Diabetes remission: Whole-food, plant-based diet may help

Foods high in fiber make you feel fuller longer, which decreases the likelihood of experiencing cravings and overeating.

“High-fiber foods can help slow down the spikes in blood sugar,” Dr. Mary Vouyiouklis Kellis, an endocrinologist at Cleveland Clinic, told MNT.

“High-fiber foods move slowly through the stomach and can help you feel full for longer. This, in turn, may make you less likely to reach for other foods or snacks, for example,” she explained.

Plant-predominant diets may also contribute to the reversal of insulin resistance.

“By avoiding meat, plant-based diets are often hypocaloric and therefore associated with improved insulin sensitivity. Some studies show that individuals following plant-based diets experience improved satiety and are therefore more likely to adhere to these diets,” Dr. Messer explained.

Additionally, plant-based diets are lower in saturated fats, which are thought to harm pancreatic B-cell function.

“A whole grain high fiber diet may improve insulin resistivity. Fiber may attenuate the glycemic response to oral carbohydrates by slowing the absorption of nutrients,“ said Dr. Messer.

“Whole grains and legumes reduce postprandial blood sugars; whole grain foods may be fermented by bacteria in the small intestine, thereby producing fatty acids which improve insulin sensitivity after passing through the liver. In addition, whole grains contain high levels of micronutrients such as vitamin D, magnesium, antioxidants, etc., which all potentially improve insulin sensitivity.“
— Dr. Caroline Messer

Previous studies have shown that whole-food, plant-predominant eating patterns can improve diabetes outcomes. However, the research mainly involved significant calorie restriction, often including fasting or liquid meal replacements.

“Liquid meal replacements are not a long term solution and not typically recommended unless used for certain situations such as, for example, in preparation for bariatric surgery,” explained Dr. Kellis.

“Healthy lifestyle dietary choices are most important. A balanced diet of high fiber foods, lean proteins, fruits, and vegetables as well as complex carbohydrates while avoiding refined sugars can help to improve blood glucose levels,” she advised.

Along with adopting healthier eating habits, weight loss, exercise, stress reduction, and avoiding alcohol can help treat diabetes.

“Weight loss is a very important factor. Exercise can play a role in helping improve blood glucose. Both strength or resistance training and cardio have been found to be helpful in patients with type 2 diabetes,” Dr. Kellis stressed.

”Aim for a goal of 150 minutes of exercise a week. Stress reduction and healthy sleep habits are also important. In addition, avoid alcohol,” she said.

To incorporate more whole and plant-based foods into their diet, it may be helpful to plan meals in advance, the experts interviewed by MNT suggested.

“Meal planning will help you stick to a change. Make a grocery list and you can use this to help you make good choices when you are food shopping,” explained Dr. Kellis.

Mackenzie Burgess, a registered dietitian nutritionist and recipe developer at Cheerful Choices, who was not involved in the study, also highlighted the importance of meal preparation.

“It can be a helpful strategy to prepare large quantities of individual whole food ingredients at a time,” Burgess said.

Here are a few examples of foods Burgess recommended preparing at the weekends and storing in the fridge:

• cooked grains (rice, quinoa, farro)
• cooked pulses (beans, lentils, chickpeas)
• other types of cooked plant proteins (air-fried tofu, sautéed tempeh, microwaved edamame)
• cooked or chopped vegetables (roasted broccoli, caramelized mushrooms, bell pepper slices)
• washed and chopped fruits (berries, apple slices, peeled oranges).

Secondly, the experts advised, it may be helpful to make protein a priority.

“Oftentimes when someone starts eating a more plant-forward diet, they make the mistake of not getting enough protein,” Burgess explained.

“This can leave you feeling unsatisfied and less likely to stick with it. I recommend stocking your kitchen with go-to plant protein sources like nuts, seeds, and pulses. Pulses include beans, lentils, and peas and they’re packed with important nutrients like protein, fiber, potassium, and iron,” she said.

“Healthy lifestyle choices are definitely important,” Dr. Kellis said.

“However,“ she cautioned, “sometimes, despite this, it may be hard to achieve type 2 diabetes remission. This can be due in part to genetics, worsening insulin resistance as we age, or long history of type 2 diabetes.“

“After many years of diabetes, there sometimes can be beta cell insufficiency, which means the pancreas sometimes may have trouble secreting enough insulin to improve blood glucose,” she explained.

The endocrinologist also cautioned that the current study faced certain limitations, so further research could help consolidate its findings.

“A big limitation of this study was that it was a case series, and there was no control group,” Dr. Kellis pointed out. “Also, the data may not be generalizable to other healthcare settings.”