Help Prevent Type 2 Diabetes and Manage Diabetes with a Plant-Based Diet

Learn all about mastering diabetes, from eating to prevent type 2 diabetes to managing diabetes, with these plant-based eating strategies.

Picture your plate painted with colorful vegetables and fruits, earthy pulses, vibrant herbs and spices, and crunchy whole grains, nuts, and seeds. It’s an eating style widely recommended for a variety of health conditions, and the list now includes both prevention and treatment of diabetes. Benefits of plant-based diets in diabetes management include better glucose control, reduced need for medication, weight management, and reduced risks of complications typically associated with diabetes. Considering that type 2 diabetes is a rapidly increasing global epidemic, with approximately 422 million cases worldwide as of 2022, a plant-based diet may hold exciting promise.

Today, a growing body of research is showing support for various types of plant-based diets in diabetes prevention and management. In fact, major health organizations, such as the American Diabetes Association, Academy of Nutrition and Dietetics, Centers for Disease Control and Prevention, and Harvard School of Public Health, are recommending a more plant-based approach to eating for diabetes.

My new book, The Plant-Powered Plan to Beat Diabetes, not only presents 100 recipes tailored specifically for diabetes prevention and management, but also the science behind why plant-based diets are the way to go in helping to prevent and manage diabetes.

The Science on Plant-Based Diabetes Prevention

Science has supported the role of plant-based diets in reducing the risk for developing type 2 diabetes for some time now. The Adventist Health Study found that when comparing diabetes incidence among five eating patterns (non-vegetarian, semi-vegetarian, pescatarian, vegetarian, and vegan), the more plant-based the diet the better in terms of protection against type 2; vegans had an astonishing 77% lower risk, and vegetarians a 54% lower risk, compared to non-vegetarians.

Health advantages have been found for a variety of plant-based eating patterns, including vegan, vegetarian, semi-vegetarian, and pescatarian; however, much of the diabetes research has shown that the more plant-based the better in terms of benefits. But it’s not just any plant-based diet that yields the greatest effect. Research shows that if people eat a higher quality plant-based diet—less refined and focusing on whole forms of plant foods further improved their odds of preventing type 2 diabetes. 

Connections Between Diet and Diabetes 

What are the underlying benefits among plant-based diets that aid in diabetes prevention, as well as reducing the risk of complications? Three main threads connect diet with the development of type 2 diabetes and other chronic conditions. 

• Chronic inflammation is at the root of the development of type 2 diabetes, as well other chronic diseases that correlate with type 2 diabetes. Plant-based diets—rich in antioxidant and anti-inflammatory compounds—have a history in reducing levels of chronic inflammation. 
• Excess body weight has long been known to increase the risk for type 2 diabetes. Plant-based diets—rich in fiber and low in fat and energy—also have an established history in better weight management.  
• The gut microbiome interacts with diabetes in many ways, such as energy balance and immune function. The gut microbiome also impacts insulin resistance and inflammation. The good news is that fiber-rich, plant-based diets have been shown to be beneficial to the gut microbiome profile. Another important factor is fiber, which feeds the gut microbiome and has many positive effects on the immune system, weight, inflammation, blood glucose control, and heart health. Getting more fiber-rich foods in the diet, such as pulses, whole grains, fruits, vegetables, nuts, and seeds is an important strategy. 

Plant Based Eating for Managing Diabetes 

The potential for plant-based diets in diabetes management is promising. Emerging evidence that shows plant-based diets may improve diabetes management, reduce complications, and decrease the need for medications is exciting. Research conducted by Neal Barnard, MD, FACC, found that vegan diets improved beta cell function, insulin resistance, blood glucose, and cholesterol levels and that those with type 2 diabetes were able to get off oral medications and insulin after 25 days on a program that included plant-based eating and physical activity.

How do plants help manage diabetes? It’s clear that plant nutrients and compounds, such as fiber, vitamins, minerals, healthful fats, phytochemicals, and low-glycemic carbohydrates can work both individually and synergistically to provide health benefits for those with diabetes. These plant-rich diets promote healthier weight and waist circumference, better glucose control, reduced levels of inflammation, greater insulin sensitivity, lower levels of blood pressure and cholesterol, and decreased risks of disease development and progression. In particular, plant foods’ rich cache of fiber, phytochemicals, antioxidants, and magnesium promotes insulin sensitivity.

In addition, plant-based diets low in animal foods, such as red and processed meat, are naturally lower in saturated fat, dietary cholesterol, sodium, and compounds associated with the cooking, curing, and processing of meats, such as N-nitroso compounds, heterocyclic amines, polycyclic aromatic hydrocarbons, glycation end products, trimethylamine N-oxide, and heme iron.

Another important factor is fiber, which feeds the gut microbiome and has many positive effects on the immune system, weight, inflammation, blood glucose control, and heart health. Studies have shown that low-fiber diets are linked with the development of type 2 diabetes, and a high-fiber diet, particularly with soluble fiber, improves glucose control, decreases hyperinsulinemia, and lowers LDL cholesterol levels in people with type 2 diabetes. The CDC now states that fiber is important in helping manage diabetes because of its powerful blood glucose control benefits. Carbohydrate foods high in fiber produce slower rises in glucose levels, as these foods take longer to break down during digestion. In addition, the CDC recognizes fiber’s role in heart health, gut health, and weight management—all important in managing diabetes. Most Americans fall short on fiber intake, getting only about 15 g per day. The official recommendation for adults is 20 to 30 g per day; however, there are benefits in aiming for even more, in the range of 40 g per day, for diabetes management. Getting more fiber-rich foods in the diet, such as pulses, whole grains, fruits, vegetables, nuts, and seeds is an important strategy.

