Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet: Results of the PREDIMED-Reus nutrition intervention randomized trial

• Published in: Diabetes care Vol. 34; no. 1; pp. 14 - 19
• Main Authors: Salas-Salvadó, Jordi, Bulló, Monica, Babio, Nancy, Martínez-González, Miguel Ángel, Ibarrola-Jurado, Núria, Basora, Josep, Estruch, Ramon, Covas, Maria Isabel, Corella, Dolores, Arós, Fernando, Ruiz-Gutiérrez, Valentina, Ros, Emilio
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.01.2011
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; body weight changes; Cardiovascular Diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Clinical trials; Diabetes; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - prevention & control; Diabetes. Impaired glucose tolerance; Diet; Diet, Mediterranean; Dietary Supplements; education; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; low fat diet; Male; Medical sciences; Mediterranean diet; Metabolic diseases; Middle Aged; Miscellaneous; noninsulin-dependent diabetes mellitus; Nutrition; nutritional intervention; Nuts; Olive Oil; Original Research; physical activity; Plant Oils; Prevention; prevention & control; Public health. Hygiene; Public health. Hygiene-occupational medicine; risk; Risk Factors; risk reduction; Spain; Studies; virgin olive oil; Spain; Endocrinopathy; Type 2 diabetes; Human; Nutrition; Mediterranean diet; Metabolic diseases; Epidemiology; Feeding; Incidence; Result; Reduction; Diet; Clinical trial; Endocrinology
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc10-1288

OBJECTIVE: To test the effects of two Mediterranean diet (MedDiet) interventions versus a low-fat diet on incidence of diabetes. RESEARCH DESIGN AND METHODS: This was a three-arm randomized trial in 418 nondiabetic subjects aged 55-80 years recruited in one center (PREDIMED-Reus, northeastern Spain) of the Prevención con Dieta Mediterránea [PREDIMED] study, a large nutrition intervention trial for primary cardiovascular prevention in individuals at high cardiovascular risk. Participants were randomly assigned to education on a low-fat diet (control group) or to one of two MedDiets, supplemented with either free virgin olive oil (1 liter/week) or nuts (30 g/day). Diets were ad libitum, and no advice on physical activity was given. The main outcome was diabetes incidence diagnosed by the 2009 American Diabetes Association criteria. RESULTS: After a median follow-up of 4.0 years, diabetes incidence was 10.1% (95% CI 5.1-15.1), 11.0% (5.9-16.1), and 17.9% (11.4-24.4) in the MedDiet with olive oil group, the MedDiet with nuts group, and the control group, respectively. Multivariable adjusted hazard ratios of diabetes were 0.49 (0.25-0.97) and 0.48 (0.24-0.96) in the MedDiet supplemented with olive oil and nuts groups, respectively, compared with the control group. When the two MedDiet groups were pooled and compared with the control group, diabetes incidence was reduced by 52% (27-86). In all study arms, increased adherence to the MedDiet was inversely associated with diabetes incidence. Diabetes risk reduction occurred in the absence of significant changes in body weight or physical activity. CONCLUSIONS: MedDiets without calorie restriction seem to be effective in the prevention of diabetes in subjects at high cardiovascular risk.