Roundup: This Diet-Exercise Combination Lowers Risk of Diabetes by 31%; and More News

Mediterranean Diet with Calorie Reduction and Exercise Cuts Diabetes Risk by Nearly a Third

A landmark European clinical trial has found that a Mediterranean diet, when paired with modest calorie reduction and regular physical activity, can significantly lower the risk of developing type 2 diabetes.

The findings, published in the Annals of Internal Medicine, highlight a 31 percent reduction in diabetes incidence among older adults at high risk.

The research, known as PREDIMED-Plus, is the largest nutrition trial conducted in Europe. Initiated in 2013, it involved 4,746 adults aged 55 to 75 who were overweight or obese and exhibited metabolic syndrome—a cluster of conditions that increase the likelihood of diabetes and heart disease. None of the participants had a prior diagnosis of diabetes or cardiovascular disease.

Led by Professor Miguel Ruiz-Canela of the University of Navarra in Spain, the trial was carried out across more than 100 primary care centers, with collaboration from over 200 researchers. Funding came from the European Research Council, the Carlos III Health Institute, and the Center for Biomedical Research Network.

Comparing Diet Approaches

The trial compared two dietary and lifestyle strategies:

• Intervention group: A calorie-reduced Mediterranean diet (approximately 600 fewer calories per day), combined with structured guidance on moderate exercise such as brisk walking and strength training.
• Control group: A traditional Mediterranean diet without calorie restriction or exercise recommendations.

Participants in the intervention group not only reduced their risk of type 2 diabetes but also achieved an average weight loss of 3.3 kilograms and a waist reduction of 3.6 centimeters over six years. In contrast, the control group lost just 0.6 kilograms and reduced waist size by 0.3 centimeters.

These results translate into preventing about three cases of diabetes for every 100 individuals enrolled in the program — a meaningful outcome at the population level.

The Mediterranean diet is based on fruits, vegetables, legumes, whole grains, olive oil, fish, and nuts, with limited red meat and processed foods. When adjusted for calorie intake and paired with regular exercise, the diet’s health benefits are amplified. As Professor Ruiz-Canela noted in a statement: “It is a tasty, sustainable and culturally accepted approach that offers a practical and effective way to prevent type 2 diabetes — a global disease that is, to a large extent, avoidable.”

Why It Matters

Type 2 diabetes is one of the fastest-growing global health threats. According to the International Diabetes Federation, more than 530 million people are currently living with the disease worldwide.

Aging populations, sedentary lifestyles, and rising obesity rates have fueled its spread. In Europe, over 65 million people are affected, while in the United States the figure reaches nearly 39 million. The condition carries a heavy burden of complications, including cardiovascular disease, kidney damage, and metabolic disorders.

“Diabetes is the first solid clinical outcome for which we have shown — using the strongest available evidence — that the Mediterranean diet with calorie reduction, physical activity and weight loss is a highly effective preventive tool,” explained Professor Miguel Ángel Martínez-González of the University of Navarra and Harvard University, one of the project’s principal investig7ators, in a news release.

The PREDIMED-Plus project continues a line of research that began with the original PREDIMED trial (2003–2010), which showed that a Mediterranean diet enriched with olive oil or nuts reduced the risk of cardiovascular disease by 30%. The latest findings provide robust evidence that primary care providers can integrate this updated approach as a cost-efficient, scalable prevention strategy for type 2 diabetes. 

Deaths from High Blood Pressure-Related Kidney Disease Rise Sharply Over 25 Years

A new study has found that deaths from kidney disease linked to high blood pressure have increased 48 percent in the United States over the past quarter-century. The research, presented at the American Heart Association’s Hypertension Scientific Sessions 2025 in Baltimore, highlights health disparities across race, ethnicity, gender, and geography.

Rising Burden of Hypertensive Kidney Disease

Hypertensive kidney disease, sometimes called hypertensive renal disease, occurs when long-term high blood pressure damages the kidneys. This condition is a leading cause of kidney failure and contributes significantly to premature death. High blood pressure itself is one of the most common chronic conditions in the U.S., often referred to as a “silent killer” because it may not cause symptoms until serious complications develop.

An estimated 1 in 5 adults in the U.S. with high blood pressure also have chronic kidney disease (CKD). High blood pressure is the second leading cause of kidney failure in the U.S. after diabetes.

The new analysis, covering data from 1999 to 2023, found that the age-adjusted mortality rate (AAMR) for hypertensive kidney disease increased by 48 percent. Age-adjusted rates allow researchers to compare death rates across populations with different age distributions, offering a clearer picture of long-term trends.

