Adopting vegetarian diet can be easy, offer cardiometabolic benefits
Whether the motivation is animal or worker welfare, environmental sustainability, personal taste or something else, people with diabetes can safely adopt a plant-based diet. In fact, vegetarian and vegan eating patterns have been shown to improve cardiovascular disease and glucose management.
“Plant-based diets represent an effective means for the prevention and treatment of cardiometabolic disease, particularly in our high-risk patients with diabetes,” Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee for Responsible Medicine in Washington, D.C., told Endocrine Today. “Staying away from red meat could potentially contribute to reductions in diabetes risk and total mortality, as well as cardiovascular and cancer mortality rates.”
Plant-based diets have been shown to reduce total and CV mortality rates, particularly those that include more unprocessed plant foods. In addition, a plant-based diet is the only eating pattern shown to not only prevent, but reverse CVD, according to Kahleova.
Among participants in the Lifestyle Heart Trial, 82% of those who adopted a plant-based diet, did not smoke, practiced stress management and walked for 30 minutes most days
reversed their atherosclerosis at 1 year with even greater regression at 5 years.
Vegetarian eating patterns have also shown specific benefits for diabetes.
“People following plant-based diets have their diabetes risk cut in half,” Kahleova said. “Furthermore, clinical trials have demonstrated significant improvements in glycemic control in people with type 2 diabetes.”
Data from a 22-week randomized clinical trial published in Diabetes Care in 2006 showed a greater mean percentage point reduction in HbA1c among adults on stable medication for type 2 diabetes (n = 49) assigned a vegan diet (–1.23) vs. similar adults (n = 50) assigned a portion-controlled diet based on American Diabetes Association guidelines (–0.38; P = .01). A meta-analysis published in Cardiovascular Diagnosis and Therapy in 2014 found that plant-based diets contributed to a –0.39 percentage points greater mean reduction in HbA1c vs. other conventional diets among adults with type 2 diabetes (P = .001).
More plants, less junk
A registered dietitian who is a diabetes care and education specialist can help someone with diabetes to adopt a safe and beneficial plant-based approach to eating, according to Susan Weiner, MS, RDN, CDCES, FADCES, owner and clinical director of Susan Weiner Nutrition PLLC, and an Endocrine Today Editorial Board Member.
“Adopting a more plant-based approach for people with type 2 diabetes doesn’t have to mean ‘all or nothing’ when it comes to reducing animal products,” Weiner told Endocrine Today. “It might be more about incorporating more low-carbohydrate, high-fiber vegetables, which are rich in antioxidants and phytonutrients as well as filling and satisfying.”
Whether the goal is “meatless Mondays,” eliminating red meat or forgoing animal products altogether, Weiner recommends adopting a new eating pattern in small steps to avoid adding carbohydrates instead of protein.
“A plant-based approach doesn’t mean a recommendation to eat more high-carb snacks like potato chips,” she said. “It’s important to eat healthy low-carb, protein-rich and nutrient-based foods, such as nuts, nut butters and seeds. Incorporating beans and legumes will increase the carbohydrate content of your diet, but also the fiber content, which is good.”
As with any healthy eating plan, most meals should be cooked at home when possible from healthy ingredients.
“The quick vegetarian frozen or prepared meals may contain a lot of sodium,” Weiner said. “Individual servings of those items may be portion-controlled, which may initially appear appealing, but they’re often very small and need to be supplemented with vegetables.” – by Jill Rollet
Baden MY, et al. Circulation 2019;doi:10.1161/CIRCULATIONAHA.119.041014.
Barnard ND, et al. Diabetes Care. 2006;doi:10.2337/dc06-0606.
Ornish D, et al. Lancet. 1990;doi:10.1016/0140-6736(90)91656-u.
Ornish D, et al. JAMA. 1998;doi:10.1001/jama.280.23.2001.
Tonstad S, et al. Diabetes Care. 2009;doi:10.2337/dc08-1886.
Yokoyama Y, et al. Cardiovasc Diagn Ther. 2014;doi:10.3978/j.issn.2223-3652.2014.10.04.
For more information:
Hana Kahleova, MD, PhD, can be reached at firstname.lastname@example.org.
Susan Weiner, MS, RDN, CDE, CDN, FAADE, can be reached at www.susanweinernutrition.com, email@example.com; Twitter: @susangweiner.
Disclosures: Kahleova reports no relevant financial disclosures. Weiner reports she is a clinical adviser to Livongo Health.