Why choosing different foods every day can lower your risk of diabetes

Why choosing different foods every day can lower your risk of diabetes

New research shows that adding variety, particularly more plant proteins, to your plate could help prevent type 2 diabetes, with notable benefits for women and people without central obesity.

In a recently published study in theInternational Journal of EpidemiologyResearchers examined the associations between dietary diversity and the incidence of type 2 diabetes (T2D).

Diabetes affected over 10% of the world's population in 2021, with T2D accounting for approximately 90% of diabetes diagnoses and a majority of related burdens. Therefore, prevention of T2D remains a policy and public health priority. Diet is recognized as a modifiable factor in T2D prevention. Dietary diversity is an essential aspect of healthy eating, and unlike quantity, quality, or frequency of food intake, it reflects the variety of foods consumed.

A healthy diet can lack variety, and a diverse diet may not necessarily be lower in salt, trans fats, or energy. The variety of protein-rich foods is important for health and T2D management. Furthermore, evidence suggests that total protein intake influences T2D risk. For example, higher amounts of animal protein increase the risk of T2D, while there is no association with the amount of plant protein. Additionally, the risk of T2D varies depending on animal protein subtype.

Higher amounts of processed and red meat increase T2D incidence, while dairy appears protective. Various protein-rich foods contain numerous bioactive compounds, and the biological effects and relative contribution of protein intake may vary depending on the administration of the diet in animal or plant protein. However, no study has examined the diversity in protein-rich foods by dietary source.

About the study

The present study examined the associations between dietary diversity and the incidence of T2D. Data were obtained from the epic-interact study. Five-diet diversity (DDSS) were derived from self-reported dietary data. These included diversity of food groups (DDS-Total5) and diversity within subtypes of vegetables (DDS-VEG), meat and alternative (DDS-Meat), animal protein (DDS-ProTA) and plant protein (DDSProtP).

Food groups included grains, dairy, fruits, vegetables, meat and alternative sources. Vegetable subtypes were root, leaf, fruit and other vegetables. Plant protein subtypes included legumes, nuts and seeds, rice and pasta, bread and other grains. Meat and alternative subtypes included red and processed meat, poultry, organ meats, fish and seafood, eggs, legumes, seeds and nuts.

Animal protein subtypes included processed meat, red meat, cheese, milk and dairy products, organ meats, fish and seafood, poultry and eggs. Prentice-weighted Cox regression models were used to assess prospective associations between individual DDs and T2D incidence, stratified by sex and obesity status. COX regression analyzes were performed to assess effect change by gender and obesity.

Results

The study population included 23,649 people from eight European countries, including 10,363 cases of T2D. On average, subjects were followed for 9.9 years or 234,324 person-years. Intake of four or five plant protein sources was associated with reduced T2D incidence across countries compared to no intake.

Additionally, consumption of each new plant protein subtype was associated with a 4% lower T2D incidence. Plant protein diversity was inversely associated with the incidence of T2D in women. The incidence of T2D was 25% lower in women who consumed three plant protein subtypes. While plant protein diversity showed an inverse association with T2D incidence in individuals with and without obesity, the result was only statistically significant for individuals without central obesity.

However, individuals without central obesity who consumed four to five subtypes of plant protein had an 18% lower incidence of T2D, a finding that was borderline significant (HR 0.82, 95% CI 0.68-1.00). For DDS-TOTAL5 and DDS-VEG, the highest values ​​were associated with a reduced incidence of T2D compared to the lowest values. Each additional food group in the diet was associated with a 9% lower incidence of T2D. Intake of the five food groups was associated with a lower incidence of T2D in women (HR 0.86, 95% CI 0.77-0.96), and while a similar pattern was observed in men, the association was not statistically significant for them (HR 0.84, 95% CI 0.68-1.04).

Eating at least three different vegetables reduced the incidence of T2D in men by 15% (HR 0.85, 95% CI 0.73-0.99). Likewise, intake of four and five major food groups reduced the incidence of T2D by 17% and 21% in individuals without central obesity. No clear associations were identified for DDS-ProTA and DDS meetings. Nevertheless, higher DDS was associated with incident T2D in people without central obesity. Interestingly, some of these results contradicted the researchers' initial hypothesis that greater diversity would be more protective for men and individuals with obesity. It is also important to note that while trends sometimes differed between subgroups, the paper reported that the formal statistical tests for these interactions were often not significant, calling for cautious interpretation of these differences.

Conclusions

In summary, consumption of four or five different plant protein sources was consistently associated with a reduced risk of T2D incidence compared to intake of these sources. Consumption of four subtypes of vegetables and five major food groups was also associated with a lower risk of T2D.

However, the researchers found that some of these associations were weakened when they conducted additional analyses. For example, the association between plant diversity and lower T2D risk in men was no longer statistically significant after accounting for other dietary diversity measures, suggesting that the results should be interpreted with caution.

The study authors also pointed out several limitations. The results rely on self-reported dietary data collected at a single point in time, which may not capture changes in diet over the years. Because the study population was European, the results may not be generalizable to other populations.

Overall, these results support dietary guidelines for consuming foods from five food groups and including a variety of vegetables and plant-based proteins in the diet.

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