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Mediterranean Diet With Calorie Cut, Exercise and Support Lowers Diabetes Risk 31% in 6-Year Trial

Participants saw only modest average weight and waist reductions, pointing to benefits beyond large weight loss.

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.
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Overview

  • Annals of Internal Medicine published a new secondary analysis on August 25, 2025, reporting results from PREDIMED-Plus, Europe’s largest nutrition and lifestyle randomized trial.
  • The study followed 4,746 adults aged 55–75 in Spain with overweight or obesity and metabolic syndrome, comparing an energy-reduced Mediterranean diet plus activity and professional support to an ad libitum Mediterranean diet.
  • The intervention targeted about a 600‑kilocalorie daily deficit and roughly 45 minutes of moderate aerobic activity most days, with added strength and balance work and regular dietitian coaching.
  • Type 2 diabetes incidence was 31% lower in the intervention group, translating to about three fewer cases per 100 participants over six years.
  • Average changes included about 3.3 kilograms of weight loss and a 3.6‑centimeter smaller waist in the intervention group versus 0.6 kilograms and 0.3 centimeters in controls, and accompanying commentary notes potential challenges to scaling such support outside Mediterranean settings.