Whole-Food Diet Reverses Type 2 Diabetes: Study

New study finds plant-centric eating can help reverse insulin resistance without calorie restriction or fasting

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A healthy, balanced diet that includes small portions of meat, fish, or poultry has been a common recommendation for diabetes management for decades. However, new research suggests that implementing a whole-food, plant-predominant diet can put some individuals’ Type 2 diabetes into remission.

Study Findings Explained

The study, published in the American Journal of Lifestyle Medicine, set out to determine whether it was feasible to reduce the need for medication and/or prompt remission in patients with Type 2 diabetes without drastic calorie restriction.

Fifty-nine participants, all of whom were Type 2 diabetics, were examined by the researchers while completing a cardiac wellness program. Participants ranged in age from 41 to 89 years, with an average age of 71. All participants followed a whole-food, plant-based eating regimen for six months or longer.

The prescribed diet was low in fat and high in fiber, with 75 percent of the total calories coming from complex carbohydrates, 15 percent from plant-based proteins, and 10 percent from fats. Fruits, vegetables, legumes, whole grains, and seeds and nuts were encouraged, along with a small quantity of egg whites and nonfat dairy (approximately 5 percent of total calories). Participants were instructed to avoid highly processed foods.

The study found that the participants demonstrated notable progress in blood glucose control, and 37 percent achieved complete diabetes remission. For the purpose of this study, remission was defined as maintaining a hemoglobin A1C level of less than 6.5 percent for at least three months without the use of surgery, medical devices, or medications intended to lower blood glucose.

The study also determined an overall reduction in the need for glucose-management medications among the participants, all of whom showed positive improvements in their body mass index, hemoglobin A1C, and fasting glucose levels, as well.

“It is a promising study that highlights the importance and efficacy of lifestyle interventions to address a global issue that has been historically tackled using pharmacological treatment,” Dr. Florence Comite, an expert in precision medicine and the founder of the Comite Center for Precision Medicine & Health, told The Epoch Times.

Although other studies have documented a reversal of insulin resistance when incorporating a plant-focused diet, this study was unique because it didn’t require participants to adhere to any type of calorie-restrictive or fasting protocols.

How Whole-Food, Plant-Based Diets Affect Diabetes

Experts have recommended nutritional lifestyle changes as a treatment approach for diabetes for decades. Traditionally, some diabetics were instructed to adopt a low-carbohydrate diet in order to control their blood glucose. While low-carb diets may cause a reduction in blood glucose values, research suggests that those benefits don’t last in the long term and are largely gone within a year.

Strict low-carb diets also eliminate or restrict many healthful foods, including whole grains, legumes, and fruits. Long-term adherence to a low-carb diet has been associated with increased mortality and a higher risk of cancer, Alzheimer’s disease, and other medical conditions.

Now, there’s significant evidence to support that a whole-food, plant-based diet has the power to improve diabetes symptoms and even put some individuals into complete remission. Research has shown that a plant-based diet is more effective in increasing insulin sensitivity than a conventional diabetic diet. Plant-based diets have also been associated with improved blood glucose control and improved insulin resistance. In general, recent evidence suggests that diets that are heavy in animal products—particularly red meat—are associated with a higher risk of diabetes, while plant-based diets are associated with a lower risk.

Researchers have explored many different potential mechanisms for the benefits of a plant-based diet. In general, plant-based, whole-food diets are often lower in calories, sugar, and fat, and are more nutrient-dense. All of these factors are known to contribute to improved insulin sensitivity.

The Fiber Factor

Plant-based diets tend to be higher in fiber—essential for people with diabetes. High-fiber foods have the ability to decrease blood sugar spikes and to help you feel fuller longer. This is because fiber can lessen the body’s glycemic response to carbohydrates.

“Patients are encouraged to eat foods high in protein and fiber prior to consuming other carbohydrates, to minimize glucose spikes (highs) or dips (lows) after a meal,” Dr. Comite said.

“Fiber supports the gut microbiome [and] helps in the production of short-chain fatty acids,“ she said. ”Reduced short-chain fatty acid production has been linked to Type 2 diabetes.”

For example, findings of a recent study suggest improvement in glucose balance and insulin secretion among people who had increased their fiber intake to 50 grams per day. Another study found that a whole-grain, high-fiber diet can improve insulin sensitivity.

High-fiber diets also have other positive health benefits, including decreasing the risk of stroke, heart disease, obesity, high blood pressure, and high cholesterol.

However, Dr. Comite said that one shouldn’t increase fiber intake too rapidly.

“Caution is advised when suggesting that everyone consume more than 35 [grams per day], especially if the current fiber intake is less. Adjust slowly to prevent potential gastrointestinal side effects like bloating, stomach cramps, and constipation. Gradually increasing fiber intake and staying hydrated throughout the day can help mitigate these side effects,” she said.

Subtracting Saturated Fats

Plant-based diets are lower in saturated fats compared to animal-based diets. Saturated fats have been found to cause harm to pancreatic cells, which influence insulin production. More specifically, when beta cells in the pancreas are damaged, their ability to produce insulin in response to increased glucose levels is inhibited.

