Experts say not all plant-based diets are the same. They offer specific advice on how to get the most out of your nutrition plans.
Type 2 diabetes is far more complicated than simply having eaten too much sugar.
However, preventing the escalation of prediabetes into type 2 diabetes can be simpler for some.
Approximately 22 percent of people diagnosed with prediabetes are able to prevent it from progressing to type 2 diabetes, according to a recent study from the Aging Research Center at the Karolinska Institute in Stockholm.
“Plant-based dietary patterns, especially when they are enriched with healthful plant-based foods, may be beneficial for the primary prevention of type 2 diabetes,” explained the report.
“Plant-based” is a trendy term these days — and often implies veganism — but in this context, the focus of a plant-based diet is on eating mostly “real” food, including some animal protein and carbohydrates.
The most immediate benefit of a plant-based diet on the prevention of type 2 diabetes is the impact that non-plant-based foods have on blood sugar levels and insulin resistance.
However, research suggests the impact is actually broader.
“Plant-based diets may also reduce the risk of type 2 diabetes through lowering the risk of excess weight gain,” the researchers noted.
“Multiple interventional and observational studies have indicated that increased consumption of plant-based foods can lead to short-term weight loss or prevention of long-term weight gain,” explained the researchers. “In turn, it is likely that a considerable proportion of the protective association between plant-based diets and risk of type 2 diabetes can be attributable to weight control.”
Experts in diabetes care and prevention agree.
“What if we had a world without processed food in it?” said Mara Schwartz, CDE, RN, a coordinator of the Diabetes Prevention Program at Self Regional Healthcare in Greenwood, South Carolina. “We wouldn’t have the weight problems we have now if it weren’t for processed food. It would be very difficult to become obese while eating a whole-food, plant-based diet.”
Indulging in a bag of chips and a milkshake is a lot easier than eating a bowl of homemade whipped cream with fresh blueberries and strawberries.
In Schwartz’s work, she has seen the difference in outcomes when a client commits to changing their nutrition habits.
“People truly have to understand that what they put in their mouth affects their health,” Schwartz, who has lived with type 1 diabetes for decades, told Healthline. “You’re gonna have to commit to yourselves and acknowledge that your current diet is hurting you.”
The recent research recommends focusing on a plant-based diet of fruits, vegetables, whole grains, legumes, and nuts.
“Moreover, refined grains, starches, and sugars can also be characterized as plant-based, although they are independently associated with a higher risk of type 2 diabetes,” the researchers said.
The study also found a “protective” association against the development of type 2 diabetes when people consumed higher amounts of vitamins, minerals, and antioxidants through plant foods and lower amounts of red meats and processed meats.
The study doesn’t advise against eating healthier animal products, such as organic eggs, and lean proteins, like chicken, turkey, and pork.
The short-term and long-term effects of an unhealthy diet actually create a more serious problem with metabolism, cravings, and relationship with food.
Schwartz points to Susan Peirce Thompson, author of the book, “Bright Line Eating,” who explained the destructive cycle that junk-quality food has on several aspects of the hormones related to our cravings and body weight.
“By eating the wrong foods, we increase our insulin levels,” said Schwartz. “Increased insulin levels actually block the production of leptin.”
Leptin is a lesser-discussed but crucial part of managing your appetite. It’s a hormone produced by your body’s fat cells and your small intestines. Its primary role is to regulate your appetite by signaling to your brain that you’re full.
When a person develops “leptin resistance” from excessive amounts of leptin in their system along with insulin resistance, your brain thinks you’re starving, creating an insatiable type of hunger that leads to mindless eating, craving junk food, and eating more processed carbohydrates.
Reversing this starts with making major changes in your diet by reducing heavily processed, packaged foods and focusing every meal on whole foods.
Transitioning to a plant-based diet doesn’t require a costly diet program, buying “diet” products, or learning how to cook a variety of time-intensive, complicated meals.
Instead, start with a look at the nutrition labels on the packages of the processed foods you currently eat.
“If you can’t pronounce half of the things on the list of ingredients, you shouldn’t be eating it,” advised Schwartz. “If you were cooking a meal with whole foods, you wouldn’t go to the store and also buy common additives like Yellow 5 or sodium benzoate or carrageenan to put into that meal.”
Processed foods, reminded Schwartz, were made for convenience and for profit, but few are actually healthy. Just because a box of cookies is labeled as organic doesn’t mean it’s not still a processed, packaged item void of any valuable nutrition.
Schwartz also cautions against filling your diet with vegan “plant-based” products such as frozen vegan meats.
“Sometimes when people follow a vegan diet, they’re eating a lot of processed foods that are no better for you than a greasy burger. Just because something is vegan doesn’t mean it’s automatically healthy if it’s loaded with highly processed ingredients like soy protein isolate, and a slew of preservatives, added flavors, chemicals, and tons of sodium,” she said.
