According to a new study, eating a nutritious plant-based diet is linked to a decreased risk of diabetes.

Consumption of healthy plant-based foods, such as fruits, vegetables, nuts, coffee, and legumes, is linked to a lower risk of developing type 2 diabetes (T2D) in otherwise healthy people, according to new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

Professor Frank Hu and colleagues at Harvard T.H. Chan School of Public Health, Boston, MA, USA, performed the study intended to discover metabolite profiles associated with various plant-based diets and evaluate any correlations between those profiles and the risk of developing T2D.

What's In the Diet?

Many substances in various diets and the complex diversity of molecules made when those compounds are broken down and converted for use by the body are all metabolites. Because foods have different chemical compositions, an individual's metabolite profile should mirror their diet.

Recent improvements in high-throughput metabolomics profiling have ushered in a new age of nutritional study. The full examination and identification of all the various metabolites in a biological sample are called metabolomics.

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Type 2 Diabetes

Type 2 diabetes accounts for over 90% of all diabetes cases, and it is a huge health hazard worldwide. In less than two decades, the global frequency of the illness in adults has quadrupled, with instances rising from roughly 150 million in 2000 to over 450 million in 2019, with a predicted rise to around 700 million in 2045.

T2D's worldwide health impact is exacerbated by the illness's various macrovascular, such as cardiovascular disease and microvascular, which affect the kidneys, eyes, and neurological system. Unhealthy diets, being overweight or obese, genetic susceptibility, and other lifestyle factors such as a lack of exercise are the primary causes of diabetes.

Plant-based diets, mainly those high in high-quality foods such as whole grains, fruits, and vegetables, have been linked to a decreased incidence of T2D, although the underlying processes are unknown.

The researchers analyzed blood plasma samples and food consumption of 10,684 people from three prospective cohorts (Nurses' Health Study, Nurses' Health Study II, and Health Professionals Follow-up Study). The majority of the participants were Caucasian, middle-aged (mean age 54 years), and had a BMI of 25.6kg/m2.

Participants

Participants in the study completed food frequency questionnaires (FFQs) that were assessed based on their adherence to one of three plant-based diets: an overall Plant-based Diet Index (PDI), a healthy Plant-based Diet Index (hPDI), or an Unhealthy Plant-Based Diet Index (UPDI).

Healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, and tea/coffee); unhealthy plant foods (refined grains, fruit juices, potatoes, sugar-sweetened beverages, and sweets/desserts); and animal foods (animal fats, dairy, eggs, fish/seafood, meat, and various animal-based foods) were used to create diet indices.

The researchers divided plant foods into healthy and harmful categories based on their links to T2D, cardiovascular disease, malignancies, and other disorders, including obesity and high blood pressure.

The researchers used blood samples collected in the early stages of the three trials listed above to establish metabolite profile scores for the participants. Any incidences of incident T2D were documented during the study's follow-up period. The team uncovered any associations between metabolite profile, diet index, and T2D risk by analyzing these data and diet index scores.

During follow-up, participants diagnosed with T2D had a lower intake of nutritious plant-based foods and lower PDI and hPDI scores than those who did not acquire the condition. They were also more likely to have high blood pressure and cholesterol levels, take blood pressure and cholesterol medications, have a family history of diabetes, and be less physically active.

Linked to Different Metabolic Profiles

According to the metabolomics data, plant-based diets were linked to distinct multi-metabolite profiles, which differed considerably between good and unhealthy plant-based diets.

Furthermore, metabolite profile scores for both the overall plant-based diet and the healthy plant-based diet were inversely associated with incident T2D in a generally healthy population, independent of BMI and other diabetes risk factors. In contrast, the unhealthy plant-based diet had no such association. Consequently, higher metabolite profile scores for PDI and hPDI suggested better diet adherence and a reduced risk of T2D.

After controlling for levels of trigonelline, hippurate, isoleucine, a limited set of triacyglycerols (TAGs), and numerous other intermediate metabolites, the relationship between plant-based diets and T2D essentially vanished, indicating that they may play a crucial role in connecting such diets to incident diabetes. Trigonelline, for example, is present in coffee and has been shown in animal studies to reduce insulin resistance.

At the same time, greater levels of hippurate are linked to improved glycaemic management, increased insulin secretion, and a decreased incidence of T2D. The researchers believe that these metabolites should be explored further because they might give mechanistic reasons for how plant-based diets can reduce T2D risk.

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