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

Serena Tonstad; Terry Butler; Ru Yan; Gary E. Fraser

doi:10.2337/dc08-1886

Original Research

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

Serena Tonstad, MD, PHD¹,
Terry Butler, DRPH²,
Ru Yan, MSC³ and
Gary E. Fraser, MD, PHD⁴

¹Department of Health Promotion and Education, School of Public Health, and the Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, California;
²Department of Biostatistics, School of Public Health, Loma Linda University, Loma Linda, California;
³Loma Linda University, Loma Linda, California;
⁴Department of Cardiology, School of Medicine, Loma Linda University, Loma Linda, California.

Corresponding author: Serena Tonstad, stonstad{at}llu.edu

Diabetes Care 2009 May; 32(5): 791-796. https://doi.org/10.2337/dc08-1886

Abstract

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.

Footnotes

The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
- Received October 17, 2008.
- Accepted February 2, 2009.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
© 2009 by the American Diabetes Association.

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