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Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes
Miguel Ruiz‐Canela, Dolores Corella, Miguel Ángel Martínez‐González, Nancy Babió, J. Alfredo Martínéz, Lluís Forga, Ángel M. Alonso‐Gómez, Julia Wärnberǵ et al.. Annals of Internal Medicine, 2025-08-25
Topic: Risk, prevention and care in population studies
The 6-year absolute risk was 12.0% (95% CI, 11.9% to 12.1%) in the control group (349 cases) and 9.5% (CI, 9.4% to 9.5%) in the intervention group (280 cases). Over a median 6-year follow-up, diabetes incidence was 31% (CI, 18% to 41%) relatively lower in the intervention group compared with the control group, with an absolute risk reduction of -2.6 cases (CI, -2.7 to -2.4) per 1000 person-years. The intervention group attained better adherence to the erMedDiet, higher physical activity levels, and greater reductions in body weight and waist circumference. LIMITATION: Secondary outcome, single-blinded design, and self-reported dietary adherence. An intensive intervention with the MedDiet adding caloric reduction, physical activity, and modest weight loss was more effective than only an ad libitum MedDiet in reducing diabetes incidence in overweight/obese persons with metabolic syndrome. PRIMARY FUNDING SOURCE: Instituto de Salud Carlos III.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Ruiz‐Canela, M., Corella, D., Martínez‐González, M. Á., Babió, N., Martínéz, J. A., Forga, L., et al. (2025). Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes. Annals of Internal Medicine. https://doi.org/10.7326/annals-25-00388
Vancouver
Ruiz‐Canela M, Corella D, Martínez‐González MÁ, Babió N, Martínéz JA, Forga L, et al. Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes. Annals of Internal Medicine. 2025. doi:10.7326/annals-25-00388. PMID: 40854218.
BibTeX
@article{ruizcanela2025-40854218,
author = {Ruiz‐Canela, Miguel and Corella, Dolores and Martínez‐González, Miguel Ángel and Babió, Nancy and Martínéz, J. Alfredo and Forga, Lluís and Alonso‐Gómez, Ángel M. and Wärnberǵ, Julia and others},
title = {{Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes}},
journal = {Annals of Internal Medicine},
year = {2025},
doi = {10.7326/annals-25-00388},
pmid = {40854218},
url = {https://doi.org/10.7326/annals-25-00388}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- The 6-year absolute risk was 12.0% (95% CI, 11.9% to 12.1%) in the control group (349 cases) and 9.5% (CI, 9.4% to 9.5%) in the intervention group (280 cases).
- Over a median 6-year follow-up, diabetes incidence was 31% (CI, 18% to 41%) relatively lower in the intervention group compared with the control group, with an absolute risk reduction of -2.6 cases (CI, -2.7 to -2.4) per 1000 person-years.
- The intervention group attained better adherence to the erMedDiet, higher physical activity levels, and greater reductions in body weight and waist circumference.
- LIMITATION: Secondary outcome, single-blinded design, and self-reported dietary adherence.
- An intensive intervention with the MedDiet adding caloric reduction, physical activity, and modest weight loss was more effective than only an ad libitum MedDiet in reducing diabetes incidence in overweight/obese persons with metabolic syndrome.
Why it matters
This trial found that an energy-reduced Mediterranean diet plus physical activity reduced type 2 diabetes incidence compared with an ad libitum Mediterranean diet in overweight or obese persons with metabolic syndrome. It does not study Alzheimer's disease outcomes.
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Study details
- Participants4,746
- Effect size12.0%; 11.9% to 12.1%; 9.5%
- Evidence strengthHigh
How this study scored 61/100
Published in a leading specialty journal. Scored zero for study design and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of Internal Medicine) |
| Journal's citation record | 4 / 4 | Annals of Internal Medicine: journal h-index 648 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 4,746 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 14 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 11.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 14 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Jordi Salas‐Salvadó: h-index 130 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multicenter collaboration | 3 / 3 | OpenAlex lists 46 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40854218) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 61 / 100 | — |
What each of these 20 components measures, and what this score is not →
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