing content remains incomplete.	Original registration identifier, protocol, SAP and changes	Propose follow-up material distinguishing the preserved identifier from actual plan access. This is a proposal; no new investigation, calculation or trial is conducted here.
19	Unverified	Full text not readStored summary read	N19 · Evidence conditionMultiple contrasts and analysis hierarchyRequired	Multiple bundled-diet contrasts and weight-adjusted analyses are not prespecified primary results for isolated components. Parent MRS classification fields are not used as an isolated-effect hierarchy. S01	Information currently required is unverified in the stored summary. Pre-recruitment contrasts, outcomes, subgroup analyses, multiplicity, adjustment and SAP are unverified. Review of existing content remains incomplete.	Plans for three groups, time points, outcomes and subgroup analyses	Propose follow-up material distinguishing all contrasts from component questions. This is a proposal; no new investigation, calculation or trial is conducted here.
20	Partly verified	Full text not readStored summary read	N20 · Evidence conditionThe same trial and absence of linked isolated-component replicationRequired	S01 DIRECT-PLUS includes the same trial's 294 participants, three groups, multiple exposures and time points. Groups, components, registration identifiers and other liver-fat sheets are not added as new independent trials, participants or isolated-component replication. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Separate direct Mankai-only or green-tea-only trials and independent-family relationships are not linked. Review of existing content remains incomplete.	Relationships among reports, groups, time points and independent trials	Propose separate research with the same component study specification. No new totals or independence certification are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
21	Unverified	Full text not readStored summary read	N21 · Evidence condition18 months and clinical liver-disease eventsRequired	18 months is the parent bundled-diet imaging-study duration. The original text records absence of clinical liver-disease events and independent confirmation trials. Long-duration imaging changes do not establish liver-disease treatment or prevention by isolated components. S01	Information currently required is unverified in the stored summary. Persistence after stopping, clinical events and long-term isolated-component findings are not linked. Review of existing content remains incomplete.	Imaging surrogates, persistence and clinical outcomes	Propose follow-up research distinguishing imaging from clinical outcomes. This is a proposal; no new investigation, calculation or trial is conducted here.
22	Unverified	Full text not readStored summary read	N22 · Evidence conditionApplication to other populations, foods and productsRequired	Direct material concerns the bundled pattern in the selected adults. Findings are not extended into isolated efficacy for ordinary green tea, other Mankai products, other diets, liver-disease patients or every population. S01	Information currently required is unverified in the stored summary. Identity, exposures and direct liver-fat or clinical material for other populations and products are not linked. Review of existing content remains incomplete.	Direct material by eligibility, disease, formulation and exposure	Propose separate material for questions with different populations or products. No intake or treatment instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.
23	Partly verified	Full text not readStored summary read	N23 · Evidence conditionMixed funding and product-related rolesRequired	Original wording of public support, California Walnut Commission support, the PI's disclosed Hinoman advisory role and funders' reported lack of involvement in design or analysis is preserved. This is not recast as complete current role or COI verification or isolated-efficacy certification. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Original funder-role disclosures, products or free support, employee authorship, advisory scope and complete COI material are unverified. Review of existing content remains incomplete.	Original funding, advisory, product-support, employee-authorship and COI material	Propose follow-up material distinguishing support types from roles. This is a proposal; no new investigation, calculation or trial is conducted here.
24	Unverified	Full text not readStored summary read	N24 · Harm-information gaps supplementing the efficacy tableSafety and gaps concerning individuals and productsSupplementary	Parent safety is unknown, and the original text states that adverse-event ascertainment was not central to the efficacy report. Nut-allergy, caffeine-sensitivity and disease-suitability wording is not used as event rates or isolated-product safety. S01	Information currently required is unverified in the stored summary. Event definitions, collection, group denominators, discontinuation and isolated-component, long-term and vulnerable-population harms are unverified. Review of existing content remains incomplete.	Harm-event collection, exposures, denominators and discontinuation	Propose follow-up material directly collecting safety information. No diet, liver-disease or weight-management instructions are provided. This is a proposal; no new investigation, calculation or trial is conducted here.
25	Partly verified	Full text not readStored summary read	N25 · Evidence conditionOriginal grades, axes, languages, dates and correctionsRequired	Parent C with 46 points, B/S/R1/I1/E~/B1, unrecorded precision, four false flags and empty override reasons, and the subclaim ? and note are preserved. Korean and English text, 2026-09-07 and empty correction and deliberation values are original records, not inherited as subclaim scores or a current completed review. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Subclaim score, status and axes, new corrections and external comparisons were not produced or performed. Review of existing content remains incomplete.	Separation of parent C with 46 points, subclaim ? and historical original values	Update records distinguishing original values, production dates and correction events. This is a proposal; no new investigation, calculation or trial is conducted here.
26	Partly verified	Full text not readStored summary read	N26 · Evidence conditionHistorical verification and actual summary readingRequired	Historical full-text, registration and scoring verification is retained as original history. This production used stored summaries and bibliography; papers, registration, protocol, SAP and COI material were unread and access was not attempted. External source links were not tested. S01	Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Detailed historical verification, original-material acquisition, external reading and content review remain pending. Review of existing content remains incomplete.	Scope of historical review, unread material and links	Update content distinguishing history from actual access events. This is a proposal; no new investigation, calculation or trial is conducted here.

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26 itemsWhat the statuses mean

