Vegetarian diet, change in dietary patterns, and diabetes risk: a prospective study

Tina H T Chiu, Wen-Harn Pan, Ming-Nan Lin, Chin-Lon Lin, Tina H T Chiu, Wen-Harn Pan, Ming-Nan Lin, Chin-Lon Lin

Abstract

Background/objectives: Vegetarian diets are inversely associated with diabetes in Westerners but their impact on Asians-whose pathophysiology differ from Westerners-is unknown. We aim to investigate the association between a vegetarian diet, change in dietary patterns and diabetes risk in a Taiwanese Buddhist population.

Methods: We prospectively followed 2918 non-smoking, non-alcohol drinking Buddhists free of diabetes, cancer, and cardiovascular diseases at baseline, for a median of 5 years, with 183 incident diabetes cases confirmed. Diet was assessed through a validated food frequency questionnaire at baseline and a simple questionnaire during follow-ups. Incident cases of diabetes were ascertained through follow-up questionnaires, fasting glucose and HbA1C. Stratified Cox Proportional Hazards Regression was used to assess the effect of diets on risk of diabetes.

Results: Consistent vegetarian diet was associated with 35% lower hazards (HR: 0.65, 95% CI: 0.46, 0.92), while converting from a nonvegetarian to a vegetarian pattern was associated with 53% lower hazards (HR: 0.47, 95% CI: 0.30, 0.71) for diabetes, comparing with nonvegetarians while adjusting for age, gender, education, physical activity, family history of diabetes, follow-up methods, use of lipid-lowering medications, and baseline BMI.

Conclusion: Vegetarian diet and converting to vegetarian diet may protect against diabetes independent of BMI among Taiwanese.

