My good friend Robert Janko has published a systematic review on a very relevant topic for all of us in this day and age, especially because diabetes is still a recurrent topic for any age section, but also because vegetarianism has been the preferred punchbag for so many deniers out there; as if vegetarianism or veganism (perhaps fomented by the extremism of hipsters and their counterparts) was the monster who came to take over and impose, rather than just offer an optional view for a better life.
Robert researched intensively and published his findings in the Journal of Diabetes Nursing this year. The topic is ever so crucial and definitely adds on to the formula looking to partially contribute to the understanding of obesity, dietary habits, lifestyle behaviours and the row of physiological impairments caused by 'acquired' diabetes type-2. Plant-based diets have been linked to the betterment of blood glucose levels, glycated haemoglobin (complex of glucose + haemoglobin = HbA1c) levels, as well as improvements in insulin resistance. Through a systematic review of results obtained by three different clinical trials, Robert was able to show that, with intra-identified limitations, non-plant diets do not contribute as effectively as plant-based diets to a better controlled insulin secretion (healthy pancreatic beta-cell functioning) and weight loss.
But prior to jumping to the most relevant findings identified in Robert's review, it is important to define a few basic concepts beforehand. This will help us to better recognise, in a simple manner, the different implications of both diets in the human physiological system. The first question we should ask ourselves is...
Why is insulin secretion levels so important to one's health?
The higher the levels of HbA1c the greater the risk of developing diabetes-associated comorbidities [2]. If diet is directly or indirectly promoting higher levels of Hb1Ac then going back to the source and tweaking the physiological iterations, is a smart approach. For a healthy individual the levels of Hb1Ac should be below 42 mml/mol [2] and a slight change in obtained levels of glycated haemoglobin can have a huge impact even for people already diagnosed with Type-1 or Type-2 diabetes. Good management of glycated haemoglobin can contribute to reducing the occurrence of microvascular issues in about 25% [2]. Imagine being able to actually control the body to a point where one avoids retinopathy (that can cause permanent blindness) and neuropathy (that can cause permanent nerve damage) [3]. In a nutshell, holding in one's dietary habits the power to not only control obesity and the extraneous emotional and physical burden to it associated, but also avoiding cataracts, heart failure, diabetic nephropathy, and even worse, the need for amputation as a result of peripheral vascular disease [2]. Another huge factor that needs to also be taken into account is the insulin resistance syndrome marked by the irresponsiveness of different cellular tissues (such as the muscular, hepatic and adipose) to effectively using insulin [4]. Glucose is left 'hanging' in the blood stream, more insulin is needed by the body for the necessary uptake of glucose by cells, and consequently the pancreas will have to work more to produce even more insulin to get the blood glucose levels within a healthy range.
Why measuring glycated haemoglobin?
The response is simple and direct. Whilst blood glucose levels offer an idea of the glucose levels in our blood at a precise point in time, Hb1Ac levels offer a more robust idea of the issue since it delivers an average over a period of time.
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The second part of this post will dive deep into Robert's article in order to share observed conclusions. I hope you visit the blog to stay informed, and who knows, make an informed decision regarding your dietary habits.
[1] Janko, RK, Wilson, P., Nworie, C. (2021). "The effects of plant-based diets on pancreatic beta-cell function: A systematic review". Journal of Diabtetes Nursing, 25(2), pp. 1-7.
[2] Guide to HbA1c, Managing Blood Glucose, [https://www.diabetes.co.uk/what-is-hba1c.html#:~:text=HbA1c%20is%20a%20measure%20of,take%2C%20usually%20from%20your%20arm], last access on the 29th of March 2021, last update on the 15th of January 2019
[3] Mackay, JD and Page, MM (1980). "Diabetic autonomic neuropathy". Diabetologia, 18, pp. 471-478.
[4] Insulin resistance and Prediabetes, National Institute of Diabetes and Digestive and kidney Diseases, [https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance], last access on the 29th of March 2021, last update on May 2018
Photo by Markus Spiske on Unsplash
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