The Singapore Chinese health study, conducted by researchers at the National University of Singapore's (NUS) Saw Swee Hock School of Public Health and Duke-NUS Medical School, concluded that the way to reduce the risk of diabetes is to have more of plant foods, such as vegetables, fruits and whole grains, and less of animal foods, such as red meat, and sweetened beverages.
Diet has been known to be an important risk factor for type-2 diabetes hence, scientists have increasingly turned attention to studying the overall dietary patterns, to capture the combined effect of a variety of food groups.
Among the various predetermined dietary patterns of the Western populations are: the alternative Mediterranean diet (aMED, an international adaptation of the eponymous diet), the Alternate Healthy Eating Index 2010 (AHEI-2010), the Dietary Approaches to Stop Hypertension (DASH) diet, the plant-based diet index (PDI) and the healthful plant-based diet index (hPDI); these are, by and large, similar. Each is rich in plant-based foods, including whole grains, vegetables and fruits, nuts and legumes, and low in red meat and sugar-sweetened beverages. All these dietary patterns have been shown to reduce the risk of diabetes and cardiovascular diseases. They are called high-quality dietary patterns.
Researchers used data from 45,511 middle-aged and elderly participants who did not have diabetes between 1993 and 1998. From the reported intake of 165 food items, the participants were scored on how similar their diet patterns were to the five high-quality diets in terms of intake of specific foods and nutrients included in these patterns. The participants were followed up over an average of 11 years; 5,207 cases of diabetes were reported in such follow-up interviews.
The study found that all five high-quality dietary patterns were inversely associated with the risk of diabetes. Study participants closest to these healthy dietary patterns had a reduction of 16%-29% in the risk of diabetes. However, this reduction in risk was not there in smokers.
"Our results are consistent with studies in other populations that a high-quality diet defined by an abundance of minimally processed plant foods such as whole grains, vegetables, fruit, nuts and legumes, but restricted intake of red and processed meat, and sweetened beverages were significantly associated with lower risk of diabetes," said Professor Rob van Dam, NUS Saw Swee Hock School of Public Health, and senior author of the study.
In a related study in Singapore, investigators found that replacing one daily serving of rice with red meat or poultry may increase the risk of diabetes by up to 40%. In contrast, the replacement of rice with wholemeal bread could reduce the risk by 18%. Although higher rice intake was not associated with a higher risk of diabetes, eating more rice had the effect of reducing the intake of whole grains (wholemeal bread and brown rice) which could reduce the risk instead.
The Health Promotion Board (HPB) of Singapore encourages Singaporeans to eat a healthy, well-balanced and quality diet by eating foods from all food groups, like fruits and vegetables, whole grains, such as brown rice and wholemeal bread, as well as meat. As part of a healthy diet, HPB also recommends that Singaporeans limit their consumption of sodium and sugars from foods as well as beverages. While Singaporeans generally have more of high-quality foods, high sugar and sodium intake remains a cause for concern.