Several observational cohort studies and a secondary prevention trial have shown a protective effect of a Mediterranean diet on cardiovascular disease. The latest results of the PREDIMED study (PREvención con DIeta MEDiterránea), which included 7,447 high cardiovascular risk participants followed up for a mean of 5 years, have confirmed that a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of cardiovascular events by 30%. This protective effect of the Mediterranean diet has been attributed to their actions on insulin sensitivity, blood pressure, lipid profile, oxidative stress, and inflammatory biomarkers related to atherosclerosis. These effects are independent of polymorphisms related to lipid changes or inflammatory response, a fact that confirms that Mediterranean diet is a useful tool in the prevention of cardiovascular disease and its main risk factors, including diabetesien