A healthful plant-based diet is associated with lower type 2 diabetes risk via improved metabolic state and organ function: A prospective cohort study - 13/02/24
, Tilman Kühn a, b, c, ⁎ Highlights |
• | A healthful plant-based diet is associated with lower type 2 diabetes risk, not only because of beneficial effects on weight control, but also due to improved liver and kidney function, lower basal inflammation, and lower IGF-1. |
• | By contrast, an unhealthful plant-based diet also low in animal products but high in processed and sugary foods is associated with a higher risk of type 2 diabetes, with greater BMI and higher triglyceride levels mediating this association. |
• | A shift towards more environmentally friendly plant-based diets can have co-benefits in diabetes prevention beyond lower BMI among people following healthful plant-based diets. |
Abstract |
Background |
Plant-based diets are becoming increasingly popular due to favourable environmental footprints and have been associated with lower risk of type 2 diabetes mellitus (T2DM). Here, we investigated the potential mechanisms to explain the lower T2DM risk observed among individuals following plant-based diets.
Methods |
Prospective data from the UK Biobank, a cohort study of participants aged 40 to 69 years at baseline, was evaluated. Associations between healthful and unhealthful plant-based indices (hPDI and uPDI) and T2DM risk were analysed by multivariable Cox regression models, followed by causal mediation analyses to investigate which cardiometabolic risk factors explained the observed associations.
Results |
Of 113,097 study participants 2,628 developed T2DM over 12 years of follow-up. Participants with the highest hPDI scores (Quartile 4) had a 24 % lower T2DM risk compared to those with the lowest scores (Quartile 1) [Hazard Ratio (HR): 0.76, 95 % Confidence Interval (CI): 0.68–0.85]. This association was mediated by a lower BMI (proportion mediated: 28 %), lower waist circumference (28 %), and lower concentrations of HBA1c (11 %), triglycerides (9 %), alanine aminotransferase (5 %), gamma glutamyl transferase (4 %), C-reactive protein (4 %), insulin-like growth factor 1 (4 %), cystatin C (4 %) and urate (4 %). Higher uPDI scores were associated with a 37 % higher T2DM risk [HR: 1.37, 95 % CI:1.22- 1.53], with higher waist circumference (proportion mediated: 17 %), BMI (7 %), and higher concentrations of triglycerides (13 %) potentially playing mediating roles.
Conclusion |
Healthful plant-based diets may protect against T2DM via lower body fatness, but also via normoglycaemia, lower basal inflammation as well as improved kidney and liver function.
Le texte complet de cet article est disponible en PDF.Keywords : Diabetes mellitus Type 2, Dietary pattern, Mediation analysis, Plant-based diet index, Prospective cohort study
Abbreviations : ALT, AST, BMI, CRP, GGT, HbA1c, hPDI, IGF-1, LDL, Lip A, NAFLD, PDI, SD, T2DM, uPDI, UK
Plan
| ☆ | Funding Source: Alysha S. Thompson holds a PhD studentship of the Department for the Economy (DfE), Northern Ireland. Solomon A. Sowah was funded by Medical Research Council Epidemiology Unit core support (MC_UU_00006/3). |
Vol 50 - N° 1
Article 101499- janvier 2024 Retour au numéro
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