The Role of Plant-Based Diets in the Management of Type 2 Diabetes

Authors

  • Heidi Dutton, MD, MSc, FRCPC, ABOM, ABLM Department of Medicine, University of Ottawa; Aroga Lifestyle Medicine Ottawa

DOI:

https://doi.org/10.58931/cdet.2023.1317

Abstract

A whole food plant-based (WFPB) diet is generally defined as a diet rich in fruits, vegetables, whole grains, legumes, nuts and seeds, and herbs and spices. Many define a WFPB diet as being exclusively plant-based with no animal products, excluding all red meat, poultry, fish, eggs, and dairy products. Other sources define it as a plant-forward dietary pattern that may still include small amounts of meat, eggs or dairy. A WFPB dietary pattern focuses on unprocessed plant foods, while avoiding processed foods containing refined grains, refined oils and added sugars. Figure 1 depicts an example of a balanced WFPB meal.

On a practical level, it is important to distinguish a WFPB diet from a vegan diet, which eliminates all animal products but may include processed vegan foods (e.g., plant-based meats, pastries and fried foods). However, in the scientific literature, the term “vegan” is often used, and at times it is difficult to assess the amount of processed food included in diets of vegans included in observational studies. This paper will focus primarily on the evidence for an exclusively WFPB dietary pattern in the prevention and management of Type 2 diabetes mellitus (T2DM) and obesity. However, given certain limitations in the literature, some data on vegan diets and plant-rich but not exclusively plant-based diets will also be included.

Author Biography

Heidi Dutton, MD, MSc, FRCPC, ABOM, ABLM, Department of Medicine, University of Ottawa; Aroga Lifestyle Medicine Ottawa

Dr. Heidi Dutton is an endocrinologist at The Ottawa Hospital in the Division of Endocrinology & Metabolism and an assistant professor at the University of Ottawa. She completed a clinical and research fellowship in Bariatric Medicine, as well as a Masters of Science degree in Clinical Epidemiology, both at the University of Ottawa. The focus of her practice is in the areas of weight management, bariatric medicine and lifestyle medicine. She works part time at The Ottawa Hospital and part time at Aroga Lifestyle Medicine Ottawa.

References

Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets. J Am Diet Assoc. 2003;103(6):748-765. DOI: https://doi.org/10.1053/jada.2003.50142

Sievenpiper JL, Chan CB, Dworatzek PD, et al, Committee DCCPGE. Nutrition therapy. Can J Diabetes. 2018;42:S64-S79. DOI: https://doi.org/10.1016/j.jcjd.2017.10.009

Tonstad S, Butler T, Yan R, et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care. 2009;32(5):791-796. DOI: https://doi.org/10.2337/dc08-1886

Satija A, Bhupathiraju SN, Rimm EB, et al. Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies. PLoS Med. 2016;13(6):e1002039. DOI: https://doi.org/10.1371/journal.pmed.1002039

Barnard ND, Cohen J, Jenkins DJ, , et al. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Am J Clin Nutr. 2009;89(5):1588S-1596S. DOI: https://doi.org/10.3945/ajcn.2009.26736H

Yokoyama Y, Barnard ND, Levin SM, et al. Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis. Cardiovasc Diagn Ther. 2014;4(5):373-382.

Campbell TM, Campbell EK, Attia J, et al. The acute effects of a DASH diet and whole food, plant-based diet on insulin requirements and related cardiometabolic markers in individuals with insulin-treated type 2 diabetes. Diabetes Res Clin Pract. 2023;202:110814. DOI: https://doi.org/10.1016/j.diabres.2023.110814

Roden M, Price TB, Perseghin G, et al. Mechanism of free fatty acid-induced insulin resistance in humans. J Clin Investig. 1996;97(12):2859-2865. DOI: https://doi.org/10.1172/JCI118742

Estadella D, Da Penha Oller Do Nascimento CM, Oyama LM, et al. Lipotoxicity: effects of dietary saturated and transfattyacids. Mediators Inflamm. 2013;2013:1-13. DOI: https://doi.org/10.1155/2013/137579

Goff LM, Bell JD, So PW, et al. Veganism and its relationship with insulin resistance and intramyocellular lipid. Eur J Clin Nutr. 2005;59(2):291-298. DOI: https://doi.org/10.1038/sj.ejcn.1602076

Anderson JW, Randles KM, Kendall CWC, et al. Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence. J Am Coll Nutr. 2004;23(1):5-17. DOI: https://doi.org/10.1080/07315724.2004.10719338

Lattimer JM, Haub MD. Effects of dietary fiber and Its components on metabolic health. Nutrients. 2010;2(12):1266-1289. DOI: https://doi.org/10.3390/nu2121266

Kim Y, Keogh J, Clifton P. A review of potential metabolic etiologies of the observed association between red meat consumption and development of type 2 diabetes mellitus. Metabolism. 2015;64(7):768-779. DOI: https://doi.org/10.1016/j.metabol.2015.03.008

Johnston BC, Kanters S, Bandayrel K, et al. Comparison of weight loss among named diet programs in overweight and obese adults. JAMA. 2014;312(9):923. DOI: https://doi.org/10.1001/jama.2014.10397

Wright N, Wilson L, Smith M, et al. The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutr Diabetes. 2017;7(3):e256-e. DOI: https://doi.org/10.1038/nutd.2017.3

Barnard ND, Alwarith J, Rembert E, et al. A Mediterranean diet and low-fat vegan diet to improve body weight and cardiometabolic risk factors: a randomized, cross-over trial. J Am Nutr Assoc 2022;41(2):127-139. DOI: https://doi.org/10.1080/07315724.2020.1869625

Ello-Martin JA, Roe LS, Ledikwe JH, et al. Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets. Am J Clin Nutr. 2007;85(6):1465-1477. DOI: https://doi.org/10.1093/ajcn/85.6.1465

Hall KD, Guo J, Courville AB, et al. Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake. Nat Med. 2021;27(2):344-353. DOI: https://doi.org/10.1038/s41591-020-01209-1

Sibbald B. Physicians’ roles on the front line of climate change. CMAJ. 2013;185(3):195. DOI: https://doi.org/10.1503/cmaj.130087

Willett W, Rockstrom J, Loken B, et al. Food in the anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019;393(10170):447-492. DOI: https://doi.org/10.1016/S0140-6736(18)31788-4

Greger M. Updated Vitamin B12 Recommendations Infographic 2023. Available from: https://nutritionfacts.org/blog/updated-vitamin-b12-recommendations-infographic/.

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Published

2023-10-12

How to Cite

Dutton, H. (2023). The Role of Plant-Based Diets in the Management of Type 2 Diabetes. Canadian Diabetes & Endocrinology Today, 1(3), 16–19. https://doi.org/10.58931/cdet.2023.1317

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