Dietary Patterns and Whole Plant Foods in Type 2 Diabetes Prevention and Management

Abstract

A healthy lifestyle including habitual intake of a high quality dietary pattern, regular physical activity, and weight control are key components of type 2 diabetes (diabetes) prevention and management. Prospective cohort studies show that high quality dietary patterns including the Alternative Healthy Eating Index score have a significant inverse association with diabetes risk, and Western dietary patterns have a positive association with risk. Higher adherence to the Mediterranean diet (MedDiet) is associated with a 19–23% reduced risk of developing diabetes, while the results of randomized controlled trials (RCTs) show that the MedDiet can reduce risk of diabetes by 30% and can reduce glycosylated hemoglobin (HbA1c) levels by 0.30–0.47% in people with diabetes. Other healthy dietary patterns which are effective in reducing diabetes risk and in management of diabetics’ health are the Dietary Approaches to Stop Hypertension (DASH), vegan and the healthy Nordic food index diets. Prospective cohort studies show that whole (minimally processed) plant foods including whole-grains, fruits, vegetables, dietary pulses, and nuts and flaxseed are significantly associated with lower risk of diabetes. For whole grains, 3 servings/day reduced diabetes risk by 23% and of the whole-grains oats and oat bran are the most effective in managing glycemic control in people with diabetes. For fruits and vegetables, higher intake of fruits, especially berries, and green leafy vegetables, yellow vegetables, non-starchy root and cruciferous vegetables are particularly effective in lowering diabetes risk. Three weekly servings of French fries significantly increase diabetes risk by 41% compared to only 5% for other forms of potatoes (baked, boiled or mashed). Higher intake of sugar sweetened fruit juice is significantly associated with increased diabetes risk by 28%, while higher intake of 100% fruit juice is not associated with diabetes risk. Higher intake of dietary pulses, peanuts, tree nuts and flaxseed are also associated with lower diabetes risk. Healthy dietary patterns and specific whole foods beneficially affect glycemic and cardiometabolic risk factors, which are important for preventing and managing diabetes, by helping to control body weight, visceral fat, glucose-insulin homeostasis, oxidative stress, inflammation, and endothelial health, lipoprotein concentrations, and blood pressure.