MedDiet Plus Energy Reduction, Physical Activity Cuts Incidence of Type 2 Diabetes

TUESDAY, Aug. 26, 2025 (HealthDay News) — For individuals with overweight or obesity and metabolic syndrome, an intensive intervention combining energy reduction, the Mediterranean diet (MedDiet), and physical activity is more effective than the MedDiet alone for reducing the incidence of type 2 diabetes, according to a study published online Aug. 26 in the Annals of Internal Medicine.

Miguel Ruiz-Canela, Pharm.D., Ph.D., from the Instituto de Salud Carlos III in Madrid, and colleagues examined whether an energy-reduced (er)MedDiet plus physical activity reduces diabetes incidence compared to a standard MedDiet in a prespecified secondary outcome analysis of the PREDIMED Plus trial conducted in 23 centers across Spain. A total of 4,746 adults aged 55 to 75 years with metabolic syndrome and overweight or obesity without prior cardiovascular disease or diabetes were included and randomly assigned to an intervention group receiving an erMedDiet (planned reduction of 600 kcal per day), increased physical activity, and behavioral strategies for reducing weight or a control group receiving ad libitum MedDiet advice.

The researchers found that the six-year absolute risk for incident type 2 diabetes was 12.0 and 9.5 percent in the control and intervention groups, respectively. Diabetes incidence was 31 percent lower in the intervention group versus the control group during a median six-year follow-up, with an absolute risk reduction of −2.6 cases per 1,000 person-years. Better adherence to the erMedDiet, higher physical activity levels, and greater reductions in body weight and waist circumference were seen in the intervention group.

“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,” coauthor Miguel Martínez-González, M.D., Ph.D., from the University of Navarra in Pamplona, Spain, said in a statement.

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