IS A PLANT-BASED DIET BENEFICIAL FOR DIABETES MANAGEMENT AND PREVENTION?

Images are for illustrative purposes only. MAT-SG-2200066-1.0 (03.2022).

What you need to know

How is a diabetic diet different from a normal diet? Eating certain foods while limiting others can help you manage diabetes. Eating more red meat and poultry is linked to diabetes risk.¹ Researchers from Duke-NUS Medical School Singapore (Duke-NUS) found that Chinese Singaporeans who ate more red meat and poultry in their diet were 23% and 15% more likely to develop type 2 diabetes, respectively.¹ This increased risk of diabetes is attributed to the higher content of heme-iron – the type of iron found in animal foods – in these meats. The findings of this study were consistent with other Western studies in which higher red meat intake and a diet with high heme-iron content were linked to greater risk of diabetes.^2-4

That said, should you remove meat from your diet entirely to achieve better diabetes management? Or you might be wondering if a plant-based diet is beneficial in keeping diabetes at bay.

Following a healthy diet and staying active are crucial for the management and prevention of diabetes.^5,6 A minimum intake of 400 g fruits and vegetables per day is recommended to prevent chronic diseases, including diabetes.⁶ In fact, individuals with a diet consisting of more vegetables and a wider variety of both fruits and vegetables are at lower risk of developing diabetes.⁷

While a plant-based diet emphasizes eating more whole foods and plants, including vegetables, fruits, whole grains, legumes, nuts and seeds, it is flexible as to whether it is necessary to limit or exclude all animal products – as opposed to a vegan diet. Diets rich in healthy plant foods and lower animal foods have been shown to reduce the risk of diabetes by about 20%.⁸ So, yes, a plant-based diet may well be worth trying if you have diabetes, but it may not be necessary to go completely meatless. For instance, fresh or unprocessed meat is a healthier choice than processed meat. Fish could also be a beneficial alternative within the animal food groups.^1,8  

If you are shifting to a more plant-based diet, it is important to make conscious choices of healthier plant foods than less healthy ones such as fruit juices, refined grains, potatoes and sweets / desserts.⁸ Research has shown that a plant-based diet that emphasized healthy plant foods can reduce diabetes risk by 34% whereas a diet that is made up of less healthy plant foods increased diabetes risk by 16%.⁸

The rise of plant-based meat

By now, you would have heard a lot about plant-based meat – the ones that are lab-grown or cultured. “Meatless meat”, essentially. Although it may be tempting to replace traditional meat alternatives such as jackfruit and soy-based foods with plant-based meat, would it be any healthier?

Not all plant-based meats are created equally and inherently healthy. It is important to consider the nutritional composition of plant-based meat. For instance, jackfruit and soy-based foods are low in calories and sodium, and are saturated-fat free.⁹ However, plant-based meats can be high in sodium, saturated fat and calories; they are also arguably more processed than whole foods.

Additionally, plant-based meats may also contain soy leghemoglobin – a genetically engineered plant-based heme – that has an equivalent bioavailability to the heme iron found in meat.^10,11 Although the long-term safety of soy leghemoglobin remains unknown,¹⁰ heme-iron has been associated with increased diabetes risk.^2-4

The bottom line

Your diet matters in the management of diabetes. However, convenience and costs of unhealthier options may make healthier choices and sticking to healthy eating more challenging.Whether shifting to a more plant-based diet or swapping out meat if you have diabetes is absolutely a personal choice. The bottom line is having a balanced diet and keeping in mind the principles of healthy eating.

Getting started with a more plant-based diet, if you have diabetes

Here are some tips to get started:¹²

1. Vary protein sources – whole grains, legumes, nuts and leafy greens are also good sources of protein if you are looking to limit animal foods.
2. Choose complex carbs – they are often high in protein and fiber, thus slowing down the rate at which glucose enters your blood stream.
3. Limit processed snacks – keeping to whole foods is your best option.
4. Prioritize your nutrient needs – certain nutrients may be scarce in some plant-based foods. Be sure to find ways to meet your nutrient needs.
5. Prioritize eating fruits and vegetables with low glycemic index (GI) values – this helps to maintain ideal blood sugar levels.¹³ GI measures the impact of a carbohydrate food on blood sugar.¹⁴

If you are visiting a hawker centre and wonder if it’s possible at all to keep to your plant-based diet, here are some food options:¹⁵

1. Chapati
2. Popiah
3. Thunder tea rice – choose brown rice
4. Unsweetened soy milk
5. Sliced fish bee hoon – if you are not excluding animal foods!

References

1. Talaei M, et al. Am J Epidemiol 2017;186:824–33.
2. Aune D, et al. Diabetologia 2009;52:2277–87.
3. Pan A, et al. Am J Clin Nutr 2011;94:1088–96.
4. Fernandez-Cao JC, et al. BMC Public Health 2013;13:1042.
5. American Diabetes Association. Diabetes Care 2017;40(Supplement_1):S33–S43.
6. World Health Organization. Diet, nutrition and the prevention of chronic diseases. Available at: http://apps.who.int/iris/bitstream/handle/10665/42665/WHO_TRS_916.pdf;jsessionid=E5D9663C09378C80D5C3364B1988476C?sequence=1. Accessed February 2022.
7. Cooper AJ, et al. Diabetes Care 2012;35:1293–300.
8. Satija A, et al. PLoS Med 2016;13:e1002039.
9. Healthline. Incorporating plant-based meat alternatives into your healthy diet. Available at: https://www.healthline.com/nutrition/is-plant-based-meat-healthy#options. Accessed February 2022.
10. Healthline. What is impossible burger, and is it healthy? Available at: https://www.healthline.com/nutrition/impossible-burger. Accessed February 2022.
11. Proulx AK, Reddy MB. J Agric Food Chem 2006;54:1518–22.
12. Ball J. Can you follow a plant-based diet if you have diabetes? Here’s what you need to know. Available at: https://www.eatingwell.com/article/7911723/can-you-follow-a-plant-based-diet-if-you-have-diabetes/. Accessed February 2022.
13. Asif M. Int J Nutr Pharmacol Neurol Dis 2011;1:27–35.
14. Health Hub. What is the glycaemic index? Available at: https://www.healthhub.sg/live-healthy/1329/what-is-the-glycaemic-index. Accessed February 2022.
15. AsiaOne. What to eat (and avoid) in hawker centres if you have diabetes. Available at: https://www.asiaone.com/lifestyle/what-eat-and-avoid-hawker-centres-if-you-have-diabetes. Accessed February 2022.