Plant-predominant whole-food diet could be “primary intervention” in fight against diabetes, experts find

Lots of fruits and vegetables on display at an outdoor market.

22 Jun 2023 — Lifestyle and eating pattern changes may be the best option for Type 2 diabetes management, according to a recent review. Moreover, the team of US-based researchers found that 37% of participants achieved remission of the disease by eating healthy foods without including liquid meal replacements or enacting “severe” caloric restrictions.

The results were obtained using a low-fat, whole-food and mainly plant-based diet.

“This case series further supports the effectiveness of a whole-food, plant-predominant eating pattern as a primary intervention to achieve remission,” says Dr. Gunadhar Panigrahi, the lead author of the study. “The need for increased education for both clinicians and patients on the successful application of lifestyle medicine principles and dietary interventions in everyday medical practice.”

Small changes, big results
The prevalence of Type 2 diabetes is on the rise, with the World Health Organization reporting that, globally, about 422 million people have some form of diabetes, resulting in about 1.5 million deaths annually.

A person pricks their finger to perform a blood glucose test.

Out of the 59 participants, 22 achieved remission of Type 2 diabetes.

Recently, researchers found that poor and unhealthy diets led to an increase of 14.1 million new cases in 2018 alone and another study showed that even implementing more whole grains could save between US$349 million and US$1.2 billion in healthcare costs.

The study, published in the American Journal of Lifestyle Medicine, included 50 diabetic patients aged 41 to 89 years. Many of the participants experienced significant reductions in body mass index (BMI) and lower fasting glucose levels. Furthermore, 22 of the patients met the criteria for full remission of the disease.

The authors note that previous studies have had similar findings but often included substantial caloric restrictions or liquid meal replacements.

“The prevalence of diabetes is growing, as is recognition in the health care community that diet as the primary intervention can achieve lasting remission in individuals with Type 2 diabetes,” says Panigrahi.

The needle in the haystack
The researchers used patients’ electronic health records to identify those who had adopted and maintained the eating habits and looked for meaningful improvements in blood glucose or HbA1c levels from the periods immediately before and after instituting the lifestyle and diet changes – though the specific timeframes from adoption to remission were not mentioned.

Additionally, the study utilized the consensus definition of Type 2 diabetes remission as put forth by the American College of Lifestyle Medicine (ACLM) in 2022. The report defines remission as “HbA1c less than 6.5% for at least three months without surgery, devices or active pharmacologic therapy to lower blood glucose.”

“Although full remission may not be possible for every patient, our research shows that every patient deserves to know that it may be possible through the adopting of appropriately dosed therapeutic lifestyle change,” highlights Dr. Micaela Karlsen, ACLM’s senior director of research.

The authors highlight that the results were obtained with significant calorie restrictions or liquid meal replacements.

Plant-predominant prophylaxis
The researchers noted that most of the patients surveyed did not self-opt in the lifestyle change but were coached and led through by healthcare providers and wellness centers.

This emphasizes the need of caregivers to be knowledgeable in this area and to stress the necessity of physical exercise and proper diet.

Dr. Karlsen also notes that changing sentiments regarding the plant-predominant is changing and physicians and patients alike can use these shifts to save lives and improve life quality.

“There is a perception that many patients may not accept the idea of adopting a whole-food, plant-predominant eating pattern,” she explains. “But there is a growing abundance of research that shows adherence to a plant-predominant dietary pattern is feasible and even enjoyable.”

Edited by William Bradford Nichols

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