jueves, 14 de noviembre de 2019

Is a Plant-Based Diet Good for Type 2 Diabetes?

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By Dr. Sanchari Sinha Dutta, Ph.D.Reviewed by Dr. Jennifer Logan, MD, MPH

Type 2 diabetes is the most common form of diabetes, and it is usually diagnosed in adults. It accounts for about 90% of all diabetes incidences. Because of the increasing prevalence of obesity, poor diet, and sedentary lifestyle, the number of diabetes cases is rising among children, adolescents, and young adults. According to the International Diabetes Federation (IDF), the number of diabetes patients will reach 642 million by 2040.

The primary cause of type 2 diabetes is insulin resistance, wherein the body’s cells stop responding to insulin, leading to elevation of blood glucose level and secretion of more insulin from the pancreas. Due to the over production of insulin, the pancreas eventually gets exhausted, causing a gradual reduction in insulin production and secretion and a simultaneous increase in blood glucose level.

The most effective strategies for managing type 2 diabetes are adopting a healthy lifestyle, including healthy food habits, regular exercise, and good body weight management.

Is a plant-based diet good for type 2 diabetes management?

Dietary habits play a significant role in insulin resistance, especially for people who are physically inactive. Too much consumption of high-calorie foods, such as fast foods, fatty meats, refined grains, fried foods, and sweetened foods/beverages is believed to be the most considerable cause of increasing prevalence of diabetes worldwide.

According to the scientific literature, a plant-based diet comprised primarily of vegetables, fruits, legumes, seeds, nuts, and whole grains is very effective in managing type 2 diabetes, as well as reducing comorbidities, such as obesity, hypertension, cardiovascular problems, kidney disorders, and hyperlipidemia.

Consumption of animal products is associated with fat deposition in body cells, which interferes with the normal insulin’s function of transporting glucose from the blood into the cells. This subsequently increases the glucose level in the blood, leading to development of hyperglycemia and type 2 diabetes. Because a plant-based diet contains very little saturated fat, fat deposition is reduced and insulin function can be maintained. It has been found that the prevalence of type 2 diabetes is 2.9% among vegan people, whereas the prevalence is 7.8% among people who mostly eat animal products.

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Hormones released from the small intestine (incretin hormones), such as glucagon-like peptide -1 and gastric inhibitory peptide, play an important role in managing overall glucose metabolism and maintaining glucose homeostasis. A plant-based diet helps increase the secretion of incretin hormones and improve the pancreatic beta cell function, insulin release, and insulin sensitivity.

Apart from managing diabetes well, a plant-base diet can reduce the risk of developing type 2 diabetes as it contains high amounts of antioxidants, micronutrients, fibers, and unsaturated fatty acids, which are known to have protective effects against diabetes. It has been found that the level of glycated hemoglobin (HbA1C), which is a biomarker to define impaired glucose metabolism, remains stable in diabetic patients who follow a strict vegetarian diet. In addition, a plant-based diet has positive effects on many secondary factors related to diabetes, including physical/emotional distress, quality of life, body weight, total cholesterol, and low-density lipoprotein (LDL) cholesterol.

A plant-based diet together with regular physical exercise not only improves diabetic condition but also reduces the need for medicines. In comparison to conventional diabetic diet, which only restricts calorie and carbohydrate intake, a plant-based diet is three times more effective in controlling blood glucose level.

Interestingly, a plant-based diet comprising high-carbohydrate and high-fiber also causes better management of glycemic status, as well as reduction in total cholesterol and triacylglycerol levels, leading to improvement in diabetic conditions. These effects are mainly due to the presence of low-glycemic index foods (whole grains, fruits, nuts, and legumes) in plant-based diets. The carbohydrates present in low-glycemic foods are digested, absorbed, and metabolized at a slow rate; thereby, causing a comparatively lower increase in blood glucose level. Another benefit of such foods is that it allows intake of high amount of carbohydrate to replace animal products, without the fear of increasing glycemic status.

Persons with diabetes should speak to their physician or a dietician about how to design an individualized diet to maximize nutritional health benefits. Although not everyone wishes to consume a plant-based diet, small changes to increase the proportion of plants and decrease the proportion of animal products in the diet can benefit both glucose control and risk of heart disease.

Sources

Kahleova H. 2019. A Plant-Based Meal Stimulates Incretin and Insulin Secretion More Than an Energy- and Macronutrient-Matched Standard Meal in Type 2 Diabetes: A Randomized Crossover Study. Nutrients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471274/
Trapp C. 2012. Preparing to Prescribe Plant-Based Diets for Diabetes Prevention and Treatment. Diabetes Spectrum. https://spectrum.diabetesjournals.org/content/25/1/38
Toumpanakis A. 2018. Effectiveness of plant-based diets in promoting well-being in the management of type 2 diabetes: a systematic review. BMJ Open Diabetes Research and Care. https://drc.bmj.com/content/6/1/e000534