If you don’t already know it, plant based diets are something I throughly believe in. I have seen, not only in myself but in others, the benefits of plant based diets, and these benefits are shown in my personal experiences and scientific studies too. I have recently began working in the field of diabetes research and I wondered what effects plant based diets have on type 2 diabetes. If they are so helpful for improving health, I am curious to see what effects they have on disease prevention and treatment. In this blog post I decided to do some research for myself to see what current evidence is available.
I searched for systematic reviews and meta analysis's. Basically, these are research terms for researchers who gather data on smaller clinical trials and put all the findings together to form a more robust and solid conclusion on the topic at hand. I didn’t want this to be biased, meaning I didn’t want to find only those research papers that agreed with my ideas. So I included every paper in this blog that has been released in the last five years, regardless of the results they found. This totalled 9 research papers. If you are someone who has diabetes, or someone who has family members with diabetes, you may find this article helpful in directing the course of your own health.
Overall, plant based diets were found by multiple research papers to be beneficial in preventing, treating and reversing type 2 diabetes [1, 2, 3, 4, 5, 6]. However this link was stronger in those people from western regions of the world [1]. This has been either comparable or even more beneficial than a conventional diet [3]. However, almost every paper stated that more research needs to be done to explore the causalities and relationships between the types of food consumed and the mechanisms in the body associated with diabetes risk [3]. Particularly, this longer term research needs to be carried out before public recommendations for those with type 2 diabetes can be amended [7].
A plant based diet has shown to be beneficial on weight status, including weight loss, reduction in waist circumference, adiposity and BMI in patients with type 2 diabetes [3, 5, 7]. Plant based diets have been associated with significant improvement in physical wellbeing when compared with standard healthy eating models [2]. It has also shown to have beneficial effects on energy metabolism [3].
Many papers found that plant based diets could significantly improve markers of glycemic control and glucose homeostasis in people with type 2 diabetes or who were pre-diabetic when compared with standard healthy eating models [2, 5, 6, 7, 8]. These markers included HbA1c, fasting glucose and insulin sensitivity [2, 5, 7]. Not only this, plant based diets have shown a significant improvement in cholesterol levels when compared with standard healthy eating diets which supports the inclusion of plant based diets in diabetic management or prevention, due to the cardiovascular risks associated with diabetes complications [2, 5].
Some other benefits of plant based diets for people with type 2 diabetes were reduced systemic inflammation [3] and increased mental wellbeing [2]. However, it is suggested that there is a lack of research on the cognitive effects of a plant based diet, which needs to be explored further before we can recommend a plant based diet to people who are diabetic or pre-diabetic [3]. There were speculations on why these beneficial effects may be happening. One conclusion was that the plant based diet has beneficial effects on the gut microbiome and this then has an impact on overall health [3]. However, once again, there needs to be more research on these concepts [3]. This theme of ‘the need for further research’ continued in many of the papers I looked at.
The beneficial effects presented here, were understandably proven even stronger when the type of plant based diet was filled with healthy plant based foods, such as fruits, vegetables, whole grains, legumes, and nuts [4, 9]. This finding is called a dose response. This means that the more of something you do/consume, the more likely a certain effect on your health will occur. This is great for those people who are interested in improving their health, but aren’t interested in eating a completely plant based diet. They are able to get similar health benefits by eating a mostly plant based diet and having meat and dairy items as a one off treat. Most research papers went on to suggest that there should be more investigation into the length of time people followed a vegetarian diet through long term studies and the type of foods they ate [1, 5, 9].
Where papers did not find such clear benefits, they found a plant based diet was helpful but not necessarily better than other conventional healthy diets. They highlighted the importance of the type of foods that were involved in a plant based diet as opposed to the plant based nature of the diet itself [9]. Due to the exclusion of certain food groups in a plant based diet, more care should be taken when following this way of eating, particularly in vulnerable groups such as the elderly, adolescents, pregnant and breastfeeding women [6]. This shows that simply following a plant based diet, may not be enough, but that focusing on whole foods, fruits and vegetables, healthy grains, legumes and nuts may be more likely to reduce diabetes risk.
Although more long-term intervention trials are required, mounting evidence supports the view that vegan and vegetarian dietary patterns should be implemented in public health strategies, in order to better control glycemic markers in individuals with type 2 diabetes [7]. Plant based diets have been associated with significant improvement in quality of life when compared with standard health eating models and this is something that shouldn't be overlooked [2].
Overall, the general findings for a plant based diet and diabetes prevention and treatment were really positive. Naturally, more research needs to be done to look at the long term effects of a plant based diet. Care should be taken in certain groups such as the elderly, adolescents, pregnant and breastfeeding women to ensure that food groups and nutrients aren't excluded which could cause deficiencies. If you are interested in taking control of your health, a plant based diet could be the way. Before making any decisions, speak to your GP or diabetic nurse to make sure that it is something that would benefit you. They can support you in your journey. Get involved online, ask questions and get the word out there as the more people talking about it, the more likely further research will be carried out.
I hope you found this useful! Please like, share and comment. Let me know how you get on with your health journey.
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You’ve got this!
Lottie x
References:
[1] Lee, Y. and Park, K. (2017) ‘Adherence to a Vegetarian Diet and Diabetes Risk: A Systematic Review and Meta-Analysis of Observational Studies’, Nutrients, 9 (6), pp. 603.
[2] Toumpanakis, A., Turnbull, T. and Alba-Barba, I. (2018) ‘Effectiveness of plant based diets in promoting well-being in the management of type 2 diabetes: a systematic review’, BMJ Open Diabetes Res Care, 6 (1), pp. e000534.
[3] Medawar, E., Huhn, S., Villringer, A. and Witte A. (2019) ‘The effects of plant based diets on the body and the brain: a systematic review’, Transl Psychiatry, 9 (1), pp. 226.
[4] Qian, F., Liu, G., Hu, F., Bhupathiraju, S. and Sun, Q. (2019) ‘Association Between Plant based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis’, JAMA Intern Med, 179 (10), pp.1335-1344.
[5] Viguiliouk, E., Kendall, C., Kahleová, H., Rahelić, D., Salas-Salvadó, J., Choo, V., Mejia, S., Stewart, S., Leiter, L., Jenkins, D. and Sievenpiper, J. (2019) ‘Effect of vegetarian dietary patterns on cardiometabolic risk factors in diabetes: A systematic review and meta-analysis of randomized controlled trials’, Clin Nutr, 38 (8), pp. 1133-1145. [6] Pollakova, D., Andreadi, A., Pacifici, F., Della-Morte, D., Lauro, D. and Tubili, C. (2021) ‘The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review’, Nutrients, 13 (6), pp. 2123.
[7] Papamichou, D., Panagiotakos, D. and Itsiopoulos, C. (2019) ‘Dietary patterns and management of type 2 diabetes: A systematic review of randomised clinical trials’, Nutr Metab Cardiovasc Dis, 29 (6), pp. 531-543.
[8] Johannesen, C., Dale, H., Jensen, C. and Lied, G. (2020) ‘Effects of Plant based Diets on Outcomes Related to Glucose Metabolism: A Systematic Review’, Diabetes Metab Syndr Obes, 13, pp. 2811-2822.
[9] Tran, E., Dale, H., Jensen, C. and Lied, G. (2020) 'Effects of Plant based Diets on Weight Status: A Systematic Review’, Diabetes Metab Syndr Obes’, 13, pp. 3433-3448.
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