A Plant-Based Diet For The Prevention And Treatment Of Type 2 Diabetes, Journal of Geriatric Cardiology, May 2017

Abstract
The prevalence of type 2 diabetes is rising worldwide, especially in older adults. Diet and lifestyle, particularly plant-based diets, are effective tools for type 2 diabetes prevention and management. Plant-based diets are eating patterns that emphasize legumes, whole grains, vegetables, fruits, nuts, and seeds and discourage most or all animal products. Cohort studies strongly support the role of plant-based diets, and food and nutrient components of plant-based diets, in reducing the risk of type 2 diabetes. Evidence from observational and interventional studies demonstrates the benefits of plant-based diets in treating type 2 diabetes and reducing key diabetes-related macrovascular and microvascular complications. Optimal macronutrient ratios for preventing and treating type 2 diabetes are controversial; the focus should instead be on eating patterns and actual foods. However, the evidence does suggest that the type and source of carbohydrate (unrefined versus refined), fats (monounsaturated and polyunsaturated versus saturated and trans), and protein (plant versus animal) play a major role in the prevention and management of type 2 diabetes. Multiple potential mechanisms underlie the benefits of a plant-based diet in ameliorating insulin resistance, including promotion of a healthy body weight, increases in fiber and phytonutrients, food-microbiome interactions, and decreases in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron.

Conclusions
There is a general consensus that the elements of a whole-foods plant-based diet—legumes, whole grains, fruits, vegetables, and nuts, with limited or no intake of refined foods and animal products—are highly beneficial for preventing and treating type 2 diabetes. Equally important, plant-based diets address the bigger picture for patients with diabetes by simultaneously treating cardiovascular disease, the leading cause of death in the United States, and its risk factors such as obesity, hypertension, hyper-lipidemia, and inflammation. The advantages of a plant-based diet also extend to reduction in risk of cancer, the second leading cause of death in the United States; the World Cancer Research Fund and the American Institute for Cancer Research recommend eating mostly foods of plant origin, avoiding all processed meats and sugary drinks, and limiting intake of red meats, energy dense foods, salt, and alcohol for cancer prevention.[149] Large healthcare organizations such as Kaiser Permanente are promoting plant-based diets for all of their patients because it is a cost effective, low-risk intervention that treats numerous chronic illnesses simultaneously and is seen as an important tool to address the rising cost of health care.[147] Plant-based eating patterns also carry significant environmental benefits. The World Health Organization and the United Nations have promoted diets higher in plant foods as not only effective for preventing chronic diseases and obesity, but also more environmentally sustainable than diets rich in animal products,[150] a position also supported in the scientific report of the 2015 United States Dietary Guidelines Advisory Committee.[151] While larger interventional studies on plant-based diets carried out for longer periods of time would add even more weight to the already mounting evidence, the case for using a plant-based diet to reduce the burden of diabetes and improve overall health has never been stronger.

Plant-based diets tend to be high in carbohydrates. It’s a good idea, as they stated, to choose carbohydrates that are less refined. That increases fiber, slows absorption, and often provides more nutrients.

After writing about this for years, it’s gratifying to see it move into the mainstream.