Background
The diabetes epidemic in Asia and particularly in China emerged simultaneously with increased meat consumption and higher proportion of energy intake from animal protein and fat [1]. Compared with Westerners, Asians tend to incur diabetes at a younger age and at a lower body mass index (BMI), possibly due to genetic susceptibility in combination with environmental exposures [2]. Vegetarian diets have been associated with a lower prevalence [3] and incidence [4] of diabetes among Seventh day Adventists. Previous clinical trials have shown vegetarian diets improve glycemic control [5] and insulin sensitivity [6]. Although several small studies reported lower glucose level and better insulin sensitivity in Taiwanese vegetarians than omnivores [7]–[9], no study thus far has examined whether a vegetarian diet protects against diabetes in Chinese ethnic Asian population, a high risk population that may incur diabetes despite having a normal BMI value [2]. Moreover, Asian diets tend to be lower in meat and higher in plant foods compared with Western diet. It remains unknown whether a diet completely avoiding meat and fish would further extend the protective effect of a plant-based diet. In addition, most studies on Asian vegetarians tend to compare vegetarians from religious groups with omnivores from the general population [7]. Religious and spiritual practices (a main determinant of vegetarian dietary practice in Asia) may be associated with social and emotional support which may confound health outcomes [10], [11].
Conclusion
We found a strong protective association between Taiwanese vegetarian diet and diabetes/IFG, after controlling for various potential confounders and risk factors.
The full study report can be found here.