title: Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial.
abstract: BACKGROUND
  Interventions promoting weight loss can reduce the incidence of type 2 diabetes mellitus. Whether dietary changes without calorie restriction also protect from diabetes has not been evaluated.
  
  
  OBJECTIVE
  To assess the efficacy of Mediterranean diets for the primary prevention of diabetes in the Prevención con Dieta Mediterránea trial, from October 2003 to December 2010 (median follow-up, 4.1 years).
  
  
  METHODS
  Subgroup analysis of a multicenter, randomized trial. (Current Controlled Trials: ISRCTN35739639) SETTING: Primary care centers in Spain.
  
  
  METHODS
  Men and women without diabetes (3541 patients aged 55 to 80 years) at high cardiovascular risk.
  
  
  METHODS
  Participants were randomly assigned and stratified by site, sex, and age but not diabetes status to receive 1 of 3 diets: Mediterranean diet supplemented with extra-virgin olive oil (EVOO), Mediterranean diet supplemented with nuts, or a control diet (advice on a low-fat diet). No intervention to increase physical activity or lose weight was included.
  
  
  METHODS
  Incidence of new-onset type 2 diabetes mellitus (prespecified secondary outcome).
  
  
  RESULTS
  During follow-up, 80, 92, and 101 new-onset cases of diabetes occurred in the Mediterranean diet supplemented with EVOO, Mediterranean diet supplemented with mixed nuts, and control diet groups, respectively, corresponding to rates of 16.0, 18.7, and 23.6 cases per 1000 person-years. Multivariate-adjusted hazard ratios were 0.60 (95% CI, 0.43 to 0.85) for the Mediterranean diet supplemented with EVOO and 0.82 (CI, 0.61 to 1.10) for the Mediterranean diet supplemented with nuts compared with the control diet.
  
  
  CONCLUSIONS
  Randomization was not stratified by diabetes status. Withdrawals were greater in the control group.
  
  
  CONCLUSIONS
  A Mediterranean diet enriched with EVOO but without energy restrictions reduced diabetes risk among persons with high cardiovascular risk.
  
  
  BACKGROUND
  Instituto de Salud Carlos III.
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.forename: Mònica
authors.initials: M
authors.lastname: Bulló
authors.forename: Ramón
authors.initials: R
authors.lastname: Estruch
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.forename: Maria-Isabel
authors.initials: MI
authors.lastname: Covas
authors.forename: Núria
authors.initials: N
authors.lastname: Ibarrola-Jurado
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.forename: Enrique
authors.initials: E
authors.lastname: Gómez-Gracia
authors.forename: Valentina
authors.initials: V
authors.lastname: Ruiz-Gutiérrez
authors.forename: Dora
authors.initials: D
authors.lastname: Romaguera
authors.forename: José
authors.initials: J
authors.lastname: Lapetra
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Lamuela-Raventós
authors.forename: Lluís
authors.initials: L
authors.lastname: Serra-Majem
authors.forename: Xavier
authors.initials: X
authors.lastname: Pintó
authors.forename: Josep
authors.initials: J
authors.lastname: Basora
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Muñoz
authors.forename: José V
authors.initials: JV
authors.lastname: Sorlí
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martínez-González
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D018752:Diet, Fat-Restricted; D038441:Diet, Mediterranean; D004042:Dietary Fats, Unsaturated; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009754:Nuts; D000069463:Olive Oil; D010938:Plant Oils; D011322:Primary Prevention; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015431:Weight Loss
chemical_list: D004042:Dietary Fats, Unsaturated; D000069463:Olive Oil; D010938:Plant Oils