Plant-Based Diets: Impact On Type 2 Diabetes

A plant-based diet is associated with a reduced risk of developing type 2 diabetes and is highly effective in its treatment. Diets that emphasise whole grains, vegetables, fruits, and legumes and exclude animal products improve blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure.

A study found that a low-carbohydrate diet comprised primarily of plant-based foods was significantly associated with lower risk of premature death among people with type 2 diabetes. The health benefits were stronger for low-carbohydrate diets that emphasised plant-based foods and high-quality carbohydrates, such as fruits, vegetables, and whole grains.

Another study found that a whole-food, plant-predominant diet could result in type 2 diabetes remission. The study showed an average reduction of glucose-lowering medications among patients who implemented these changes in their lifestyles.

Plant-based diets are associated with a reduced risk of developing type 2 diabetes

Observational studies have shown that plant-based diets are associated with a lower prevalence of type 2 diabetes. For example, the Adventist Health Study 2 examined disease prevalence by different eating patterns and found that the prevalence of type 2 diabetes was lowest among vegans, at 2.9%. The study also found that semi-vegetarians experienced intermediate benefit.

The benefits of plant-based diets in treating type 2 diabetes have been demonstrated in intervention studies. For example, a randomised clinical trial found that a low-fat vegan diet improved glycemic control and cardiovascular risk factors in individuals with type 2 diabetes. The vegan group had a significantly greater reduction in HbA1c (1.23% compared with 0.38%, P = 0.01) and weight loss (–6.5 kg compared with –3.1 kg, P < 0.001) compared to the control group.

Plant-based diets are thought to reduce the risk of developing type 2 diabetes and improve outcomes for those with the condition through a variety of mechanisms. These include:

• Promotion of a healthy body weight
• Increases in fibre and phytonutrients
• Food-microbiome interactions
• Decreases in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron

Plant-based diets are highly effective in the treatment of type 2 diabetes

Type 2 diabetes is a global health challenge affecting hundreds of millions of people worldwide. In the US alone, the number of people with diabetes is expected to increase to 578 million by 2030. Diabetes is a major cause of death and disability, and it is also a leading cause of cardiovascular and microvascular complications.

Plant-based diets for the prevention and treatment of type 2 diabetes

A plant-based diet is associated with a reduced risk of developing type 2 diabetes and is highly effective in its treatment. Plant-based diets that emphasise whole grains, vegetables, fruits, and legumes and exclude animal products improve blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure. They also play an important role in reducing the risk of cardiovascular and microvascular complications.

Observational studies have found that populations consuming vegan and vegetarian eating patterns have a significantly lower risk of developing diabetes compared to those consuming non-vegetarian diets. For example, in the Adventist Health Study, men and women who consumed meat had a 97% and 93% greater risk of developing diabetes, respectively, compared to vegetarian participants.

A plant-based diet is also effective in treating type 2 diabetes. A meta-analysis of six randomised controlled trials found that vegetarian diets were associated with a 0.4% greater reduction in glycated haemoglobin (HbA1c) when compared with other prescribed eating patterns for diabetes.

Mechanisms by which plant-based diets improve body weight, insulin sensitivity, and β-cell function

Insulin resistance and impaired β-cell function are the hallmarks of type 2 diabetes pathophysiology. Plant-based diets are beneficial for patients with diabetes by improving insulin sensitivity and body weight.

Plant-based diets may also improve β-cell function. In a randomised trial, participants who were overweight or obese were assigned to a low-fat plant-based diet or no diet changes for 16 weeks. The meal-stimulated insulin secretion markedly increased in the intervention group compared with controls.

Weight management and plant-based diets

Weight management plays an important role in improving insulin sensitivity and glycemic control and reducing cardiovascular disease (CVD) risk factors. Individuals following vegetarian, especially vegan, diets have lower mean BMIs compared to non-vegetarians.

Plant-based diets for macrovascular and microvascular complications of diabetes

The effects of plant-based diets on glycemia, body weight, plasma lipids, and blood pressure collectively reduce the risk of CVD, the leading cause of morbidity and mortality in diabetes patients.

Practical considerations for the use of a plant-based diet for diabetes

Caregivers should help patients who have (or are at risk of) diabetes to understand the benefits of a plant-based eating pattern and encourage a trial. Patients are typically willing to try a plant-based diet when its rationale has been explained, and they can adapt nutrition guidelines to suit their preferences.

Plant-based diets improve blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure

A plant-based diet is associated with a reduced risk of developing type 2 diabetes and is highly effective in its treatment. Plant-based diets improve blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure.

Plant-based diets are eating patterns that emphasise whole grains, vegetables, fruits, legumes, nuts, and seeds, and discourage most or all animal products. Plant-based diets are highly effective in the treatment of type 2 diabetes. Plant-based diets improve blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure.

Observational studies strongly support the role of plant-based diets, and components of plant-based diets, in reducing the risk of type 2 diabetes. Evidence from observational and interventional studies demonstrates the benefits of plant-based diets in treating type 2 diabetes and reducing key diabetes-related macrovascular and microvascular complications.

A plant-based diet is a whole-foods diet that includes legumes, whole grains, fruits, vegetables, and nuts. All of these elements have been found to be protective against diabetes. Whole grains, including whole-grain bread, whole-grain cereals, and brown rice, have been associated with reduced risk of developing diabetes; specific fruits and vegetables, including root vegetables, green leafy vegetables, blueberries, grapes, and apples, have been linked to lower diabetes rates. Legumes have also been shown to ameliorate insulin resistance and protect against metabolic syndrome. Greater nut consumption has been associated with lower diabetes risk. Cereal fibre appears to be especially protective against type 2 diabetes.

