How can we prevent diabetes and heart disease?

Growing evidence supports the idea that a plant-based diet protects cardiometabolic health. Image credit: Studio Firma/Stocksy.
  • Current dietary guidelines include a healthy vegetarian diet as a viable option to prevent disease. However, nutrition experts still do not often recommend these diets.
  • As part of a larger project to update nutritional practices, two new scientific reviews have investigated these diets for improving cardiometabolic health.
  • The results suggest that vegetarian and vegan diets may benefit people with type 2 diabetes and help prevent heart disease in the general population.

Eating more fruits, vegetables, and plant-based foods has been a long-standing nutritional recommendation for improving health.

However, some nutrition and medical experts are hesitant to endorse vegetarian or vegan diets. This may be due to outdated resources or misunderstandings.

Researchers recently reviewed the literature regarding these diets and their effects on cardiometabolic health.

They aimed to inform healthcare professionals about the effectiveness of vegetarian and vegan diets in clinical care and bridge the gap between research and practice.

Two review studies published in October 2024 highlight that vegetarian and vegan diets are beneficial for people with type 2 diabetes and may reduce heart disease risk for the general adult population as a whole.

This study contributes to efforts to update the Academy of Nutrition and Dietetics (AND). Evidence analysis librarysupporting nutritional practices based on scientific evidence.

“There are now so many studies examining vegetarian dietary patterns that we are revisiting the reviews to systematically examine the research and contribute to evidence-based clinical practice.” Dr. Matthew Landry, RDNthe authors of both studies said: press release.

Landry is an assistant professor of population health and disease prevention at the UC Irvine Joe C. Wen School of Population and Public Health. His previous studies were some of the prestigious studies. Twin diet research.

In a systematic review and meta-analysis, researchers examined seven randomized controlled trials of vegetarian and vegan diets for the treatment of type 2 diabetes in adults.

These studies lasted an average of 26 weeks and involved 770 middle-aged participants, primarily between the ages of 44 and 61.

A vegetarian diet generally eliminates meat, poultry, and seafood, while a vegan diet further eliminates other animal products such as eggs and dairy products. In this review, “vegetarian” includes all types.

The results suggest with moderate certainty that a vegetarian diet supports glycemic control and lowers blood sugar levels. hemoglobin A1c 0.40% decrease, resulting in a 0.96 decrease in BMI.

These diets may also enable reductions in antidiabetic medications and improve insulin sensitivity by approximately 10% compared to non-vegetarian diets, although evidence for these effects was weak.

These results are primarily supported by previous scientific reviews specific to patients with type 2 diabetes.

However, in other reviews, vegan and vegetarian Diet can help lower LDL cholesterol, especially for people with cardiometabolic risk factors.

In the second study, researchers conducted a comprehensive review of 21 systematic reviews to analyze how vegetarian, vegan, and non-vegetarian diets affect cardiovascular health outcomes and risk factors. A review was conducted.

To ensure more up-to-date information, only reviews published since 2018 are included.

The subjects were likely healthy adults over the age of 18 from the general population, and most of the included studies were observational.

Compared to a non-vegetarian diet, a vegetarian dietary pattern appears to reduce the incidence of cardiovascular disease by 15% and the risk of death from cardiovascular disease by 8%.

Specifically, vegan diets were associated with improvements in cardiometabolic risk factors, including reduced risk of:

People on a vegan diet were shown to have lower levels of C-reactive protein, an inflammatory marker that is often elevated in cardiovascular disease.

The study authors said there was moderate certainty that a vegetarian diet “probably” reduces the incidence of cardiovascular disease. However, evidence for other outcomes was generally less certain due to a variety of observational studies.

They call for more randomized controlled trials to investigate the protective effects of vegan and vegetarian diets on cardiovascular health.

Still, this study supports earlier research linking these diets to reduced risk of cardiovascular disease.

Today's medical news I talked to Avantika Waring, MarylandA board-certified physician in endocrinology, diabetes and metabolism, and chief medical officer of 9amHealth, he was not involved in the study, but has researched how vegan and vegetarian diets can help prevent and manage these chronic diseases. He talked about how it helps.

