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      Type of Vegetarian Diet, Body Weight, and Prevalence of Type 2 Diabetes

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      Author(s): , MD, PHD 1 , , DRPH 2 , , MSC 3 , , MD, PHD 4
      Publication date (Print):
      Journal: Diabetes Care
      Publisher: American Diabetes Association

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          Abstract

          OBJECTIVE

          We assessed the prevalence of type 2 diabetes in people following different types of vegetarian diets compared with that in nonvegetarians.

          RESEARCH DESIGN AND METHODS

          The study population comprised 22,434 men and 38,469 women who participated in the Adventist Health Study-2 conducted in 2002–2006. We collected self-reported demographic, anthropometric, medical history, and lifestyle data from Seventh-Day Adventist church members across North America. The type of vegetarian diet was categorized based on a food-frequency questionnaire. We calculated odds ratios (ORs) and 95% CIs using multivariate-adjusted logistic regression.

          RESULTS

          Mean BMI was lowest in vegans (23.6 kg/m 2) and incrementally higher in lacto-ovo vegetarians (25.7 kg/m 2), pesco-vegetarians (26.3 kg/m 2), semi-vegetarians (27.3 kg/m 2), and nonvegetarians (28.8 kg/m 2). Prevalence of type 2 diabetes increased from 2.9% in vegans to 7.6% in nonvegetarians; the prevalence was intermediate in participants consuming lacto-ovo (3.2%), pesco (4.8%), or semi-vegetarian (6.1%) diets. After adjustment for age, sex, ethnicity, education, income, physical activity, television watching, sleep habits, alcohol use, and BMI, vegans (OR 0.51 [95% CI 0.40–0.66]), lacto-ovo vegetarians (0.54 [0.49–0.60]), pesco-vegetarians (0.70 [0.61–0.80]), and semi-vegetarians (0.76 [0.65–0.90]) had a lower risk of type 2 diabetes than nonvegetarians.

          CONCLUSIONS

          The 5-unit BMI difference between vegans and nonvegetarians indicates a substantial potential of vegetarianism to protect against obesity. Increased conformity to vegetarian diets protected against risk of type 2 diabetes after lifestyle characteristics and BMI were taken into account. Pesco- and semi-vegetarian diets afforded intermediate protection.

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          Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists.

          Gary E Fraser (1999)
          Results associating diet with chronic disease in a cohort of 34192 California Seventh-day Adventists are summarized. Most Seventh-day Adventists do not smoke cigarettes or drink alcohol, and there is a wide range of dietary exposures within the population. About 50% of those studied ate meat products or =3 times/wk compared with vegetarians], significant protective associations between nut consumption and fatal and nonfatal IHD in both sexes (RR approximately 0.5 for subjects who ate nuts > or =5 times/wk compared with those who ate nuts <1 time/wk), and reduced risk of IHD in subjects preferring whole-grain to white bread. The lifetime risk of IHD was reduced by approximately 31% in those who consumed nuts frequently and by 37% in male vegetarians compared with nonvegetarians. Cancers of the colon and prostate were significantly more likely in nonvegetarians (RR of 1.88 and 1.54, respectively), and frequent beef consumers also had higher risk of bladder cancer. Intake of legumes was negatively associated with risk of colon cancer in nonvegetarians and risk of pancreatic cancer. Higher consumption of all fruit or dried fruit was associated with lower risks of lung, prostate, and pancreatic cancers. Cross-sectional data suggest vegetarian Seventh-day Adventists have lower risks of diabetes mellitus, hypertension, and arthritis than nonvegetarians. Thus, among Seventh-day Adventists, vegetarians are healthier than nonvegetarians but this cannot be ascribed only to the absence of meat.
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            Meats, Processed Meats, Obesity, Weight Gain and Occurrence of Diabetes among Adults: Findings from Adventist Health Studies

            Arnold Vang, Pramil N Singh, Jerry Lee … (2008)
            Aim: To examine the relation between meat intake and diabetes occurrence in adults. Methods: In a prospective cohort study we examined the relation between diet and incident diabetes recorded among 8,401 cohort members (ages 45–88 years) of the Adventist Mortality Study and Adventist Health Study (California, USA) who were non-diabetic at baseline. During the 17-year follow-up, we identified 543 incident diabetes cases. Results: (1) Subjects who were weekly consumers of all meats were 29% (OR = 1.29; 95% CI 1.08, 1.55) more likely (relative to zero meat intake) to develop diabetes. (2) Subjects who consumed any processed meats (salted fish and frankfurters) were 38% (OR = 1.38; 95% CI 1.05–1.82) more likely to develop diabetes. (3) Long-term adherence (over a 17-year interval) to a diet that included at least weekly meat intake was associated with a 74% increase (OR = 1.74; 95% CI 1.36–2.22) in odds of diabetes relative to long-term adherence to a vegetarian diet (zero meat intake). Further analyses indicated that some of this risk may be attributable to obesity and/or weight gain – both of which were strong risk factors in this cohort. It is noteworthy that even after control for weight and weight change, weekly meat intake remained an important risk factor (OR = 1.38; 95% CI 1.06–1.08) for diabetes. Conclusions: Our findings raise the possibility that meat intake, particularly processed meats, is a dietary risk factor for diabetes.
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              Does a vegetarian diet reduce the occurrence of diabetes?

              D Snowdon, Ian Phillips (1985)
              We propose the hypothesis that a vegetarian diet reduces the risk of developing diabetes. Findings that have generated this hypothesis are from a population of 25,698 adult White Seventh-day Adventists identified in 1960. During 21 years of follow-up, the risk of diabetes as an underlying cause of death in Adventists was approximately one-half the risk for all US Whites. Within the male Adventist population, vegetarians had a substantially lower risk than non-vegetarians of diabetes as an underlying or contributing cause of death. Within both the male and female Adventist populations, the prevalence of self-reported diabetes also was lower in vegetarians than in non-vegetarians. The associations observed between diabetes and meat consumption were apparently not due to confounding by over- or under-weight, other selected dietary factors, or physical activity. All of the associations between meat consumption and diabetes were stronger in males than in females.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Diabetes Care
                Journal ID (hwp): diacare
                Journal ID (pmc): dcare
                Journal ID (publisher-id): Diabetes Care
                Title: Diabetes Care
                Publisher: American Diabetes Association
                ISSN (Print): 0149-5992
                ISSN (Electronic): 1935-5548
                Publication date (Print): May 2009
                Volume: 32
                Issue: 5
                Pages: 791-796
                Affiliations
                [1] 1Department of Health Promotion and Education, School of Public Health, and the Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, California;
                [2] 2Department of Biostatistics, School of Public Health, Loma Linda University, Loma Linda, California;
                [3] 3Loma Linda University, Loma Linda, California;
                [4] 4Department of Cardiology, School of Medicine, Loma Linda University, Loma Linda, California.
                Author notes
                Corresponding author: Serena Tonstad, stonstad@ 123456llu.edu
                Article
                Publisher ID: 1886
                DOI: 10.2337/dc08-1886
                PMC ID: 2671114
                PubMed ID: 19351712
                SO-VID: ba4bd013-4d43-433a-95af-eee736426f3f
                Copyright © © 2009 by the American Diabetes Association.
                License:

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

                History
                Date received : 17 October 2008
                Date accepted : 2 February 2009
                Funding
                Funded by: National Institutes of Health
                Award ID: 1R01CA94594
                Categories
                Subject: Original Research
                Subject: Clinical Care/Education/Nutrition/Psychosocial Research

                ScienceOpen disciplines: Endocrinology & Diabetes
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes

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