Abstract
Background/objectivesVegetarian diets are inversely associated with diabetes in Westerners but their impact on Asians—whose pathophysiology differ from Westerners—is unknown. We aim to investigate the association between a vegetarian diet, change in dietary patterns and diabetes risk in a Taiwanese Buddhist population.MethodsWe prospectively followed 2918 non-smoking, non-alcohol drinking Buddhists free of diabetes, cancer, and cardiovascular diseases at baseline, for a median of 5 years, with 183 incident diabetes cases confirmed. Diet was assessed through a validated food frequency questionnaire at baseline and a simple questionnaire during follow-ups. Incident cases of diabetes were ascertained through follow-up questionnaires, fasting glucose and HbA1C. Stratified Cox Proportional Hazards Regression was used to assess the effect of diets on risk of diabetes.ResultsConsistent vegetarian diet was associated with 35% lower hazards (HR: 0.65, 95% CI: 0.46, 0.92), while converting from a nonvegetarian to a vegetarian pattern was associated with 53% lower hazards (HR: 0.47, 95% CI: 0.30, 0.71) for diabetes, comparing with nonvegetarians while adjusting for age, gender, education, physical activity, family history of diabetes, follow-up methods, use of lipid-lowering medications, and baseline BMI.ConclusionVegetarian diet and converting to vegetarian diet may protect against diabetes independent of BMI among Taiwanese.
Highlights
The rapid growth of diabetes creates tremendous health and economic burdens worldwide[1]
Consistent vegetarian diet was associated with 35% lower hazards (HR: 0.65, 95% CI: 0.46, 0.92), while converting from a nonvegetarian to a vegetarian pattern was associated with 53% lower hazards (HR: 0.47, 95% CI: 0.30, 0.71) for diabetes, comparing with nonvegetarians while adjusting for age, gender, education, physical activity, family history of diabetes, follow-up methods, use of lipid-lowering medications, and baseline BMI
Vegetarian diet and converting to vegetarian diet may protect against diabetes independent of BMI among Taiwanese
Summary
The rapid growth of diabetes creates tremendous health and economic burdens worldwide[1]. Preventive strategies are desperately needed, in Asia, where the largest number of diabetes cases is expected[1], and diabetes tend to occur despite lower BMI4. Diabetes is driven by impaired insulin action (insulin resistance) and insulin secretion (islet dysfunction and incretin failure), co-influenced by genetics and environment[5]. While diabetes in Caucasian is highly attributed to obesity and insulin resistance, emerging evidence suggests that β-cell dysfunction may be more predictive of diabetes in East Asians[6]. Japanese with normal glucose tolerance already showed an insulin secretion ability similar to Caucasian diabetes patients[7]. The potential pathophysiological difference warrants research on population-specific preventive strategies
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