Advertisement

A Comprehensive Review of the Literature Supporting Recommendations From the Canadian Diabetes Association for the Use of a Plant-Based Diet for Management of Type 2 Diabetes

      Abstract

      Type 2 diabetes mellitus is considered one of the fastest growing diseases in Canada, representing a serious public health concern. Thus, clinicians have begun targeting modifiable risk factors to manage type 2 diabetes, including dietary patterns such as a plant-based diets (PBDs). The Canadian Diabetes Association has included PBDs among the recommended dietary patterns to be used in medical nutrition therapy for persons with type 2 diabetes.
      To support knowledge translation, this review summarizes the current literature relating to PBDs and the prevalence of type 2 diabetes, its clinical applications and its acceptability in the management of type 2 diabetes as well as its application in community settings.
      This comprehensive review seeks to close the literature gap by providing background and rationale to support the use of PBDs as medical nutrition therapy. Within this review is support from large observational studies, which have shown that PBDs were associated with lower prevalence of type 2 diabetes. As well, intervention studies have shown that PBDs were just as effective, if not more effective, than other diabetes diets in improving body weight, cardiovascular risk factors, insulin sensitivity, glycated hemoglobin levels, oxidative stress markers and renovascular markers. Furthermore, patient acceptability was comparable to other diabetes diets, and PBDs reduced the need for diabetes medications.
      Diabetes education centres in Canada could improve patients' perceptions of PBDs by developing PBD-focused education and support as well as providing individualized counselling sessions addressing barriers to change. The development of more standardized and user-friendly PBD practice guidelines could overcome the disparity in recommendations and, thereby, increase how frequently practitioners recommend PBDs. Based on current published research, PBDs lend support in the management of type 2 diabetes.

      Résumé

      Le diabète sucré de type 2 est considéré comme étant l'une des maladies à connaître la croissance la plus rapide au Canada et constitue une préoccupation sérieuse de santé publique. Par conséquent, les cliniciens ont commencé à déterminer les facteurs de risque modifiables pour prendre en charge le diabète de type 2, dont les modèles de consommation alimentaire tels que les régimes alimentaires à base de végétaux (RABV). L'Association canadienne du diabète a intégré les RABV aux modèles de consommation alimentaire à utiliser lors de la thérapie nutritionnelle médicale des personnes souffrant du diabète de type 2.
      Afin de soutenir le transfert des connaissances, la présente revue résume la littérature actuelle sur les RABV et la prévalence du diabète de type 2, leurs applications cliniques et leur acceptabilité dans la prise en charge du diabète de type 2 ainsi que leur application dans les milieux communautaires.
      Cette revue exhaustive cherche à combler les lacunes de la littérature en fournissant le contexte et les raisons pour appuyer l'utilisation des RABV comme thérapie nutritionnelle médicale. Cette revue s'appuie sur de vastes études observationnelles qui ont montré que les RABV étaient associés à une prévalence plus faible du diabète de type 2. Aussi, les études d'intervention ont montré que les RABV étaient tout aussi efficaces, sinon plus, que les autres régimes alimentaires destinés aux personnes diabétiques pour améliorer le poids corporel, les facteurs de risque cardiovasculaire, l'insulinosensibilité, les concentrations d'hémoglobine glyquée, les marqueurs du stress oxydatif et les marqueurs rénovasculaires. De plus, les RABV dont l'acceptabilité par les patients se comparait à celle des autres régimes alimentaires destinés aux personnes diabétiques réduisaient les besoins en médicaments contre le diabète.
      Les centres d'enseignement sur le diabète du Canada pourraient améliorer la perception des patients au sujet des RABV en développant l'enseignement axé sur les RABV et le soutien ainsi qu'en offrant des séances de counseling individuel pour surmonter les obstacles au changement. L'élaboration de lignes directrices de pratique en matière de RABV plus standardisées et faciles à utiliser pourrait surmonter les disparités des recommandations et, ainsi, augmenter la fréquence à laquelle les praticiens recommandent les RABV. Reposant sur la publication de recherche actuelle, les RABV apportent un soutien à la prise en charge du diabète de type 2.

