Few chronic diseases are studied more than type 2 diabetes.
It is one of the most common chronic diseases worldwide, with an estimated 462 million people living with the disease in 2017. The global disease burden is expected to grow by 17% of the current numbers by 2030.
From a public health perspective, these numbers are alarming; clinicians, researchers, governments, the private sector, and public health professionals express an urgent need to identify effective prevention and disease management strategies.
Diet has long been considered an effective diabetes prevention and management strategy. Still, chronic disease professionals have engaged in an ongoing debate about which dietary regimens are most effective and realistic for people to adopt as a strategy.
The plant-based diet may be a potential dietary prescription for people who are at risk for or living with type 2 diabetes. The research examining its effectiveness is piling up, and you might be wondering what the latest research says and whether it might be a realistic option for your clients.
In this article, we review the most recent research and guidelines around plant-based diets for type 2 diabetes prevention and management.
Research Findings on Plant-Based Diets for Type 2 Diabetes
Plant-based diets may help prevent and manage type 2 diabetes, but macronutrient sources are important to consider.
Plant-based diets emphasize the consumption of legumes, whole grains, vegetables, fruits, nuts, and seeds significantly over animal-sourced foods. Researchers McMacken and Shah reviewed the clinical evidence behind the relationship between plant-based diets and diabetes prevention and the use of plant-based diets as part of a diabetes treatment strategy. After looking into the detailed evidence generated by dozens of studies, the positive effect of plant-based diets on diabetes prevention and treatment strategies is undeniable.
The researchers emphasize that plant-based diets generally maximize protective foods like fruits, vegetables, legumes, nuts, and seeds, but they also exclude animal-based foods that tend to promote insulin resistance.
However, the researchers point out that the macronutrient composition of plant-based diets is an important factor to consider. When individuals equate the lack of animal-sourced ingredients in their food with health without consideration for nutrient composition, they may overlook the effects of macronutrient sources on their health.
In other words, plant-based diets do not necessarily exclude ultra-processed foods, saturated fats, and refined carbohydrates from the diet. Regardless of the source, diets rich in these types of food may increase a person’s risk of developing diabetes.
On a population level, plant-based diets are associated with a 16 to 34% lower risk of developing type 2 diabetes and other improved health outcomes.
A group of researchers at the Department of Nutrition of the Harvard T.H. Chan School of Public Health took data from three cohort studies and examined dietary data to create a plant-based index to quantify the relationship between the consumption of plant-based foods and type 2 diabetes health outcomes. In total, researchers analyzed data from more than 200,000 male and female health professionals across the US for more than 20 years.
The researchers found that having a diet that emphasized plant foods and was low in animal foods was associated with a 20% reduction in the risk of developing type 2 diabetes.
In people who followed diets that emphasized the consumption of healthy plant foods, there was a 34% decrease in diabetes risk compared to those who consumed non-plant-based diets.
People who followed diets with a significant proportion of unhealthy plant-based foods still had a 16% lower risk of developing diabetes than those that consumed non-plant-based diets.
The authors of this research paper also highlight that plant-based diets may include less-healthy plant foods and synthetic foods and additives. They remind public health professionals to continue to work to create healthy food environments and to individualize recommendations.
Comprehensive literature reviews support the use of plant-based diets as a form of medical nutritional therapy for type 2 diabetes management.
The Canadian Diabetes Association has included plant-based diets among the dietary patterns recommended as medical nutritional therapy for people living with type 2 diabetes.
Researchers from the Division of Food and Nutritional Sciences at Brescia University College at Western University in Ontario, Canada, conducted a comprehensive literature review to provide background and rationale to support the use of plant-based diets as therapy for people living with type 2 diabetes.
The literature review identified that plant-based diets:
- Are associated with a lower prevalence of type 2 diabetes
- Are equally, if not more effective than other diabetes diets in improving body weight, cardiovascular risk factors, insulin sensitivity, glycated hemoglobin levels, oxidative stress markers, and renovascular markets
- Had acceptability comparable to other diabetes diets
- Led to a reduction in the need for diabetes medications
The researchers did identify some potential roadblocks for the adoption of plant-based diets on community levels. They recommended that healthcare centers and professionals develop educational materials and programs focused on plant-based diets and individual counseling sessions that help to address barriers to change.
Plant-based diets together with support may improve the self-management of diabetes in medically underserved communities.
Medically underserved communities are at a disadvantage when it comes to receiving support for chronic diseases like type 2 diabetes. Type 2 diabetes management often implies frequent visits to dietician and physician offices, which are inaccessible and inconvenient in some communities; BIPOC, rural, and low-income communities are those most at risk of living in medically underserved areas.
Researchers from Loma Linda University examined whether plant-based diets coupled with a 5-week educational support program would improve the A1c of Latinos living in a medically underserved community.
Researchers found that six months after initiating the intervention, those who had received educational support on the plant-based diet had significantly lower A1c levels than those who continued with their regular diet.
Plant-based diets may reduce the need for diabetes medication.
Research published in the Journal of the American College of Nutrition examined whether eating a plant-based diet reduced the need for diabetes medication. It reviewed several clinical studies that included people living with type 2 diabetes who had their medication discontinued or decreased after adopting a plant-based diet.
While the researcher noted that there is a lack of studies that examine the effect of plant-based diets on the need for medication, the available evidence suggests that plant-based diets may reduce the need for diabetes medication. He notes that, while the recommendation must be examined on a case-by-case basis, the information may be a motivational or decisive factor for people with type 2 diabetes to adopt and sustain a plant-based diet.
Main Takeaways: Weighing the Evidence and Taking Action
Type 2 diabetes is a complex condition that may develop as a result of combined genetic, autoimmune, lifestyle, and trauma-related factors. Diabetes management plans often include a dietary component, where suggested food patterns prioritize the consumption of foods with low to moderate effects on blood glucose and minimize or eliminate the consumption of foods that produce spikes in blood glucose.
The plant-based diet is one of the recommended dietary regimens for people living with type 2 diabetes. Whether you are a person at risk of or diagnosed with type 2 diabetes, or you are a health coach looking to be of support to your client living with type 2 diabetes, a plant-based diet may be an effective option. However, if the individual did not previously follow a plant-based diet, it is important to consider the financial, social, cultural, and psychological impact of adopting a plant-based diet as a long-term diabetes prevention or management strategy.
If you or your client determine that adopting a plant-based diet is unrealistic or too jarring of a change, you can consider taking small but significant steps to increase the consumption of foods that help to manage blood glucose and minimize the consumption of foods that cause it to spike.
Additionally, remember that diet is only one component of a diabetes management plan. Small steps in the right direction in terms of eating habits and physical activity, in addition to measuring glucose and taking any medications as directed, work together to support people with diabetes to live healthy and fulfilling lives.