Diets based on whole plant foods not only maximise protective foods but also exclude key animal-based foods that tend to promote insulin resistance, particularly processed and unprocessed red meat. Risk estimates from recent meta-analyses on meat consumption and type 2 diabetes range from 1.13 to 1.19 per 100 g of total red meat per day and from 1.19 to 1.51 per 50 g of processed meat per day. Animal protein and animal fats have also been linked in both metabolic as well as large cohort studies to worsening insulin resistance and increased incidence of type 2 diabetes.

Plant-based diets are also associated with a reduction in diabetes-related complications. Plant-based diets have demonstrated improvements in glycemic control while also reducing macro- and micro-vascular risks of type 2 diabetes. Plant-based diets are highly beneficial for preventing and treating cardiovascular disease, the leading cause of premature mortality in the diabetic population. Plant-based diets are also associated with a reduction in diabetic nephropathy. Plant-based diets can also ameliorate diabetic neuropathic pain.

Plant-based diets tend to be low in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron dietary elements that have been associated with insulin resistance in epidemiologic and metabolic studies. Plant-based diets also tend to promote weight loss and lower adiposity, factors that are highly protective against insulin resistance. In contrast, meat consumption (including poultry) is highly predictive of obesity and weight gain over time.

Plant-based diets play an important role in reducing the risk of cardiovascular and microvascular complications

Plant-based diets are associated with a reduced risk of developing type 2 diabetes and are highly effective in its treatment. They improve blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure, and play an important role in reducing the risk of cardiovascular and microvascular complications.

Plant-Based Diets and Cardiovascular Complications

A plant-based diet is associated with a lower risk of developing type 2 diabetes and is highly effective in its treatment. It improves blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure. Plant-based diets are high in fibre, antioxidants, and magnesium and promote insulin sensitivity through loss of excess weight and maintenance of a healthier body weight.

The American Heart Association has published studies showing that eating a plant-based diet at any age may lower the risk for heart attacks and other types of cardiovascular disease. A plant-based diet can lower all-cause mortality and lower the risk of ischemic heart disease with reduced IHD-related mortality. It can also optimise blood pressure, glycemic and lipid control, and thus reduce the need for medications.

Plant-Based Diets and Microvascular Complications

Plant-based diets may also help reverse atherosclerotic plaques. A study demonstrated significant regression in coronary artery stenosis in patients with moderate to severe coronary artery disease. Participants were randomly assigned to usual care or a low-fat vegetarian diet combined with exercise, stress management, and smoking cessation. After 5 years, there was a mean reduction in atherosclerotic stenosis in the vegetarian group, whereas there was a progression of atherosclerosis in the control group.

Chronic kidney disease is increasingly prevalent, and diabetes accounts for 44% of all new cases. A Western dietary pattern, characterised by a high consumption of red meat, fat, salt, and sugar, is a major contributor to metabolic disturbances leading to the progression of kidney disease. A 24-year follow-up of 14,868 adults found that a higher adherence to a healthy plant-based diet was associated with a lower risk of chronic kidney disease.

Several studies have reported a reduction of urinary albumin excretion in patients with diabetic nephropathy when consuming a plant-based or reduced-red-meat diet. One study showed a 54% decrease in urinary albumin in patients with type 1 diabetes after 8 weeks of a plant-based diet.

Plant-based diets improve insulin sensitivity and β-cell function

Plant-based diets have been associated with a reduced risk of developing type 2 diabetes and are highly effective in its treatment. Diets that emphasise whole grains, vegetables, fruits, and legumes and exclude animal products improve blood glucose concentrations, body weight, plasma lipid concentrations, and blood pressure. They also play an important role in reducing the risk of cardiovascular and microvascular complications.

Plant-based diets are beneficial for patients with diabetes by improving insulin sensitivity and body weight. Insulin resistance is caused by lipid accumulation within muscle and liver cells, which can begin many years before a type 2 diabetes diagnosis. This lipid accumulation is highly responsive to diet changes.

High-fat diets downregulate the genes required for mitochondrial oxidative phosphorylation in skeletal muscle. They also appear to disrupt the normal intestinal barrier to bacterial endotoxins, which can enter the bloodstream and disrupt glucose oxidation processes. The effects of changes in fat intake on glycemic control can be observed not only after long-term interventions but also after single meals; high-fat meals can cause postprandial elevations in plasma glucose that can remain high for a long period.

Case-Control Studies

A case-control study compared 24 healthy vegans to 25 healthy omnivores matched for sex, age, BMI, body fat percentage, energy intake, and physical activity levels. Vegans had significantly lower intramyocellular lipid concentration, which was associated with 32% greater homeostatic model assessment of β-cell function.

Randomised Controlled Trials

A randomised trial assigned 75 participants who were overweight or obese to a low-fat plant-based diet or no diet changes for 16 weeks. Meal-stimulated insulin secretion markedly increased in the intervention group compared with controls. This study demonstrates the potential that a plant-based eating pattern can play a role in reversing β-cell dysfunction and peripheral insulin resistance in patients with type 2 diabetes.

Another randomised trial of individuals with type 2 diabetes found that a low-fat vegan diet prescribed with no energy-intake limits was associated with greater weight loss at 22 weeks compared with a conventional diet that required energy-intake restrictions.

A plant-based diet is a powerful tool for preventing, managing, and even reversing type 2 diabetes. Not only is this the most delicious "prescription" you can imagine, but it's also easy to follow. Unlike other diets, there's no calorie counting, no skimpy portions, and no carb counting. Plus, all the "side effects" are good ones.

Frequently asked questions