Decreased Risk of Diabetes With Diet Emphasizing Plant-Based Foods Interview with:

Frank Qian, MPH Department of Nutrition Harvard T. H. Chan School of Public Health Boston, Massachusetts

Frank Qian

Frank Qian, MPH
Department of Nutrition
Harvard T. H. Chan School of Public Health
Boston, Massachusetts What is the background for this study?

Response: Plant-based diets have really grown in popularity in the last several years, particularly among the younger generation in the United States, many of whom are adopting a plant-based or vegetarian/vegan diet. However, the quality of such a diet can vary drastically. While many prior studies have demonstrated beneficial associations for risk of type 2 diabetes with healthful plant-based foods such as fruits, vegetables, nuts/seeds, whole grains, and legumes, the opposite is true for less healthful plant-based foods such as potatoes and refined grains such as white rice. In addition, some animal-based foods, such as dairy and fish, have shown protective associations against the development of type 2 diabetes, so strict vegetarian diets which exclude these foods may miss out on the potential benefits.

Given these divergent findings, we sought to pool all the available data from prior cohort studies to analyze whether the overall association of a diet which emphasizes plant-based foods (both healthful and unhealthful) are related to risk of type 2 diabetes. What are the main findings?

Response: The main findings of our study suggest that following a diet which emphasizes plant-based foods, particularly the healthful ones I alluded to above, is associated with a substantial reduction in risk of type 2 diabetes. In addition, this effect seems to be operating independently of body weight, because we continued to observe a beneficial association even after accounting for an individual’s body mass index. In addition, we found a linear dose-response relationship between higher adherence to a plant-based diet and risk of type 2 diabetes. What should readers take away from your report? 

Response: Our findings suggest that following a healthful plant-based diet over the long-term may be beneficial for the prevention of type 2 diabetes, and the higher the adherence, the greater the potential benefit. While our study doesn’t address whether being a strict vegetarian and excluding all animal-based foods may produce greater reductions in risk, it is likely prudent to reduce or minimize red and processed meats, which have consistently demonstrated harmful associations with risk ofdiabetes. What recommendations do you have for future research as a result of this work?

Response: Future studies should seek to better understand the mechanism underlying the associations we found in this study, particularly the potential interactions between a plant-based diet and the gut microbiome, which has not been well-elucidated. Our study only included cohorts from high-income countries, and it would be interesting to see if the results can be generalized to populations of low- and middle-income countries, particularly as many of these populations shift from their traditional, plant-predominant diet to a modern diet that often includes higher amounts of animal products. Is there anything else you would like to add?

Response: Our study provides further evidence for the promotion of healthful plant-based foods to prevent cardiometabolic diseases, such as type 2 diabetes, which continue to increase in the US and globally.


Qian F, Liu G, Hu FB, Bhupathiraju SN, Sun Q. Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Intern Med. Published online July 22, 2019. doi:10.1001/jamainternmed.2019.2195

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Last Updated on July 22, 2019 by Marie Benz MD FAAD