Diabetes affects 425 million people worldwide, and 1 in 2 adults remains undiagnosed, according to the International Diabetes Federation Diabetes Atlas. Health care providers must urgently increase our advocacy for improved food systems, which will reduce the occurrence of noncommunicable diseases such as diabetes. We need to align agricultural policies with nutrition goals, improve access to and encourage consumption of nutrient-dense foods, increase the availability of nutrition education and include telehealth among clinics and hospitals.
Diana L. Malkin-Washeim
When we shift our focus to a plant-based food system, we can slow climate change and provide nutrient-dense foods to the global population. When we focus on sustainable crops, we focus on foods that are nutritionally adequate, economically affordable, culturally acceptable and environmentally friendly.
Rural health disparities
Families living in poverty experience food and medication insecurity and consequently are at risk for developing diabetes and other noncommunicable diseases. Although global poverty is decreasing, the prevalence of diabetes among rural communities may be increasing. According to the Diabetes Research Institute Foundation, in the past 10 years, the incidence of diabetes has increased 50%. WHO projects that mortality from diabetes will double by 2030, with approximately 80% of the deaths occurring among low- and middle-income countries.
Rural living limits access to medical care and medications, which affects health outcomes. Health disparities may be the contributing factor that increases the prevalence of comorbidities and mortality from diabetes among populations living in both low-income and high-resource countries. Health disparities are systemic, affecting health outcomes and socioeconomics.
The epidemic of diabetes provides us a reason to target changes in dietary patterns. With a global shift to Western-style, calorie-dense food consumption, nutrient-poor food patterns have emerged. This shift, in turn, has increased the prevalence of malnutrition and noncommunicable diseases. Globally, 1 in 5 deaths in 2017 was associated with poor quality diet and cardiovascular disease, raising noncommunicable disease rates among developing and developed countries.
We need to align agricultural policies with nutrition goals, improve access to and encourage consumption of nutrient-dense foods, increase the availability of nutrition education and include telehealth among clinics and hospitals.
Source: Adobe Stock
Increasing access to nutrient-dense foods with sustainable crops may reduce the risks for these diseases, including diabetes.
A sustainable diet may be able to address global food insecurity. The Food and Agriculture Organization of the United Nations calls for a shift in policies that support diets that are nutritionally adequate, economically affordable, culturally acceptable and environmentally friendly. Sustainable diets include legumes, soybeans, nuts, seeds and green leafy vegetables. Promoting plant-based foods increases sustainability and, in the long term, results in cheaper and nutrient-dense food choices for many nations.
What is sustainable for the planet can also be healthy for people. People who consume predominately plant-based diets are at a reduced risk for ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer and obesity. Consuming a plant-based diet of unprocessed, whole foods can help to control blood glucose. Vegetables and fruits are high in fiber, and nuts, seeds and whole grains provide healthy fats to replace saturated and trans fats that have been shown to cause insulin resistance.
Hunger and the planet
A plant-based diet can address human hunger. Worldwide, 60% of the food supply is grown for human consumption. A switch to plant-based diets would provide an estimated 50% calorie surplus for humans. Currently, there are 1 billion people who are experiencing hunger. A shift by 1 in 10 people from animal consumption to plant-based consumption would provide more food for the food insecure, enhance planet sustainability and decrease prevalence of diabetes. - by Diana L. Malkin-Washeim, PhD, MPH, RDN, CDE, CD-N, and Christopher Vogliano, MS, RD
For more information:
Diana L. Malkin-Washeim, PhD, MPH, RDN, CDE, CD-N, is director of the nutrition and diabetes program in the population health department at BronxCare Health System in New York. She can be reached at email@example.com.
Christopher Vogliano, MS, RD, is a PhD candidate at Massey University College of Health Sciences in Wellington, New Zealand. He can be reached at firstname.lastname@example.org.
Disclosures: Malkin-Washeim and Vogliano report no relevant financial disclosures.