Effects of total and green vegetable intakes on glycated hemoglobin A1c and triglycerides in elderly patients with type 2 diabetes mellitus: The Japanese Elderly Intervention Trial

Abstract

Aim:Many reports have shown that vegetable intake is effective in inhibiting the onset and progression of diabetes mellitus, although the amount of vegetable intake required to be effective remains as unclear. The present study therefore aimed to clarify the relationship between the amount of vegetable intake and glycated hemoglobin A1c (HbA1c) and other metabolic parameters using male Japanese type 2 diabetic patients aged 65 years or older as subjects.Method: Participants were 417 male type 2 diabetic patients aged 65 years or older enrolled in the Japanese Elderly Diabetes Intervention Trial. Dietary intakes were measured by using the Food Frequency Questionnaires method. The patients were divided into five groups by their daily total vegetable intake (A1:~100 g, A2: 100~150 g, A3: 150~200 g, A4: 200~300 g, A5: 300 g~), and compared HbA1c and other metabolic parameters. Furthermore, the relationship between daily green vegetable intake and HbA1c and other metabolic parameters were examined among five groups divided by quintile methods.Results: There were significant decreases in HbA1c, triglycerides and waist circumference with an increase of total vegetable intake. A significant decrease of HbA1c levels was observed in patients with a daily total vegetable intake of 150 g or more. Furthermore, there was a significant decrease of serum triglyceride levels in patients with a total vegetable intake of 200 g or more. HbA1c levels showed a decreasing tendency with the increase of green vegetable intake, and HbA1c levels in the Q1 group (green vegetable intake: less than 40 g) was significantly higher than those in the other four groups (ANOVA P = 0.025). In addition, there were significant decreases of body mass index, triglyceride levels and waist circumference with the increase of green vegetable intake. Triglyceride levels decreased significantly from the Q3 group (green vegetable intake: 70 g or more) to the Q5 group (green vegetable intake: 130 g or more; ANOVA P = 0.016). In the group with a lower intake of total vegetables and green vegetables, the protein energy ratio decreased significantly. As a result, the fat energy ratio and energy intake tended to increase with the decrease of total and green vegetable intakes. Furthermore, intake of grains, sweets and alcoholic beverages increased with the decrease of total vegetable intake. In contrast, intake of nuts, potatoes, sugar, legumes, fruit, seaweed and fish increased with the increase of total vegetable intake Conclusions: Daily total vegetable intake of 200 g or more, and green vegetable intake of 70 g or more correlated with improved control of HbA1c and triglyceride levels in elderly type 2 diabetes patients through achieving a well-balanced diet. Geriatr Gerontol Int 2012; 12 (Suppl. 1): 50-58.

An evidence‐based approach to developing low‐carbohydrate diets for type 2 diabetes management: A systematic review of interventions and methods

“…Most vegetables have a low digestible CHO content owing to their high proportions of water and fibre, and often displace the intake of highly processed CHO and discretionary foods . Many of the included low‐CHO protocols are ultimately in alignment with public health recommendations to consume a vegetable‐rich diet for chronic disease prevention and management …”

“…71,72 Many of the included low-CHO protocols are ultimately in alignment with public health recommendations to consume a vegetable-rich diet for chronic disease prevention and management. [73][74][75] Recommendations for the amount and type of dietary fat to consume remains a more heavily debated topic in T2D management. Traditional approaches for T2D promote low or reduced intakes of total and saturated fat while many of the low-CHO diets analysed in the present review recommended increased, high or unrestricted fat intakes.…”

Assessment of Daily Food and Nutrient Intake in Japanese Type 2 Diabetes Mellitus Patients Using Dietary Reference Intakes

“…The results of cohort studies showed that a sufficient intake of vegetables and fruit reduced the frequency of developing diabetes [16,17], and a diet high in dietary fiber containing vegetables might improve glycemic control [18,19]. Several studies conducted with elderly Japanese participants with T2DM demonstrated that diets rich in vegetables were correlated with improved HbA1c, serum triglyceride levels [20], and life prognosis [21]. Therefore, it is important to educate Japanese T2DM patients about the health advantages of consuming vegetables.…”

Promotion of novel plant-based dishes among older consumers using the ‘dish of the day’ as a nudging strategy in 4 EU countries

“…Intakes of healthy food can prevent or alleviate chronic diseases (Boeing et al, 2012;Takahashi et al, 2012;Woodside, Young, & McKinley, 2013), especially intakes of plant-based foods, such as vegetables, fruits, grain and legumes, which are associated with the cognitive performance of older people (Nurk et al, 2010). Among plant-based foods, vegetables have apparent advantages with high fibre and low sugar contents (Slavin & Lloyd, 2012).…”