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Grand Rounds

Could Plant-Based Diets Help Prevent Type 2 Diabetes?

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BACKGROUND AND PURPOSE:

  • There is data suggesting that plant-based diets (e..g, lacto-ovo-vegetarian and vegan) may be useful in the management of type 2 diabetes, CVD and cancer
  • Data on the role of these diets for primary prevention of type 2 diabetes is limited
  • Qian et al. (JAMA Intern Med., 2019) sought to determine if there is an association between plant-based diet and risk of type 2 diabetes

METHODS:

  • Systematic review and meta-analysis
    • Full-text assessments and data abstraction were independently conducted by two authors
  • Inclusion criteria
    • Prospective observational studies
    • Studies that that examined the association between adherence to plant-based diet and type 2 diabetes
  • Participants
    • Adults ≥18 years
  • Exposure
    • Adherence to plant-based dietary patterns defined as
      • Higher consumption of plant-based foods
      • Lower consumption or exclusion of animal-based foods
  • Data analysis
    • Meta-analysis was conducted using the random-effects method
    • Overall relative risk (RR) and 95% CI calculated
  • Primary outcomes
    • Level of adherence to a plant-based diet
    • Incidence of type 2 diabetes

RESULTS:

  • 9 studies | 307,099 participants | 23,544 cases of type 2 diabetes
  • Higher adherence to a plant-based dietary pattern was significantly associated with a lower risk of type 2 diabetes
    • RR, 0.77 (95% CI, 0.71 to 0.84)
  • Consistent associations were observed across predefined subgroups
    • Age | Sex | Global region | Definitions of plant-based diets (e.g., vegetarian or vegan pattern vs plant-based dietary scores)
    • The association was stronger when the following healthy plant-based foods were included in the definition of plant-based patterns
      • Fruits | Vegetables | Whole grains | Legumes | Nuts
      • RR 0.70 (95% CI, 0.62 to 0.79)
  • Associations maintained even after controlling for BMI
  • Most studies were considered good quality for the following
    • Dietary assessment
    • Disease outcomes
    • Statistical adjustment for confounding factors
  • A dose-response association was identified between plant-based dietary indices and decreasing risk of type 2 diabetes

CONCLUSION:

  • Better adherence to a plant-based diet was inversely associated with the risk of type 2 diabetes
  • Results were broadly consistent
  • Plant-based diets may be useful for the primary prevention of type 2 diabetes
  • These diets are even more effective when enriched with known healthful plant-based foods
  • The dose-response finding would indicate that one does not need to eat a meatless diet to benefit from increased consumption of plant-based diet

Learn More – Primary Sources:

Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes – A Systematic Review and Meta-analysis

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Related ObG Topics:

Does the Type of Dietary Fat Affect Mortality and Heart Disease in Individuals with Type 2 Diabetes?
Does Eating a Mediterranean Diet Reduce Risk of Stroke in Both Men and Women?
Does a Mediterranean Diet with Extra Olive Oil Decrease Risk of Gestational Diabetes Mellitus?

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