Discussion: A Plant-Based Diet for the Prevention and Treatment of Type 2 Diabetes

Toby Smithson, MS, RDN, LD, CDE, is a diabetes lifestyle expert, registered and licensed dietitian, and certified diabetes educator, with a Master of Science in Nutrition and Wellness. She serves in leadership roles for the American Association of Diabetes Educators (AADE), currently is a media spokesperson for AADE, and is on the advisory board of Diabetic Living magazine. Toby is a former national spokesperson for the Academy of Nutrition and Dietetics. She is also the principal author of Diabetes Meal Planning and Nutrition for Dummies (John Wiley & Sons, October 2013), and writes regularly for U.S. News and World Report and Type2Diabetes.com. She has successfully managed her own type 1 diabetes for five decades, and in 2010 founded DiabetesEveryDay.com as an online technical and lifestyle support resource for people with diabetes.

I sat down with Toby to get her feedback on how a plant-based diet can be a good fit for diabetes prevention and management. So, sit down and check out our conversation below. And watch the video interview I hosted on my Plant Chat with Toby on Plant-Based Eating for Diabetes here. 

Q&A with Toby and Sharon on Diabetes Prevention and Management with Plant Based Diet 

Sharon: As a vegetarian living with type 1 diabetes, how have you found this diet to be impactful for you in managing diabetes, as well as living a vibrant, healthful life?

Toby: I credit my in-target blood glucose and lipid levels, along with management of my weight to following a vegetarian meal pattern. Most importantly, I enjoy my food.

Sharon: How long have you been eating this diet? What impacts have you seen since you made this change?

Toby: I have been eating a plant-based diet with occasional consumption of fish ever since college…let’s just say it’s been several decades. Since I have followed this eating plan all of my adult life, it’s hard to say what impacts I have seen in comparison to eating an animal protein based diet. I do know that a plant-based diet has enabled me to keep my glucose, lipids, blood pressure and weight in target ranges which is a huge benefit for good management of diabetes.

Sharon: What does the science tell us about the benefits of managing diabetes by plant-based eating styles, such as flexitarian, vegetarian and vegan diets?

Toby: People with diabetes are at double the risk of heart disease. AHA published a study showing a 42% reduction in heart disease in people who followed a vegetarian eating plan versus a meat-based eating plan. The nutrient benefits of plant-based eating are nutritionally sound to help in the prevention of heart disease. Plant-based eating patterns are higher in fiber, vitamins, minerals, phytochemicals, and healthy fats while typically lower in saturated fat and cholesterol.

Sharon: Do vegetarian and vegan diets help people prevent type 2 diabetes? Why?

Toby: A plant-based diet has the potential to help people lose weight, lower their blood glucose and blood pressure, prevent heart disease, and ultimately prevent type 2 diabetes, or at least slow the progression of type 2 diabetes.

There have been numerous studies looking at vegan, vegetarian, plant-based diets and people with diabetes. The studies show a positive impact from following this type of eating pattern. Chronic inflammation appears to be reduced and insulin sensitivity is improved in people following a plant-based diet.

Sharon: Is it possible for people to use a plant-based diet—such as a vegan diet—to reverse type 2 diabetes?

Toby: We can’t “reverse” diabetes. Diabetes is a manageable chronic condition. Once you have been diagnosed, you will always have diabetes, but the good news is that it can be self- managed. Studies do show benefits from eating plant based but I heed some caution with a vegan diet versus a plant-based or vegetarian diet. When you follow a vegan diet, there are some limitations due to the sources of protein coming with carbohydrate.

The 2018 Standards of Medical Care for People with Diabetes notes that nutrition through healthful eating patterns that contain nutrient dense foods as an integral part of diabetes management. Plant-based, Mediterranean and the DASH diet eating patterns are suggested eating plans for people with diabetes.

Sharon: What are your best diet tips for those living with diabetes that follow a plant-based diet?

Toby: When following a plant-based diet, it is important to have a balance of nutrients. Because a plant-based diet can include many servings of carbohydrate food sources, I suggest having a focus on obtaining sources of protein from no to low carb containing foods such as eggs, cheese, fish (if you include these in your eating plan), soy, and nuts or nut butters to combine with the carb sources to complete your meal. For example, Seitan, milk and yogurt contain protein, but they also contain carbohydrate. I suggest reading food labels for foods that are especially new to your diet. For example, jack fruit is making a more prominent appearance in vegetarian/vegan cooking and restaurant menus, but know that jack fruit is very low in protein while containing carbohydrate. A balanced diet for people with diabetes will contain a combination of carbohydrate, protein, and fat sources from foods.

To help with planning your meals, I like to start with the protein source of the meal and then add which carbohydrate foods would fit, as well as the vegetable for the meal. Typically, I consume one serving of vegetable at lunch two servings of vegetables at dinner.

Sharon: What does a typical day of your diet look like?

Toby:

Breakfast:

½ cup cooked oats with 6 almonds, ½ teaspoon cinnamon and ½ packet of Splenda Naturals; 1 soy sausage patty; Hot or iced tea.

Lunch:

2 ounces Swiss cheese; 15 grams worth of crackers or 3 cups popped popcorn sprinkled with parmesan cheese; raw vegetables with salad dressing as the dip; 1 small apple or 1 cup watermelon; 1 piece of dark chocolate and pistachios; Iced tea.

Dinner:

Tempeh stir fry; 1 egg roll; ½ cup sugar free chocolate pudding; shelled peanuts; iced tea

Bedtime snack:

Greek yogurt with nuts (either pistachios, peanuts or almonds)

Sharon: What are some foods you always include in your diet?

Toby: Nuts three times per day (almonds, peanuts and/or pistachios); Vegetables at lunch (one serving) and dinner (2 servings); Fruit at least once per day; Greek yogurt once per day; Oatmeal every morning; Typically have cheese for lunch every day.

I love using this Tempeh stir fry recipe because it is easy to have the ingredients on hand, and it is a great plant-based meal; quick to prepare and I love the flavors!

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For other information on plant-based diets for diabetes, check out the following:

Try some of these 10 Diabetes Friendly Recipes on my blog:

Main image: Raw Purple Power Salad from The Plant-Powered Plan to Beat Diabetes, Sharon Palmer, RDN

Photographer: Ghazalle Badiozamani