During this 25-year period, hypertensive kidney disease caused 274,667 deaths among people aged 15 and older. Men had higher mortality than women, and deaths were especially elevated among Black and Hispanic adults and in certain regions of the country.

Stark Disparities Across Groups

The findings underscore the persistence of racial and ethnic disparities in hypertension-related outcomes. “Black individuals still had over three times the death rate compared to other groups of people,” stated lead study author Joiven Nyongbella, M.D., an internal medicine resident at Wayne State University/Henry Ford Rochester Hospital, in a news release.

Key statistics from the study include:

• Black adults had the highest mortality, with an AAMR of 10.37 deaths per 100,000 people—far exceeding other population groups (3.33–3.90 per 100,000).
• Hispanic individuals experienced a 15 percent higher rate of death compared with non-Hispanic individuals.
• Men had a 22 percent higher mortality compared with women.
• Certain regions, particularly in the South, showed the greatest impact. Washington, D.C. had the highest rate (7.6 deaths per 100,000), followed by Tennessee and Mississippi.

“These data reinforce that high blood pressure isn’t just about strokes or heart attacks—it’s also a major cause of kidney disease and death, especially in Black and Hispanic communities,” Dr. Nyongbella emphasized. “The message is simple: check your blood pressure, treat it early and don’t ignore it.”

Public Health Implications

The study’s findings align with the American Heart Association’s 2025 High Blood Pressure Guideline, which highlights the importance of prevention, early diagnosis, and treatment. Dr. Sidney C. Smith Jr., a cardiologist and AHA volunteer expert, noted a news release: “These findings point to the urgent need for better blood pressure control and attention to social factors that place some communities at higher risk.”

Researchers cautioned that the study relied on death certificates, which may not always accurately reflect cause of death. In addition, information on access to care, diet, and medication use was not available. More research is needed to explore how these factors influence long-term outcomes.

‘Gait Retraining’ Your Walking Technique Can Relieve Osteoarthritis, Researchers Find

Gait retraining – an adjustment to how a person walks – can substantially relieve osteoarthritis, a degenerative joint disease that erodes the cartilage cushioning bones, affecting nearly one in four adults over 40.

This painful condition often leads to disability, with treatment options limited to pain management through medications and, eventually, joint replacement surgery. Now, new research from Stanford University suggests gait retraining as a promising alternative.

What Is Gait Retraining?

Gait retraining is the process of modifying how a person walks to reduce stress on specific joints. In this study, researchers focused on adjusting the angle of participants’ feet while walking. Even a small change—turning the toes slightly inward or outward—helped reduce pressure on the knee joint. Over time, this adjustment eased pain and slowed cartilage damage.

The Stanford Study

The findings, published in The Lancet Rheumatology, come from the first randomized, placebo-controlled clinical trial to test this approach for knee osteoarthritis. Sixty-eight participants with mild-to-moderate knee OA were recruited. Using motion-capture technology and pressure-sensitive treadmills, researchers identified a personalized foot angle for each individual that would best relieve strain on the inside of the knee, where damage is most common.

Half of the participants were assigned to the intervention group, adopting the new foot angle, while the other half received a sham treatment that mimicked their natural gait. Both groups underwent six weeks of supervised training with real-time biofeedback from wearable devices, followed by daily practice at home for up to a year.

Significant Results

After 12 months, participants who practiced gait retraining reported pain reduction comparable to commonly used medications. Importantly, MRI scans showed less cartilage degradation in this group compared to the control group.

Lead author Scott Uhlrich explained: “We’ve known that higher loads in the knee accelerate osteoarthritis, and changing the foot angle can reduce that load. This is the first study to show in a placebo-controlled trial that such an approach is effective.”

Senior author Scott Delp added, “The MRIs also showed improved biomarkers of cartilage health in the intervention group. This is an exciting finding that gives hope to people with osteoarthritis.”

A Personalized Approach

Notably, the intervention was customized. Researchers determined whether a slight inward or outward adjustment would help each participant. This avoided the pitfalls of past studies, which applied the same method to all participants, sometimes worsening knee strain.

Personalization proved critical. As Uhlrich emphasized, “We used a personalized approach to selecting each individual’s new walking pattern, which improved how much individuals could offload their knee and likely contributed to the positive effect on pain and cartilage.”

While promising, gait retraining is not yet widely available in clinical practice. Current methods rely on expensive motion-capture systems. However, researchers envision a future where physical therapists can prescribe these adjustments using affordable tools such as smartphone video analysis or “smart shoes” equipped with sensors.

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