Fresh fruit and vegetables, whole grains, fish, olive oil and wine are the makings of a great meal. Now, they may also be the prescription to help prevent Type 2 diabetes. A large new study published in the British Medical Journal finds that people who adhered closely to a traditional Mediterranean diet, which is also low in meat and dairy products, had "substantial protection" against the disease.

That's good news for those who like to eat a variety of foods. The Mediterranean diet's culinary foundation features popular foods that are good for the palate, especially tempting for those who have struggled to adhere to either more spartan low-fat diets or very low-carbohydrate Atkins approaches in recent years.

"The Mediterranean diet has been around for thousands of years for a good reason," says Michael Ozner, professor of medicine at the University of Miami. "At the end of the day, satiety is what is important."

So, of course, is health. It appears from a number of major clinical trials that the Mediterranean approach can provide both. Not only does this way of eating help lead to a healthier body weight, but there's strong evidence that a Mediterranean diet can lower the risk of heart disease, reduce some types of cancer and perhaps even cut the risk of Alzheimer's disease.

Mediterranean ingredients seem to produce these benefits by reducing inflammation, a chronic condition that produces high levels of substances known to accelerate aging and contribute to several ailments, including arthritis.

Now the newest findings underscore the added benefits that the Mediterranean diet can have in reducing Type 2 diabetes, a condition where the pancreas does not make enough insulin, or what it does produce is ineffective, and that in turn produces dangerously high levels of blood sugar. This disease, once seen only in older people but now covering most age groups thanks to the obesity crisis, is reaching epidemic proportions throughout the world.

Previous research has suggested that the Mediterranean diet could help reduce diabetes risk in those who already have health problems. But this is one of the first studies to look at the effects in healthy people.

In 1999, researchers at the University of Navarra in Pamplona, Spain, began recruiting about 13,000 university graduates, ages 20 to 90, to participate in the study. Participants answered extensive questionnaires about their diet, lifestyle, risk factors and medical status. Follow-up questionnaires were sent every two years over the next four years.

The study found that those who most closely adhered to the traditional Mediterranean diet had the lowest risk of developing Type 2 diabetes. This held true even for those who were older, heavier and had a family history of Type 2 diabetes -- all factors that placed them at increased risk for the disorder.

Instructions and a wager

Those findings don't surprise Ozner, who has been prescribing a Mediterranean approach to his patients for years. He regularly gives his patients a set of instructions and recipes to try for a month and throws in a $1 bet: If the food doesn't taste as good, takes longer to prepare or costs more than what they have been eating, Ozner will pay up.

"Ninety-nine percent of the time, I don't have to pay the bet," says Ozner, who has since compiled his instructions into "The Miami Mediterranean Diet" (Benbella Books; $24.95).

Even so, Ozner is quick to note that the traditional Mediterranean approach doesn't simply mean liberally pouring olive oil on foods and drinking a lot of wine -- common misconceptions. Olive oil adds 120 calories per tablespoon. Wine is beneficial only in moderation, which means one drink a day for women; two for men. (A drink is equal to 5 ounces of wine, 12 ounces of beer or 1.5 ounces of distilled spirits.)

The olive oil is used for cooking and flavoring, rather than butter or oils with unhealthy trans fatty acids. Red meat and dairy products are eaten sparingly. Processed or fast food is not on the menu. Daily physical activity is also a key part of the Mediterranean lifestyle.

"Of all the diets that are out there," Ozner says, "the Mediterranean diet has been one of the most studied and it has shown in clinical trials to reduce the risk of heart disease, cancer and overall mortality."

In other words, a delicious way to eat -- and be -- healthy.

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