by Jessica Pyhtila, PharmD, BCPS, BCGP
Type 2 diabetes is by far the most common subtype of the disorder, impacting about 90% of people with diabetes. In turn, Type 2 diabetes is closely related to lifestyle, and risk factors often involve diet and weight.
For this reason, many people turn to nutrition to help manage their diabetes risk, or to help improve their blood sugars and overall health. One of the top diet strategies people consider is a plant-based diet.
What is a Plant-Based Diet?
A plant-based diet means a diet that focuses on vegetable-based products. However, this does not mean switching to a salad-only diet and consuming only green vegetables. Many different types of plant-based diets exist, including:
● Vegans, who eat absolutely no animal products or ingredients including gelatin or honey
● Vegetarians, who can have different gradations of avoiding animal products. While some vegetarians avoid all animal products, others consume some animal items. Subtypes of vegetarians include:
○ Lacto-vegetarians, who consume milk
○ Ovo-vegetarians, who consume eggs (generally from free-range chickens)
○ Lacto-ovo-vegetarians, who consume milk and eggs
○ Pescatarians, who consume fish
● Flexitarians, who sometimes consume a vegetarian diet and sometimes do not
Can I Be Vegetarian if I Have Diabetes?
You can follow a vegetarian diet even if you have diabetes. In fact, a vegetarian can help your diabetes in several ways. The American Diabetes Association makes nutritional recommendations based on a plate method. This can accommodate people who follow a vegetarian or vegan diet:
● 50% of your meal should be non-starchy vegetables. This means avoiding starchy vegetables like potatoes and instead choosing green or leafy vegetables like broccoli or spinach.
● 25% of your plate should be lean protein like turkey or fish
● 25% of your plate should be whole-grain carbohydrate foods like brown rice or quinoa.
● To drink, you should have water or a zero-calorie beverage. It is important to avoid sugary drinks like juice or sugary soda.
In addition, plant-based diets often focus on whole, unprocessed foods. This means that plant-based diets frequently minimize refined grains, sugars, and oils. This further makes a plant-based diet a healthy choice for a person with diabetes.
Is Eating Red Meat Bad If You Have Diabetes?
Eating red or processed meat can cause a cascade of effects at the cellular level in your body that may cause or worsen diabetes. Together, these effects harm your body’s insulin resistance, which stops you from using insulin efficiently and increases your blood sugar. The effects from red or processed meat include increases in potentially harmful substances like:
● Branched-chain amino acids
● Saturated fatty acids
● Advanced glycation end products
● Sodium nitrite and N-nitroso compounds
Can A Plant-Based Diet Prevent Diabetes?
Studies have shown that a plant-based diet can both prevent and treat diabetes. Some forms of plant-based diets are more effective than others in improving diabetes. Among those who follow plant-based diets:
● Only 2.9% of vegans develop diabetes
● Only 3.2% of lacto-ovo-vegetarians (who consume eggs and dairy) develop diabetes
● Only 4.8% of pesco-vegetarians (who eat fish) develop diabetes
● 6.1% of flexitarians (semi-vegetarians) develop diabetes
● 7.6% of non-vegetarians develop diabetes
Can A Plant-Based Diet Treat Diabetes?
Even if you already have diabetes, a plant-based diet can help. Besides helping to reduce your weight, a plant-based diet can lower your A1c by 0.3% to 0.4% and can also lower your LDL cholesterol (also called bad cholesterol). In part, this is because the saturated fat in meat and cheese has been linked with high cholesterol levels.
Further, experts are currently researching whether the omega-3 α-linoleic acid (ALA) content of plant-based foods like flax, walnuts, and soy may help reduce cardiovascular risk. The high fiber content of many vegetables has already been linked to lower cardiovascular risk.
Should I Supplement With Vitamins While Eating a Plant-Based Diet for Diabetes?
Experts recommend considering a vitamin if you eat a plant-based diet and have diabetes. This is due to two factors:
● An overall increased risk of nutrient deficiencies if you have diabetes
● Lower intake of certain macronutrients such as Vitamin B12 if you follow a vegetarian or vegan diet. Ovo-vegetarians (who eat eggs) and lacto-vegetarians (who eat dairy) may not require this supplementation. Vegetarians and vegans can also increase their B12 intake through consuming fortified foods like:
● Non-dairy milks like almond or oat milk
● Yeast extracts, which are different from yeasts in food and can come as a liquid or paste
● Breakfast cereals, which are labeled with their nutritional ingredients
It is also important to talk to your doctor to make sure you are getting enough calcium. Low-oxalate vegetables like broccoli and brussels sprouts are chock full of highly absorbable calcium, and you should make sure you are eating enough for your bone health.
How Can I Eat Vegetarian and Get Enough Protein?
There are many diabetes-friendly ways to get enough protein. Many different vegetable-based products contain several grams of protein per serving, including:
● Nuts and seeds, like pumpkin seeds, flax seeds, chia seeds, walnuts, and almonds
● Non-dairy milks, like soy milk
● Legumes, like peas, lentils, kidney beans, and chickpeas
● Soy products, like tofu, tempeh, and seitan
● Grains like spelt, amaranth, quinoa, and brown rice
Will I Lose Weight on a Plant-Based Diet?
A plant-based diet has been shown to help with weight loss in people with diabetes. On average, people lose around 4.4 pounds on plant-based diets. Further, waist circumference also reduces on plant-based diets. However, it is important to not simply replace meat and fish with processed foods like packaged snacks and meals. Filling your diet with empty calories can instead cause you to gain weight even if you are avoiding meat. High-fat, high-calorie foods should be replaced with low-calorie, whole-grain replacements.
If you are looking for a healthier lifestyle to treat or prevent diabetes, a plant-based diet – particularly one rich in whole foods – may be an option. Talk to your doctor to see if a plant- based diet is right for you.