A modified Mediterranean diet, incorporating calorie reduction, increased physical activity, and professional weight loss support, significantly reduced the risk of developing type 2 diabetes by 31%. This finding comes from the PREDIMED-Plus trial, a major Spanish clinical study involving 4,746 adults aged 55 to 75.
Participants in the study all had overweight or obesity and metabolic syndrome but were free of diabetes or cardiovascular disease at the outset. Researchers followed these individuals for six years to assess the effectiveness of an intensive Mediterranean lifestyle plan compared to a traditional Mediterranean diet alone. The results were published inAnnals of Internal Medicine.
Study Methodology and Outcomes
One group of participants adhered to a calorie-reduced Mediterranean diet, consuming approximately 600 fewer calories daily. This group also engaged in moderate physical activity, including brisk walking, strength, and balance training, and received professional guidance for weight loss. The comparison group followed a traditional Mediterranean diet without specific calorie restrictions or exercise recommendations.
The intervention group demonstrated a 31% lower likelihood of developing type 2 diabetes compared to the control group. At the same time, the intervention group achieved greater weight loss, averaging 3.3 kg, and reduced waist circumference by 3.6 cm. In contrast, the control group lost only 0.6 kg and trimmed waist size by 0.3 cm. Researchers estimated that this program prevented approximately three cases of type 2 diabetes for every 100 participants.
Broader Implications and Funding
A modified Mediterranean diet, incorporating calorie reduction, increased physical activity, and professional weight loss support, significantly reduced the risk of developing type 2 diabetes by 31%.
Miguel Ángel Martínez-González, Professor of Preventive Medicine and Public Health at the University of Navarra and Adjunct Professor of Nutrition at Harvard University, stated, "Diabetes is the first solid clinical outcome for which we have shown -- using the strongest available evidence -- that the Mediterranean diet with calorie reduction, physical activity and weight loss is a highly effective preventive tool." He added that applying these lifestyle changes at scale could prevent thousands of new diagnoses annually.
The PREDIMED-Plus trial, the largest nutrition study conducted in Europe, involved the University of Navarra and over 200 researchers from 22 other Spanish universities, hospitals, and research centers.
The project began in 2013 with an Advanced Grant from the European Research Council (ERC) exceeding €2 million. Additional funding between 2014 and 2016 brought the total to over €15 million, primarily from the Carlos III Health Institute (ISCIII) and the Center for Biomedical Research Network (CIBEROBN, CIBERESP, and CIBERDEM).
Miguel Ruiz-Canela, Professor and Chair of Preventive Medicine and Public Health Department at the University of Navarra's School of Medicine and the study's first author, noted, "The Mediterranean diet acts synergistically to improve insulin sensitivity and reduce inflammation. With PREDIMED-Plus, we demonstrate that combining calorie control and physical activity enhances these benefits." He described the approach as a "tasty, sustainable and culturally accepted way to prevent type 2 diabetes."
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