The Mediterranean diet supplemented with extra-virgin olive oil or nuts resulted in a 30% lower risk of cardiovascular disease events compared to the control group. The Mediterranean diet supplemented with extra-virgin olive oil resulted in a 40% lower risk of developing diabetes, while the Mediterranean diet with nuts had a smaller, non-significant reduction in diabetes risk. The Mediterranean diet, with or without supplements, led to improvements in various cardiovascular disease risk factors such as blood pressure, insulin sensitivity, lipid profiles, inflammation, and atherosclerosis. Here, INS is linked to atherosclerosis.