Diabetes is becoming more prevalent worldwide. As of 2015, 30.3 million people in the United States, or about 9.4 percent of the population, had diabetes.
Unfortunately, more than 1 in 4 people with diabetes don’t know they have it. Having undiagnosed diabetes increases the risk of complications from lack of prompt treatment.
Diabetes mellitus, or diabetes, is a disease affecting the regulation of blood glucose (sugar) levels. An organ called the pancreas creates the hormone insulin, which helps keep blood sugar levels in a healthy range.
With diabetes, the pancreas either doesn’t make enough insulin, or the body doesn’t respond to it well. Without proper insulin function, blood glucose levels rise and can lead to health problems if left untreated.
Many people also have prediabetes, a condition where blood sugars are slightly elevated but not high enough to be considered diabetes.
Having prediabetes is a major risk factor for eventually developing type 2 diabetes. The U.S. Centers for Disease Control (CDC) estimates that up to 30% of people with prediabetes will develop type 2 diabetes within five years of their prediabetes diagnosis.
Chronic high blood sugars increase the risk of diabetes complications, so keeping blood sugar levels controlled is the main priority for managing diabetes.
One of the ways to help promote good blood sugar control is through healthy lifestyle habits. Along with other aspects of diabetes self-management, a healthy diet can help improve blood sugars and reduce the risk of other chronic diseases like heart disease and hypertension, which people with diabetes are more likely to have.
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What is a vegetarian diet?
There are many vegetarian diets, but the “standard” vegetarian diet doesn’t include any meat, including seafood.
A typical vegetarian diet includes eggs and dairy products, but some variations of a vegetarian diet exclude them.
Other types of vegetarians include:
- Ovo vegetarianism: excludes all meat and dairy but includes eggs
- Lacto vegetarianism: excludes all meat and eggs but includes dairy food
- Ovo-lacto vegetarianism: excludes all meat but consists of both dairy, milk, and honey (the “standard” vegetarian diet)
- Veganism: excludes all meat (and animal products like leather) plus dairy, eggs, honey, and any other product made from animals in any way
- Raw veganism: includes only fresh and uncooked fruit, nuts, seeds, and vegetables. Vegetables can only be cooked up to a certain temperature
- Pescetarianism: excludes all meat consumption but includes fish
- Flexitarianism: is not really a form of vegetarianism, but those who call themselves “flexitarians” eat a mostly vegetarian diet, with the occasional inclusion of meat, dairy, or eggs
The typical vegetarian diet isn’t prevalent, especially in the United States, where the average consumer eats around 220 pounds of meat per year. For perspective, only about 5% of Americans identified themselves as vegetarians, compared to India’s 38%.
Benefits of a vegetarian diet for diabetes
The health benefits of a vegetarian diet are well-documented, including preventing and treating certain diseases such as cardiovascular disease, hypertension, diabetes, cancer, osteoporosis, renal disease, dementia, and diverticular disease, gallstones, and rheumatoid arthritis.
Vegetarians usually have lower intakes of saturated fat and cholesterol from animal protein as well as higher intakes of complex carbohydrates, dietary fiber, magnesium, folic acid, vitamin C and E, carotenoids, and other phytochemicals found in pigmented fruits and vegetables.
Diabetes prevention. Vegetarian diets have a great track record in diabetes prevention. Researchers have followed Seventh-Day Adventists (a type of religion) who follow a vegetarian diet. They have found that they have about half the incidence rate of diabetes compared to the general population. Studies have also found that a lifelong adherence to a vegetarian diet was associated with a 35% lower risk of developing diabetes.
Improved blood sugar. Studies have also found an association between a vegetarian diet and improved glycemic control in people with diabetes. Vegetarian diets are usually higher in dietary fiber, which lowers the glycemic load of meals to promote healthy blood sugars.
Lower risk of kidney disease. Evidence suggests that incorporating soy- and plant-based protein in place of animal protein may help reduce the risk of developing kidney disease among those with diabetes.
Improved blood pressure. People with diabetes are more likely to suffer from hypertension (high blood pressure). A diet rich in phytochemicals from plant-based foods, such as a vegetarian diet, is associated with improved blood pressure outcomes.
Lower risk of heart disease. Diabetes increases the risk of developing cardiovascular disease, otherwise known as heart disease. A vegetarian diet can help reduce the risk of heart disease. Vegetarian diets are often lower in saturated fat and higher in dietary fiber, improving heart health, and promoting healthy cholesterol levels.
Possible drawbacks of a vegetarian diet
A vegetarian diet can be more challenging to maintain when other people in the same household don’t also follow a vegetarian diet. This is especially true when the person who is a vegetarian isn’t the one responsible for cooking.
Dining out can also be a challenge if there aren’t many vegetarian-friendly options. Many restaurants offer tofu as a vegetarian option, but not every vegetarian enjoys eating tofu. Restaurants specializing in vegetarian and vegan meals often have more options and offer more appealing meals than a restaurant not specialized in vegetarianism.
Reliance on vegetarian products such as meat substitutes may also increase sodium and additives from processed foods. A standard veggie burger contains almost 20% of the daily value for sodium, whereas real meat is virtually sodium-free. Some products can be marketed as healthy because they are meat-free, when they may contain other ingredients that aren’t beneficial for health.
There are also possible nutrient deficiencies from a poorly-planned vegetarian diet, which will be discussed later on. For this reason, it’s especially important for a vegetarian diet to be very well planned out if parents decide to have their children follow it.
Children are especially at risk of calcium and iron deficiencies, which can impact their growth and development, so special care should be taken to ensure they consume adequate amounts of these nutrients.