Assessment scope

Stored-material review date: Not recorded
Original evidence cut-off: 2026-09-07
Scope actually checked: Existing review summaries and stored records of methodological application. Full papers, supplements, registrations, plans and original data were not read.
What the dates mean: This is the date the stored materials were checked, not the date of a new search of the clinical literature.
Population: 294 adults with abdominal obesity or dyslipidemia. Retention of 89.8% at 18 months, eligible follow-up MRS of 78% and the original 22% without eligible MRS describe different denominator states. No participant counts or attrition rates are calculated. Group denominators and eligibility or missingness reasons are unverified.
Ingredient, formulation and route: A bundled green-MED pattern. Distinguish physical activity common to three groups and 28 g/day walnuts common to both MED groups from added green-MED exposures of 3-4 cups/day green tea, 100 g/day frozen Mankai and greater red and processed meat restriction. Individual component effects were not separated.
Dose: Only original research exposure records are preserved. Products, components, actual adherence and correspondence to other products are unverified. No Mankai or green-tea intake, recommended amounts, diets, exercise or energy conversions are created.
Comparator: Three groups: healthy-diet guidance, conventional MED and green-MED. Weight-adjusted P=.035 describes green-MED versus MED and is not mixed with the HDG comparator in parent classification fields.
Measured outcome: 18-month proton-MRS intrahepatic-fat proportional reductions of -38.9/-19.6/-12.2% and weight-adjusted P=.035 concern the bundled pattern. They are not converted into absolute percentage points, between-group differences or Mankai-only or green-tea-only effects. Small standardized-effect wording is historical; exact effects, CIs, denominators and measurement methods are unverified.
Duration: 18-month assessment of a bundled diet. Direct isolated-component trials, long-term clinical liver-disease events and persistence after stopping are not linked.
Questions outside this scope: Classifying activity common to three groups or walnuts common to both MED groups as additions unique to green-MED, or mixing different contrasts; Attributing simultaneous green-tea, Mankai and meat-restriction changes to Mankai or green tea alone; Converting -38.9/-19.6/-12.2% proportional reductions into absolute percentage points, new between-group effects, CIs or component efficacy; Treating 89.8% retention, 78% eligible MRS and original 22% absent imaging as the same attrition rate, or calculating participant counts; Transferring weight-adjusted P=.035 or historical small standardized-effect wording into isolated causal effects or new grades; Adding registration, groups, time points or other sheets as independent studies, or inheriting parent C with 46 points, unrecorded precision, axes or historical verification as subclaim values or current review results; New arithmetic, effects, CIs, hypothetical figures, component or product intake, diets, liver-disease or weight management, or treatment-replacement instructions

Evidence and sources

The links below lead to the sources. A link alone does not mean the original source was read or its latest publication status verified.

S01 · Yaskolka Meir A et al. 2021 DIRECT-PLUS

PubMed

Material type: Three-arm 18-month randomized lifestyle trial
Materials actually read: Summary read; external material unread
Findings recorded in the stored summary: Green-MED -38.9%, MED -19.6%, HDG -12.2%; weight-adjusted green-MED versus MED P=.035
Record level: Outcome wording in the stored summary
Study overlap and independent replication: S01 DIRECT-PLUS2021 reports a three-group 18-month lifestyle trial in 294 adults with abdominal obesity or dyslipidemia: healthy-diet guidance, MED and green-MED. Physical activity common to all groups and 28 g/day walnuts common to both MED groups are distinguished from added green-MED exposures of 3-4 cups/day green tea, 100 g/day frozen Mankai and greater meat restriction. Intrahepatic-fat proportional reductions -38.9/-19.6/-12.2% and weight-adjusted green-MED versus MED P=.035 concern the bundled pattern; Mankai-only and green-tea-only effects were not separated. Retention of 89.8%, eligible MRS of 78% and original 22% absent imaging are distinct; no denominator arithmetic is produced. Groups, time points, centers, registration, other sheets or people from one report are not added to unique-trial, participant or independent-replication totals. No new calculations, verdicts, independence certification or diet, intake or treatment instructions are produced.

Public availability, access and reading status by material
Material	Public availability	Access status	Actually read	Notes
Stored summary	Stored file	Stored summary	Summary read	Only stored-summary and bibliographic content was used for production. External material verification/review is not complete.
External paper	Public availability unverified; only bibliography links preserved	Unread; access not attempted	Not read	No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status.
Registration material	Public availability unverified; only bibliography links preserved	Unread; access not attempted	Not read	No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status.
Protocol	Public availability unverified; only bibliography links preserved	Unread; access not attempted	Not read	No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status.
Statistical analysis plan	Public availability unverified; only bibliography links preserved	Unread; access not attempted	Not read	No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status.
Funding, product-support and COI material	Public availability unverified; only bibliography links preserved	Unread; access not attempted	Not read	No external access or click testing was performed in the original preparation. URLs or registration identifiers alone do not upgrade acquisition/reading status.

Report counts versus independent study counts

S01 DIRECT-PLUS2021 reports a three-group 18-month lifestyle trial in 294 adults with abdominal obesity or dyslipidemia: healthy-diet guidance, MED and green-MED. Physical activity common to all groups and 28 g/day walnuts common to both MED groups are distinguished from added green-MED exposures of 3-4 cups/day green tea, 100 g/day frozen Mankai and greater meat restriction. Intrahepatic-fat proportional reductions -38.9/-19.6/-12.2% and weight-adjusted green-MED versus MED P=.035 concern the bundled pattern; Mankai-only and green-tea-only effects were not separated. Retention of 89.8%, eligible MRS of 78% and original 22% absent imaging are distinct; no denominator arithmetic is produced. Groups, time points, centers, registration, other sheets or people from one report are not added to unique-trial, participant or independent-replication totals. No new calculations, verdicts, independence certification or diet, intake or treatment instructions are produced.

Review criteria

Version 1.0 · Criteria record date 2026-10-06. These are Chamgap's own application conditions, informed by the referenced methods. They do not constitute official assessment-tool certification or a new efficacy score.

N01 · Selected isolated-component question and original grade

Required materials and conditions: Mankai or green-tea wording, note and grade, and the parent dietary verdict
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Mankai or green-tea wording, note and grade, and the parent dietary verdict. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Mankai or green-tea wording, note and grade, and the parent dietary verdict to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.5, §4.6.3; limits of this material conversion follow the review scope and internal design

N02 · Boundary between the bundled diet and component attribution

Required materials and conditions: Simultaneously changed components, factor separation and isolated comparisons
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Simultaneously changed components, factor separation and isolated comparisons. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Simultaneously changed components, factor separation and isolated comparisons to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M03 §3.2.2–3.2.3; reverse-direction labels and checking adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application

N03 · Physical activity common to all three groups

Required materials and conditions: Common exposures in all groups and actual implementation
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Common exposures in all groups and actual implementation. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Common exposures in all groups and actual implementation to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.2–3.2.3; Reverse-direction labels and assessment adaptation are Chamgap design; M03 §3.2.3 and M08 §8.2.2–8.2.3; Chamgap application

N04 · Walnuts common to both MED groups

Required materials and conditions: Common and different food exposures by group
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Common and different food exposures by group. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Common and different food exposures by group to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are in-house design; M03 §3.2.3, M08 §8.2.2–8.2.3; in-house application; M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is in-house design

N05 · Study exposures added in green-MED

Required materials and conditions: Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction labels and checking adaptations are internally designed; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application; M03 §3.2.1–3.2.4; dose, duration and effect-modification details are internally designed

N06 · Direct material for Mankai alone

Required materials and conditions: Isolated formulation, comparator, population, outcome and denominators
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Isolated formulation, comparator, population, outcome and denominators. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Isolated formulation, comparator, population, outcome and denominators to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.6.1–4.6.2 distinctions between studies and reports; cohort and outcome linkage is internal application; M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M15 §15.3.1–15.3.3; internal application

N07 · Direct material for green tea alone

Required materials and conditions: Isolated formulation, comparator, population, outcome and denominators
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Isolated formulation, comparator, population, outcome and denominators. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Isolated formulation, comparator, population, outcome and denominators to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.6.1–4.6.2 distinctions between studies and reports; cohort and outcome linkage is internal application; M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M15 §15.3.1–15.3.3; internal application

N08 · Actual population of the parent trial

Required materials and conditions: Abdominal obesity or dyslipidemia, eligibility and denominators
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Abdominal obesity or dyslipidemia, eligibility and denominators. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Abdominal obesity or dyslipidemia, eligibility and denominators to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.1; detailed population conditions are internally designed. M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; design-specific adaptations are internally designed.