Helping Preventing Diabetes Complications with Diet 

One of the foremost goals of managing type 1 and type 2 diabetes is to help prevent devastating complications that affect health, productivity, and quality of life. An estimated 63% of people with diabetes have hypertension, 56% have dyslipidemia, 18% are obese, and more than one-half die of coronary vascular disease (especially heart disease and stroke). In addition, they suffer higher risks of Alzheimer’s and certain cancers, and have the potential for damage to organs, such as kidneys, eyes, and nerves, making diabetes a major cause of blindness and lower limb amputation.

A diet lush with colorful vegetables and fruits, earthy pulses, vibrant herbs and spices, and crunchy whole grains, nuts, and seeds is a good place to start. Benefits for plant-based diets in diabetes management include better glucose control, reduced need for medication, weight management, and reduced risks of complications typically associated with diabetes. Diabetes expert Michelle McMacken, MD agrees: “Healthful plant-based diets, rich in vegetables, fruits, whole grains, beans, lentils, nuts, and seeds, are powerful for lowering the risk of type 2 diabetes. Moreover, for people who already have type 2 diabetes, a healthful plant-based diet can not only improve blood sugar and potentially reduce the need for medications, but it can lower blood pressure, cholesterol, inflammation, and the risk of serious complications such as heart disease and kidney disease.” 

Another factor behind the benefits of plant-based eating is meat reduction, in particular, red and processed meats. Research has increasingly linked these foods, especially processed meats, with increased risks of heart disease, type 2 diabetes, and certain types of cancer. A Harvard study found that eating processed meat was linked with a 42% higher risk of heart disease and a 19% higher risk of type 2 diabetes. Optimal diets should include healthier alternatives to red meat, such as fish, tofu, and legumes. 

Tips for Managing Diabetes with Diet

What diet tips can help you manage your disease through plant-based eating? Now that we better understand why plant-based diets are essential in managing and preventing diabetes, we can focus on how we can move to a more plant-based diabetes fighting diet. 

Start with What You Know

“First, start off with the plant-based meals you already eat and like,” suggests diabetes expert Jill Weisenberger. “Add them into rotation more often. Try one new recipe every week or every other week until you have a large collection of recipes you like. If you want to boost protein without raising carb counts so much, I recommend more tofu and edamame beans.”

Manage carbohydrate levels

Creating a more balanced plate with plant-based food sources that have higher carbohydrate levels is key. Fill your plate with half non-starchy vegetables, one-fourth plant protein (beans, tofu, nuts), and one-fourth whole grains, starchy vegetables, or fruit. “When following a plant-based eating plan to manage diabetes, it’s all a matter of balancing your food selections,” says Toby Smithson, MS, RD, who manages type 1 diabetes herself. “Since some of the plant-based choices are higher in carbohydrate content, adding lower-carb side dishes will help balance the amount of carbs per meal. For instance, if you’re eating a serving of black bean chili at lunch, balance your plate with side dishes of lower-carb vegetables like steamed green beans, a leafy green salad, roasted broccoli, or sliced tomatoes.”

According to Smithson, “it will be trial and error” for patients taking insulin to determine “the correct dosing of insulin to carb ratio until they see a blood glucose pattern.” She says, “Personally, with managing my own diabetes, I monitor my blood glucose patterns and add two servings of vegetables with lunch and dinner to help with the carbohydrate distribution balance and help me feel satiated.”

Get Your Fiber 

Smithson says, “Plant food choices with fiber, such as nuts, seeds, beans, oatmeal, and other whole grains, can help slow down the absorption of carbohydrate, offering the benefit of a slower rise in blood sugar levels. These foods can help keep blood sugar levels steady and improve insulin sensitivity,” adding that some fruits and vegetables, such as leafy greens, root vegetables, blueberries, and grapes, have been shown to lower the risk of diabetes.

Extra bonuses

The advantages of plant-based eating for patients with diabetes can expand in different directions. “Plant-based eating can cause a positive domino effect for people with diabetes,” Smithson says. “Consuming meat and meat products increases sleep disruptions, including sleep apnea. Improving sleep is very important for all people, but also has a key role in diabetes management. When a person with diabetes has nights of poor sleep, they often will see higher fasting blood glucose levels due to an increase in cortisol and increase in stress. If a plant-based plan is consumed as part of a balanced meal plan, it will provide a variety of vitamins, minerals, antioxidants, and phytochemicals, which in turn will reduce oxidative stress and improve immunity.”

If you are interested in delving deeper, The Plant-Powered Plan to Beat Diabetes presents many more tips and professional advice on the “how” and “why” to move towards a more healthful, plant-based lifestyle to master diabetes. 

Learn more about plant-based eating for diabetes here:

• Eating a Plant-Based Diet to Fight Diabetes
• Do Plant-Based Diets Work for Diabetes?
• Plant-Based Eating for Diabetes with Toby Smithson
• Plant-Based Diabetes Meal Planning with Toby Amidor

References:

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