Type 2 diabetes risk – more proof diet is key


In the UK forward thinking doctors such as Dr David Unwin have been winning recognition for advocating diet change and lifestyle choices over drugs to combat type 2 diabetes (T2D). Now findings from the Singapore Chinese Health Study have also shown a high-quality diet – one with low intake of animal foods such as red meat, a high intake of plant foods such as vegetables, fruits and whole grains, as well as lower consumption of sweetened beverages – is associated with reducing the risk of diabetes.

The study aimed to test whether predefined dietary patterns that are inversely related to risk of T2D in Western populations were similarly associated with lower T2D risk in an Asian population. 45,411 middle-aged and older participants (ages 45–74 years) in the Singapore Chinese Health Study who were free of diabetes, cancer, and cardiovascular disease at baseline (1993–1998) were analysed. Participants were followed up for T2D diagnosis through 2010. Dietary information was collected using a validated food frequency questionnaire.

Dietary pattern scores were calculated for five predetermined dietary patterns originating in Western populations, i.e. the alternative Mediterranean diet (aMED, an international adaptation of the eponymous diet), the Alternate Healthy Eating Index 2010 (AHEI-2010), the Dietary Approaches to Stop Hypertension (DASH) diet, the plant-based diet index (PDI) and the healthful plant-based diet index (hPDI), are similar in being rich in plant-based foods, including whole grains, vegetables and fruits, nuts and legumes, and low in red meat and sugar-sweetened beverages. These dietary patterns have been shown to reduce the risk of diabetes and cardiovascular diseases and are considered high-quality dietary patterns.

During a median of 11.1 years of follow-up, 5,207 incident cases of T2D occurred. After adjustment for multiple potential confounders, the 5 dietary pattern scores were significantly associated with 16% (for aMED) to 29% (for DASH) lower risks of T2D when comparing the highest score quintiles with the lowest. What’s more the associations did not vary substantially by baseline age, sex, body mass index, or hypertension status, but were limited to non-smokers.

Clearly following a high-quality diet, as reflected by several predefined diet quality indices derived in Western populations, was significantly associated with lower T2D risk in an Asian population as well, but for me the most important point for broader health – and not just the avoidance of T2D – is the value of this research into the synergistic effects of diverse foods consumed together, rather than just into the impact of individual food items. Overall dietary patterns capturing the combined effect of a variety of food groups is in my view essential to appreciating the links between food and better health. When it comes to food, there is no one magic food – no single silver bullet. Increasing the proportion of real food in our diets is a great place to start and then take it from there.

By focusing on a high-quality diet with an abundance of minimally processed plant foods such as whole grains, vegetables, fruit, nuts and legumes, with less emphasis on red and processed meat, while avoiding sweetened drinks is the right direction to take.

Make eating real food Just Routine

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Iris is the founder of No Targets Just Routine. She has researched food since 2009 and believes “Happiness is real food shared with loved ones.”

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