Whole, plant-based diet best for remission of type 2 diabetes: ACLM consensus statement
USA: Dietary modification by emphasizing whole, plant-based foods are most effective for achieving remission in adults with type 2 diabetes, according to an expert consensus statement released by the American College of Lifestyle Medicine.
The objective of the Expert Consensus Statement, published in the American Journal of Lifestyle Medicine, was to assist clinicians in the remission of type 2 diabetes (T2D) in adults by using diet as a primary intervention. A multi-disciplinary panel of expert healthcare professionals agreed upon the 69 consensus evidence-informed statements.
"Diet as a primary intervention can achieve remission for many with type 2 diabetes and should focus on plant-based foods with minimal consumption of meat and other animal products," a multidisciplinary panel of health care professionals with expertise in diabetes treatment, research, and remission wrote in their document that was developed using a modified Delphi process.
The panel reached a consensus on a number of issues, including the following:
- Diet as a primary intervention can achieve remission in many adults with type 2 diabetes and is related to the intensity of the intervention (i.e., the degree of dietary restrictions imposed and the frequency and duration of patient contact or counseling).
- Remission is a realistic and achievable goal for some adults with type 2 diabetes.
- Healthy, food-based dietary interventions (e.g., Mediterranean, DASH, whole-food plant-based diets) are preferable to calorie or isolated nutrient restriction (e.g., low carbohydrate, low fat, and high protein) for long-term remission of type 2 diabetes.
- Diet as a primary intervention for type 2 diabetes is most effective in achieving remission when emphasizing whole, plant-based foods with minimal consumption of meat and other animal products.
- A very low-carbohydrate diet can be associated with significant adverse events and cardiovascular risk that make this diet inadvisable for long-term remission of type 2 diabetes.
- The risk of adverse events, including the potential to cause or exacerbate chronic disease and to increased cardiovascular risk, should influence the choice of diet as a primary intervention for type 2 diabetes remission.
- A whole-food, plant-based diet with intermittent fasting or time-restricted feeding could achieve remission of type 2 diabetes in some patients.
- Dietary intervention should be combined with other lifestyle interventions, such as regular exercise, for achieving remission of type 2 diabetes.
The authors however noted that the consensus statement was limited by gaps and uncertainties in the relevant medical literature. Regarding potential conflicts of interest, panelists self-reported that their diets, on average, consisted of 89% plant-based foods, ranging from 50% to 100%, with most food choices described as whole or minimally processed.
"This high prevalence of healthy, plant-based eating, as well as our discussion focused on plant-forward dietary patterns, may have introduced bias in favor of this approach that impacted responses to the iterative Delphi surveys," the authors wrote. "We have therefore disclosed this information so the reader can draw their own conclusions."
Reference:
Rosenfeld RM, Kelly JH, Agarwal M, et al. Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission: An Expert Consensus Statement from the American College of Lifestyle Medicine. American Journal of Lifestyle Medicine. 2022;16(3):342-362. doi:10.1177/15598276221087624