      Keywords

      Mots clés

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Diabetes
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Tuso P.J.
        • Ismail M.H.
        • Ha B.P.
        • Bartolotto C.
        Nutritional update for physicians: Plant-based diets.
        Perm J. 2013; 17: 61-66
        • Trapp C.
        • Levin S.
        Preparing to prescribe plant-based diets for diabetes prevention and treatment.
        Diabetes Spectr. 2012; 25: 38-44
        • Lee V.
        • McKay T.
        • Ardern C.I.
        Awareness and perception of plant-based diets for the treatment and management of type 2 diabetes in a community education clinic: A pilot study.
        J Nutr Metab. 2015; 6 (article ID 236234)
        • Government of Canada
        Type 2 diabetes.
        (Healthy Canadians) (Accessed September 1, 2015)
        • American Dietetic Association
        • Dietitians of Canada
        Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets.
        J Am Diet Assoc. 2003; 103: 748-765
        • Dworatzek P.D.
        • Arcudi K.
        • Gougeon R.
        • et al.
        Nutrition therapy.
        Can J Diabetes. 2013; 37: S45-55
        • Tonstad S.
        • Butler T.
        • Yan R.
        • Fraser G.E.
        Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.
        Diabetes Care. 2009; 32: 791-796
        • Tonstad S.
        • Stewart K.
        • Oda K.
        • et al.
        Vegetarian diets and incidence of diabetes in the Adventist Health Study-2.
        Nutr Metab Cardiovasc Dis. 2013; 23: 292-299
        • Barnard N.
        • Levin S.
        • Trapp C.
        Meat consumption as a risk factor for type 2 diabetes.
        Nutrients. 2014; 6: 897-910https://doi.org/10.3390/nu6020897
        • De Mello V.D.F.
        • Zelmanovitz T.
        • Perassolo M.S.
        • et al.
        Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria.
        Am J Clin Nutr. 2006; 83: 1032-1038
        • Yang S.-Y.
        • Li X.-J.
        • Zhang W.
        • et al.
        Chinese lacto-vegetarian diet exerts favorable effects on metabolic parameters, intima-media thickness, and cardiovascular risks in healthy men.
        Nutr Clin Pract. 2012; 27: 392-398
        • Nicholson A.S.
        Toward improved management of NIDDM: A randomized, controlled, pilot intervention using a lowfat, vegetarian diet.
        Prev Med (Baltim). 1999; 29 (Accessed July 22, 2016): 87-91
        • Kahleova H.
        • Matoulek M.
        • Malinska H.
        • et al.
        Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with type 2 diabetes.
        Diabet Med. 2011; 28: 549-559
        • Barnard N.D.
        • Cohen J.
        • Jenkins D.J.A.
        • et al.
        A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: A randomized, controlled, 74-wk clinical trial.
        Am J Clin Nutr. 2009; 89: 1588-1596
        • Yokoyama Y.
        • Barnard N.D.
        • Levin S.M.
        • Watanabe M.
        Vegetarian diets and glycemic control in diabetes: A systematic review and meta-analysis.
        Cardiovasc Diagn Ther. 2014; 4: 373-382
        • Kahleova H.
        • Hrachovinova T.
        • Hill M.
        • Pelikanova T.
        Vegetarian diet in type 2 diabetes: Improvement in quality of life, mood and eating behaviour.
        Diabet Med. 2013; 30: 127-129
        • Barnard N.D.
        • Gloede L.
        • Cohen J.
        • et al.
        A low-fat vegan diet elicits greater macronutrient changes, but is comparable in adherence and acceptability, compared with a more conventional diabetes diet among individuals with type 2 diabetes.
        J Am Diet Assoc. 2009; 109: 263-272
        • Ferdowsian H.R.
        • Barnard N.D.
        • Hoover V.J.
        • et al.
        A multicomponent intervention reduces body weight and cardiovascular risk at a GEICO corporate site.
        Am J Health Promot. 2010; 24: 384-388
        • Mishra S.
        • Xu J.
        • Agarwal U.
        • et al.
        A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: The GEICO study.
        Eur J Clin Nutr. 2013; 67: 718-724