Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

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Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

A new study expanded on the data that type 2 diabetes (T2D) is associated with increased consumption of heme iron, which is naturally present in certain animal products and added to some meat alternatives to enhance flavor.

Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

Frank Hu, MD, PhD, of the Harvard T.H. Chan School of Public Health, Boston, and colleagues reported in a paper published in Nature Metabolism in August that participants with the highest heme iron intake had a 26% higher risk of developing type 2 diabetes compared to those with the lowest intake, as determined by a multivariable-adjusted hazard ratio (95% CI, 1.20-1.33; P for trend <.001).

"Eating a more plant-based diet and reducing the consumption of heme iron from red meat should be considered as a strategy to lower risk of diabetes and the prevention of chronic diseases," Hu told Medscape Medical News in an interview.

"Too much heme iron has also been associated with increased risk of cardiovascular disease and even some cancers, like colorectal cancer," he noted.

The results of Hu and colleagues' investigation into a potential link between red meat consumption and T2D risk, which was published in the American Journal of Clinical Nutrition last year, are expanded upon in this work.

Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

When Marilyn Tan, MD, the clinic chief of the endocrine clinic at Stanford University School of Medicine in Palo Alto, California, was asked to comment on the recent publication by Hu and coauthors, she pointed out the limits of research generally meant to examine the impact of dietary choices on health.

"Many studies have noted associations between various dietary factors and certain disease states, but in studies relying solely on epidemiological data, association cannot prove causation," Tan told Medscape Medical News in an email. "In addition, aside from the specific diet component being studied, the remainder of diets can be very heterogeneous."

She added that general diet studies are unable to fully account for other important lifestyle factors like exercise, idle time, and sleep quality.

Tan did, however, draw attention to the additional measures Hu and colleagues made in adjusting for specific health and lifestyle factors when examining the relationship between heme iron and diabetes risk.

Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

According to Tan, they also employed metabolic indicators, such as chemical breakdown and small-molecule metabolites from food, to help clarify some of the potential explanations for the link between heme intake and diabetes risk.

"The attributable risk of diabetes associated with heme iron that was calculated in the study was notable, and it appeared to be dose dependent," she noted.

Research Plan

Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

Hu and colleagues analyzed 36 years' worth of dietary reports from 204,615 persons who were part of the Health Professionals Follow-Up Study and the Nurses' Health Studies I and II. Based on the amount of heme iron consumed, they divided these results into five groups.

Hu reported to Medscape Medical News that there were 2554/1,052,982 (about 2.4 instances of T2D/person-years of follow-up) in the lowest quintile. It was 5881/1,047,447 in the highest quintile (or around 5.6 per 1000 person-years).

Hu and colleagues discovered that although individuals in the lower heme group reported having approximately two to three servings per week of unprocessed red meat, those in the high heme iron groups across the various studies reported eating about eight to ten servings.
Combining the data from all the studies produced low heme groups with a median of 0.7 mg/d and high heme iron quintiles with an estimated median of 1.5 mg/d. The recommended daily allowance of heme iron is not defined.

Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

According to Hu and colleagues, those with higher intakes of nonheme iron and total iron also reported being less likely to smoke, more likely to be physically active, and more likely to use multivitamins. They consumed more fruits, vegetables, fiber from cereal, and magnesium. Higher heme iron consumers also tended to be less physically active, smoke more frequently, and consume more red meat, chicken, and fish while consuming fewer fruits, whole grains, fiber from cereals, and magnesium.

Hu claimed that in their statistical analysis, he and his coauthors considered these variables.

Occasional Steak vs. Turkey Sausage

Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

When contacted about the Hu paper, Dariush Mozaffarian, MD, a cardiologist and the head of Tufts University's Food is Medicine Institute in Medford, Massachusetts, provided an alternative interpretation of the results. Mozaffarian focused on the examination of processed meat and T2D in the paper.

Hu and colleagues observed in the research that whereas heme iron intake accounted for almost half of the correlation between the risk of diabetes and unprocessed red meat, it only explained a minor amount of the link for processed red meat." They added the "harmful association of processed red meat and T2D risk might be attributed to the high content of other compounds, such as nitrates and nitrites."
The medical establishment has recommended a diet high in saturated fat, but Mozaffarian noted that the Hu and coauthors' article and other research revealed there may be other factors at play as well, such as inflammatory chemicals.

Eat a Plant-Based Diet to Reduce Your Chance of Diabetes

In light of this, he suggested that the emphasis on fat content be reexamined because it could encourage individuals to believe that highly processed meals are healthier options.

According to him, a fresh meat burger or steak would be a better option than turkey sausage and low-fat deli meat. He disagrees with opponents who consider red meat as horribly hazardous as well as many paleo diet advocates who see it as necessary.

"The main take-home message for patients is that red meat neither deserves a health halo for being something you must seek out, but it also doesn't deserve devil's horns for being the worst thing in the food supply," he said.