Fewer calories plus exercise on Mediterranean diet found to lower diabetes risk

Following a Mediterranean diet while eating fewer calories, doing moderate exercise, and adhering to professional support for weight loss can lower type 2 diabetes risk by 31%, according to a recent clinical trial. The study stresses significant public health benefits from making small lifestyle changes. 

Predimed-Plus, dubbed the “largest European nutrition trial,” followed 4,746 Spanish people aged 55 to 75 years with overweight or obesity and metabolic syndrome. They had no history of cardiovascular disease or diabetes and were followed for six years.

The Mediterranean diet is a popular weight management strategy with a focus on whole foods like fruits, vegetables, and whole grains. It also incorporates lean protein sources like seafood, dairy products, and the occasional treat.

This year, the U.S. News and World Report scored the Mediterranean diet as the “most highly rated” out of 38 diets examined.

Gretel Schueller, managing editor of health at U.S. News, told Nutrition Insight that while the origins of this diet focus on the eating patterns of countries around the Mediterranean, its basic tenets can be adapted to any country’s cuisine or anyone’s dietary preference. “You could do a Japanese, Columbian, or vegan version of this diet.”

Significant and promising benefits

The University of Navarra, Spain, researchers highlight that the intervention group experienced weight loss on average at 3.3 kg and reduced waist circumference by 3.6 cm, as opposed to the control group recording just 0.6 kg and 0.3 cm, respectively.

The study, published in Annals of Internal Medicine, reveals that three of every 100 participants were prevented from developing type 2 diabetes.. 

The intervention group followed an improved version of the Mediterranean diet, consuming about 600 kcal less per day, and engaged in brisk walking along with strength and balance exercises. They also received professional guidance. 

The control followed the traditional Mediterranean diet without calorie restriction or exercise advice.

“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,” says lead researcher Miguel Angel Martinez-Gonzalez, professor of Preventive Medicine and Public Health at the University of Navarra and adjunct professor of Nutrition at Harvard University, US.

The intervention group following the Mediterranean diet consumed about 600 kcal less per day and engaged in brisk walking along with strength and balance exercises.“Applied at scale in at-risk populations, these modest and sustained lifestyle changes could prevent thousands of new diagnoses every year. We hope soon to show similar evidence for other major public health challenges.”

Global challenge

According to the International Diabetes Federation, type 2 diabetes affects over 530 million people globally. Urbanization, which comes with unhealthy diets and sedentary lifestyles, drives the number up alongside an aging population and rising rates of obesity.

In Europe, 65 million people suffer from diabetes, with 4.7 million adults in Spain, the researchers emphasize. In the US, this number reaches approximately 38.5 million — surpassing the global average. 

The study underlines the need for preventive measures, as diabetes significantly raises the risk of cardiovascular, renal, and metabolic complications.

“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,” explains first author Miguel Ruiz-Canela, professor and chair of the Department of Preventive Medicine and Public Health at the University of Navarra.

“It is a tasty, sustainable, and culturally accepted approach that offers a practical and effective way to prevent type 2 diabetes — a global disease that is, to a large extent, avoidable.”

Latest research on diabetes 

Following one of three proven healthy eating patterns can significantly reduce the risk of type 2 diabetes, according to a meta-analysis of over 800,000 participants’ diets conducted by the UK University of Cambridge. These patterns include the Mediterranean Diet, the Alternative Healthy Eating Index, and the Dietary Approaches to Stop Hypertension (DASH).

Researchers in a recent clinical trial found that modifying the DASH diet, designed to lower blood pressure, can also lower glucose in adults with type 2 diabetes.

Also, French fries and PFAS were linked to a higher risk of developing type 2 diabetes, according to recent research.