Q&A: People with diabetes can benefit from whole foods, plant-based eating plan
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Susan Weiner, MS, RDN, CDN, CDCES, FADCES, talks with Lauren Plunkett, RDN, LD, CDCES, about benefits of plant-based nutrition for people with diabetes and strategies for incorporating whole foods and plants into eating plans.
Weiner: What are some health benefits of plant-based eating? Is there evidence that plant-based eating plans are beneficial for people living with diabetes or other chronic diseases?
Plunkett: Evidence strongly supports the benefits of a plant-predominant diet on physical and mental health. Decades of research has explored the role of nutrition in prevention and improvement of chronic conditions, particularly in diabetes care.
With respect to prevention and longevity, whole foods, plant-based eating plans consistently outperform high-fat, high-protein, animal-based diets. Substantial findings highlight the effectiveness of low-fat whole foods, plant-based diets in improving blood glucose levels, managing body weight and promoting cardiovascular health. The evidence is substantial for all types of diabetes, including prediabetes.
Additionally, there is an advantage to plant-based nutrition on athletic performance attributable to recovery efficiency. On a personal note, I can attest to the positive impact of a whole foods, plant-based diet in reducing insulin resistance. Having lived with type 1 diabetes for over 30 years, I adopted a plant-based lifestyle 14 years ago. In this time, I’ve experienced noticeable improvements in my overall health and athletic ability.
A disease-fighting and performance-enhancing eating plan includes foods rich in nutrients and short-chain fatty acids derived from plants. For people with diabetes, gut health is of the utmost importance. Our microbiome is connected to every system in our bodies, and the health of these systems impacts our mental and emotional health; the way we think and feel are essential considerations in a life-altering disease like diabetes.
Weiner: What advice can you give a person who is concerned about the carbohydrate content of a plant-based eating plan? Is a plant-based diet restrictive in terms of selection or food choice?
Plunkett: People with diabetes have the same nutrient needs as all well-nourished people and do not require restrictions on nutritious plant foods. Vegetables, fruit, beans and whole grains are abundant in health-promoting properties. In contrast, pastries and chips are also categorized as carbohydrates, yet they differ significantly in terms of nutritional content. For instance, cookies, doughnuts and chips have a high percentage of fat with little to no fiber. Despite all these foods being classified as carbohydrates, their impact on digestion and overall nutritional value varies considerably.
Research highlighting the positive effects of nutritionally adequate and personalized carbohydrate intake has been available for over a century, dating back to the discovery of insulin. However, early studies were not promoted for euglycemia as the emphasis on control advocated for carbohydrate restriction. The notion that “carbs raise blood glucose and therefore must be limited” became the dominant recommendation for decades.
Importantly, insulin resistance is not caused by low-fat whole foods, plant-based foods.
I encourage people with all types of diabetes to eat a wide variety of foods that reduce insulin resistance, while limiting their intake of foods that contribute to the condition. Discovering that carbohydrates are a solution to improving metabolic health might be surprising, given the prevalent misconception that carbohydrates are the problem. However, we can be confident of the health benefits of vegetables and fruits, while incorporating more of them into our diet at our own pace. Gradually increasing portions of beans and whole grains while decreasing the consumption of foods high in saturated fat, oil and added sugar is another positive step.
Transitioning to a whole foods, plant-based diet can be a big change and having support is crucial. Working with a professional well versed in plant-based nutrition can make for a smooth adjustment to this lifestyle, especially considering the constant influx of inaccurate nutrition advice. Trusting the process becomes more achievable with the right guidance.
Weiner: Does plant-based eating provide adequate nutrition for people living with diabetes and other chronic health conditions, such as cardiovascular disease?
Plunkett: Absolutely, yes! We can optimize our nutrition effectively without consuming any animal products.
The foundation of nourishment starts with selecting a wide variety of whole plant foods to ensure that individual macronutrient and micronutrient needs are met. Energy needs are a top priority when transitioning to a whole foods, plant-based diet. Individuals can consider supplementing vitamin D and B12, which is a concern not exclusive to herbivores as omnivores often face deficiencies in these nutrients as well.
Whole plant foods offer an abundance of immune-boosting and disease-fighting properties that are not found in animal products. Contrary to common belief, the idea that plants lack essential amino acids is a misconception. With few exceptions, the majority of widely consumed plant foods contain all amino acids, eliminating the need for specific combinations to form complete proteins. Instead, eating a variety of plant foods is the best method for obtaining all the nutrients, including protein, and an abundance of fiber that individuals need.
Weiner: How can a person begin to increase their consumption of plant-based foods and the fiber content of their diet?
Plunkett: The simplest first step is to identify whole, fiber-rich foods that you already enjoy in your own kitchen. From here, craft a grocery list focused on high-fiber foods that includes beans, vegetables, fruit and whole grains, to expand your options. Emphasize flavor by incorporating herbs and spices and add them to your list. Be aware that taste buds tend to evolve and “awaken” as fat, sugar and salt intake decreases.
If your current fiber intake is low, increase these foods gradually toward 25 g per day for women and 38 g per day for men. Many people who eat a whole foods, plant-based diet see the best results from eating more than 40 g of fiber per day. There are many low-fat whole foods, plant-based recipes specifically designed to help reverse insulin resistance. The websites below are a good place to start:
Consider consulting with a registered dietitian for personalized guidance. A dietitian can calculate daily grams of carbohydrates, protein and fat based on individual nutrient needs. These calculations are relevant for everyone with health goals, whether they are competitive athletes, individuals aiming for weight loss or growing kids.
References:
- Barber TM, et al. Nutrients. 2021;doi:10.3390/nu13041187.
- Gardner C, et al. Nutr Rev. 2019;doi:10.1093/nutrit/nuy073.
- Jardine MA, et al. Adv Nutr. 2021;doi:10.1093/advances/nmab063.
- Kelly KL, et al. ADCES Practice. 2023; doi:10.1177/2633559X231166930.
- Shang X, et al. Am J Clin Nutr. 2016;doi:10.3945/ajcn.116.140954.
- Toumpanakis A, et al. BMJ Open Diabetes Res Care. 2018;doi:10.1136/bmjdrc-2018-000534.
For more information:
Lauren Plunkett, RDN, LD, CDCES, is a registered dietitian nutritionist and certified diabetes care and education specialist. She has lived with type 1 diabetes for more than 30 years. She specializes in performance nutrition, diabetes health coaching and type 2 diabetes remission. She is author of Type One Determination. She can be reached at lauren@lpnutritionconsulting.com.
Susan Weiner, MS, RDN, CDN, CDCES, FADCES, is co-author of The Complete Diabetes Organizer and Diabetes: 365 Tips for Living Well. She is the owner of Susan Weiner Nutrition PLLC and is the Endocrine Today Diabetes in Real Life column editor. She can be reached at susan@susanweinernutrition.com; X (Twitter): @susangweiner.
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