N09 · Different conventional-MED and healthy-diet-guidance contrasts

Required materials and conditions: Three-group exposures, denominators and comparison specifications
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Three-group exposures, denominators and comparison specifications. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Three-group exposures, denominators and comparison specifications to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application

N10 · Intrahepatic-fat MRS and isolated-component results

Required materials and conditions: Proton-MRS definitions, units, time points and directness
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Proton-MRS definitions, units, time points and directness. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Proton-MRS definitions, units, time points and directness to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.4 and M15 §15.3.1–15.3.3; Question-specific outcome adaptation is Chamgap design; M08 Table 8.2.a and M03 §3.2.4; Chamgap application; M03 §3.2.4; Chamgap interpretation boundary

N11 · Proportional reductions and absolute or between-group effects

Required materials and conditions: Group proportional changes, denominators and estimates
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Group proportional changes, denominators and estimates. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Group proportional changes, denominators and estimates to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed; M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application

N12 · Weight-adjusted P values and causal component attribution

Required materials and conditions: Adjusted models, contrasts, weight changes and effects
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Adjusted models, contrasts, weight changes and effects. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Adjusted models, contrasts, weight changes and effects to connect required material for the selected question with currently available material.
Referenced methods: M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application

N13 · Historical wording of a small standardized effect

Required materials and conditions: Original standardized estimates, denominators and interpretation specifications
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original standardized estimates, denominators and interpretation specifications. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Original standardized estimates, denominators and interpretation specifications to connect required material for the selected question with currently available material.
Referenced methods: M15 §15.3.1–15.3.3; Chamgap adaptation; M04 §4.5, §4.6.3; limitations of the current material conversion follow the review scope and Chamgap design

N14 · Retention and eligible MRS have different denominators

Required materials and conditions: Randomization, retention, imaging eligibility and group missingness
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Randomization, retention, imaging eligibility and group missingness. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Randomization, retention, imaging eligibility and group missingness to connect required material for the selected question with currently available material.
Referenced methods: M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; Design-specific adaptation is Chamgap design; M08 §8.2.2 and M15 §15.3.1; Chamgap application

N15 · Missing imaging, analysis populations and sensitivity analyses

Required materials and conditions: Missing-data handling, ITT or PP, selection and estimate stability
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Missing-data handling, ITT or PP, selection and estimate stability. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Missing-data handling, ITT or PP, selection and estimate stability to connect required material for the selected question with currently available material.
Referenced methods: M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; Design-specific adaptation is Chamgap design; M08 §8.2.2 and M15 §15.3.1; Chamgap application

N16 · Randomization and assessment masking

Required materials and conditions: Allocation, concealment, MRS reading, contact and expectations
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Allocation, concealment, MRS reading, contact and expectations. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Allocation, concealment, MRS reading, contact and expectations to connect required material for the selected question with currently available material.
Referenced methods: M08 §8.1–8.2.3; internal application; M08 Table 8.2.a, M03 §3.2.4; internal application

N17 · Actual diets, activity and other concurrent exposures

Required materials and conditions: Food, weight, activity and management adherence material
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Food, weight, activity and management adherence material. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Food, weight, activity and management adherence material to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.3, M08 §8.2.2–8.2.3; our own application; M08 §8.2.2, M15 §15.3.1; our own application

N18 · Registration identifier and access to actual plans

Required materials and conditions: Original registration identifier, protocol, SAP and changes
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original registration identifier, protocol, SAP and changes. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Original registration identifier, protocol, SAP and changes to connect required material for the selected question with currently available material.
Referenced methods: Data collection and selection principles in M04 §4.5–4.6; separation of access from reading and the hyperlink contract are internally designed; M08 Table 8.2.a, M04 §4.6.3; internal application; M04 §4.5, §4.6.3; limits of this material conversion reflect the review scope and internal design

N19 · Multiple contrasts and analysis hierarchy

Required materials and conditions: Plans for three groups, time points, outcomes and subgroup analyses
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Plans for three groups, time points, outcomes and subgroup analyses. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Plans for three groups, time points, outcomes and subgroup analyses to connect required material for the selected question with currently available material.
Referenced methods: M08 Table 8.2.a, M04 §4.6.3; internal application; M08 §8.2.2, M15 §15.3.1; internal application; M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is internally designed

N20 · The same trial and absence of linked isolated-component replication

Required materials and conditions: Relationships among reports, groups, time points and independent trials
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Relationships among reports, groups, time points and independent trials. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Relationships among reports, groups, time points and independent trials to connect required material for the selected question with currently available material.
Referenced methods: Study/report distinction in M04 §4.6.1–4.6.2; Cohort/outcome linkage is Chamgap application; M04 §4.6.1–4.6.2 and M15 §15.3.1; Chamgap application

N21 · 18 months and clinical liver-disease events

Required materials and conditions: Imaging surrogates, persistence and clinical outcomes
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Imaging surrogates, persistence and clinical outcomes. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Imaging surrogates, persistence and clinical outcomes to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are internally designed; M03 §3.2.4; internally defined extension boundaries; M04 §4.5, §4.6.3; current material-conversion limits follow the review scope and internal design

N22 · Application to other populations, foods and products

Required materials and conditions: Direct material by eligibility, disease, formulation and exposure
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Direct material by eligibility, disease, formulation and exposure. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Direct material by eligibility, disease, formulation and exposure to connect required material for the selected question with currently available material.
Referenced methods: M03 §3.2.1; detailed population conditions are our own design; M03 §3.2.2–3.2.3; reverse-direction labels and test adaptations are our own design; M03 §3.2.1–3.2.4; dose, duration and effect-modification details are our own design

N23 · Mixed funding and product-related roles

Required materials and conditions: Original funding, advisory, product-support, employee-authorship and COI material
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original funding, advisory, product-support, employee-authorship and COI material. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Original funding, advisory, product-support, employee-authorship and COI material to connect required material for the selected question with currently available material.
Referenced methods: Chamgap's own conditions for independence and attribution. The official methodological sections used in this example do not validate every detail of these items.