Because saturated fat is a known contributor to insulin resistance, a low-fat, plant-based diet is recommended for those attempting diabetes remission.

Quality Carbohydrates Are Complex

Carbs are often seen as the “bad guy” when discussing diabetes. However, it’s important to note that carbohydrates aren’t inherently bad, even for diabetics. What matters more is the quality of the carbohydrates that you consume.

“People might confuse plant-based with a high-carb diet, which could lead to higher intakes of rice, pasta, breads, and other white starches that are not as beneficial as whole grains,” Dr. Comite said.

Complex carbohydrates, such as those found in whole grains, legumes, fruits, and starchy vegetables, are preferred for glucose control and have the power to correct insulin resistance.

For example, complex carbs originating from whole grains produce fatty acids when digested. These fatty acids actually improve insulin sensitivity when passed through the liver. Complex carbs also have the power to lower post-meal blood glucose levels, especially when paired with fiber.

“Consumption of whole grains and legumes, which are high in fiber, reduces [post-meal] glucose,” Dr. Comite said. “This approach has important implications for prolonged glucose control and the proactive prevention and reversal of prediabetes and even diabetes.”

Still, Dr. Comite said that a plant-based diet isn’t a perfect fit for everyone.

“Individuals who cannot maintain adequate glucose will suffer with hypoglycemia (low glucose). When hypoglycemia is revealed on a plant-based diet, adding alternative sources of protein makes a difference by correcting hypoglycemia and has reversed symptoms such as migraines, fatigue, lack of energy, mood, and sleep disturbances,” Dr. Comite said.

Diabetes Remission Factors

Recent research has revealed that people in Type 2 diabetic remission have the ability to return to maximal insulin secretion rates and normal functional pancreatic beta cell mass, indicating that sustained remission can reverse diabetes altogether.

While remission is an excellent goal, many factors can affect a person’s ability to reasonably accomplish it. Eating habits, weight loss, exercise, stress levels, sleep habits, and alcohol use all play important roles in whether a person can realistically achieve diabetes remission.

Unfortunately, diabetes remission can be especially difficult—and sometimes impossible—for patients with genetic predispositions, severe insulin resistance because of age, or a prolonged history of diabetes.

Still, even if complete remission isn’t possible for some patients, improved glucose control while decreasing medication reliance is a worthwhile goal that can improve quality of life.

Dr. Comite said that while a plant-based diet can be a critical aspect of remission, patients are likely to have better success if they implement exercise, stress management, and improved sleep habits into their routines.

“Losing fat and gaining muscle improves insulin sensitivity and glucose utilization,” Dr. Comite said. “Stress and poor sleep can negatively alter glucose metabolism.”

How to Implement a Whole-Food, Plant-Based Diet

Any significant lifestyle change can be challenging, and switching to a whole-food, plant-based diet is no exception.

Meal planning can help you stay on track with your healthy eating goals. Prepping certain foods ahead of time and storing them in your refrigerator or freezer can make the process even easier.

Some easy plant-based foods to prepare for use in meals include:

• Cooked whole grains (brown rice, oats, quinoa, farro).
• Cooked legumes (beans, lentils, chickpeas).
• Cooked plant-based proteins (tofu, tempeh, seitan).
• Cooked vegetables.
• Washed fruits.
• Unsalted nuts and seeds.

Dr. Comite recommends that her patients use a continuous glucose monitoring (CGM) device—regardless of their state of remission—because CGM “allows patients to own their decisions and reveals the effects of food, beverages, activities, and other habits, on glucose response. The impact can be enormous, as ‘cause and effect’ is immediately acknowledged and appropriate reactions will follow if taken seriously.”

That said, one of the reasons that many people turn to a high-fat, low-carb diet is because such CGM may indicate healthier blood sugar ranges. This effect, however, doesn’t accurately reflect the long-term health benefits and risks of the diet.

Study Limitations and Implications

Diabetes is the most prevalent noncontagious disease in the world, and it carries many health risks and comorbidities, including cardiovascular disease, stroke, neuropathy, retinopathy, and more. Diabetes is “deadlier and far more common than people think,” Dr. Comite said.

Fortunately, dietary lifestyle changes are an effective diabetes treatment and can cause remission, thus decreasing the dangerous risks associated with it.

This particular study had a few limitations, including a small sample size and the lack of a control group. Dr. Comite said that the researchers also indicated that “their protocol consisted of other recommendations, such as avoiding all tobacco products (which, in theory, would help lower inflammation), limiting or even avoiding alcohol intake, and participating in regular exercise for a minimum of 150 minutes per week.” Thus, it’s unclear as to what level the participants adhered to these other recommendations, in addition to adopting the plant-based diet.

However, the study does provide encouraging evidence of the positive role that a plant-based diet can have on diabetes remission. It also confirms that diabetes remission through a plant-based diet—without the need for calorie restriction or fasting—is possible, which can make long-term dietary compliance easier for some patients.

“This study adds hope [and] validity to the fact that diabetes can be reversed,” Dr. Comite said.