Scientists found a smarter Mediterranean diet that slashes diabetes risk by 31%
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Scientists found a smarter Mediterranean diet that slashes diabetes risk by 31%
A revamped Mediterranean diet with exercise and modest weight loss slashed type 2 diabetes risk by 31% in a major long-term study.
Date:
May 19, 2026
Source:
Universidad de Navarra
Summary:
A large European study revealed that a lower-calorie Mediterranean diet paired with exercise and coaching dramatically reduced the risk of type 2 diabetes. Participants who made these lifestyle changes were 31% less likely to develop the disease over six years. They also lost more weight and trimmed their waistlines compared to those following a standard Mediterranean diet alone.
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A major Spanish clinical trial found that a Mediterranean-style diet combined with modest calorie reduction, regular moderate exercise, and professional weight-loss support cut the risk of developing type 2 diabetes by 31%. Credit: Shutterstock
A Mediterranean diet is already famous for its heart and metabolic benefits. But a major Spanish clinical trial suggests it may work even better against type 2 diabetes when paired with three realistic upgrades: eating fewer calories, moving more, and getting professional support for weight loss.
The PREDIMED-Plus trial found that this more structured version of Mediterranean living reduced the risk of developing type 2 diabetes by 31%. The project is the largest nutrition trial conducted in Europe and involved the University of Navarra along with more than 200 researchers from 22 other Spanish universities, hospitals, and research centers. The work was carried out in more than 100 primary care centers within Spain's National Health System.
A Smarter Version of a Famous Diet
PREDIMED-Plus began in 2013 after the University of Navarra received an Advanced Grant from the European Research Council (ERC) worth more than €2 million. Between 2014 and 2016, additional institutions joined, bringing total funding to more than 15 million euros. Most of that support came from the Carlos III Health Institute (ISCIII) and the Center for Biomedical Research Network through its areas of Physiopathology of Obesity and Nutrition (CIBEROBN), Epidemiology and Public Health (CIBERESP) and Diabetes and Associated Metabolic Diseases (CIBERDEM ).
The results, published in Annals of Internal Medicine, were based on 4,746 adults between ages 55 and 75. All had overweight or obesity and metabolic syndrome, but none had diabetes or cardiovascular disease at the start of the study. Researchers followed participants for six years to see whether a more intensive Mediterranean based lifestyle plan could offer stronger protection against type 2 diabetes than the traditional Mediterranean diet alone.
One group followed a calorie reduced Mediterranean diet (about 600 kcal fewer per day), added moderate physical activity (brisk walking, strength and balance training), and received professional guidance. The comparison group followed a traditional Mediterranean diet without calorie restriction or exercise advice.
Small Changes, Big Diabetes Protection
The difference between the two approaches was striking. Participants in the intervention group were 31% less likely to develop type 2 diabetes than those in the comparison group.
They also lost more weight and reduced abdominal fat more effectively. On average, the intervention group lost 3.3 kg and reduced waist circumference by 3.6 cm. The control group lost only 0.6 kg and trimmed waist size by 0.3 cm.
In real world terms, the researchers estimated that the program prevented about three cases of type 2 diabetes for every 100 participants. For a condition affecting hundreds of millions of people globally, that kind of prevention could add up quickly if applied broadly among people at elevated risk.
"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," said Miguel Ángel Martínez-González, Professor of Preventive Medicine and Public Health at the University of Navarra, Adjunct Professor of Nutrition at Harvard University, and one of the principal investigators of the project. "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."
Why This Matters for a Global Health Crisis
Type 2 diabetes is one of the world's fastest growing chronic diseases. The International Diabetes Federation estimates that more than 530 million people worldwide now live with diabetes. The rise has been fueled by urbanization, less healthy diets, more sedentary lifestyles, reduced physical activity, population aging, and increasing rates of ov