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Vegetarian and Vegan Type 1 Diabetes

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Selection of plant-based foods -- Vegetarian and Vegan Type 1 Diabetes
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With all the talk and hype about Paleo, keto and low-carb diets, you might think that interest in vegetarian and vegan eating has taken a nosedive. But according to a Gallup poll survey conducted in 2018, 5% of Americans report that they’re vegetarian, and 3% report that they’re vegan. These numbers have apparently remained stable over the past 20 or so years.

Nevertheless, vegetarianism and veganism (defined in a moment), as well as following a more “plant-based” diet, are of interest to many Americans, even if they don’t consider themselves to be “full-time” vegetarians (and can you really be a “part-time” vegetarian?). In fact, a Nielsen Homescan survey in 2017 that 39% of Americans are making an effort to eat more plant-based foods.

People have their reasons for choosing to follow a more plant-based diet, as well: health benefits, weight loss, ethical reasons, religious and cultural beliefs, and concerns about the environment are among the top reasons.

If you have type 1 diabetes, you might be curious if vegetarian or vegan eating is a) OK and b) beneficial to managing your diabetes.

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Clarifying some definitions

What do vegetarian, vegan, flexitarian and plant-based really mean? Let’s define them.

Vegetarian

Someone who avoids eating all types of meat, poultry and fish. They may include dairy foods and eggs.

Vegan

Someone who avoids eating all animal products, including dairy products, eggs, honey and gelatin. Some vegans also avoid wearing anything that comes from an animal, such as leather and silk, and they may choose to feed their pets an animal-free diet, as well.

Plant-based (plant-forward)

Someone who primarily eats foods derived from plants, including vegetables, fruits, grains, legumes, nuts and seeds. They may or may not eat any animal foods.

Just to make things more interesting, there are still more terms that you may come across:

Flexitarian

Someone who is a part-time vegetarian. This person may occasionally eat meat, poultry and seafood, but he or she does so sparingly.

Pescatarian

Someone who doesn’t eat meat or poultry but does eat fish and seafood.

Lacto-vegetarian

Someone who avoids meat, poultry, fish and eggs but eats dairy foods.

Lacto-ovo vegetarian

Someone who avoids meat, poultry and fish but consumes eggs and dairy foods.

Ovo-vegetarian

Someone who eats no meat, poultry, fish or dairy foods, but does eat eggs.

Pegan

Someone who follows a hybrid of a vegan and Paleo diet.

Why go plant-based?

Plant-based diets (whether it’s vegetarian, vegan or flexitarian) offer a number of health benefits that are applicable to people with type 1 diabetes. These include a lower risk of:

Heart disease

• Stroke

High blood pressure

High cholesterol

• Obesity

• Many types of cancer

There’s also evidence that a plant-based diet can lower the risk of developing type 2 diabetes.

In terms of the environment, many researchers believe that plant-based eating can help the health of the earth, too, by protecting resources such as water, and by reducing carbon emissions and waste byproducts that pollute our oceans.

Major health organizations support more plant-forward eating, as well, including the American Diabetes Association, the American Heart Association, the U.S. Departments of Agriculture and Health and Human Services (the 2015-2020 Dietary Guidelines for Americans strongly encourage us to eat more plant-based foods). And interest in plant-based diets has spurned other movements, as well, including “Meatless Monday,” a global movement that promotes going meat-free for one day out of the week.

How can a plant-based diet help type 1 diabetes?

Plant-based diets have been looked at more closely in terms of how they may reduce the risk of developing type 2 diabetes, as well improving diabetes control in those with existing type 2 diabetes.

Can being vegetarian, vegan or flexitarian help those with type 1 diabetes? Unfortunately, not as much research has been done in this area; however, many of the benefits of plant-based diets are applicable to both type 1 and type 2 diabetes. Let’s take a look.

