• Jordi Salas-Salvadó, Monica Bulló, Nancy Babio, Miguel Ángel Martínez-González, Núria Ibarrola-Jurado, Josep Basora, Ramon Estruch, Maria Isabel Covas, Dolores Corella, Fernando Arós, Valentina Ruiz-Gutiérrez, Emilio Ros, and PREDIMED Study Investigators.
• Human Nutrition Unit, Hospital Universitari de Sant Joan, Departament de Bioquímica i Biotecnologia, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain. jordi.salas@urv.cat
• Diabetes Care. 2011 Jan 1; 34 (1): 14-9.

ObjectiveTo test the effects of two Mediterranean diet (MedDiet) interventions versus a low-fat diet on incidence of diabetes.Research Design And MethodsThis 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.ResultsAfter 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.ConclusionsMedDiets without calorie restriction seem to be effective in the prevention of diabetes in subjects at high cardiovascular risk.

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