N24 · Safety and gaps concerning individuals and products

Required materials and conditions: Harm-event collection, exposures, denominators and discontinuation
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Harm-event collection, exposures, denominators and discontinuation. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Supplementary
Application exceptions: Address safety-material gaps for the selected subclaim. Diet, isolated-component or imaging findings, or parent safety wording do not determine safety or create harm incidence rates or new use instructions.
Why this condition is needed: This applied condition distinguishes Harm-event collection, exposures, denominators and discontinuation to connect required material for the selected question with currently available material.
Referenced methods: M19 §19.1.2–19.2.4; internal application. M19 §19.1.2–19.2.4; detailed distinctions are internally designed. M19 §19.2 covers design-specific harm questions; detailed temporal relationships are internally designed. M19 §19.2.2–19.2.4 and M03 §3.2.3; internal application. M19 §19.1.2–19.2.4; internal application. M19 §19.2.2–19.2.4 considers design; detailed confounding records are internally designed. M19 §19.1.2–19.2.4 and M04 §4.6.3; internal application. M19 §19.1.2–19.2.4; internal application. Interpretation boundaries are internally defined, informed by M19 principles; no official causality tool is executed.

N25 · Original grades, axes, languages, dates and corrections

Required materials and conditions: Separation of parent C with 46 points, subclaim ? and historical original values
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Separation of parent C with 46 points, subclaim ? and historical original values. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Separation of parent C with 46 points, subclaim ? and historical original values to connect required material for the selected question with currently available material.
Referenced methods: M04 §4.5, §4.6.3; limits of this material conversion follow the review scope and internal design; M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed

N26 · Historical verification and actual summary reading

Required materials and conditions: Scope of historical review, unread material and links
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Scope of historical review, unread material and links. Stored wording is linked; review of existing content remains incomplete.
Requirement and applicability: Required
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Why this condition is needed: This applied condition distinguishes Scope of historical review, unread material and links to connect required material for the selected question with currently available material.
Referenced methods: M04 §4.5–4.6 covers material collection and selection; distinctions between access and reading and hyperlink specifications are internally designed. M04 §4.6.1–4.6.2 distinguishes studies and reports; cohort and outcome linkage is an internal application. M04 §4.5 and §4.6.3; current evidence-conversion limits reflect review scope and internal design.

Referenced methods and the sections actually reviewed

M03 · Cochrane Handbook 6.5 (2024), chapter updated 2023-08

Official methodology · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13

Referenced principle: Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.
Extent of review: Preserved method HTML copies; no current method-content re-review or official tool execution

M04 · Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03

Official methodology · §4.5, §4.6.1–4.6.3, MECIR C42

Referenced principle: Distinguish studies from reports and link them; do not omit a study solely because results are unreported.
Extent of review: Preserved method HTML copies; no current method-content re-review or official tool execution

M08 · Cochrane Handbook 6.5 (2024), chapter updated 2019-10

Official methodology · §8.1–8.2.3, Table 8.2.a

Referenced principle: Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.
Extent of review: Preserved method HTML copies; no current method-content re-review or official tool execution

M15 · Cochrane Handbook 6.5 (2024), chapter updated 2023-08

Official methodology · §15.2.4, §15.3.1–15.3.3

Referenced principle: Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.
Extent of review: Preserved method HTML copies; no current method-content re-review or official tool execution

M19 · Cochrane Handbook 6.5 (2024), chapter updated 2019-10

Official methodology · §19.1.2, §19.2.1–19.2.4

Referenced principle: Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.
Extent of review: Preserved method HTML copies; no current method-content re-review or official tool execution

What the statuses mean

Met: Status for necessary evidence confirmed after existing content review. No completion is declared in the current presentation.
Partly verified: Some information in the stored summary is linked into the table. External comparison/content review is not complete.
Unverified: The article leaves this unverified, or required material is absent from the current stored summary. This is distinct from zero, absence or safety.
Review incomplete: Existing content review remains incomplete.
Not reported: Not reported within the stored material actually read; not extended to the entire primary paper.
Inaccessible: Means an actual access failure. Access not attempted here is not assigned this state.
Not applicable: Not used as a substitute for an evidence gap.
Conflicting data: Requires an observed disagreement under the same comparison criteria; not automatically judged in this production.
Insufficient evidence for the conditions: Marks a gap in additional material required by the selected conditions; not a new efficacy grade.

Change history

2026-10-15 · Public page/material version 1.0

The reader view and materials were prepared from the existing 26 items. No new clinical search, verification-status changes or scoring were performed.

The stored-material review date (Not recorded) and original evidence cut-off (2026-09-07) were retained unchanged.

Researcher downloads

These materials provide the same evidence, scope and verification status as this page.

View all item details

N01 · Selected isolated-component question and original grade

Current findings: The selected existing record is liver-fat reduction from Mankai or green tea alone, grade ?, with a note that individual component effects were not separated. Subclaim score, status and axes are absent and are not filled with parent C with 46 points.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Separate subclaim score, status, axes and direct isolated-component effects are absent from the original material. Review of existing content remains incomplete.
Reason for missing information: Separate subclaim score, status, axes and direct isolated-component effects are absent from the original material.
Required materials and conditions: Mankai or green-tea wording, note and grade, and the parent dietary verdict
Materials to obtain first: Selected original version and editorial comments
Further research: Record updates distinguishing isolated-component and bundled-diet questions. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Mankai or green-tea wording, note and grade, and the parent dietary verdict. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Mankai or green-tea wording, note and grade, and the parent dietary verdict to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.5, §4.6.3; limits of this material conversion follow the review scope and internal design

Related sources S01

N02 · Boundary between the bundled diet and component attribution

Current findings: The original text records results for a package of foods and meat restriction. Its overall descriptions of Mankai, green tea, walnuts and meat restriction are not transferred into efficacy of any one component.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Direct comparisons changing only Mankai or green tea, component-specific effects and interactions are not linked. Review of existing content remains incomplete.
Reason for missing information: Direct comparisons changing only Mankai or green tea, component-specific effects and interactions are not linked.
Required materials and conditions: Simultaneously changed components, factor separation and isolated comparisons
Materials to obtain first: Component-specific comparison designs, denominators and original results
Further research: Propose follow-up research separating component attribution from the bundled pattern. No product or diet instructions are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Simultaneously changed components, factor separation and isolated comparisons. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Simultaneously changed components, factor separation and isolated comparisons to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M03 §3.2.2–3.2.3; reverse-direction labels and checking adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application

