Improving Quality of Diet Decreases Diabetes Risk

Written by Amy Hess Fischl, MS, RD, LDN, BC-ADM, CDE , Susan A Spinasanta

You have just been told that you are at risk of developing type 2 diabetes. But you are unsure about what type of diet is best for preventing diabetes

A new study suggests that improving the quality of your diet can help prevent type 2 diabetes. “We learned over recent years that dietary patterns—not just one food item, but the overall quality of food intake has some impact on diabetes prevention,” reported Sylvia H. Ley, PhD, a postdoctoral fellow at the Harvard School of Public Health, during a presentation at the American Diabetes Association 2014 Scientific Sessions, held San Francisco, California.1

What does improving quality of food intake mean? According to Dr. Ley, this includes consuming whole grains, fruits and vegetables, nuts and seeds, and less saturated fat. These higher quality foods have been shown to reduce the risk of diabetes and improve glycemic control and blood lipids in patients with diabetes, reported Dr. Ley, a postdoctoral fellow in the department of nutrition at the Harvard School of Public Health, Boston.

Identiftying Quality Foods

The new study highlighted the best meal plan methods for prevention and management of type 2 diabetes. While individualization is key to any successful meal plan, it did highlight some trends that focused on the quality of the foods consumed:

In essence, the above recommendations can be achieved by using the Dietary Guidelines for Americans as the foundation for healthier eating habits.2

Tips for Eating Better

Some practical tips for increasing the quality of the foods we eat:
Increase vegetables:

Increase whole fruit:

Increase dairy, especially yogurt:

Add mixed nuts:

Add more plant-based protein:

Increase whole grains:

Study Design

The research team reviewed the eating patterns of more than 148,000 people enrolled in three long-term lifestyle studies in the United States (Nurses’ Health Study I (1976-2010); Nurses’ Health Study II (1986-2010); and Health Profes-sionals Follow-up Study (1989-2011).

Every two years participants were asked to record any incidence of diabetes, and every four years they were asked about their diet (eg, dietary patterns, diet quality). Dr. Ley’s team used the Alternative Healthy Eating Index (AHEI) score to assess diet quality. AHEI score is comprised of 11 variables, including red meat, nuts, sugar-sweetened beverages, fruits, vegetables, polyunsaturated fat, trans fat, omega-3 fats, moderate alcohol consumption, sodium, and whole grains.3

“When we looked at these scores, people who improved their scores by 10% or more had actual reduction in their incidence of diabetes four years later. Whereas, people who worsened their scores by 10% or more had an increased risk of developing diabetes,” Dr. Ley stated. “Healthy eating is still somewhat abstract, and people have difficulty understand-ing what better-quality eating means,” noted Dr. Ley.

During Dr. Ley’s presentation, five types of diets were associated with a lower risk of diabetes: Mediterranean diet; Dietary Approaches to Stop Hypertension (DASH); Vegetarian and vegan diets; Dietary guidelines—Alternative Healthy Eating Index (AHEI); and Prudent dietary pattern. All these diet emphasis an increase in fruits and vegetables, as well as consumption on healthy fats and lean-proteins.

Furthermore, it was determined that it didn’t matter whether study participants started out as poor eaters or healthy eat-ers. Regardless of where patients started, improving the quality of foods eaten benefited patients by lowing the incidence of diabetes.