Combining a Mediterranean diet with calorie restriction, moderate physical activity, and professional weight management support reduces the risk of type 2 diabetes by 31 per cent, a groundbreaking European clinical trial has shown.
The PREDIMED-Plus study represents Europe's most extensive nutrition and lifestyle randomised trial to date, tracking nearly 5,000 participants across six years.
Researchers from Harvard T.H. Chan School of Public Health collaborated with 23 Spanish universities to conduct this comprehensive investigation.
The findings, published in the Annals of Internal Medicine, suggest these combined lifestyle modifications could potentially prevent millions of diabetes cases globally.
Scientists recommend adding calorie control and physical activity to the Mediterranean diet
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The trial methodology involved dividing 4,746 participants into two distinct groups for comparison purposes.
Intervention group members followed a Mediterranean diet, reducing their daily caloric consumption by approximately 600 calories, participated in moderate exercise, including brisk walking and strength and balance training, and received professional weight loss guidance.
Control group participants maintained a Mediterranean diet without any calorie restrictions, exercise programmes, or professional support services.
All study subjects were aged between 55 and 75 years, classified as overweight or obese with metabolic syndrome, though none had developed type 2 diabetes at the beginning of the study.
The intervention group demonstrated a 31 per cent reduction in type 2 diabetes development compared to their control counterparts over the six-year study period.
Participants following the comprehensive lifestyle approach achieved an average weight loss of 3.3 kilograms alongside a 3.6-centimetre reduction in waist circumference.
In contrast, the control group experienced minimal changes, losing just 0.6 kilograms on average, with waist measurements decreasing by only 0.3 centimetres.
These results highlight the significant physical improvements achieved through combining dietary modifications with calorie control and regular exercise, demonstrating measurable health benefits beyond diabetes prevention alone.
Leading researchers highlighted the global significance of these findings in addressing the worldwide diabetes crisis.
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The lifestyle modifications could prevent millions of cases globally
| GETTY"We're facing a global epidemic of diabetes," said co-author Frank Hu, Fredrick J. Stare Professor of Nutrition and Epidemiology and chair of the Department of Nutrition.
"With the highest-level evidence, our study shows that modest, sustained changes in diet and lifestyle could prevent millions of cases of this disease worldwide."
Co-author Miguel Martínez-González, professor at the University of Navarra and adjunct professor of nutrition at Harvard Chan School, highlighted the practical implications: "In practical terms, adding calorie control and physical activity to the Mediterranean diet prevented around three out of every 100 people from developing diabetes - a clear, measurable benefit for public health."