Vegetarian diets and incidence of diabetes in the Adventist Health Study-2
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Aim To evaluate the relationship of diet to incident diabetes among non-Black and Black participants in the Adventist Health Study-2.Methods and results Participants were 15,200 men and 26,187 women (17.3% Blacks) across the U.S. and Canada who were free of diabetes and who provided demographic, anthropometric, lifestyle and dietary data. Participants were grouped as vegan, lacto ovo vegetarian, pesco vegetarian, semi-vegetarian or non-vegetarian (reference group). A follow-up questionnaire after two years elicited information on the development of diabetes. Cases of diabetes developed in 0.54% of vegans, 1.08% of lacto ovo vegetarians, 1.29% of pesco vegetarians, 0.92% of semi-vegetarians and 2.12% of non-vegetarians. Blacks had an increased risk compared to non-Blacks (odds ratio [OR] 1.364; 95% confidence interval [CI], 1.093-1.702). In multiple logistic regression analysis controlling for age, gender, education, income, television watching, physical activity, sleep, alcohol use, smoking and BMI, vegans (OR 0.381; 95% CI 0.236-0.617), lacto ovo vegetarians (OR 0.618; 95% CI 0.503-0.760) and semi-vegetarians (OR 0.486, 95% CI 0.312-0.755) had a lower risk of diabetes than non-vegetarians. In non-Blacks vegan, lacto ovo and semi-vegetarian diets were protective against diabetes (OR 0.429, 95% CI 0.249-0.740; OR 0.684, 95% CI 0.542-0.862; OR 0.501, 95% CI 0.303-0.827); among Blacks vegan and lacto ovo vegetarian diets were protective (OR 0.304, 95% CI 0.110-0.842; OR 0.472, 95% CI 0.270-0.825). These associations were strengthened when BMI was removed from the analyses.Conclusion Vegetarian diets (vegan, lacto ovo, semi-) were associated with a substantial and independent reduction in diabetes incidence. In Blacks the dimension of the protection associated with vegetarian diets was as great as the excess risk associated with Black ethnicity.
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Vegetarian diets are associated with a substantial risk reduction for diabetes.
“While vegetarian diets are associated with a substantial risk reduction for diabetes [78], it is unclear if substitution of plant protein for animal protein helps to drive this risk reduction.”
From Plant Proteins: Assessing Their Nutritional Quality and Effects on Health and Physical Function (2020) · cites this paper as [78]
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- Authors
- Tonstad, S., Stewart, K., Oda, K., Batech, M., Herring, R. P., & Fraser, G. E.
- Affiliations
- Loma Linda University (US)
- Venue
- Nutrition Metabolism and Cardiovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2013-04
- Volume
- 23
- Issue
- 4
- Pages
- 292-299
- ISSN
- 0939-4753 (ISSN-L)
- PMC
- PMC3638849
- OpenAlex
- W2140047436
- Cited by
- 442
- References
- 34
- Citations by year
- 2026: 19 · 2025: 33 · 2024: 34 · 2023: 41 · 2022: 40 · 2021: 48 · 2020: 36 · 2019: 45 · 2018: 33 · 2017: 29 · 2016: 21 · 2015: 18 · 2014: 30 · 2013: 12 · 2012: 2
- FWCI
- 13.82
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Nutrition Metabolism and Cardiovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (U01CA152939, 1R01-CA-94594, R01CA094594)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- vegetarian diet, vegan diet, lacto-ovo-vegetarian diet, pesco-vegetarian diet, semi-vegetarian diet, type 2 diabetes incidence, racial differences, African Americans, Adventist Health Study-2, dietary habits, diabetes risk factors, physical activity, alcohol consumption, smoking, sleep duration, television viewing, body mass index
- MeSH terms
- Adult, Aged, Asian, Black or African American, Canada, Diabetes Mellitus, Female, Hispanic or Latino, Humans, Indians, North American, Life Style, Male, Middle Aged, Nutritional Status, Prognosis, Prospective Studies, Surveys and Questionnaires, Risk Factors, Time Factors, United States, Diet, Vegetarian, Incidence, Chi-Square Distribution, Logistic Models, Odds Ratio, Risk Assessment, Protestantism, Risk Reduction Behavior, White People, Native Hawaiian or Pacific Islander
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