Eating vegetables and type 2 diabetes

In Australia, National Diabetes Week runs in July, and unfortunately, the stats on incidence and consequences seem to get more alarming each year.

In Australia, type 1 diabetes affects 10% of the estimated 1.7million with diabetes, with type 2 comprising 85% of this population.¹ Mismanagement can lead to devastating consequences, such as loss of eyesight, being on dialysis, and amputation.

Treatments include monitoring blood glucose levels and administering appropriate doses of insulin when required. This is especially true for those with type 1, or when type 2 become insulin dependent.

However, diet and lifestyle play a major role in the manifestation and severity of the disease. In particular, at least 58% of cases of type 2 diabetes can be prevented, and even reversed, through exercise and appropriate dietary changes.²

And one of those changes is learning to love the veg!

Veg, fruit and type 2 diabetes

Over 1,500 adults undertook dietary surveys in the U.K., and these were measured against markers for inflammation and oxidative stress in the blood.

The researchers found a strong correlation between high intake of vegetables and fruit with lower inflammation and higher antioxidant status – no real surprises there. But this anti-inflammatory and antioxidant rich dietary pattern also may be correlated with reduced incidence of type 2 diabetes.⁵

Inflammatory markers throughout the body are implicated in type 2 diabetes – though full understanding of the cause is yet to be understood. Low-grade systemic inflammation it seems can be induced by central adiposity. Furthermore, local inflammation of the liver, skeletal muscle tissue and pancreas can interfere with insulin signalling, or cause pancreatic b-cell dysfunction, leading to insulin resistance.³

Therefore, there could be a role for anti-inflammatory therapies such as a diet high in a variety of vegetables and fruit.

A study recently shared by Harvard T.H. Chan School of Public Health⁷ has also found a reason to encourage higher intake of high-quality plant foods.

Using data from the Nurses Health Study, researchers measured the incidence of type 2 diabetes in those consuming a plant-based diet, a healthful plant-based diet, and an unhealthful plant-based diet.

The results saw significantly less incidence of type 2 diabetes in those consuming a plant-based diet, with even better results in those with a healthy plant-based diet. This is independent of body mass index and other risk factors for type 2 diabetes.

Those consuming an unhealthy plant-based diet, however, were positively associated with type 2 diabetes, higher in foods that a heavily processed and refined such as “fruit juices, sugar-sweetened beverages, refined grains, potatoes, and sweets/desserts”.⁷ 

Whilst the study was focusing on plant-based diet, the point wasn’t to ask us to abstain from meat, poultry or fish! Only that a diet high in plant foods has a correlation with positive health outcomes. So if you eat them, serve meat, poultry and fish with a load of veg, and ensure they are of high quality – meaning not highly processed like ham or sausages, but grass-fed, free-range, or sustainably caught (and where possible, organic) as part of a whole food diet.

In fact, researchers do believe there is potential that a diet higher in protein can help with prevention and management of type 2 diabetes, though further research is required as to whether there is greater benefit from animal or plant-based protein, or whether both are beneficial.^4;5;6

Overall, it seems the dietary factors associated with increased risk of type 2 diabetes are due to high consumption of foods that are highly processed – be it sugar, salami or soda.

Type 2 diabetes and eating well

It is important that in order to gain benefits of anti-inflammatory and antioxidant rich foods like a variety of veg, we reduce the intake of the pro-inflammatory stuff. This means cutting back on refined and heavily processed foods, like potato crisps, hot dogs, soft drinks and white bread.

Feeding your body with nourishing whole foods could really a the big-ticket item when contending with type 2 diabetes, as diet and incidence are intimately related.⁸ And according to a recently released study from Harvard, home cooked meals are the way to go to reduce risk!⁹

Naturally, making meals from scratch means you know what is going in, and researchers believe you are likely to eat less, and the food is of higher quality.

In saying all this, we will always advocate seeking support from your healthcare practitioner in order to individualise your treatment should you be contending with any form of diabetes. Every person is unique and any dietary, lifestyle and medical therapy should be adjusted to meet your needs.

By Angela Johnson (BHSc Nut. Med.)

References:

1. Diabetes Australia 2015, Diabetes in Australia, viewed 11 July 2016, <https://www.diabetesaustralia.com.au/diabetes-in-australia>
2. Diabetes Australia 2015, Myths and Facts, viewed 11 July 2016, <https://www.diabetesaustralia.com.au/myths-facts>
3. Esser, N, Legrand-Poels, S, Piette, J, Scheen, AJ, & Paquot, N 2014, ‘Invited Review: Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes’, Diabetes Research and Clinical Practice, vol. 105, pp. 141-150.
4. Markova, M Hornemann, S Sucher, S Pivovarova, O & Pfeiffer, AFH 2015, ‘Effects of an isocaloric high-protein diet in subjects with type 2 diabetes: Animal versus plant protein’, Experimental & Clinical Endocrinology & Diabetes; vol. 123, p13.
5. McGeoghegan, L Muirhead, CR, & Almoosawi, S 2015, ‘Association between an anti-inflammatory and anti-oxidant dietary pattern and diabetes in British adults: results from the national diet and nutrition survey rolling programme years 1–4.’ International Journal of Food Sciences and Nutrition, vol. 67, no. 5
6. Ng, AP, Viguiliouk, E, Stewart, SE, Mejia, SB, Sievenpiper, JL, Kendall, CC, de Souza, RJ, Leiter, LA, Josse, RG, Jenkins, DA, Jayalath, VH, Mirrahimi, A, Bazinet, RP, & Hanley, AJ 2015, ‘Effect of Replacing Animal Protein with Plant Protein on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials’, Nutrients, vol. 7, no. 12, pp. 9804-9824 21p.
7. Satija, A, Bhupathiraju, SN, Rimm, EB, Spiegelman, D, Chiuve, SE, Borgi, L, Willett, WC, Manson, JE, Sun, Q, & Hu, FB 2016, ‘Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies’,PLoS Medicine, vol. 13, no. 6, pp. 1-18.
8. Xi, P & Liu, RH 2016, ‘Whole food approach for type 2 diabetes prevention’, Molecular Nutrition & Food Research, [Epub ahead of print].
9. Zong, G, Eisenberg, DM, Hu, FB, & Sun, Q 2016, ‘Consumption of Meals Prepared at Home and Risk of Type 2 Diabetes: An Analysis of Two Prospective Cohort Studies’, Plos Medicine, vol. 13, no. 7, p. e1002052.