Related sources S01

N03 · Physical activity common to all three groups

Current findings: The original account allocated 294 participants to healthy-diet guidance, MED and green-MED, all undertaking a physical-activity program. Activity is not recast as unique to green-MED or as an isolated-component effect.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Activity specifications, group implementation, contact and actual exposure by period are unverified. Review of existing content remains incomplete.
Reason for missing information: Activity specifications, group implementation, contact and actual exposure by period are unverified.
Required materials and conditions: Common exposures in all groups and actual implementation
Materials to obtain first: S01 group activity, contact and implementation records
Further research: Propose follow-up material distinguishing common exposures from dietary differences. Exercise instructions are not written. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Common exposures in all groups and actual implementation. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Common exposures in all groups and actual implementation to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.2–3.2.3; Reverse-direction labels and assessment adaptation are Chamgap design; M03 §3.2.3 and M08 §8.2.2–8.2.3; Chamgap application

Related sources S01

N04 · Walnuts common to both MED groups

Current findings: The study condition that both MED groups received 28 g/day walnuts is preserved. The green-MED versus conventional-MED difference is not explained as a walnut-only effect or as walnuts added only in green-MED.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Actual walnut adherence, correspondence with other foods and isolated comparisons are unverified. Review of existing content remains incomplete.
Reason for missing information: Actual walnut adherence, correspondence with other foods and isolated comparisons are unverified.
Required materials and conditions: Common and different food exposures by group
Materials to obtain first: S01 food and adherence records for both MED groups and separate component comparisons
Further research: Propose follow-up material disclosing common foods and different components. No intake guidance is provided. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Common and different food exposures by group. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Common and different food exposures by group to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are in-house design; M03 §3.2.3, M08 §8.2.2–8.2.3; in-house application; M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is in-house design

Related sources S01

N05 · Study exposures added in green-MED

Current findings: Green-MED jointly added 3-4 cups/day green tea, 100 g/day frozen Mankai and greater restriction of red and processed meat. These figures are study conditions, not individual products, recommended amounts or doses establishing isolated efficacy.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Actual adherence, component and product specifications, meat-restriction amounts and individual exposures are unverified. Review of existing content remains incomplete.
Reason for missing information: Actual adherence, component and product specifications, meat-restriction amounts and individual exposures are unverified.
Required materials and conditions: Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures
Materials to obtain first: S01 food and product specifications, actual intake and concurrent restriction records
Further research: Propose follow-up material separating planned from actual component exposures. No dose or energy conversions are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Simultaneous planned and actual green-tea, Mankai and meat-restriction exposures to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction labels and checking adaptations are internally designed; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application; M03 §3.2.1–3.2.4; dose, duration and effect-modification details are internally designed

Related sources S01

N06 · Direct material for Mankai alone

Current findings: The current stored summary concerns the DIRECT-PLUS bundled pattern. Direct liver-fat trials of Mankai alone are not linked in the preserved citation list, and the bundled-group -38.9% is not used as an isolated effect.
Verification status: Unverified
Materials actually read: Summary read; external material unread
Why unverified: Information currently required is unverified in the stored summary. Mankai-only trials, formulations, exposure, direct comparisons, effects, CIs and denominators are not linked. Review of existing content remains incomplete.
Reason for missing information: Mankai-only trials, formulations, exposure, direct comparisons, effects, CIs and denominators are not linked.
Required materials and conditions: Isolated formulation, comparator, population, outcome and denominators
Materials to obtain first: Exact reports, plans and original findings for the Mankai-only question
Further research: Propose follow-up research separating the isolated-component study specification. No hypothetical reports or effects are created. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Isolated formulation, comparator, population, outcome and denominators. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Isolated formulation, comparator, population, outcome and denominators to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.6.1–4.6.2 distinctions between studies and reports; cohort and outcome linkage is internal application; M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M15 §15.3.1–15.3.3; internal application

Related sources S01

N07 · Direct material for green tea alone

Current findings: The current stored summary concerns a bundled diet including green tea. Direct liver-fat trials of green tea alone are not linked, and bundled results are not recast as green-tea treatment of fatty liver.
Verification status: Unverified
Materials actually read: Summary read; external material unread
Why unverified: Information currently required is unverified in the stored summary. Green-tea-only trials, formulations, components, exposure, comparisons, effects, CIs and denominators are not linked. Review of existing content remains incomplete.
Reason for missing information: Green-tea-only trials, formulations, components, exposure, comparisons, effects, CIs and denominators are not linked.
Required materials and conditions: Isolated formulation, comparator, population, outcome and denominators
Materials to obtain first: Exact reports, plans and original findings for the green-tea-only question
Further research: Propose follow-up research distinguishing isolated components from bundled diets. No intake or treatment instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Isolated formulation, comparator, population, outcome and denominators. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Isolated formulation, comparator, population, outcome and denominators to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed; M04 §4.6.1–4.6.2 distinctions between studies and reports; cohort and outcome linkage is internal application; M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M15 §15.3.1–15.3.3; internal application

Related sources S01

N08 · Actual population of the parent trial

Current findings: The original text describes 294 adults with abdominal obesity or dyslipidemia. Findings are not extended into isolated-component efficacy in selected liver-disease patients or everyone.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Age, sex, baseline liver fat and disease, recruitment and group allocation and analysis denominators are unverified. Review of existing content remains incomplete.
Reason for missing information: Age, sex, baseline liver fat and disease, recruitment and group allocation and analysis denominators are unverified.
Required materials and conditions: Abdominal obesity or dyslipidemia, eligibility and denominators
Materials to obtain first: S01 eligibility, recruitment, baseline characteristics and group flow charts
Further research: Propose follow-up material distinguishing populations and application boundaries for isolated and bundled questions. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Abdominal obesity or dyslipidemia, eligibility and denominators. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Abdominal obesity or dyslipidemia, eligibility and denominators to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.1; detailed population conditions are internally designed. M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; design-specific adaptations are internally designed.

