Researchers studied 490 adults with type 2 diabetes to see how eating more plant-based foods affects heart health. They found that people who ate healthier plant-based diets had better cholesterol numbers and lower risk factors for heart disease. Interestingly, eating unhealthy plant-based foods (like processed plant-based snacks) was linked to more belly fat. Overall, people who ate more plant-based foods were less likely to need heart bypass surgery. While these results are promising, doctors say we need more research to confirm these findings before making major diet changes.

The Quick Take

  • What they studied: Whether eating more plant-based foods helps people with type 2 diabetes reduce their heart disease risk and improve their body measurements
  • Who participated: 490 randomly selected adults who all have type 2 diabetes
  • Key finding: People who ate healthier plant-based diets had better cholesterol numbers and lower heart disease risk scores. Those eating more plant-based foods overall were less likely to need heart bypass surgery. However, eating unhealthy plant-based processed foods was linked to increased belly fat.
  • What it means for you: If you have type 2 diabetes, eating more whole plant-based foods like vegetables, fruits, beans, and whole grains may help protect your heart. However, this study shows a connection, not proof of cause-and-effect, so talk to your doctor before making major diet changes.

The Research Details

This was a cross-sectional study, which means researchers looked at 490 people with type 2 diabetes at one point in time and compared their eating habits to their health markers. They asked participants detailed questions about what they ate using a food questionnaire, then calculated three different plant-based diet scores: one measuring overall plant-based eating, one measuring healthy plant-based choices, and one measuring unhealthy plant-based choices (like processed plant-based foods). The researchers then looked at various heart disease risk factors and body measurements to see if they were connected to these diet scores.

This approach is useful because it shows real-world patterns in how people eat and their health outcomes. By looking at multiple types of plant-based eating patterns, the study can show that not all plant-based foods are equally healthy. The researchers also measured newer, more detailed heart disease risk factors that doctors are increasingly using instead of just cholesterol levels.

This study has some strengths: it included a decent number of participants (490), used a validated food questionnaire, and measured multiple health markers. However, because it’s a snapshot in time rather than following people over years, we can’t be certain that the diet caused the health differences. The study also relied on people remembering what they ate, which can be inaccurate. These results need to be confirmed with longer-term studies before making strong recommendations.

What the Results Show

People who ate the most healthy plant-based foods had significantly better cholesterol numbers. Specifically, they had 58% lower cholesterol risk scores and 57% lower heart disease risk ratios compared to those eating the least healthy plant-based foods. Additionally, people who ate more plant-based foods overall were about 51% less likely to have needed heart bypass surgery in the past. These are meaningful differences that suggest plant-based eating patterns may protect the heart in people with diabetes.

The study also found that eating unhealthy plant-based foods (processed plant-based products) was linked to a 64% increase in abdominal fat measurements. This is important because belly fat is particularly harmful for heart health. The study measured several other heart disease risk factors, but the healthiest plant-based diet group showed improvements in most of them, even if some weren’t statistically significant.

This research builds on previous studies showing that plant-based diets can be heart-healthy. However, this study adds important nuance by showing that the quality of plant-based foods matters—eating whole plant foods is better than eating processed plant-based alternatives. The findings align with general nutrition science showing that whole foods are healthier than processed versions, whether plant-based or not.

This study has several important limitations. First, it’s a snapshot in time, so we can’t prove the diet caused the health differences—people with better health might simply choose to eat better. Second, people reported their own eating habits, which can be inaccurate. Third, the study only included people with type 2 diabetes, so results may not apply to others. Finally, the study didn’t account for all possible factors that affect heart health, like exercise or stress. The researchers themselves noted that these findings need confirmation through longer-term studies.

The Bottom Line

If you have type 2 diabetes, eating more whole plant-based foods like vegetables, fruits, beans, lentils, nuts, and whole grains may help protect your heart. Focus on whole foods rather than processed plant-based products. However, these findings are suggestive rather than definitive, so discuss any major diet changes with your doctor or a registered dietitian. Confidence level: Moderate—this is good evidence but needs confirmation.

This research is most relevant for people with type 2 diabetes who want to reduce their heart disease risk. It may also be interesting to people without diabetes considering plant-based eating. People with specific medical conditions or those taking certain medications should consult their doctor before making diet changes. This study doesn’t apply to children or pregnant women.

Heart health improvements from diet changes typically take weeks to months to show up in blood tests. You might notice improved energy and digestion within days or weeks, but cholesterol and other risk factors usually take 4-12 weeks to improve measurably. Larger changes in heart disease risk may take months to years.

Want to Apply This Research?

  • Track daily servings of whole plant-based foods (vegetables, fruits, beans, whole grains, nuts, seeds) separately from processed plant-based products. Aim for at least 5-7 servings of whole plant foods daily and limit processed plant-based items to occasional consumption.
  • Start by adding one extra serving of vegetables or beans to one meal daily. Replace one processed snack per week with a whole plant-based option like nuts, fruit, or hummus with vegetables. Gradually increase whole plant foods while decreasing processed plant-based products.
  • Weekly: track plant-based food servings and quality (whole vs. processed). Monthly: note energy levels and digestion changes. Every 3 months: work with your doctor to check cholesterol and heart disease risk markers. Use the app to identify patterns between your eating and how you feel.

This research shows associations between plant-based eating and heart health markers in people with type 2 diabetes, but does not prove cause-and-effect. This study is a snapshot in time and needs confirmation through longer-term research. If you have type 2 diabetes or heart disease, consult your doctor or registered dietitian before making significant diet changes, especially if you take medications that affect blood sugar or cholesterol. This information is educational and should not replace professional medical advice.