November 04, 2020
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“Eating more fruit and vegetables can reduce the risk of developing diabetes by almost a quarter,” reports The Independent.
The headline is prompted by a new review that pooled the results of 9 studies looking at the link between how “plant-based” over 300,000 people’s diets were, and their risk of developing type 2 diabetes.
The review found that people whose diets were more plant-based were about 23% less likely to develop diabetes. This might mean, for example, that if all of the participants in the studies had eaten a more plant-based diet, 6 out of every 100 might have developed type 2 diabetes instead of almost 8 in every 100.
While this type of study can never fully prove that 1 factor is directly causing an effect, the results do support what we know already – that eating a more plant-based diet is good for our health. Being overweight or obese increases our risk of developing type 2 diabetes, and eating a balanced diet and being physically active is our best way to avoid this.
Some information about the study
This study was conducted by researchers from the Harvard T. H. Chan School of Public Health and Harvard Medical School in Boston. The study was funded by the US National Institutes of Health. The study was published in the peer-reviewed Journal of the American Medical Association.
This was a systematic review of prospective cohort studies assessing whether how plant-based people’s diets were affected their risk of developing type 2 diabetes.
Some previous reviews have suggested that plant-based diets are associated with a lower risk of type 2 diabetes, cardiovascular disease and cancer. However, the findings are not conclusive as these reviews included cross-sectional studies, which cannot establish whether diet is influencing diabetes risk or vice versa. Also, some plant-based foods, such as refined grains and sugars, have been linked to a higher risk of type 2 diabetes.
Researchers defined plant-based diets as any diet where a person ate more plant-based foods and less or no animal-based foods (dairy, eggs, meat or fish). This would include vegetarian and vegan diets, as well as diets where people ate some animal-based foods, but not much.
Nine studies used food frequency questionnaires to assess diet. Three studies compared people eating vegetarian or vegan diets versus those not doing so. Five of the studies assessed how plant-based a person’s diet was on a scale, and 1 study developed its own definition of a plant-based diet based on analysis of what people reported eating. Four of the studies also looked at the effect of a “healthy” plant-based diet specifically – which included more fruits, vegetables, whole grains, legumes and nuts.
In most of the studies participants reported whether they developed type 2 diabetes themselves, and answered standard questionnaires about their symptoms and medicine use to confirm their reports.
The researchers pooled the results of the studies using accepted statistical methods. For each study, they used the results that had taken into account the most factors that could potentially influence the results (potential confounders). Most of the studies took into account known risk factors for diabetes, such as age, body mass index (BMI), smoking and family history of diabetes.
The researchers assessed whether the results varied across the different studies, and investigated factors that might explain this. For example, they looked at whether how a plant-based diet was defined by the study impacted the results.
Results of the studies
The 9 studies included 307,099 participants and followed them for between 2 and 28 years. The participants had an average age of between 36 and 64 years, and their average BMI was between 23 and 26.7 at the start of the studies. During follow up 23,544 participants (7.7%) developed type 2 diabetes.
Overall, following a more plant-based diet was associated with a 23% reduction in the risk of developing type 2 diabetes (relative risk (RR) 0.77, 95% confidence interval (CI) 0.71 to 0.84). Results suggested that the more plant-based a diet was the greater the reduction in risk. Following a healthier plant-based diet with more foods such as fruits, vegetables and whole grains was associated with a slightly greater reduction in the risk of developing type 2 diabetes (30% reduction in risk; RR 0.70, 95% CI 0.62 to 0.79).
There was some variability in the results of individual studies, with studies that looked specifically at defined plant-based diets (vegetarian or vegan diets) showing greater risk reductions for type 2 diabetes than those that scored diets on a scale of how plant-based they were.
This review has shown a link between eating more plant-based foods and a reduced risk of type 2 diabetes. People eating more plant-based foods could be following healthier lifestyle patterns in general, and several factors or behaviours may contribute to reduce type 2 diabetes risk.
The results do not suggest that we need to eliminate animal-based foods altogether. In the studies that looked at how risk changed with increasingly plant-based diets, even the most plant-based diets included some animal-based foods. Having said that, we do know that limiting red and processed meat and saturated fats (which mostly come from animal sources) are better for health.
Eating a healthy balanced diet and keeping physically active is the best way to reduce your risk of type 2 diabetes as well as many other conditions.
Source: UK NATIONAL HEALTH SERVICE
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