Related sources S01

N09 · Different conventional-MED and healthy-diet-guidance contrasts

Current findings: The parent classification fields identify healthy-diet guidance as the comparator, while weight-adjusted P=.035 describes green-MED versus conventional MED. Effects, P values and comparator exposures from different contrasts are not mixed.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact contrast-specific estimates, denominators and correspondence of whole diets and contact are unverified. Review of existing content remains incomplete.
Reason for missing information: Exact contrast-specific estimates, denominators and correspondence of whole diets and contact are unverified.
Required materials and conditions: Three-group exposures, denominators and comparison specifications
Materials to obtain first: S01 group diets, contrast-specific original tables and models
Further research: Propose follow-up material with disclosed comparator-specific study specifications. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Three-group exposures, denominators and comparison specifications. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Three-group exposures, denominators and comparison specifications to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.2–3.2.3; reverse-direction markers and test adaptation are internally designed; M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application

Related sources S01

N10 · Intrahepatic-fat MRS and isolated-component results

Current findings: S01 describes 18-month change in intrahepatic fat by proton MRS. Imaging findings are not transferred into direct clinical treatment results for Mankai or green tea alone, or into other MRI-PDFF trials.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. MRS acquisition, reading, location, units, eligibility criteria and isolated-comparison findings are unverified. Review of existing content remains incomplete.
Reason for missing information: MRS acquisition, reading, location, units, eligibility criteria and isolated-comparison findings are unverified.
Required materials and conditions: Proton-MRS definitions, units, time points and directness
Materials to obtain first: S01 MRS methods, reading and eligibility procedures, and separate isolated results
Further research: Propose follow-up material separating measurement methods from component attribution. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Proton-MRS definitions, units, time points and directness. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Proton-MRS definitions, units, time points and directness to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.4 and M15 §15.3.1–15.3.3; Question-specific outcome adaptation is Chamgap design; M08 Table 8.2.a and M03 §3.2.4; Chamgap application; M03 §3.2.4; Chamgap interpretation boundary

Related sources S01

N11 · Proportional reductions and absolute or between-group effects

Current findings: Green-MED -38.9%, MED -19.6% and HDG -12.2% are original proportional intrahepatic-fat reductions. They are not recast as absolute percentage points, isolated-component effects, between-group differences or CIs, or new relative or absolute calculations.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Group original values, variances, exact comparative effects and CIs, within-person calculations and denominators are unverified. Review of existing content remains incomplete.
Reason for missing information: Group original values, variances, exact comparative effects and CIs, within-person calculations and denominators are unverified.
Required materials and conditions: Group proportional changes, denominators and estimates
Materials to obtain first: S01 original tables, proportional and absolute definitions, and comparative analyses
Further research: Propose follow-up material separating units and scope of reported estimates. No new calculations are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Group proportional changes, denominators and estimates. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Group proportional changes, denominators and estimates to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.4, M15 §15.3.1–15.3.3; question-specific outcome adaptations are internally designed; M08 Table 8.2.a, M15 §15.3, M19 §19.1.2–19.2.4; design-specific adaptations are internally designed; M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application

Related sources S01

N12 · Weight-adjusted P values and causal component attribution

Current findings: Weight-adjusted green-MED versus MED P=.035 and similar weight-loss wording concern a bundled-diet comparison. Possibilities beyond weight change do not establish causal effects of Mankai or green tea alone.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact adjusted models, coefficients and CIs, weight-analysis denominators and separate mediation or component effects are unverified. Review of existing content remains incomplete.
Reason for missing information: Exact adjusted models, coefficients and CIs, weight-analysis denominators and separate mediation or component effects are unverified.
Required materials and conditions: Adjusted models, contrasts, weight changes and effects
Materials to obtain first: S01 adjusted models, weight and liver-fat original tables, and separate component material
Further research: Propose follow-up research separating weight change from component attribution. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Adjusted models, contrasts, weight changes and effects. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Adjusted models, contrasts, weight changes and effects to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M08 §8.2.2, M15 §15.3.1; internal application; M15 §15.3.1–15.3.3; internal application; M03 §3.2.3, M08 §8.2.2–8.2.3; internal application

Related sources S01

N13 · Historical wording of a small standardized effect

Current findings: The parent text describes a small standardized effect versus conventional MED. No new standardized values or CIs, isolated-component magnitudes or grades are created from that wording.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Exact standardized estimates, variances, specifications, CIs and relevance thresholds are unverified. Review of existing content remains incomplete.
Reason for missing information: Exact standardized estimates, variances, specifications, CIs and relevance thresholds are unverified.
Required materials and conditions: Original standardized estimates, denominators and interpretation specifications
Materials to obtain first: S01 original effect tables and historical standardized-effect and interpretation material
Further research: Propose follow-up records separating reported effects from the historical scope of verdict interpretation. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original standardized estimates, denominators and interpretation specifications. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Original standardized estimates, denominators and interpretation specifications to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M15 §15.3.1–15.3.3; Chamgap adaptation; M04 §4.5, §4.6.3; limitations of the current material conversion follow the review scope and Chamgap design

Related sources S01

N14 · Retention and eligible MRS have different denominators

Current findings: The original 294 randomized participants, 89.8% retention at 18 months and 78% eligible follow-up MRS are preserved separately. The original 22% without eligible MRS is not recast as 22% trial attrition or exact participant counts.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Group retention, MRS eligibility and missingness, reasons, and selected and analysis denominators are unverified. Review of existing content remains incomplete.
Reason for missing information: Group retention, MRS eligibility and missingness, reasons, and selected and analysis denominators are unverified.
Required materials and conditions: Randomization, retention, imaging eligibility and group missingness
Materials to obtain first: S01 participant and imaging flows and group eligibility and missingness reasons
Further research: Propose follow-up material distinguishing retention from imaging-analysis eligibility. No new count or rate calculations are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Randomization, retention, imaging eligibility and group missingness. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Randomization, retention, imaging eligibility and group missingness to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; Design-specific adaptation is Chamgap design; M08 §8.2.2 and M15 §15.3.1; Chamgap application

Related sources S01

N15 · Missing imaging, analysis populations and sensitivity analyses

Current findings: Imaging missingness reflected in 78% eligible MRS is recorded as a limitation of the parent verdict. It is not used as proof that everyone completed imaging or as ITT evidence for an isolated-component effect.
Verification status: Unverified
Materials actually read: Summary read; external material unread
Why unverified: Information currently required is unverified in the stored summary. ITT or PP, imaging-missingness handling, imputation, sensitivity analyses and baseline associations are unverified. Review of existing content remains incomplete.
Reason for missing information: ITT or PP, imaging-missingness handling, imputation, sensitivity analyses and baseline associations are unverified.
Required materials and conditions: Missing-data handling, ITT or PP, selection and estimate stability
Materials to obtain first: S01 analysis populations, missingness and sensitivity analyses, and SAP
Further research: Propose follow-up material distinguishing missingness from analysis specifications. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Missing-data handling, ITT or PP, selection and estimate stability. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Missing-data handling, ITT or PP, selection and estimate stability to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M08 Table 8.2.a, M15 §15.3 and M19 §19.1.2–19.2.4; Design-specific adaptation is Chamgap design; M08 §8.2.2 and M15 §15.3.1; Chamgap application