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

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References

    1. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet 2016; 387: 1513-1530. e-pub ahead of print 2016/04/12; 10.1016/s0140-6736(16)00618-8
    1. Cheng JS, et al. Trend and factors associated with healthcare use and costs in type 2 diabetes mellitus: a decade experience of a universal health insurance program. Med. Care. 2015;53:116–124. doi: 10.1097/MLR.0000000000000288.
    1. Lo WC, et al. Adult mortality of diseases and injuries attributable to selected metabolic, lifestyle, environmental, and infectious risk factors in Taiwan: a comparative risk assessment. Popul. Health Metr. 2017;15:17. doi: 10.1186/s12963-017-0134-4.
    1. Ramachandran A, Ma RC, Snehalatha C. Diabetes in Asia. Lancet. 2010;375:408–418. doi: 10.1016/S0140-6736(09)60937-5.
    1. Franks PW, McCarthy MI. Exposing the exposures responsible for type 2 diabetes and obesity. Science. 2016;354:69–73. doi: 10.1126/science.aaf5094.
    1. Ohn JH, et al. 10-year trajectory of beta-cell function and insulin sensitivity in the development of type 2 diabetes: a community-based prospective cohort study. Lancet Diabetes Endocrinol. 2016;4:27–34. doi: 10.1016/S2213-8587(15)00336-8.
    1. Fukushima M, Suzuki H, Seino Y. Insulin secretion capacity in the development from normal glucose tolerance to type 2 diabetes. Diabetes Res Clin. Pract. 2004;66(Suppl 1):S37–S43. doi: 10.1016/j.diabres.2003.11.024.
    1. Tonstad S, et al. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutr. Metab. Cardiovasc Dis. 2013;23:292–299. doi: 10.1016/j.numecd.2011.07.004.
    1. Satija A, et al. Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies. PLoS Med. 2016;13:e1002039. doi: 10.1371/journal.pmed.1002039.
    1. Aune D, Ursin G, Veierod MB. Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia. 2009;52:2277–2287. doi: 10.1007/s00125-009-1481-x.
    1. Wallin A, et al. Fish consumption, dietary long-chain n-3 fatty acids, and risk of type 2 diabetes: systematic review and meta-analysis of prospective studies. Diabetes care. 2012;35:918–929. doi: 10.2337/dc11-1631.
    1. Villegas R, et al. The association of meat intake and the risk of type 2 diabetes may be modified by body weight. Int J. Med Sci. 2006;3:152–159. doi: 10.7150/ijms.3.152.
    1. Kurotani K, et al. Red meat consumption is associated with the risk of type 2 diabetes in men but not in women: a Japan Public Health Center-based Prospective Study. Br. J. Nutr. 2013;110:1910–1918. doi: 10.1017/S0007114513001128.
    1. Erber E, et al. Dietary patterns and risk for diabetes: the multiethnic cohort. Diabetes Care. 2010;33:532–538. doi: 10.2337/dc09-1621.
    1. Chiu TH, et al. Taiwanese vegetarians and omnivores: dietary composition, prevalence of diabetes and IFG. PLoS One. 2014;9:e88547. doi: 10.1371/journal.pone.0088547.
    1. Chiu TH, et al. Relative validity and reproducibility of a quantitative FFQ for assessing nutrient intakes of vegetarians in Taiwan. Public Health Nutr. 2014;17:1459–1466. doi: 10.1017/S1368980013001560.
    1. Odegaard AO, et al. Dietary patterns and incident type 2 diabetes in chinese men and women: the singapore chinese health study. Diabetes Care. 2011;34:880–885. doi: 10.2337/dc10-2350.
    1. Salas-Salvado J, et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care. 2011;34:14–19. doi: 10.2337/dc10-1288.
    1. Orlich MJ, et al. Patterns of food consumption among vegetarians and non-vegetarians. Br. J. Nutr. 2014;112:1644–1653. doi: 10.1017/S000711451400261X.
    1. Dong JY, Xun P, He K, Qin LQ. Magnesium intake and risk of type 2 diabetes: meta-analysis of prospective cohort studies. Diabetes Care. 2011;34:2116–2122. doi: 10.2337/dc11-0518.
    1. Suarez A, et al. Impaired tyrosine-kinase activity of muscle insulin receptors from hypomagnesaemic rats. Diabetologia. 1995;38:1262–1270. doi: 10.1007/BF00401757.
    1. van Nielen M, Feskens EJ, Rietman A, Siebelink E, Mensink M. Partly replacing meat protein with soy protein alters insulin resistance and blood lipids in postmenopausal women with abdominal obesity. J. Nutr. 2014;144:1423–1429. doi: 10.3945/jn.114.193706.
    1. Azadbakht L, et al. Soy inclusion in the diet improves features of the metabolic syndrome: a randomized crossover study in postmenopausal women. Am. J. Clin. Nutr. 2007;85:735–741. doi: 10.1093/ajcn/85.3.735.
    1. Villegas R, et al. Legume and soy food intake and the incidence of type 2 diabetes in the Shanghai Women’s Health Study. Am. J. Clin. Nutr. 2008;87:162–167. doi: 10.1093/ajcn/87.1.162.
    1. Cunha DA, et al. Death protein 5 and p53-upregulated modulator of apoptosis mediate the endoplasmic reticulum stress-mitochondrial dialog triggering lipotoxic rodent and human beta-cell apoptosis. Diabetes. 2012;61:2763–2775. doi: 10.2337/db12-0123.
    1. Wanders AJ, et al. Fatty acid intake and its dietary sources in relation with markers of type 2 diabetes risk: The NEO study. Eur. J. Clin. Nutr. 2016;71:245–251. doi: 10.1038/ejcn.2016.204.
    1. Bozzetto L, et al. Polyphenol-rich diets improve glucose metabolism in people at high cardiometabolic risk: a controlled randomised intervention trial. Diabetologia. 2015;58:1551–1560. doi: 10.1007/s00125-015-3592-x.
    1. Harris LLS, et al. Alterations in 3-hydroxyisobutyrate and FGF21 metabolism are associated with protein ingestion-induced insulin resistance. Diabetes. 2017;66:1871–1878. doi: 10.2337/db16-1475.
    1. Shang X, et al. Dietary protein intake and risk of type 2 diabetes: results from the Melbourne Collaborative Cohort Study and a meta-analysis of prospective studies. Am. J. Clin. Nutr. 2016;104:1352–1365. doi: 10.3945/ajcn.116.140954.
    1. Gluckman PD, Hanson MA, Cooper C, Thornburg KL. Effect of in utero and early-life conditions on adult health and disease. N. Engl. J. Med. 2008;359:61–73. doi: 10.1056/NEJMra0708473.
    1. Boniol M, Dragomir M, Autier P, Boyle P. Physical activity and change in fasting glucose and HbA1c: a quantitative meta-analysis of randomized trials. Acta Diabetol. 2017;54:983–991. doi: 10.1007/s00592-017-1037-3.
    1. Knowler WC, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 2002;346:393–403. doi: 10.1056/NEJMoa012512.
    1. Pan A, et al. Changes in red meat consumption and subsequent risk of type 2 diabetes mellitus: three cohorts of US men and women. JAMA Intern. Med. 2013;173:1328–1335. doi: 10.1001/jamainternmed.2013.6633.
    1. Yokoyama Y, Barnard ND, Levin SM, Watanabe M. Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis. Cardiovasc. Diagn. Ther. 2014;4:373–382.
    1. David LA, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505:559–563. doi: 10.1038/nature12820.
    1. Li D, Kirsop J, Tang WH. Listening to our gut: contribution of gut microbiota and cardiovascular risk in diabetes pathogenesis. Curr. Diabetes Rep. 2015;15:63. doi: 10.1007/s11892-015-0634-1.
    1. Celis-Morales CA, et al. Objective vs. self-reported physical activity and sedentary time: effects of measurement method on relationships with risk biomarkers. PLoS One. 2012;7:e36345. doi: 10.1371/journal.pone.0036345.
    1. Springmann M, Godfray HC, Rayner M, Scarborough P. Analysis and valuation of the health and climate change cobenefits of dietary change. Proc. Natl. Acad. Sci. USA. 2016;113:4146–4151. doi: 10.1073/pnas.1523119113.

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