And it’s important not to fall for advertising phrases such as “whole-grain” or “low-fat” on the packaging.
“Even a whole-wheat pasta is heavily processed. If it was truly whole wheat, you’d see chunks of actual wheat in there — and you don’t because it’s been broken down through processing, combined with a variety of additives, and packaged to make you think it’s a whole food,” Schwartz explained.
A low-fat, whole-wheat English muffin, for example, is still a heavily processed product that offers little to no original vitamins, minerals, or quality nutrition. It’s made of processed flour and more than a dozen additives to make it taste good.
But what should you eat instead?
“It doesn’t take that much more time to make something that’s not processed. You can buy riced cauliflower and spiralized zucchini noodles ready-to-go at the store these days,” said Schwartz.
Breakfast could be eggs, berries, and a serving of whole oats, or a lower-carb option of almonds.
Lunch could be a giant bowl of greens with a serving of black beans, cucumber, chicken, and a careful serving of your favorite salad dressing.
You can make simple swaps for high-starch or highly processed grains, for example, including wild rice instead of white rice and farro or quinoa instead of pasta.
Sweet potato or brown rice may be high in carbohydrates — something to be careful about as a person with diabetes, since carbohydrates are the first macronutrient with the biggest impact on blood sugar levels — but they’ll still offer far more nutrition and less of a blood sugar spike compared to processed bread and pasta.
If you do still want some pasta, Schwartz suggests quickly sautéing a variety of vegetables and then adding a small amount of pasta to the plate. Even though the goal is to focus on eating more vegetables, that doesn’t mean it has to be entirely vegetables.
“It’s very hard to overeat a healthy meal because the fiber from the vegetables is so filling,” she said.
And the vegetables don’t have to always have been freshly diced — a simple bag of frozen microwave vegetables is still better for you than a bag of chips.
Typically, when you significantly reduce or remove animal products from your diet, you inevitably increase the amount of carbohydrate you’re eating in order to still consume adequate calories.
For those with diabetes, even the American Diabetes Association has reversed its stance on low-carbohydrate diets as a tool for improving blood sugar levels. The organization now recommends a lower-carb approach.
Schwartz avoids carbohydrates in her personal diabetes nutrition management because she feels eating them simply leads her to crave more carbs, never feeling fully satisfied.
Other experts in diabetes care agree that a plant-based diet that includes too many servings of carbohydrates isn’t the best option.
“I do not feel grains are a healthy choice for a diabetic,” Ryan Attar, ND, MS, who lives with type 1 diabetes and has devoted his healthcare work at the Connecticut Integrative Medical Center to helping the diabetes population.
“What do grains offer our bodies? Very energy-dense, carbohydrate-dense foods, which have very little nutrient value. The amount of nutrients in grains are so low that by law grains must be fortified,” Attar told Healthline.
Attar compared grains in general to a long chain of glucose molecules paired with a list of synthetic vitamins added to it.
He also argued that choosing brown rice over white won’t have a big impact on how significantly it spikes your blood sugar.
“The amount of increased fiber and nutrients in whole grains is very small. Take a look at white versus brown rice. Both have the same amount of carbohydrates, 45 grams in 1 cup. The brown rice has 3 grams more fiber than white rice. Leaving you 41.5 grams of starchy carbohydrate versus 44.4 in white rice,” he said.
Attar suggests nixing grains from your diet completely but still striving to eat a diet largely focused on plants.
“Get those nutrients from eating more non-starchy leafy greens instead,” he said.
A plate full of plant-based food can still contribute to being overweight and higher blood sugar levels if you’re not being mindful about how much you’re eating.
“Portions do matter, no matter what you’re eating,” said Schwartz. “If you’re eating a 12-ounce steak with three cups of mashed potatoes and a huge wallop of blue cheese dressing on your side salad, you’re overdoing it.”
Instead, cut the steak in half, swap the potatoes — or at least most of the potatoes — for greens. Keep the dressing on the side to dip your fork into instead of covering the salad with it.
“Eating something in moderation is also a very vague plan,” said Schwartz, who often sees her clients struggle with using this common terminology to include less-than-healthy items in their diet too frequently.
“The difference between the patients who succeed in improving their blood sugars and the patients who don’t often comes down to a willingness to commit and make changes,” said Schwartz.
“There’s always an excuse if you let yourself make one for choosing junky processed food over real food. I’ve had a stressful day. I was hungry and the cafeteria was closed. I was at a party. I didn’t say no to cake because I might offend someone. It’s too expensive to eat healthy.”
If you can afford cigarettes, Netflix, or fast food, you can afford healthier food.
“You learn how to eat from how you were raised, but you can change those habits, too. Take more ownership over the fact that you do have control over what you put in your mouth,” said Schwartz.