Heart health

People with diabetes (type 1 or type 2) have a higher risk of heart disease and are more likely to die from cardiovascular issues (e.g., a heart attack) than people without diabetes. A healthful, plant-based diet can lower these risks by reducing LDL (bad) cholesterol levels, reducing inflammation, lowering blood pressure levels, and decreasing blockages in arteries. In fact, some research points to plant-based diets not only preventing heart disease, but possibly even reversing it.

Insulin resistance

Insulin resistance is when the cells in the body are unable to use insulin effectively. Insulin resistance is more common in those with type 2 diabetes, but people with type 1 diabetes can be insulin resistant, too. Some health experts call this “double diabetes,” and insulin resistance in someone with type 1 greatly increase the risk of heart disease. And here’s where more of a plant-forward eating plan can help.

Weight management

People with type 1 diabetes are often thought of as being thin, but approximately 50% of those with type 1 diabetes are either overweight or obese, according to a 2017 study published in the journal Current Diabetes Reports. A nutritious plant-based eating plan can support the achievement and maintenance of a healthy weight in people with type 1 diabetes.

Are there risks to plant-based diets?

There are pros and cons to any eating plan. When it comes to vegetarian and vegan diets, for example, one of the risks can be getting enough of certain nutrients that are mainly provided by animal foods. These nutrients include:

• Protein

• Iron

• Vitamin B12

• Calcium

Vitamin D

However, with careful planning and eating a wide variety of plant-based foods, it’s certainly possible to meet all of your nutrient needs.

Another concern for those with diabetes is the carbohydrate content of plant-based diets. This is a valid concern, as restricting or eliminating animal foods such as meat, poultry, fish, eggs and dairy foods, which are primarily protein-based, means that not only do you need to find alternate sources of protein, you may end up eating more carbohydrate. And more carbohydrate can have an impact on your blood sugars.

Making the move to a plant-based diet

If you’re considering making the move to a vegetarian or vegan diet, talk it over first with your healthcare team. You will likely need to make adjustments in your insulin, and if you take medication for blood pressure and/or cholesterol control, those may need some tweaking as well.

Meet with a dietitian — ideally, one who is familiar with both plant-based eating and diabetes — to map out an eating plan and ensure that you’re getting enough of key nutrients (see above). A dietitian will also help you aim for a balance of nutrients, such as carbohydrate, protein and fat, and discuss the use of supplements, say, for vitamin B12 or omega-3 fatty acids, if indicated.

Keep in mind that it’s possible to be eating “plant-based” and yet, not be eating very healthfully. For example, French fries, white bread and soda are technically “vegetarian,” yet they’re hardly healthy foods to include in your eating plan. Go for whole grains, legumes, fresh vegetables and fruit as your carb sources — they’ll have a lower glycemic impact on your blood sugars, as well, compared with refined carbs.

Also be vigilant about monitoring your glucose levels. Any time you change up your eating style, it’s likely to affect your diabetes. Be patient and give yourself time to adapt. You may find that you need to adjust your meal-time insulin doses (up or down) to compensate for more carb — or more fiber, for example.

It’s a good idea to make the move gradually, especially if your partner or family isn’t completely on board. It takes time to adapt to a different way of cooking and meal preparation, for example. A good place to start is to incorporate “Meatless Mondays” into your lifestyle. For more on Meatless Mondays, visit www.meatlessmonday.com.

Also check out the Vegetarian Starter Kit for more tips about vegetarian and plant based diets.

Diabetes Self-Management’s website provides a number of plant-based, vegetarian and vegan options. The American Heart Association has a nice library of recipes, as well.

Want to learn more about type 1 diabetes? Read “Type 1 Diabetes Questions and Answers,” “Six Type 1 Diabetes Symptoms You Need to Know” and see our type 1 diabetes videos.

Amy Campbell, MS, RD, LDN, CDE

Amy Campbell, MS, RD, LDN, CDE

Amy Campbell, MS, RD, LDN, CDE on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

 

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