A Spanish study reveals that a calorie-reduced Mediterranean diet combined with regular exercise and professional support can lower type 2 diabetes risk by 31%, proving that small, sustainable lifestyle changes offer a powerful path to prevention.
A new Spanish study has found that a smarter version of the Mediterranean diet—lower in calories and paired with moderate exercise—can reduce the risk of type 2 diabetes by an impressive 31%. Researchers say the results highlight how small, sustainable lifestyle changes can lead to major long-term health benefits. The study is published in Annals of Internal Medicine.
A Healthier Twist on a Classic Diet
The findings come from the PREDIMED-Plus trial, one of Europe’s largest nutrition studies, led by the University of Navarra. More than 4,700 adults between 55 and 75 years old took part. All participants were overweight or obese and at risk of developing diabetes, but none had it yet.
Half of the group followed a calorie-reduced Mediterranean diet, cutting about 600 kilocalories per day. They also added moderate physical activity—like brisk walking and light strength training—and received regular professional support. The other half continued their usual Mediterranean diet without calorie limits or exercise advice.
After six years, the results were clear. Those on the calorie-controlled plan lost more weight, trimmed more from their waists, and were far less likely to develop diabetes. On average, they lost 3.3 kilograms and 3.6 centimeters from their waistlines, compared to just 0.6 kilograms and 0.3 centimeters in the control group.
A Tasty Path to Prevention
“The Mediterranean diet acts synergistically to improve insulin sensitivity and reduce inflammation,” explained lead author Dr. Miguel Ruiz-Canela from the University of Navarra. “When combined with calorie control and physical activity, its benefits multiply. It’s a tasty, sustainable way to prevent diabetes.”
Senior investigator Dr. Miguel Ángel Martínez-González added that the trial provides “the strongest evidence so far” that lifestyle adjustments—not just medication—can protect against diabetes. “If applied widely, these modest, consistent changes could prevent thousands of new diagnoses every year,” he said.
Global Relevance and Real-World Potential
Experts from Temple University in the U.S. praised the research, noting its real-world impact. They emphasized, however, that replicating such results elsewhere—especially in places like the United States—requires tackling deeper issues such as unequal access to healthy food and urban environments that discourage exercise.
The PREDIMED-Plus project, which ran from 2013 to 2024, builds on the earlier PREDIMED study showing that a traditional Mediterranean diet rich in olive oil or nuts lowers heart disease risk by 30%.
A Realistic, Delicious Defense
As type 2 diabetes rates continue to rise—affecting over 530 million people globally—the Spanish team’s message is simple: prevention doesn’t have to mean deprivation. A balanced Mediterranean-style diet, portion control, and regular activity remain among the most delicious and sustainable ways to protect long-term health.