A combination of three manageable lifestyle changes could reduce the risk of developing type 2 diabetes by 31 percent, new research suggests, offering hope in the face of what health experts are calling a “global epidemic” of the disease.
The study, published in Annals of Internal Medicine, highlights the impact of a Mediterranean-style diet, reduced caloric intake, and moderate physical activity. Researchers say these interventions, paired with professional weight-loss support, may prevent millions of cases worldwide.
“With the highest-level evidence, our study shows that modest, sustained changes in diet and lifestyle could prevent millions of cases of this disease worldwide,” said co-author Frank Hu, Fredrick J. Stare Professor of Nutrition and Epidemiology and chair of the Department of Nutrition.
The Study and Its Findings
The research team, including collaborators from 23 universities in Spain and Harvard Chan School, analyzed 4,746 participants aged 55 to 75 who were overweight or obese and had metabolic syndrome, but no diagnosis of type 2 diabetes. Participants were divided into two groups: an intervention group and a control group.
The intervention group followed a Mediterranean diet rich in fruits, vegetables, whole grains, and healthy fats, while reducing daily caloric intake by about 600 calories. They also engaged in moderate physical activity, such as brisk walking and strength exercises, and received professional support for weight-loss management. The control group followed the Mediterranean diet alone, without calorie restriction, exercise guidance, or additional support.
After six years, researchers found that the intervention group had a 31 percent lower risk of developing type 2 diabetes compared to the control group. On average, participants in the intervention group lost 3.3 kilograms and reduced their waist circumference by 3.6 centimeters, versus 0.6 kilograms and 0.3 centimeters in the control 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,” said co-author Miguel Martínez-González, professor at the University of Navarra and adjunct professor of nutrition at Harvard Chan School.
Why the Mediterranean Diet Matters
The Mediterranean diet has long been associated with improved health outcomes, including better insulin sensitivity and lower inflammation. The diet emphasizes plant-based foods, healthy fats like olive oil, moderate dairy and lean proteins, and minimal red meat.
This latest research from the PREDIMED-Plus clinical trial—the largest nutrition and lifestyle randomized trial in Europe—demonstrates that while the diet alone offers benefits, its effects are amplified when combined with calorie control and consistent exercise.
Type 2 diabetes, often called the “silent killer” due to its subtle symptoms, affects approximately 4.6 million people in the UK, with 90 percent of cases being type 2. Many cases remain undiagnosed, making preventive lifestyle changes critical.
Taking Action to Reduce Risk
Experts recommend adopting a Mediterranean-style diet, maintaining a modest calorie deficit, and incorporating moderate physical activity into daily routines. Even small, sustainable changes can make a measurable difference in lowering diabetes risk and improving overall health.
“We’re facing a global epidemic of diabetes,” Hu said. “These lifestyle interventions are simple, achievable, and could have a profound impact if widely implemented.”
A combination of three manageable lifestyle changes could reduce the risk of developing type 2 diabetes by 31 percent, new research suggests, offering hope in the face of what health experts are calling a “global epidemic” of the disease.
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