The study, which was conducted by a team from Harvard T.H. Chan School of Public Health in Boston, sought to identify metabolite profiles related to different plant-based diets and investigate possible associations between the profiles and the risk of developing T2D.
Over 90 percent of diabetes cases are T2D. Global prevalence of T2D in adults has more than tripled in less than two decades, with cases increasing from around 150 million in 2000 to over 450 million in 2019. It is expected to further rise to around 700 million by 2045.
The global health burden of T2D is further increased by the complications arising from the disease that could damage the kidneys, the eyes and the nervous system. The diabetes epidemic is caused by unhealthy diets, obesity, genetic predisposition and other lifestyle factors like lack of exercise.
On the other hand, the consumption of plant-based foods like whole grains, fruits and vegetables has been associated with a lower risk of developing T2D, but the underlying mechanisms involved are still not fully understood. (Related: Intermittent fasting works like a diabetes drug, study finds... and it also reduces inflammation throughout the body.)
For their study, the team conducted an analysis of blood plasma samples and the dietary intake of 10,684 participants from prospective cohorts. The participants were predominantly white and middle-aged, with a mean body mass index of 25.6 kg/m2.
The researchers also looked at data from earlier studies. Analysis of these results enabled the team to find correlations between metabolite profile, diet index and T2D risk.
The study found that compared with participants who did not develop T2D, those who were diagnosed with the disease during the follow-up had a lower intake of healthy plant-based foods, as well as lower plant-based diet index (PDI) and healthy PDI (hPDI) scores. Moreover, they also had a higher average body mass index (BMI) and were more likely to have high blood pressure and cholesterol levels. They also use blood pressure and cholesterol drugs, have a family history of diabetes and are less physically active.
Professor Frank Hu, one of the researchers, explained that while it is difficult to tease out the contributions of individual foods because they were analyzed as a pattern, individual metabolites from consumption of polyphenol-rich foods are all closely linked to healthy plant-based diets and lower risk of diabetes.
"Our findings support the beneficial role of healthy plant-based diets in diabetes prevention and provide new insights for future investigation…our findings regarding the intermediate metabolites are at the moment intriguing, but further studies are needed to confirm their causal role in the associations of plant-based diets and the risk of developing type 2 diabetes," the researchers said. (Related: Exploring the inhibitory activity of Tinospora cordifolia (heart-leaved moonseed) against diabetes symptoms.)
These findings have been supported by a wealth of previous evidence suggesting that vegan and vegetarian diets are good for people. Hu said the results in themselves are not surprising, given that the health benefits of healthy, plant-based foods have been well-d0cumented. He also said that understanding the link between specific compounds and plant foods could help better inform people which diets are healthiest for preventing certain illnesses like diabetes.
However, not all plant-based diets were equally beneficial. Those that are high in processed plant-based foods such as refined grains, fruit juice, potatoes and sweets were not linked to a lower risk of diabetes.
Based on data from metabolites, it seems that specific nutrients in polyphenol-rich foods may account for the health benefits of certain plant-based diets. Coffee, for instance, is high in trigonelline, which is linked to better insulin sensitivity in some research. Another compound linked to the consumption of coffee called hippurate has been linked to more stable blood sugar.
"When adopting a plant-based diet, we recommend consumers to choose healthy plant foods, such as whole grains, fruits, vegetables, legumes and nuts. Limit the consumption of unhealthy plant foods, such as refined grains like white bread and pizza and high glycemic foods like sweets and sugar-sweetened beverages," Hu said.
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