Healthy plant-based diet linked to lower risk for type 2 diabetes
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Metabolite profiles demonstrate that eating a healthy plant-based diet rich in whole grains, fruits, vegetables and nuts can lower one’s risk for developing type 2 diabetes, according to study findings published in Diabetologia.
In an analysis of dietary profiles from people in three prospective cohorts, individuals who ate more healthy plant-based food had a different metabolite profile and a lower risk for developing type 2 diabetes than those who ate a diet rich in “unhealthy” plant-based foods, such as refined grains, potatoes and sweets.
“Healthy plant-based diets could be promoted for type 2 diabetes prevention,” Frank B. Hu, MDPhD, professor and chair of the department of nutrition at the Harvard T.H. Chan School of Public Health, told Healio. “The metabolite profiles we identified could be used to assess the adherence and metabolic response to plant-based diets during dietary interventions.”
Hu and colleagues collected data from three prospective cohort studies: the Nurses’ Health Study, Nurses’ Health Study II and the Health Professionals Follow-Up Study. A total of 8,827 participants with dietary intake data available were included. Blood samples were analyzed from each participant and semiquantitative food frequency questionnaires were used to evaluate self-reported dietary data. Healthy plant-based foods included whole grains, fruits, vegetables, nuts, legumes, vegetable oil, tea and coffee; unhealthy plant-based foods included refined grains, fruit juices, potatoes, sugar-sweetened beverages, and sweets and desserts; and animal-based foods included animal fats, dairy, eggs, fish, meat and other animal-based products. An overall plant-based diet index, a healthy plant-based diet index and an unhealthy plant-based diet index were developed to assess participants’ diet adherence based on their food frequency questionnaire responses. Elastic net regression combined with a test and training approach was used to identify metabolite profiles correlated to plant-based diets.
A panel of 55 metabolites was correlated with an overall plant-based diet, a panel of 93 metabolites correlated with a healthy plant-based diet and a panel of 75 metabolites correlated with an unhealthy plant-based diet.
After multivariable adjustment, participants with a higher plant-based diet index score (adjusted HR = 0.83; 95% CI, 0.76-0.9) and a higher healthy plant-based diet index score (aHR = 0.8; 95% CI, 0.73-0.87) had a reduced risk for type 2 diabetes.
“We did not observe an association between the metabolite profile of unhealthy plant-based diets and type 2 diabetes risk,” Hu said. “One reason could be that the metabolomics platform adopted in the present study did not adequately capture the harmful metabolic effects of unhealthy plant foods.”
Of the metabolites analyzed in the study, the gamma-aminobutyric acid, C5-carnitine and three triacylglycerol metabolites were associated with a lower plant-based diet index score and a higher risk for type 2 diabetes. Conversely, trigonelline, betaine and glycine were associated with a higher plant-based diet index score and lower risk for type 2 diabetes. Isoleucine, C22:0 ceramide and six triacylglycerol metabolites were inversely associated with a healthy plant-based diet index and an increased type 2 diabetes risk, whereas trigonelline, hippurate and C22:6 ceramide were associated with a higher healthy plant-based diet index score and a lower risk for type 2 diabetes.
“Further studies are needed to understand the role of healthy vs. unhealthy plant-based foods and diets in reducing risk of other chronic diseases including heart disease, stroke and cancer,” Hu said.
For more information:
Frank B. Hu, MD, PhD, can be reached at fhu@hsph.harvard.edu.
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The data from three large cohort studies from more than 10,000 participants showed that plasma metabolite profiles related to plant-based diets, assessed by high-throughput liquid chromatography mass spectrometry, were associated with a reduced risk for type 2 diabetes. Metabolite profile scores for the overall plant-based diet index were associated with a 19% lower risk and the ones for the healthy plant-based diet index with a 23% lower risk, whereas the metabolite profile score for unhealthy plant-based diet index was not associated with the risk for type 2 diabetes.
These findings are in line with previous studies that showed benefits of plant-based diets in the prevention of type 2 diabetes and are important for two main reasons. First, the identified metabolic profiles may be used as biomarkers of plant-based diets in future studies, and second, they provide insights into metabolic response to plant-based diets for the prevention of type 2 diabetes. This study is a good reminder to put fruits, vegetables, whole grains and legumes in the center of the dietary recommendations for diabetes prevention.
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