Study in CDC Journal Links Plant-Forward Eating to 28% Lower Odds of Diabetes

A new study of 33,532 American adults, published on November 5 in the CDC's journal Preventing Chronic Disease, links plant-forward eating to a lower body mass index, 30% lower odds of obesity and 28% lower odds of diabetes.

The research brief is the work of Darren Lov of the UCLA Fielding School of Public Health. He pooled data from 2009 to 2023 from the National Health and Nutrition Examination Survey (NHANES), the US government's long-running survey that weighs and measures people and tests their blood, so the results represent American adults as a whole.

"Plant-forward" here means mostly minimally processed plant foods, with room for moderate amounts of animal foods. Rather than counting foods directly, the study scored each person's average intake from two 24-hour food recalls on three nutrients: points for more fiber, and points for less saturated fat and less cholesterol. Everyone was then split into three groups, from lowest to highest score.

After adjusting for age, sex, ethnicity, income, food security, exercise, total calories and survey year, the top group came out well ahead. Compared with the lowest-scoring third, their BMI was 1.45 points lower, their odds of obesity were 30% lower and their odds of diabetes (including cases picked up only by the blood test) were 28% lower. In the study's adjusted estimates, about 34% of high scorers had obesity against 42% of low scorers, and 11.2% had diabetes against 14.4%. For BMI and obesity, the middle group landed neatly in between.

Lov's conclusion is refreshingly direct:

Greater adherence to the plant-forward dietary pattern was associated with more favorable cardiometabolic outcomes. These findings support public health strategies that promote dietary patterns emphasizing minimally processed plant foods as part of broader efforts to improve cardiometabolic health.

Why does this matter? The paper points out that current US dietary recommendations "emphasize dietary patterns comprising relatively high consumption of animal-source foods, particularly red meat", while intake of minimally processed plant foods remains low among many US adults. It names Food Is Medicine schemes and the fruit and vegetable benefit in the WIC nutrition program as ways to make those foods easier to get hold of.

The study has honest limits, and Lov sets them out himself. It is a cross-sectional snapshot, so it shows a link rather than cause and effect, and reverse causation cannot be ruled out. Food recalls are self-reported, and the score is a nutrient-based proxy rather than a validated food-based index. No link was found with prediabetes, and the study did not measure blood pressure, cholesterol levels or heart disease itself. The full paper is free to read.

The practical takeaway is pleasingly simple. More fiber and less saturated fat and cholesterol is exactly what a plate built on beans, lentils, whole grains, vegetables, fruit, nuts and seeds delivers (dietary cholesterol is only found in animal foods).

It's the latest piece of a growing picture. In September the American College of Cardiology backed diets centered on minimally processed plant foods, while research in June found the new meat-heavy US dietary guidelines would raise emissions, land and fertilizer use by up to 32%. Earlier this year Harvard researchers linked fiber from grains and fruit to up to 23% lower diabetes risk, and in October a low-fat vegan diet cut liver fat by a third in people with type 2 diabetes.

This article is for information only and is not medical advice. If you have diabetes or another health condition, talk to your doctor before making big changes to your diet.

Pass the lentils.