Related sources S01

N16 · Randomization and assessment masking

Current findings: The original S01 design is a three-arm 18-month randomized lifestyle trial. The design label does not establish allocation concealment or participant, imaging-reader or analyst masking.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Sequence generation, concealment, reading and analysis masking, and group contact and expectations are unverified. Review of existing content remains incomplete.
Reason for missing information: Sequence generation, concealment, reading and analysis masking, and group contact and expectations are unverified.
Required materials and conditions: Allocation, concealment, MRS reading, contact and expectations
Materials to obtain first: S01 allocation, reading, contact and analysis procedures
Further research: Propose follow-up material disclosing lifestyle exposures and imaging-assessment conditions. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Allocation, concealment, MRS reading, contact and expectations. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Allocation, concealment, MRS reading, contact and expectations to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M08 §8.1–8.2.3; internal application; M08 Table 8.2.a, M03 §3.2.4; internal application

Related sources S01

N17 · Actual diets, activity and other concurrent exposures

Current findings: Activity common to all three groups, walnuts common to both MED groups and added green-MED components are recorded as originally described. This is not interpreted as a trial isolating components without actual adherence or concurrent-management differences.
Verification status: Unverified
Materials actually read: Summary read; external material unread
Why unverified: Information currently required is unverified in the stored summary. Group energy intake, whole diets, activity, medications, management and individual adherence are unverified. Review of existing content remains incomplete.
Reason for missing information: Group energy intake, whole diets, activity, medications, management and individual adherence are unverified.
Required materials and conditions: Food, weight, activity and management adherence material
Materials to obtain first: S01 group diet, activity, concurrent management and adherence records
Further research: Propose follow-up material distinguishing common from different exposures. No diet or weight-management instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Food, weight, activity and management adherence material. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Food, weight, activity and management adherence material to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.3, M08 §8.2.2–8.2.3; our own application; M08 §8.2.2, M15 §15.3.1; our own application

Related sources S01

N18 · Registration identifier and access to actual plans

Current findings: The original evidence and citation lists identify NCT03020186. The identifier and historical parent registration verification do not establish current registration reading or isolated-component plans before recruitment.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Recruitment and registration timing, protocol, SAP, outcome and component hierarchy, and changes remain unread. Review of existing content remains incomplete.
Reason for missing information: Recruitment and registration timing, protocol, SAP, outcome and component hierarchy, and changes remain unread.
Required materials and conditions: Original registration identifier, protocol, SAP and changes
Materials to obtain first: NCT03020186 original registration, plans and change history
Further research: Propose follow-up material distinguishing the preserved identifier from actual plan access. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original registration identifier, protocol, SAP and changes. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Original registration identifier, protocol, SAP and changes to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: Data collection and selection principles in M04 §4.5–4.6; separation of access from reading and the hyperlink contract are internally designed; M08 Table 8.2.a, M04 §4.6.3; internal application; M04 §4.5, §4.6.3; limits of this material conversion reflect the review scope and internal design

Related sources S01

N19 · Multiple contrasts and analysis hierarchy

Current findings: Multiple bundled-diet contrasts and weight-adjusted analyses are not prespecified primary results for isolated components. Parent MRS classification fields are not used as an isolated-effect hierarchy.
Verification status: Unverified
Materials actually read: Summary read; external material unread
Why unverified: Information currently required is unverified in the stored summary. Pre-recruitment contrasts, outcomes, subgroup analyses, multiplicity, adjustment and SAP are unverified. Review of existing content remains incomplete.
Reason for missing information: Pre-recruitment contrasts, outcomes, subgroup analyses, multiplicity, adjustment and SAP are unverified.
Required materials and conditions: Plans for three groups, time points, outcomes and subgroup analyses
Materials to obtain first: S01 complete analysis plans, original tables and separate component study specifications
Further research: Propose follow-up material distinguishing all contrasts from component questions. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Plans for three groups, time points, outcomes and subgroup analyses. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Plans for three groups, time points, outcomes and subgroup analyses to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M08 Table 8.2.a, M04 §4.6.3; internal application; M08 §8.2.2, M15 §15.3.1; internal application; M04 §4.6.3, M15 §15.3.1–15.3.3; status separation is internally designed

Related sources S01

N20 · The same trial and absence of linked isolated-component replication

Current findings: S01 DIRECT-PLUS includes the same trial's 294 participants, three groups, multiple exposures and time points. Groups, components, registration identifiers and other liver-fat sheets are not added as new independent trials, participants or isolated-component replication.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Separate direct Mankai-only or green-tea-only trials and independent-family relationships are not linked. Review of existing content remains incomplete.
Reason for missing information: Separate direct Mankai-only or green-tea-only trials and independent-family relationships are not linked.
Required materials and conditions: Relationships among reports, groups, time points and independent trials
Materials to obtain first: Report, group and registration relationships, and separate isolated-component trial material
Further research: Propose separate research with the same component study specification. No new totals or independence certification are produced. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Relationships among reports, groups, time points and independent trials. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Relationships among reports, groups, time points and independent trials to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: Study/report distinction in M04 §4.6.1–4.6.2; Cohort/outcome linkage is Chamgap application; M04 §4.6.1–4.6.2 and M15 §15.3.1; Chamgap application

Related sources S01

N21 · 18 months and clinical liver-disease events

Current findings: 18 months is the parent bundled-diet imaging-study duration. The original text records absence of clinical liver-disease events and independent confirmation trials. Long-duration imaging changes do not establish liver-disease treatment or prevention by isolated components.
Verification status: Unverified
Materials actually read: Summary read; external material unread
Why unverified: Information currently required is unverified in the stored summary. Persistence after stopping, clinical events and long-term isolated-component findings are not linked. Review of existing content remains incomplete.
Reason for missing information: Persistence after stopping, clinical events and long-term isolated-component findings are not linked.
Required materials and conditions: Imaging surrogates, persistence and clinical outcomes
Materials to obtain first: Time-specific imaging and clinical events, and separate isolated-component material
Further research: Propose follow-up research distinguishing imaging from clinical outcomes. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Imaging surrogates, persistence and clinical outcomes. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Imaging surrogates, persistence and clinical outcomes to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.1–3.2.4; dose, persistence and effect-modification details are internally designed; M03 §3.2.4; internally defined extension boundaries; M04 §4.5, §4.6.3; current material-conversion limits follow the review scope and internal design

