The Mediterranean diet has long been praised for protecting the heart and supporting longevity. Now, scientists say a lighter version of it—combined with regular exercise and coaching—could also lower your risk of type 2 diabetes by 31%.
The finding comes from a major Spanish study led by the University of Navarra, published in Annals of Internal Medicine. Known as PREDIMED-Plus, it’s one of the largest nutrition trials ever done in Europe. Here’s what researchers found, and how this smarter version of the classic Mediterranean diet could help prevent diabetes worldwide.
The Mediterranean diet and diabetes risk
The trial followed nearly 4,800 adults between 55 and 75 who were overweight or obese and showed early signs of metabolic syndrome. None of them had diabetes or heart disease at the start. Over six years, researchers compared two groups: one that followed a calorie-reduced Mediterranean diet with guidance and exercise, and another that followed a traditional Mediterranean diet without calorie limits or structured activity.
The group that ate fewer calories, moved more, and received professional weight-loss support cut their diabetes risk by 31%. They also lost more weight and reduced their waistlines by an average of 3.6 centimeters, about six times more than the control group. Those who stuck with the plan prevented roughly three new cases of type 2 diabetes for every 100 people.
According to Professor Miguel Ángel Martínez-González, lead investigator and professor of preventive medicine at the University of Navarra and adjunct professor of nutrition at Harvard University, this marks the first time researchers have shown “using the strongest available evidence” that a calorie-reduced Mediterranean diet combined with physical activity is an effective tool to prevent diabetes.
“The Mediterranean diet acts synergistically to improve insulin sensitivity and reduce inflammation“, added co-author Dr. Miguel Ruiz-Canela, who chairs the Department of Preventive Medicine and Public Health at the University of Navarra. He noted that calorie control and exercise enhance those benefits, making the plan both realistic and culturally adaptable.
How to put these findings into practice
The Mediterranean diet already includes plenty of foods linked to better metabolic health, such as olive oil, nuts, fruits, vegetables, legumes, and fish. The study shows that modest calorie reduction and moderate exercise make that pattern even more powerful. Here are a few evidence-backed habits inspired by the study:
- Trim portions without cutting flavor. Use olive oil instead of butter, choose lean protein like fish or chicken, and fill your plate with vegetables and whole grains.
- Add moderate activity. Brisk walking, light strength training, or balance exercises several times a week improve insulin sensitivity and support weight control.
- Seek professional guidance. The participants who worked with dietitians and coaches maintained healthier routines and achieved more consistent results.
- Stick with it. The benefits came from steady habits, not short-term efforts. Even modest weight loss over time reduced diabetes risk.
Type 2 diabetes affects around 589 million people globally, including 38 million in the US, and cases are still climbing. This research shows that prevention doesn’t have to rely only on medication or extreme measures. A balanced, calorie-conscious Mediterranean diet—paired with daily movement—can be central for protecting your health.