Type of Vegetarian Diet, Body Weight, and Prevalence of Type 2 Diabetes

• Published in: Diabetes care Vol. 32; no. 5; pp. 791 - 796
• Main Authors: Tonstad, Serena, Butler, Terry, Yan, Ru, Fraser, Gary E
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.05.2009
• Subjects: Biological and medical sciences; Blood Glucose - analysis; Body Weight; Canada - epidemiology; Cohort Studies; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diet; Diet therapy; Diet, Vegetarian - statistics & numerical data; Educational Status; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Ethnicity; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fishes; Humans; Income; Life Style; Male; Medical sciences; Metabolic diseases; Miscellaneous; Nutrition; Original Research; Prevalence; Prevalence studies (Epidemiology); Protestantism; Public health. Hygiene; Public health. Hygiene-occupational medicine; Racial Groups; Smoking; Surveys; Surveys and Questionnaires; Type 2 diabetes; United States - epidemiology; Vegetarianism; Weight; Canada; United States; Endocrinopathy; Type 2 diabetes; Human; Prevalence; Nutrition; Body weight; Vegetarian diet; Metabolic diseases; Corporal biometry; Epidemiology; Endocrinology
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc08-1886

OBJECTIVE: We assessed the prevalence of type 2 diabetes in people following different types of vegetarian diets compared with that in nonvegetarians. RESEARCH DESIGN AND METHODS: The study population comprised 22,434 men and 38,469 women who participated in the Adventist Health Study-2 conducted in 2002-2006. We collected self-reported demographic, anthropometric, medical history, and lifestyle data from Seventh-Day Adventist church members across North America. The type of vegetarian diet was categorized based on a food-frequency questionnaire. We calculated odds ratios (ORs) and 95% CIs using multivariate-adjusted logistic regression. RESULTS: Mean BMI was lowest in vegans (23.6 kg/m²) and incrementally higher in lacto-ovo vegetarians (25.7 kg/m²), pesco-vegetarians (26.3 kg/m²), semi-vegetarians (27.3 kg/m²), and nonvegetarians (28.8 kg/m²). Prevalence of type 2 diabetes increased from 2.9% in vegans to 7.6% in nonvegetarians; the prevalence was intermediate in participants consuming lacto-ovo (3.2%), pesco (4.8%), or semi-vegetarian (6.1%) diets. After adjustment for age, sex, ethnicity, education, income, physical activity, television watching, sleep habits, alcohol use, and BMI, vegans (OR 0.51 [95% CI 0.40-0.66]), lacto-ovo vegetarians (0.54 [0.49-0.60]), pesco-vegetarians (0.70 [0.61-0.80]), and semi-vegetarians (0.76 [0.65-0.90]) had a lower risk of type 2 diabetes than nonvegetarians. CONCLUSIONS: The 5-unit BMI difference between vegans and nonvegetarians indicates a substantial potential of vegetarianism to protect against obesity. Increased conformity to vegetarian diets protected against risk of type 2 diabetes after lifestyle characteristics and BMI were taken into account. Pesco- and semi-vegetarian diets afforded intermediate protection.