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Energy-Reduced Mediterranean Diet Plus Exercise Cuts Type 2 Diabetes Risk by 31% in 6-Year Trial

The result comes from a six-year randomized trial in Spain that layered calorie reduction, daily activity and dietitian support onto a Mediterranean-style plan.

Walking for 45 minutes daily, at least six days a week was a key part of the lifestyle changes that reduced the risk of type 2 diabetes.
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The final preparation of a healthy salad and at the end the woman pours olive oil.

Overview

  • Findings were published August 25 in Annals of Internal Medicine as a secondary analysis of the PREDIMED-Plus randomized clinical trial.
  • Among 4,746 adults ages 55–75 with overweight or obesity and metabolic syndrome, the intensified program lowered incident diabetes by 31% versus a Mediterranean diet without added guidance.
  • The protocol targeted roughly 600 fewer kilocalories per day, about 45 minutes of aerobic exercise six days per week plus strength and balance work, supported by frequent dietitian-led behavioral counseling.
  • The relative reduction corresponded to an adjusted absolute risk drop of about 2.4% over the study period (roughly three fewer cases per 100 participants), alongside mean losses of ~3.3 kg and 3.6 cm in waist circumference.
  • Authors note key caveats: diabetes was a secondary outcome, adherence was self-reported, and results from older adults in a Mediterranean setting may not generalize broadly.