Ask the Dietitian: How Can a Plant-Based Diet Help with Managing Diabetes?

Dear Jillian,

I’ve heard that plant-based diets can be helpful for people with type 2 diabetes. Is this true?

— Bezzy Type 2 Diabetes Member

Plant-based diets are commonly recommended by healthcare providers like dietitians to help people with diabetes manage their blood sugar and improve other aspects of their health.

But are they actually effective?

In this article, I’ll tell you everything you need to know about plant-based diets for diabetes to help you decide whether it may be a good choice for you.

Join the free T2D community!

Connect with thousands of members and find support through daily live chats, curated resources, and one-to-one messaging.

Sign up

What does ‘plant-based’ even mean?

Depending on who you ask, a plant-based diet can mean very different things. In fact, the term is used inconsistently by nutrition researchers.

Some define a plant-based diet as a diet that completely excludes all animal products. Others define a plant-based diet as an omnivorous diet that’s primarily composed of plant foods. The authors of a 2021 review suggested that, when used in research studies, the term “plant-based” should be accompanied by a thorough description of the diet to avoid confusion.

So, because the term is vague, “plant-based” can be used to describe any dietary pattern that’s primarily composed of plant foods. This means that plant-based diets don’t necessarily have to exclude all animal products.

For example, a person who consumes mostly plant foods like vegetables, beans, grains, nuts, seeds, and fruit — but eats small amounts of animal products like eggs, fish, and dairy — would be following a plant-based diet.

A vegan diet, which completely restricts all animal products, and a vegetarian diet, which excludes certain types of animal products like meat and poultry, are considered plant-based diets, too.

Are plant-based diets helpful for diabetes?

First, it’s important to understand that there isn’t one “best” diet for people with type 2 diabetes.

The best diet for you to follow depends on many factors, including your blood sugar management, blood lipid levels, family health history, body weight, food preferences, and more.

It’s always best to follow a dietary pattern that’s tailored to your specific health needs. If you have questions about your diet and aren’t sure which way of eating is best, talk with a dietitian who specializes in type 2 diabetes. They can help you come up with a nutritious eating plan that works for you.

Now, on to the benefits. In my opinion, a plant-based or plant-centric diet — remember, this doesn’t necessarily mean vegan or vegetarian — can benefit most people regardless of their health status.

And science agrees with me here. Overall, diets mostly composed of minimally-processed plant foods like veggies, fruits, and nuts, have been linked to a longer lifespan and an overall lower risk of many diseases, from heart disease to colon cancer.

Plant-based foods are chock full of protective compounds like fiber, vitamins, minerals, and plant chemicals that help protect against cellular damage.

For people with diabetes, a plant-based diet can be beneficial in the following ways:

• Improve insulin sensitivity: Studies show that plant-based diets improve your body’s sensitivity to insulin, which can help reduce blood sugar levels.
• Weight loss: Plant-based diets that include whole foods tend to be lower in calories than standard diets. Plus, they’re high in fiber, a nutrient that can help promote fullness and healthy body weight maintenance.
• Protection from heart disease: People with type 2 diabetes are at a higher risk of developing heart disease. A plant-based diet could help reduce this risk by lowering heart disease risk factors like high blood lipid levels.
• Improve blood sugar control: Plant-based diets could help lower hemoglobin A1c (HbA1c). HbA1c is what your doctor tests to assess your long-term blood sugar control.
• Improve mental health and well-being: In a 2018 review, researchers found that plant-based diets were linked to improved psychological health and overall quality of life in people with type 2 diabetes.

In addition to the benefits for people with diabetes, plant-based diets can also help reduce your risk of developing diabetes or prediabetes in the first place.

Plus, most plant-based diets are better for the environment than diets high in animal products. Shifting toward a more plant-based eating pattern can help reduce your diet-related greenhouse gas emissions, which can help lower your overall environmental footprint.

Foods to focus on and foods to limit

If you’re interested in shifting to a more plant-based diet, you’ll want to increase your intake of foods like whole vegetables and fruits.

You’ll also want to reduce your overall intake of animal products, especially ultra-processed animal products like lunch meats and chicken nuggets.

You can still eat animal foods like fish, dairy, and eggs, which are good protein sources. They also contain important fats, minerals, and vitamins that are either missing from or in low supply in plant foods.

For those who currently follow a diet that’s high in animal products and low in plant-based foods, consider focusing on increasing your intake of the following:

• Vegetables: This includes spinach, zucchini, tomatoes, broccoli, cauliflower, carrots, asparagus, and peppers.
• Fruits: This includes foods like apples, berries, citrus fruits, pears, peaches, pineapple, and bananas.
• Whole grains: Think oats, brown rice, farro, barley, and quinoa.
• Legumes: This includes chickpeas, black beans, kidney beans, lentils, peanuts, etc.
• Seeds, nuts, and nut butters: This includes pumpkin seeds, sunflower seeds, almonds, cashews, walnuts, macadamia nuts, natural almond butter, and tahini.
• Unsweetened plant-based milks: Such as coconut milk, almond milk, and cashew milk.

