Diabetes is the most prevalent non-communicable disease in the world. In the United States alone, a total of 37.3 million people have diabetes, which equals 11.3 percent of the US population. Studies to date have found lifestyle changes can have a profound and positive effect on the prevention of type 2 diabetes, particularly incorporating healthy plant-based diets composed of fruits, vegetables, legumes, and whole grains.
According to a new study published in the American Journal of Lifestyle Medicine, adhering to a whole-food, plant-based eating pattern can successfully reverse type 2 diabetes.
The study, conducted in collaboration with the American College of Lifestyle Medicine (ACLM), focused on a sample of 59 patients from a cardiac wellness program in Virginia who also had type 2 diabetes.
The study determined that these patients achieved significant improvements in blood glucose control, with 37 percent experiencing full remission of their diabetes. Notably, the improvements in glucose control were accompanied by significant reductions in BMI.
The treatment approach involved implementing a low-fat, whole-foods plant-based diet alongside standard medical care at the wellness center. The prescribed diet was low in fat and high in fiber, consisting of vegetables, legumes, whole grains, fruits, nuts, and seeds.
On the prescribed diet, 75 percent of calories were derived from complex carbohydrates, 15 percent from plant-based protein, and 10 percent from fat. Patients were also instructed to avoid animal-derived products, processed foods, and added fats/oils.
A small quantity of egg white and no-fat dairy were allowed (approximately 5 percent of total calories) for occasional use.
While previous studies have demonstrated the positive effects of whole-food, plant-based eating patterns on diabetes outcomes, the study authors noted that those studies often involved calorie restriction, liquid meal replacements, or fasting.
This new research stands out by assessing remission as a primary outcome, offering valuable insights into the feasibility of achieving remission simply through healthy eating.
“The prevalence of diabetes is growing, as is recognition in the healthcare community that diet as the primary intervention can achieve lasting remission in individuals with type 2 diabetes,” Dr. Gunadhar Panigrahi, the study’s first author, said in a statement.
“This case series further supports the effectiveness of a whole-food, plant-predominant eating pattern as a primary intervention to achieve remission, as well as the need for increased education for both clinicians and patients on the successful application of lifestyle medicine principles and dietary interventions in everyday medical practice,” Panigrahi said,
Plant-based diet reverses diabetes
To conduct the study, researchers reviewed electronic health records of patients treated at the wellness clinic between 2007 and 2021. They identified individuals who had adopted a whole-food, plant-based eating pattern and achieved meaningful improvements in HbA1c (hemoglobin A1c) or blood glucose control, as well as remission of type 2 diabetes. Data points were collected from the periods before and after the lifestyle intervention.
The study employed the 2022 consensus definition of remission endorsed by the ACLM, which required patients to maintain an HbA1c level below 6.5 percent for at least three months without surgery, devices, or active pharmacologic therapy to lower blood glucose. This definition received support from the American Association of Clinical Endocrinology, the Academy of Nutrition and Dietetics, and the Endocrine Society.
The patients in the study had a mean age of 71.5 years, ranging from 41 to 89 years. Among the 59 patients, 22 met the criteria for type 2 diabetes remission. The study also revealed that patients experienced a reduction in glucose-lowering medications on average, aligning with a recent qualitative case series that provided guidelines for when and how to deprescribe medications following lifestyle changes.
Interestingly, many patients did not initially choose a lifestyle medicine treatment program for type 2 diabetes but were educated about the benefits of a whole-food, plant-predominant dietary pattern and regular physical activity as part of their routine care at the wellness center.
“There is a perception that many patients may not accept the idea of adopting a whole-food, plant-predominant eating pattern, but there is a growing abundance of research that shows adherence to such a dietary pattern is feasible and even enjoyable,” Micaela Karlsen, ACLM Senior Director of Research, said in a statement.
“Although full remission may not be possible for every patient, our research shows that every patient deserves to know that it may be possible through the adopting of appropriately dosed therapeutic lifestyle change.”
Meat increases diabetes risk
While a plant-based diet has proven benefits for diabetics, other studies have shown that the frequent consumption of meat increases the risk of developing diabetes. A study published earlier this year in the medical journal PLOS Medicine found that nitrates, a type of food additive commonly used in processed meats, have been linked to a higher risk of type 2 diabetes.
This was the first large-scale cohort study to suggest a direct association between additives-originated nitrates and type 2 diabetes risk. The researchers found that participants in the NutriNet-Santé cohort reported a higher intake of nitrates overall and specifically from food additives and non-additives sources had a higher risk of developing type 2 diabetes.
“These results provide a new piece of evidence in the context of current discussions regarding the need for a reduction of nitrite additives’ use in processed meats by the food industry, and could support the need for better regulation of soil contamination by fertilizers,” the researchers said in a statement.