Energy-reduced MedDiet plus physical activity prevents T2D in persons with obesity

An intensive intervention with energy-reduced Mediterranean diet (MedDiet) combined with physical activity demonstrates greater efficacy than an ad libitum MedDiet only in lowering the incidence of diabetes in persons with overweight or obesity and metabolic syndrome, according to a study. 

A team of investigators enrolled 4,746 adults aged 55 to 75 years with metabolic syndrome and overweight or obesity, with no prior cardiovascular disease or type 2 diabetes (T2D), in this randomized controlled trial conducted at 23 centres across Spain. 

Participants were randomly allocated to receive an energy-reduced MedDiet (planned reduction of 600 kcal per day), increased physical activity, and behavioural strategies for reducing weight (intervention group; n=280) or to an ad libitum MedDiet advice (control group; n=349).

The investigators assessed diabetes incidence based on the American Diabetes Association criteria and obtained anthropometric measurements yearly. They also examined the effect of the intervention using Cox regression models.

At year 6, the absolute risk of T2D was 9.5 percent (95 percent confidence interval [CI], 9.4–9.5) in the intervention group compared with 12.0 percent (95 percent CI, 11.9–12.1) in the control group.

Diabetes incidence over a median follow-up of 6 years was relatively lower by 31 percent (95 percent CI, 18–41) in the intervention group compared with the control group (absolute risk reduction, –2.6 per 1,000 person-years, 95 percent CI, –2.7 to –2.4).

Participants in the intervention group also showed greater adherence to the energy-reduced MedDiet, higher physical activity levels, and greater reductions in body weight and waist circumference.