It’s no secret that eating more plants is good for everyone’s health. The nutrients and antioxidants they provide protect cells from oxidative damage and inflammation. That may in turn, reduce the risk of developing many chronic diseases, including diabetes.

However, people with prediabetes or diabetes often ask whether diets that restrict animal protein are a good choice for managing blood sugar, or are they too high in carbohydrates? Here’s a look at some current research and recommendations for patients regarding vegetarian and vegan diets.

Research on Diabetes and Vegetarian Diets

Vegetarian diets can range from vegan, which restricts all animal foods, to those which include eggs, dairy, and occasionally fish or chicken. All types of vegetarian diets can have health benefits. In particular, research suggests that compared to people who eat more animal foods, and especially meat, vegetarians and vegans have a lower risk of developing diabetes.

• In a study on nearly 3,000 Buddhists, those with a lifelong adherence to a vegetarian diet had a 35% lower risk of developing diabetes.

• Research on Seventh Day Adventists, who commonly follow various vegetarian diet patterns, shows that this population has 45% of diabetes rates compared to the general public. In addition, a study that followed 8,400 Seventh Day Adventists for 17 years found that among those who ate meat just once per week, the risk of developing diabetes increased by 29%.

• A more in-depth look into the Adventist population and their different types of vegetarian diets found that vegans had the lowest risk of developing diabetes. They were followed by lacto-ovo vegetarians, then pesco-vegetarians, and finally, semi-vegetarians who ate meat occasionally, but not daily.

• Research on diabetes management also supports the use of both vegan and vegetarian diets. A meta-analysis that looked at five studies on vegans and one on lacto-ovo-vegetarians found that both types of diets reduced A1c levels over an average 24-week period.3

• Finally, a small study on 93 Asian people with diabetes compared the effects of a brown-rice vegan diet, which provided an average 76% of calories from carbohydrates and a Korean Diabetes Association diet, which averaged 64% carbohydrate. While both improved A1c levels, researchers found the vegan diet to be slightly more effective, with a more considerable reduction in A1c levels after 12 weeks.

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Numerous advances in diabetes management and medical nutrition therapy (MNT) for individuals with diabetes make this an exciting time. Historically, a challenge to proving the benefit of MNT has been the lack of clinical and behavioral research. In recent years, however, evidence-based outcomes research that documents the clinical effectiveness of MNT in diabetes has been reported.

The term “medical nutrition therapy” was introduced in 1994 by the American Dietetic Association to better articulate the nutrition therapy process. It is defined as the use of specific nutrition services to treat an illness, injury, or condition and involves two phases: 1) assessment of the nutritional status of the client and 2) treatment, which includes nutrition therapy, counseling, and the use of specialized nutrition supplements (1). MNT for diabetes incorporates a process that, when implemented correctly, includes: 1) an assessment of the patient’s nutrition and diabetes self-management knowledge and skills; 2) identification and negotiation of individually designed nutrition goals; 3) nutrition intervention involving a careful match of both a meal-planning approach and educational materials to the patient’s needs, with flexibility in mind to have the plan be implemented by the patient; and 4) evaluation of outcomes and ongoing monitoring. These four steps are necessary to assist patients in acquiring and maintaining the knowledge, skills, attitudes, behaviors, and commitment to successfully meet the challenges of daily diabetes self-management (2).

The primary purpose of this article is to review the evidence for the effectiveness of MNT in diabetes, both as an independent variable and in combination with other components of diabetes self-management training (DSMT). In addition, the recent studies that have demonstrated the effectiveness of lifestyle intervention, which included MNT, in preventing type 2 diabetes will be highlighted. Evidence from several studies that supports the cost-effectiveness of MNT in diabetes will also be presented.

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