You can include animal products in your diet in moderation and consider using more plant-based protein sources, like beans and lentils, instead.

It’s also a good idea to purchase humane, high quality animal products whenever possible. For example, try buying eggs from pasture-raised hens, wild-caught seafood from sustainable fisheries, and dairy from pasture-raised cattle when you can.

You’ll also want to limit your intake of the following foods. But remember that these foods should be limited in any healthy diet, not just plant-based diets.

• Fast food: french fries, fried chicken, cheeseburgers, hot dogs, chicken nuggets, etc.
• Refined grains: white bread, white pasta, bagels, etc.
• Packaged and convenience foods: cereal bars, chips, frozen dinners, etc.
• Added sugars and sweets: table sugar, soda, cookies, sweet tea, ice cream, candy, pastries, sugary cereals, etc.
• Artificial sweeteners: brands like Equal, Splenda, Sweet’N Low, etc.
• Processed animal products: bacon, beef jerky, lunch meats, sausage, etc.

Another thing to keep an eye out for is ultra-processed foods marketed to people on plant-based diets. Examples of these products include fake meats like plant-based bacon, margarine, vegan pastries, and ultra-processed plant-based cheeses.

Just because a product is plant-based or vegan, doesn’t mean it’s automatically healthier. Vegan products can still be loaded with added sugar, refined carbs, artificial sweeteners, and other ingredients that should be limited to promote overall health.

Do plant-based diets have any downsides?

Even though plant-based diets are linked to a bunch of benefits, keep in mind that not all plant-based diets are healthy.

It’s entirely possible to follow a plant-based diet high in ultra-processed foods and added sugar, especially if you’re not consuming mostly whole, minimally-processed foods.

Overconsumption of ultra-processed plant-based foods like candy, fast food, and pastries is just as problematic as overconsumption of animal-based ultra-processed foods.

A nutritious eating pattern, whether you’re following a vegan or omnivorous diet, should be composed mostly of minimally-processed, nutritious foods.

Some plant-based diets can also be fairly restrictive. Diets that cut out many foods tend to increase your risk of developing nutrient deficiencies.

For example, strictly vegan and vegetarian diets could be low in nutrients primarily found in animal foods like the omega-3 fats DHA and EPA, iron, calcium, B12, and zinc. This is why it’s recommended that people following vegan and strict vegetarian diets take dietary supplements that cover their needs for these and other nutrients.

Tips for upping your plant intake

If your diet is currently low in plant foods or if you want to transition to a more plant-based diet, the following tips can help boost your intake:

• Use plant-based proteins more often: Try using beans and lentils instead of animal-based proteins like beef. For example, try topping your salad with chickpeas instead of chicken and making black bean and veggie tacos instead of beef tacos.
• Find plant-based swaps for go-to meals: There are plenty of plant-based alternatives to popular meat-based recipes. Black bean burgers, bean-based chili, and sweet potato curry are just some ideas for plant-based dishes.
• Reduce your portion sizes of animal proteins: To make room for more plant foods, try reducing your protein portions. For example, if you currently eat large chicken breasts or steaks, opt for smaller cuts and add more veggies to your plate.
• Cook more meals at home: If you’re used to relying on fast food and takeout, cooking more meals at home could help you eat more plant foods like vegetables and fruits. Start with cooking a few meals per week at home.
• Choose plant foods you enjoy: It’s perfectly normal to dislike some fruits and veggies. Be sure to stock your kitchen with fruits, vegetables, and other plant-based foods that you enjoy eating.
• Stock your freezer with frozen fruits and veggies: If you’re concerned that your produce will go bad before you eat it, consider purchasing more frozen fruits and veggies. Frozen produce lasts much longer than fresh and is just as nutritious.

If you’re not a fruit and veggie person and feel a little overwhelmed by changing your diet, consider shifting your focus.

Instead of worrying about what you should be cutting out or avoiding, try paying more attention to which foods you should be adding to your diet.

If you’re currently not eating any fruits or vegetables, try adding one fruit and one serving of vegetables to what you eat each day. Once that becomes a habit, then you can continue to add in more produce and make positive changes that will help improve your overall diet quality over time.

The bottom line

Not only can healthy plant-based diets benefit overall health by reducing disease risk and improving diet quality, but they have specific benefits for people with type 2 diabetes such as improving insulin sensitivity and reducing HbA1c.

If you’re interested in moving toward a more plant-based way of eating, try using some of the tips in this article to boost your intake of healthy plant foods like vegetables and beans.

Remember, there’s no one perfect diet for people with diabetes, so be sure to tailor your nutrition goals based on your blood sugar control, food preferences, body weight, and overall health.