Common questions about a vegetarian diet
Will I get enough protein?
Meat is naturally protein-rich, so many people assume it’s difficult to get enough protein on a vegetarian diet. This isn’t the case, as it’s very easy to get adequate protein on a plant-based diet. The standard vegetarian diet also includes eggs and dairy products, which are protein-packed.
There is a misconception that people have much higher protein needs than they really do. The average person requires about 0.8 grams of protein per kilogram of body weight. This equates to a 150-pound person needing about 54 grams of protein per day. For perspective, a standard container of Greek yogurt provides around 17 grams of protein or over 25% of that daily requirement.
Protein is essential for promoting muscle health and wound healing. People trying to build muscle or recovering from a wound or burn have increased protein needs.
Some examples of protein-rich vegetarian foods include:
- Soybeans and soy-based products such as tofu, tempeh, and soy milk
- Beans and lentils
- Dairy products
- Sprouted and whole-grain breads
How can I get enough calcium and iron?
It’s relatively easy to meet calcium requirements on a vegetarian diet, especially when dairy products are consumed. Calcium-rich foods like dairy products and enriched milk alternatives provide the majority of calcium needs for those on a vegetarian diet, but there are other sources as well.
Some calcium-rich foods include:
- Fortified orange juice
- Cheese (hard, soft, and cottage)
- Cow’s milk
- Fortified milk alternatives, e.g., almond milk, soy milk, etc.
- Fortified breakfast cereal
- Turnip greens
- Chia seeds
- Chinese cabbage (bok choy)
Iron is a mineral used to help make hemoglobin, a part of red blood cells responsible for carrying oxygen to the rest of the body. Without adequate amounts of iron, iron-deficiency anemia can occur. Iron can be a bit more challenging to consume on a vegetarian diet since most excellent sources come from meat.
There are plenty of vegetarian-friendly iron foods, which should strategically be planned into a well-balanced vegetarian plant based diet to avoid nutrient deficiencies. Some vegetarian sources of iron include:
- Dark green leafy vegetables, such as spinach
- Dried fruit, such as raisins and apricots
- Iron-fortified cereals, breads, and pasta
Iron is better absorbed when consumed with vitamin C. Some sources of vitamin C are plant based foods:
- Citrus fruits
- Tomatoes and tomato juice
- Bell peppers
- Brussels sprouts
Iron and calcium compete for absorption when consumed simultaneously, which can lower the absorption of iron in the body. Because of this, it’s recommended not to consume large amounts of calcium at the same time as iron-rich foods. Children who drink large quantities of milk and who may not eat much meat can become anemic due to the reduced absorption of iron from the high calcium intake.
Can vegetarian diets cause nutrient deficiencies?
There is a potential for vegetarian diets to be low in calcium and iron if an effort isn’t made to consume adequate amounts of those foods on a regular basis or if they aren’t supplemented through a multivitamin or specific nutrient supplement.
A well-planned vegetarian diet should provide adequate amounts of all nutrients. Some potential nutrient deficiencies besides calcium and iron include:
Vitamin B12: Vitamin B12 is responsible for helping with DNA synthesis as well as red blood cell production. It’s found in animal products such as dairy products, meat (including poultry and fish), and eggs. It’s also found in fortified products such as nutritional yeast, which is popular with vegans since they don’t consume dairy products.
Symptoms of a vitamin B12 deficiency include:
- Weakness, tiredness, or lightheadedness
- Heart palpitations and shortness of breath
- Pale skin
- A smooth tongue
- Constipation, diarrhea, loss of appetite, or gas
- Nerve problems like numbness or tingling, muscle weakness, and problems walking
- Vision loss
- Mental issues like depression, memory loss, or behavioral changes
Zinc: Zinc is a mineral necessary for immune system functioning as well as the production of DNA. A vegetarian diet can be deficient in zinc because many good sources are animal-based, such as oysters, meat, and poultry. Zinc deficiencies are rare in America but include:
- Growth retardation
- Loss of appetite
- Impaired immune function
- Hair loss
- Delayed sexual maturation
- Eye and skin lesions
- Weight loss
- Delayed wound healing
- Taste abnormalities
Sources of zinc include:
- Fortified breakfast cereal
- Pumpkin seeds
- Flounder or sole
Shouldn’t I be eating fish for omega-3 fatty acids?
Omega-3 fatty acids are known for their health benefits, such as reducing inflammation and improving heart health. Some of the signs of a deficiency in omega-3 fatty acids are:
- Rough, scaly skin
Oily fish such as salmon is the gold standard for providing quality omega-3 fatty acids, but they can be found in vegetarian-friendly foods as well. Plant sources of omega-3 fatty acids include:
- Chia seeds
- Hemp seeds
Omega-3 fatty acids can also be taken in supplement form, whether pure omega-3s or in a fish oil complex.
The health benefits of a vegetarian diet are numerous, including a lower risk of developing type 2 diabetes, heart disease, and certain cancers. They may also help people with existing diabetes achieve better blood sugar control. Part of the reason is because vegetarian diets are often lower in saturated fat, higher in certain phytochemicals, and richer in dietary fiber.
There are some potential drawbacks of a vegetarian diet, including nutrient deficiencies. These deficiencies can be avoided by having a well planned and balanced vegetarian diet. Common nutrients that can be low in a poorly-planned vegetarian diet include calcium, iron, vitamin B12, and zinc. However, it’s easy to avoid this potential drawback by increasing one’s knowledge of a well-balanced vegetarian diet and the ways to prevent nutritional deficiencies.
The bottom line is that a vegetarian diet can be very healthy and safe for most people, especially those with diabetes or those wanting to reduce their diabetes risk.