Santorini, Greek seaside
Blood markers of inflammation in our bodies are linked to higher rates of type 2 diabetes. One such marker is C-reactive protein: the higher the CRP, the greater the risk of T2 diabetes. Another inflammatory marker is adiponectin, a protein secreted by fat cells. Adiponectin levels are inversely related to ongoing inflammation: higher levels of adiponectin indicate lower levels of inflammation. Folks with higher adiponectin levels are at lower risk of type 2 diabetes.
Italian researchers affiliated with the MEDITA clinical trial took 215 men and women with newly diagnosed type 2 diabetes and randomized them to eat either a Mediterranean diet or a low-fat diet. Hemoglobin A1c and inflammatory markers were followed for up to eight years. (I’m not sure, but I think these were relatively mild diabetics from the get-go, probably with HgbA1c under 7%.)
At the end of year one, CRP dropped by 37% and adiponectin rose by 43% in the Mediterranean diet group. In other words, inflammatory markers moved in a healthful direction.
Levels in the low-fat group were unchanged.
For individual Mediterranean dieters who were deemed diet failures (HgbA1c over 7%) at one year, CRP levels were higher and adiponectin levels were lower than their counterparts without diet failure.
Values were also measured two and four years after baseline, but results are not easy to summarize, and I don’t give too much credence to a diet modification purported to last that long. After six to 12 months of a new diet, most folks drift back to their usual way of eating.
Grapes are a time-honored component of the Mediterranean diet
Action Plan
If you have type 2 diabetes or want to avoid it, consider a Mediterranean-style diet.
Steve Parker, M.D.
PS: Even if you think inflammation is important, you’ll find no shortage of chapters in my books.
Reference: Anti-inflammatory effect of Mediterranean diet in type 2 diabetes is durable: 8-year follow-up of a controlled trial. Diabetes Care, 2016. doi: 10.2337/dc15-2356
Front cover of book
Diabetic Mediterranean Diet 
I was in Italy and their Mediterranean Diet was made up of meat, fish, chicken, pasta, vegetables, cheese in relatively small portions (compared to the US) and wine (mostly red).
Since most Italians eat this way, I’m surprised the Italian scientists found low fat subjects.