In the Look-AHEAD trial (Action in Health in Diabetes), intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes Participants (n=5145) were randomized to conventional therapy or an intensive lifestyle modification program that included a hypocaloric, low-fat diet; use of Table 12. Mediterranean Diet Used in the Primary Prevention of Cardiovascular Disease With a Mediterranean Diet Trial Mediterranean Diet Recommended Olive oil* 4 tbsp/d Tree nuts and peanuts 3 servings/wk Fresh fruits 3 servings/d Vegetables 2 servings/d Fish (especially fatty fish), seafood 3 servings/wk Legumes 3 servings/wk Sauce made with tomato and onion, slowly simmered with olive oil White meat Instead of red meat Wine with meals (socially, with moderation) Discouraged Soda drinks <1 drink/d Commercial bakery goods, sweets, and pastries Spread fats <1 serving/d Red and processed meats <1 serving/d CVD indicates cardiovascular disease. *The amount of olive oil includes oil used for cooking and salads and oil consumed in meals eaten outside the home. In the group assigned to the Mediterranean diet with extravirgin olive oil, the goal was to consume 50 g ( 4 tbsp) per day of the polyphenol-rich olive oil supplied, instead of the ordinary refined variety, which is low in polyphenols. Modified from Estruch et al.304 Copyright 2013, Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society. Bozkurt et al meal replacement products; 175 min/wk of physical activ- ity; and frequent visits with study personnel. Weight loss was greater in the intervention group than in the control group throughout the study (8.6% versus 0.7% at 1 year; 6.0% versus 3.5% at study end). 