She says these diets are “generally defined by what they eliminate; [like animal products, meat, and fish]the health benefits may be primarily due to what it contains

Compared to omnivorous diets, vegan and vegetarian diets typically contain more of the following:

Waring suggested that replacing animal fats with plant-based unsaturated fats could reduce the risk of cardiovascular disease by reducing inflammation and preventing blockages in blood vessels.

Additionally, unsaturated fats and fiber may strengthen blood vessel function and lower blood pressure.

Waring said they may also help lower triglycerides, reduce insulin resistance, and improve blood sugar levels and metabolic health.

Thomas M. Holland, MD, MSPhysician-scientist and assistant professor at the RUSH Institute for Healthy Aging, School of Health Sciences, RUSH University, who was not involved in the study, agreed.

Professor Holland pointed out that vegan and vegetarian diets often reduce overall fat intake and increase fiber, which slows sugar absorption, reduces insulin spikes and improves insulin sensitivity. .

Another important factor is reduced inflammation, likely due to increased antioxidants and polyphenols found in fruits, vegetables, and whole grains, which reduces atherosclerosis and lowers the risk of cardiovascular disease. Then he said:

MNT I also talked to Sheri Gow, RDN, CDCESThe registered dietitian, certified diabetes care and education specialist and owner of The Plant Strong Dietitian was also not involved in the study.

More broadly, Mr Gau highlighted that weight management is an important way in which a vegetarian diet provides cardiometabolic benefits.

She said research suggests people are eating mostly plant-based diets. Lose up to 30 poundshigher than the general population on average.

She also pointed out that the study We show that weight loss significantly contributes to lower hemoglobin A1C levels, reflecting improved glycemic control.

Vegan, vegetarian and plant-based diets are on the rise.

International Food Information Council (IFIC) 2024 Annual Health Survey Current research indicates that approximately 8% of Americans identify as following one of these diets.

Therefore, it is beneficial to recognize the potential role of these diets in the prevention and management of chronic diseases.

To find out whether a vegetarian or vegan diet is optimal for cardiometabolic health, or whether a diet consisting primarily of plants and some lean animal foods may have a similar impact. , further large-scale studies are needed.

Still, Waring, Holland and Gow are unanimous that current evidence supports the recommendation of healthy, high-quality vegetarian and vegan diets for diabetes management and heart disease prevention. Agreed.

“However,” says Goh, “a vegetarian diet rich in refined carbohydrates from desserts and sugary drinks, highly processed foods, trans fats, and saturated fats like palm and coconut oils is It can increase your risk of diabetes and cardiovascular disease, stroke, inflammation, obesity, and vitamin and mineral deficiencies. ”

Waring also emphasized that the benefits of a diet can only be achieved if it is sustainable, suggesting that a vegetarian or vegan diet is only recommended for people who are interested in sticking to it long-term. did.

“Rather than just encouraging people to follow a particular diet, we should encourage them to incorporate elements of their diet that are specifically associated with promoting health, such as fresh fruits and vegetables, complex carbohydrates and whole grains, and vegetable fats. I recommend it.”

Although research supports adopting a healthy vegetarian eating pattern, many myths persist, from concerns about protein deficiency to the perception that vegetarian meals are bland or unsatisfying. .

There is also widespread belief among some medical experts that to get the amino acids you need, you must combine plant protein with every meal. This is based on outdated research.

“It's true that you need to be a little more intentional about incorporating enough protein into your diet without using animal products, but there are many delicious and filling foods like nuts, grains like quinoa, and lentils that are delicious and filling.” , there are a lot of healthy plant-based protein sources. That and beans,” Waring said.

Holland said other common misconceptions about vegetarian and vegan diets include beliefs that they are nutritionally inadequate, expensive or difficult to follow.

These diets can certainly cause certain nutrient deficiencies if not followed carefully.

This is especially true for vegan diets and lack of vitamin B12, which is found primarily in animal foods. However, proper levels can be easily maintained through fortified foods and supplements.

“Stigma can also stem from cultural preferences for meat or a lack of diversity in plant-based diets,” Holland added.

He suggested that barriers “can be addressed by educating individuals about nutritious, plant-based food options.” affordable priceand emphasizes health benefits. ”

Finally, he offered practical tips such as meal planning, exploring a variety of plant-based cuisines, and gradually incorporating plant-based days to ease the transition to these diets.

If you are considering switching to a vegetarian or vegan diet, consult a registered dietitian for guidance on meeting your nutritional needs.

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