Related sources S01

N22 · Application to other populations, foods and products

Current findings: Direct material concerns the bundled pattern in the selected adults. Findings are not extended into isolated efficacy for ordinary green tea, other Mankai products, other diets, liver-disease patients or every population.
Verification status: Unverified
Materials actually read: Summary read; external material unread
Why unverified: Information currently required is unverified in the stored summary. Identity, exposures and direct liver-fat or clinical material for other populations and products are not linked. Review of existing content remains incomplete.
Reason for missing information: Identity, exposures and direct liver-fat or clinical material for other populations and products are not linked.
Required materials and conditions: Direct material by eligibility, disease, formulation and exposure
Materials to obtain first: Direct material for other populations, components and products
Further research: Propose separate material for questions with different populations or products. No intake or treatment instructions are given. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Direct material by eligibility, disease, formulation and exposure. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Direct material by eligibility, disease, formulation and exposure to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M03 §3.2.1; detailed population conditions are our own design; M03 §3.2.2–3.2.3; reverse-direction labels and test adaptations are our own design; M03 §3.2.1–3.2.4; dose, duration and effect-modification details are our own design

Related sources S01

N23 · Mixed funding and product-related roles

Current findings: Original wording of public support, California Walnut Commission support, the PI's disclosed Hinoman advisory role and funders' reported lack of involvement in design or analysis is preserved. This is not recast as complete current role or COI verification or isolated-efficacy certification.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Original funder-role disclosures, products or free support, employee authorship, advisory scope and complete COI material are unverified. Review of existing content remains incomplete.
Reason for missing information: Original funder-role disclosures, products or free support, employee authorship, advisory scope and complete COI material are unverified.
Required materials and conditions: Original funding, advisory, product-support, employee-authorship and COI material
Materials to obtain first: S01 original funding, product-support, affiliation, contribution, advisory and COI material
Further research: Propose follow-up material distinguishing support types from roles. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Original funding, advisory, product-support, employee-authorship and COI material. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Original funding, advisory, product-support, employee-authorship and COI material to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: Chamgap's own conditions for independence and attribution. The official methodological sections used in this example do not validate every detail of these items.

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N24 · Safety and gaps concerning individuals and products

Current findings: Parent safety is unknown, and the original text states that adverse-event ascertainment was not central to the efficacy report. Nut-allergy, caffeine-sensitivity and disease-suitability wording is not used as event rates or isolated-product safety.
Verification status: Unverified
Materials actually read: Summary read; external material unread
Why unverified: Information currently required is unverified in the stored summary. Event definitions, collection, group denominators, discontinuation and isolated-component, long-term and vulnerable-population harms are unverified. Review of existing content remains incomplete.
Reason for missing information: Event definitions, collection, group denominators, discontinuation and isolated-component, long-term and vulnerable-population harms are unverified.
Required materials and conditions: Harm-event collection, exposures, denominators and discontinuation
Materials to obtain first: S01 harm events, exposures, denominators and separate component-safety material
Further research: Propose follow-up material directly collecting safety information. No diet, liver-disease or weight-management instructions are provided. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Harm-event collection, exposures, denominators and discontinuation. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Harm-event collection, exposures, denominators and discontinuation to connect required material for the selected question with currently available material.
Application exceptions: Address safety-material gaps for the selected subclaim. Diet, isolated-component or imaging findings, or parent safety wording do not determine safety or create harm incidence rates or new use instructions.
Referenced methods: M19 §19.1.2–19.2.4; internal application. M19 §19.1.2–19.2.4; detailed distinctions are internally designed. M19 §19.2 covers design-specific harm questions; detailed temporal relationships are internally designed. M19 §19.2.2–19.2.4 and M03 §3.2.3; internal application. M19 §19.1.2–19.2.4; internal application. M19 §19.2.2–19.2.4 considers design; detailed confounding records are internally designed. M19 §19.1.2–19.2.4 and M04 §4.6.3; internal application. M19 §19.1.2–19.2.4; internal application. Interpretation boundaries are internally defined, informed by M19 principles; no official causality tool is executed.

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N25 · Original grades, axes, languages, dates and corrections

Current findings: Parent C with 46 points, B/S/R1/I1/E~/B1, unrecorded precision, four false flags and empty override reasons, and the subclaim ? and note are preserved. Korean and English text, 2026-09-07 and empty correction and deliberation values are original records, not inherited as subclaim scores or a current completed review.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Subclaim score, status and axes, new corrections and external comparisons were not produced or performed. Review of existing content remains incomplete.
Reason for missing information: Subclaim score, status and axes, new corrections and external comparisons were not produced or performed.
Required materials and conditions: Separation of parent C with 46 points, subclaim ? and historical original values
Materials to obtain first: Original versions, corrections and user feedback
Further research: Update records distinguishing original values, production dates and correction events. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Separation of parent C with 46 points, subclaim ? and historical original values. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Separation of parent C with 46 points, subclaim ? and historical original values to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M04 §4.5, §4.6.3; limits of this material conversion follow the review scope and internal design; M03 §3.1, §3.2.1–3.2.4 question-clarification principles; detailed separation rules are internally designed

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N26 · Historical verification and actual summary reading

Current findings: Historical full-text, registration and scoring verification is retained as original history. This production used stored summaries and bibliography; papers, registration, protocol, SAP and COI material were unread and access was not attempted. External source links were not tested.
Verification status: Partly verified
Materials actually read: Summary read; external material unread
Why unverified: Only corresponding stored-summary information is recorded. Detailed original material is unread and review of existing content remains incomplete. Detailed historical verification, original-material acquisition, external reading and content review remain pending. Review of existing content remains incomplete.
Reason for missing information: Detailed historical verification, original-material acquisition, external reading and content review remain pending.
Required materials and conditions: Scope of historical review, unread material and links
Materials to obtain first: Original papers, registration and plans by report, historical versions and comments
Further research: Update content distinguishing history from actual access events. This is a proposal; no new investigation, calculation or trial is conducted here.
Remaining uncertainty: This record links preserved-summary statements; it does not establish external-paper comparison, a new efficacy verdict or completed content review.
Conditions for verification: Original material and analysis scope for this requirement must be provided, with unverified points distinguishable: Scope of historical review, unread material and links. Stored wording is linked; review of existing content remains incomplete.
Why this condition is needed: This applied condition distinguishes Scope of historical review, unread material and links to connect required material for the selected question with currently available material.
Application exceptions: Stay within the stored-summary scope of the selected diet, population, endpoint and duration. Do not substitute figures from other diets, trials or endpoints, or unread external material.
Referenced methods: M04 §4.5–4.6 covers material collection and selection; distinctions between access and reading and hyperlink specifications are internally designed. M04 §4.6.1–4.6.2 distinguishes studies and reports; cohort and outcome linkage is an internal application. M04 §4.5 and §4.6.3; current evidence-conversion limits reflect review scope and internal design.

Related sources S01