Media release

From: American College of Physicians

Mediterranean diet combined with physical activity and weight loss cuts diabetes risk by 31%

A secondary outcome analysis of a randomized controlled trial evaluated whether an energy-reduced Mediterranean Diet (erMedDiet) plus physical activity reduced diabetes incidence compared to a standard MedDiet in adults with overweight or obesity and metabolic syndrome. The study found that following a MedDiet with caloric reduction, physical activity and modest weight loss was more effective at reducing diabetes incidence than an ad libitum MedDiet. The study is published in Annals of Internal Medicine.  

Researchers from Centro de Investigación Biomédica en Red (CIBER) in collaboration with different Institutes of health research and Universities from Spain conducted a secondary outcome analysis of the PREDIMED-Plus trial, a multicenter, randomized, parallel-group, single-blind, lifestyle intervention trial aiming to assess the effects of a weight-loss intervention with an erMedDiet and increased physical activity (intervention group) versus a control MedDiet group for primary cardiovascular prevention. Diabetes incidence was a predefined secondary endpoint of the PREDIMED-Plus trial. Participants in this analysis included 4,746 adults aged 55 – 75 years with overweight or obesity, without document cardiovascular disease or diabetes at baseline, and with metabolic syndrome.

Participants were randomly allocated 1:1 to one of the study arms. Participants in the intervention group were instructed to follow an erMedDiet with physical activity recommendations and behavioral support for weight loss. The control group received educational sessions on the traditional MedDiet with ad libitum caloric intake following the PREDIMED-1 trial recommendations. Both groups received 1 L per month of extra-virgin olive oil to support adherence and retention. Diabetes incidence was assessed yearly for seven years of follow-up, with the American Diabetes Association criteria being used to ascertain incident diabetes.

After 6 years, the adjusted absolute risk difference for incident diabetes between the intervention and control groups was −2.4% (95% CI, −3.1 to −1.8), corresponding to a 31% (CI, 18% to 41%) relative risk reduction in the intervention group as compared with the control group. This reduction was consistent across subgroups of age, education, and baseline metabolic status, with a greater effect observed in men than women. The results indicate that the MedDiet could be a beneficial dietary strategy plan for diabetes prevention, especially when combined with moderately reduced energy intake and physical activity. This multicomponent lifestyle modification represents a practical and sustainable strategy that could be incorporated into routine clinical practice for diabetes prevention.