Researchers in China followed nearly 30,000 adults for almost 6 years to see if eating a healthy, plant-based diet could prevent type 2 diabetes. They found that people who followed the EAT-Lancet diet—which emphasizes vegetables, whole grains, nuts, and limits red meat—had about 30% lower chances of developing diabetes compared to those who didn’t follow it as closely. For every small improvement in diet quality, diabetes risk dropped by 2%. This research suggests that making better food choices, especially in countries where Western fast food is becoming more popular, could be a powerful way to prevent this common disease.

The Quick Take

  • What they studied: Whether eating according to the EAT-Lancet diet (a plant-focused eating plan) helps prevent type 2 diabetes in Chinese adults
  • Who participated: Nearly 30,000 adults living in Shanghai, China, who had no diabetes at the start and were tracked for an average of 5.6 years
  • Key finding: People who followed the EAT-Lancet diet most closely had a 30% lower risk of developing diabetes compared to those who followed it least. Each small improvement in diet quality reduced diabetes risk by 2%.
  • What it means for you: Eating more plant-based foods and fewer processed foods may help prevent type 2 diabetes, though this study shows a connection rather than proof that diet alone prevents diabetes. Individual results may vary based on genetics, exercise, and other lifestyle factors.

The Research Details

This was a long-term follow-up study where researchers tracked the same group of people over time. They started with 29,507 adults in Shanghai who didn’t have diabetes and asked them detailed questions about what they ate over the past year. Researchers then created a score (called the EAT-Lancet Diet Index) based on how well each person’s eating matched the recommended healthy diet. The diet focuses on eating lots of vegetables, fruits, whole grains, nuts, and beans while eating less red meat, processed foods, and added sugars. Over the next 5-6 years, researchers checked medical records to see who developed type 2 diabetes and compared this to their diet scores.

The researchers used a special questionnaire that asked about 29 different food categories to understand eating patterns. They scored each person’s diet on a scale from 0 to 42 points, with higher scores meaning better adherence to the healthy eating pattern. This approach allowed them to see if there was a clear connection between how well people followed the diet and their chances of getting diabetes.

Following people over time (rather than just asking them once) gives us stronger evidence about whether diet actually affects diabetes risk. By measuring diet carefully and tracking who developed diabetes, researchers could see a real-world connection. This matters especially in China, where Western fast food is becoming more common and diabetes rates are rising quickly.

This study is fairly reliable because it followed a large number of people for several years and used detailed food records. However, people had to remember what they ate, which can be imperfect. The study was done only in Shanghai, so results might be different in other parts of China or other countries. The researchers adjusted their analysis for other important factors like age, exercise, and smoking, which strengthens the findings.

What the Results Show

During the study period, 977 people developed type 2 diabetes. People who scored highest on the EAT-Lancet Diet Index (33 points or higher) had about 30% lower risk of developing diabetes compared to those who scored lowest (26 points or lower). This means that if 100 people with low diet scores developed diabetes, only about 70 people with high diet scores would develop it.

The researchers also found that the benefit wasn’t all-or-nothing. For every single point increase in the diet score, the risk of diabetes dropped by 2%. This suggests that even small improvements in eating habits can help. The relationship between diet quality and diabetes risk appeared to be strongest when people scored above 32 points on the diet index, suggesting there’s a threshold where the benefits become most noticeable.

The study showed a clear pattern: as people’s diet scores improved, their chances of developing diabetes decreased. The rate of new diabetes cases dropped from 6.7 per 1,000 people per year (in those with the worst diet scores) to 4.6 per 1,000 people per year (in those with the best diet scores).

The researchers found that the connection between diet quality and diabetes risk wasn’t perfectly straight-line—it was slightly curved, meaning the biggest benefits appeared when people made more substantial dietary improvements rather than tiny changes. This suggests that meaningful dietary changes matter more than minor tweaks.

This study supports what other research has shown: plant-based and Mediterranean-style diets help prevent type 2 diabetes. The EAT-Lancet diet is relatively new as a prevention strategy, so this research adds important evidence that it works in real-world settings, particularly in Asian populations where diabetes rates are rising rapidly.

The study has several important limitations. First, people reported their own eating habits from memory, which can be inaccurate—people might forget what they ate or underestimate portion sizes. Second, the study only included people from Shanghai, so results might not apply to other regions of China or other countries with different food cultures. Third, while the study shows a connection between diet and diabetes, it doesn’t prove that diet alone causes the difference—other factors like genetics, stress, or sleep could play a role. Finally, people who follow healthier diets might also exercise more or have other healthy habits, making it hard to know if the diet itself is responsible for the benefit.

The Bottom Line

If you want to reduce your diabetes risk, consider moving toward the EAT-Lancet diet by eating more vegetables, fruits, whole grains, nuts, and beans while reducing red meat and processed foods. This evidence is moderately strong (based on a large, long-term study) but not definitive proof. Combine dietary changes with regular exercise and maintaining a healthy weight for best results. Talk to your doctor or a dietitian before making major dietary changes, especially if you have existing health conditions.

This research is most relevant for adults, particularly those with family history of diabetes, those who are overweight, or those living in areas where Western fast food is becoming more common. It’s also important for people in China and other Asian countries experiencing rising diabetes rates. However, the findings may be less directly applicable to people with very different food cultures or those with genetic conditions affecting metabolism.

Don’t expect overnight results. The study followed people for 5-6 years to see benefits. Realistic expectations: you might notice improved energy and weight changes within weeks to months, but measurable reductions in diabetes risk likely take several months to years of consistent healthy eating.

Want to Apply This Research?

  • Track your daily intake of the 14 key food components in the EAT-Lancet diet: vegetables, fruits, whole grains, legumes, nuts, seeds, fish, eggs, dairy, red meat, processed meat, added sugars, refined grains, and oils. Use the app to score yourself weekly (0-42 scale) and aim to reach 33+ points.
  • Start by adding one plant-based meal per week, then gradually increase. Use the app to log meals and see your EAT-Lancet score improve in real-time. Set a goal to reach 32+ points on the index within 3 months.
  • Check your diet score weekly and track any health markers your doctor monitors (like blood sugar levels if available). Note energy levels, weight changes, and how you feel. Review progress monthly and adjust food choices to improve your score incrementally.

This research shows an association between diet quality and diabetes risk but does not prove that diet alone prevents diabetes. Individual results vary based on genetics, exercise, weight, age, and other health factors. This information is for educational purposes only and should not replace professional medical advice. If you have diabetes, prediabetes, or are at risk for diabetes, consult your healthcare provider or registered dietitian before making significant dietary changes. People with certain medical conditions, food allergies, or taking specific medications should discuss dietary changes with their doctor first.