Review published in Advances in Nutrition finds plant-based diets may help prevent new cases of diabetes and better manage symptoms for existing cases
According to the CDC’s 2020 National Diabetes Statistics Report, 13% of the US adult population have diabetes. If current trends continue, by the year 2050, that figure is projected to climb to between 21% and 33% of the adult population. Most of these cases are projected to be type 2 diabetes, which currently accounts for 90% to 95% of all diabetes cases.
The American Diabetes Association estimates the cost of treating diagnosed diabetes in the US at $327 billion dollars annually. The CDC, however, estimates that more than one-fifth of Americans with diabetes have not been diagnosed. The actual healthcare costs associated with diabetes therefore is likely significantly higher.
Because there is no known cure for diabetes, prevention is key. Given the high prevalence of diabetes, however, finding low-cost treatment and disease management options is also critical. A Perspective published in Advances in Nutrition, “Plant-Based Eating Pattern for Type 2 Diabetes Prevention and Treatment: Efficacy, Mechanisms, and Practical Considerations” offers strong evidence based on a review of the current scientific research that “a plant-based eating pattern is associated with a reduced risk of developing type 2 diabetes and is highly effective in its treatment.”
According to the Perspective authors, “observational studies in widely diverse locales have identified large reductions in diabetes risk among populations consuming vegan and vegetarian eating patterns compared with other dietary patterns.” As an example, the authors pointed to the Adventist Health Study-2, which was launched in 2002 and includes data from more than 60,000 study participants. In this long-term cohort study, the prevalence of diabetes was 49% less among vegans and 46% less among lacto-ovo vegetarians compared with non-vegetarians.
In addition to lowering the risk of developing type 2 diabetes, there is also evidence that plant-based diets, particularly vegan diets, can be effective in treating and managing type 2 diabetes by improving glycemic control, body weight, and cardiovascular risk factors. A meta-analysis of six randomized controlled trials involving 255 study participants with type 2 diabetes, for example, demonstrated that vegetarian diets were associated with a greater reduction in glycated hemoglobin, a standard measure of blood glucose, when compared with other eating patterns.
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Diets such as the Mediterranean Diet and the DASH diet, which are not vegetarian, but nonetheless emphasize the consumption of fruits, vegetables and whole grains, may also be effective in the prevention and treatment of type 2 diabetes. Research, however, is limited. The authors have therefore stated, “high-quality studies comparing vegan and vegetarian eating patterns with DASH and/or the Mediterranean eating patterns would provide more detail on how various eating patterns affect diabetes outcomes.”
The beneficial effects of a plant-based diet, of course, only work if the patient adheres to the diet. According to one study cited by the authors, “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.” Moreover, a plant-based diet does not require limits on calories, carbohydrates, or portions. Most patients therefore find it to be no more challenging than other therapeutic diets.
In conclusion, the authors of this Advances in Nutrition Perspective believe “health care providers should feel confident in counseling their patients to follow a plant-based eating pattern and should be prepared to provide education and support to improve their patients’ diabetes outcomes, general health, and psychological well-being.”
Meghan A Jardine, Hana Kahleova, Susan M Levin, Zeeshan Ali, Caroline B Trapp, Neal D Barnard, Perspective: Plant-Based Eating Pattern for Type 2 Diabetes Prevention and Treatment: Efficacy, Mechanisms, and Practical Considerations, Advances in Nutrition, 2021;, nmab063, https://doi.org/10.1093/advances/nmab063.
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