A Plant-Based Eating Pattern for Diabetes
By Meghan Jardine MS, MBA, RD, LD, CDE
Director of Diabetes Nutrition Education, Physician's Committee for Responsible Medicine
Is it reasonable to ask a patient to switch to a “vegan” diet? No meat, fish, dairy, or eggs? So many individuals I talk to can’t fathom life without animal products. Many medical professionals also feel this way further dissuading patients from trying this “radical” lifestyle change. However, there is a large body of evidence suggesting that a plant-based eating pattern reduces the risk of obesity, diabetes, heart disease, and some types of cancer.
Vegetarian diets tend to be higher in whole grains, nuts, legumes, and fruits and vegetables, foods that are higher in micronutrients and protective factors for diabetes and cardiovascular disease. Observational studies have demonstrated that vegetarian or vegan diets are associated with a lower risk of type 2 diabetes and a lower risk of complications for those with existing diabetes. One of the most remarkable studies include the Adventist Health Study 2, where those following a vegan diet had almost a 50% reduction in the risk of developing type 2 diabetes compared to those following a non-vegetarian diet. This significance was noted after controlling for other confounding factors such as age, gender, ethnicity, education, income, physical activity, alcohol use, and body mass index.
Many might be worried about not getting enough nutrition from a plant-based eating pattern. The position of the Academy of Nutrition and Dietetics states that “appropriately planned vegetarian, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases”. The one caveat is those not consuming any animal products should take a vitamin B12 supplement.
Changing from the standard American diet to a healthy plant-based diet can be daunting for most. Diabetes educators and registered dietitian nutritionists play a unique role in the prevention and treatment of type 2 diabetes and can provide support and education to individuals who are motivated to make this change. Following a plant-based eating pattern is easier than ever. There are many easy to follow recipes on the Internet; there are many healthy vegan cookbooks available. Even eating at restaurants is easier than it used to be. However, for most individuals, adopting a plant-based eating pattern should be broken down into steps:
• The first step is to learn the basics principles of a low-fat plant-based diet:
o Choose healthy plant-based food groups: whole grains, legumes, fruit, and vegetables
o Consume 1 oz. of nuts or seeds per day
o Avoid animal products (meat, dairy products, and eggs)
o Avoid added oils and fats, fried foods
o Choose high-fiber foods
• The second step involves planning and preparing; identifying meals to try, shopping, and seeking out restaurants with plant-based options. Take 2 weeks to try new recipes, modify your current favorite recipes, and get used to the idea of giving this a try.
• Then, give the diet a three week “test drive”. It takes three weeks to form a habit and this is plenty of time to see beneficial results. Know in the back of your mind, you can go back to your old eating pattern after three weeks.
NOTE: Anticipate hypoglycemia. A low-fat plant-based diet can dramatically improve insulin sensitivity. Be sure to instruct patients on medications that cause hypoglycemia, how to recognize symptoms and, treat low blood glucose levels. It is extremely important that the patient notifies their health care provider for medication adjustments as needed. Those who are matching insulin to carbohydrates may also need to alter their ratios and should be guided through this process.
Plant-based nutrition is not dull and monotonous. It’s tasty, appetizing and quite satisfying. There’s no end to the healthy and delicious options. If you want to introduce this to your patients it’s important that you give it a try yourself. Here are some resources:
1. The Engine 2 Challenge – a 28-day challenge promoted by Whole Foods: http://engine2diet.com/28-day-challenge-2015/
2. The Vegetarian Resource Group – a great resource on vegetarian nutrition, recipes, specific health concerns related to vegan diets: http://www.vrg.org/
3. The 21-Day Vegan Kick Start – a 21 day vegan challenge; 21 days of motivational messages, shopping lists, and recipes, all planned by registered dietitians (also available in Spanish, Chinese, Japanese, and Indian cuisine (in English): http://www.pcrm.org/health/diets/kickstart/kickstart-programs/
4. Vegan Health – website with credible vegetarian nutrition information by a registered dietitian: http://www.veganhealth.org/
Meghan Jardine will be presenting this topic" Plant based diet", at the PA State Confernce, May 14 & 15. The link below will take you to the registration page. Early registration dicount for members and non members ends March 15.
http://www.myaadenetwork.org/p/co/ly/gid=61&req=load&fid=2418