The prevalence of type 2 diabetes is rising worldwide, especially in older adults. Diet and lifestyle, particularly plant-based diets, are effective tools for type 2 diabetes prevention and management. Plant-based diets are eating patterns that emphasize legumes, whole grains, vegetables, fruits, nuts, and seeds and discourage most or all animal products. Cohort studies strongly support the role of plant-based diets, and food and nutrient 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. Optimal macronutrient ratios for preventing and treating type 2 diabetes are controversial; the focus should instead be on eating patterns and actual foods. However, the evidence does suggest that the type and source of carbohydrate unrefined versus refined, fats monounsaturated and polyunsaturated versus saturated and trans, and protein plant versus animal play a major role in the prevention and management of type 2 diabetes. Multiple potential mechanisms underlie the benefits of a plant-based diet in ameliorating insulin resistance, including promotion of a healthy body weight, increases in fiber and phytonutrients, food-microbiome interactions, and decreases in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron. Type 2 diabetes is a global epidemic, with approximately million cases worldwide and a rapidly rising prevalence in middle- and low-income countries. Dietary choices are a key driver of insulin resistance, especially in an aging, more sedentary population.
In a recent week randomised trial 1, researchers from the PCRM Physicians Committee for Responsible Medicine demonstrated that a plant-based diet improves factors that can lead to the development of type 2 diabetes in overweight adults. The specific markers looked at were beta-cell function and fasting insulin resistance. Impairment of pancreatic beta-cell function is a key factor in type 2 diabetes 2. It is typically preceded by insulin resistance in both muscle cells and liver cells. This study wanted to test whether a plant-based vegan diet intervention alone without restricting calories or specific macronutrient intake could improve beta-cell function and insulin sensitivity. That is, the subjects in both the intervention group and the control group were not expected to reduce the calories they consumed each day. And while the subjects were overweight, they were not yet classified as being diabetic. Testing its level in the blood can help evaluate endogenous production made by the body itself and help to differentiate it from exogenous insulin from outside the body. The dietary intervention produced significant increases in meal-stimulated insulin secretion and beta-cell glucose sensitivity, along with decreased fasting insulin resistance and decreased fasting and postprandial plasma glucose concentrations, in individuals with no history of diabetes.
Acceptability of a low-fat vegan diet compares favorably to a step II diet in a randomized, controlled trial. Reply to comment 58 by Glynna Schmehl. Serum concentrations of cholesterol, apolipoprotein A-I and apolipoprotein B in a total of meat-eaters, fish-eaters, vegetarians and vegans. Literally millions of people throughout human history have fasted without problems. I agree. Obes Rev.