Type 2 diabetes and the vegetarian diet

Type 2 diabetes and the vegetarian diet1,2,3,4
David JA Jenkins, Cyril WC Kendall, Augustine Marchie, Alexandra L Jenkins,
Livia SA Augustin, David S Ludwig, Neal D Barnard and James W Anderson
1 From the Clinical Nutrition & Risk Factor Modification Center (DJAJ, CWCK,
AM, ALJ, and LSAA) and the Department of Medicine, Division of Endocrinology
and Metabolism (DJAJ), St Michael's Hospital, Toronto; the Department of
Nutritional Sciences, Faculty of Medicine, University of Toronto (DJAJ,
CWCK, AM, and LSAA); the Department of Medicine, Children's Hospital, Boston
(DSL); the Physicians Committee for Responsible Medicine, Washington, DC
(NDB); and the VA Medical Center, Graduate Center for Nutritional Sciences,
University of Kentucky, Lexington (JWA).


Based on what is known of the components of plant-based diets and their
effects from cohort studies, there is reason to believe that vegetarian
diets would have advantages in the treatment of type 2 diabetes. At present
there are few data on vegetarian diets in diabetes that do not in addition
have weight loss or exercise components. Nevertheless, the use of
whole-grain or traditionally processed cereals and legumes has been
associated with improved glycemic control in both diabetic and
insulin-resistant individuals. Long-term cohort studies have indicated that
whole-grain consumption reduces the risk of both type 2 diabetes and
cardiovascular disease. In addition, nuts (eg, almonds), viscous fibers (eg,
fibers from oats and barley), soy proteins, and plant sterols, which may be
part of the vegetarian diet, reduce serum lipids. In combination, these
plant food components may have a very significant impact on cardiovascular
disease, one of the major complications of diabetes. Furthermore,
substituting soy or other vegetable proteins for animal protein may also
decrease renal hyperfiltration, proteinuria, and renal acid load and in the
long term reduce the risk of developing renal disease in type 2 diabetes.
The vegetarian diet, therefore, contains a portfolio of natural products and
food forms of benefit for both the carbohydrate and lipid abnormalities in
diabetes. It is anticipated that their combined use in vegetarian diets will
produce very significant metabolic advantages for the prevention and
treatment of diabetes and its complications