Are plant-based dietary habits the low-cost solution to pervasive lifestyle diseases?
As of 2021, South Africa has witnessed a significant rise in the number of adults living with diabetes, with estimates surpassing 4 million.
This chronic metabolic disorder, known for its impact on blood sugar regulation, particularly highlights the prevalence of type 2 diabetes mellitus (T2DM) as a prominent lifestyle disease.
According to a recent review, the escalating numbers of South Africans impacted by T2DM have resulted in substantial healthcare costs, with the average direct costs for patients in 2016 estimated at R2 486 per patient and indirect costs averaging R18 711.
Left untreated, this condition can lead to severe complications such as heart disease, blindness, kidney failure, and the need for amputations, further exacerbating the economic and health burdens for individuals and society at large.
As the global number of adults affected by T2DM reaches an alarming 537 million, the need for effective prevention and management strategies becomes increasingly apparent.
A timely study done by two close affiliates of ProVeg South Africa – the Physicians Association for Nutrition and Ubuntu Wellness – has raised the question: could plant-based diets offer a potential solution to alleviate the burden of T2DM in South Africa?
“Given the growing economic strain and health implications associated with T2DM, the role of plant-based diets in preventing and managing this condition is a topic worthy of exploration," commented a leading health specialist involved in the study.
While the potential health benefits of prescribing plant-based diets in the context of T2DM management are being investigated, this emerging research presents a promising avenue for addressing the rising concerns surrounding diabetes in South Africa and worldwide.
Lifestyle medicine – a missing link in healthcare
A diagnosis of T2DM is not always a life sentence. Improving lifestyle factors can prevent, manage and potentially reverse T2DM.
South African health systems recommend three months of lifestyle changes for all persons diagnosed with T2DM, with or without pharmaceutical interventions.
A high-quality diet, regular exercise, improved sleep and stress management can be powerful lifestyle changes to enable health and wellbeing.
21 Days of plant-based eating for diabetes
Dietary approaches to increasing plant-based food consumption are gaining popularity worldwide, including in South Africa.
In a groundbreaking initiative, the Ubuntu Wellness Centre in Cape Town introduced the Ubuntu 21-day whole food plant-based eating challenge designed specifically for individuals managing T2DM.
Participation in the programme, conducted nationwide and from the comfort of participants' homes, includes access to medical care and guidance through a comprehensive recipe book entitled “Healing Diabetes and Other Lifestyle Disease: Cooking Africa's Plant-Based Whole Foods”.
The recipe book, featuring 80 affordable recipes and a sample 7-day meal plan, serves as a cornerstone of the programme.
To gain insights into the impact of the healthy plant-based eating challenge, the Physicians Association for Nutrition (PAN) South Africa and North-West University embarked on a multiple-case study involving 10 programme participants.
Through in-depth interviews with both participants and their physicians, the research aims to shed light on the unique experiences and perspectives surrounding the challenge and its influence on participants' health and daily routines.
According to Dr Nanine Wyma, managing director of PAN South Africa: “There is a lack of sufficient scientific evidence on the potential benefits of healthy plant-based eating for South Africans.
“This study represents a significant stride in the exploration of plant-based dietary approaches for diabetes and other chronic diseases in South Africa."
Dr Christi Niesing, a senior lecturer at North-West University, expressed her support for the study, emphasising its importance in laying a foundation for future health investigations.
"Understanding the various factors influencing individuals' behaviour changes is key to the development of effective health promotion strategies," she noted.
Participants in the study initially faced challenges adapting to the plant-based diet during the first week. However, they soon reported remarkable health improvements.
The plant-based dietary approach positively impacted their blood sugar control, leading some to reduce or entirely discontinue their medications.
Additionally, participants experienced weight loss and reduced abdominal circumference, and noted psychological benefits.
Professor Andrew Robinson, a public health physician and the study’s principal investigator, was impressed by how this simple intervention empowered patients to take control of their own health.
He pointed out the study's potential significance, stating: “This study suggests the possibility of reversing T2DM with nutritional interventions in South Africa. Effective health promotion interventions are essential in mitigating the economic impact of non-communicable diseases, and are integral to the success of the NHI.”
Physicians who monitored the challenge participants echoed the sentiment, with one describing the impact of plant-based eating in chronic disease management as “very powerful”.
The positive outcomes have generated genuine interest among local healthcare clinics and workers, indicating the potential for transforming diabetes management practices in the country.
The reality of plant-based diets in South Africa
“Dietary choices are influenced by a variety of factors, and South Africa's food environments largely promote animal-based diets, making it challenging to access a diverse range of fruits, vegetables, and healthy plant-based meals,” noted a representative from PAN South Africa.
This situation underscores the need for greater awareness and understanding of plant-based nutrition among South African healthcare professionals.
South African food culture, deeply entrenched across ethnic groups, predominantly revolves around the consumption of animal products. As a result, transitioning to a plant-based diet may encounter resistance and discord within these traditional norms.
Another concern highlighted by recent surveys is the inadequate education on plant-based nutrition for future healthcare professionals in South Africa.
A significant percentage of medical and dietetic students expressed the need for more comprehensive training in this area, reflecting a vital gap in their competencies to address lifestyle-related illnesses such as diabetes.
For individuals grappling with a T2DM diagnosis and seeking to address their lifestyle habits, healthcare professionals recommend initiating a conversation with their doctors or dietitians regarding the potential benefits of a plant-based diet.
They can also utilise resources like the plant-based friendly healthcare providers database for South Africa to find suitable professionals and consider participating in the ProVeg Veggie Challenge for guidance and meal plans tailored to a whole month of following a plant-based diet.
Additionally, healthcare professionals can access a nutritional journal series for further insights and information on plant-based nutrition.