South African Study Suggests Plant-Based Prescription to a Type 2 Diabetes Diagnosis
Are plant-based dietary habits the low-cost solution to pervasive lifestyle diseases?
In 2021, it was estimated that over 4 million South African adults were living with diabetes, a chronic metabolic disorder characterised by dysregulation of blood sugar. In terms of lifestyle diseases, type 2 diabetes mellitus [T2DM] is arguably a leading scourge of our modern consumption habits, underscoring the seemingly inevitable detriments of society’s high intake of calories, refined sugars and animal products.
The number of South Africans living with T2DM is staggering and contributes to equally high healthcare costs. One review of medical schemes in South Africa estimates that the average direct costs for patients in 2016 were ZAR 2 486 per patient, alongside ZAR 18 711 indirect costs on average. If left untreated, long-term complications may include heart disease, blindness, kidney failure, and the need for amputations – further exacerbating the costs of treatment and its debilitating effects.
With approximately 537 million adults afflicted with T2DM worldwide as of 2021, this represents a significant economic strain that can both be prevented and remedied. Could plant-based diets play a role in preventing and managing the burden of T2DM in South Africa? A new study suggests that a plant-based prescription may offer various health benefits.
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. A person with T2DM who consults with a registered dietician for medical nutrition therapy can improve blood sugar control and reduce healthcare costs.
21 Days of Plant-Based Eating for Diabetes
Dietary approaches increasing plant-based food consumption are gaining popularity worldwide, including in South Africa. In 2021, UBUNTU Wellness centre in Cape Town developed the UBUNTU 21-day whole food plant-based eating challenge for T2DM. All over the country, and in the comfort of their own home, participants of the challenge are provided with medical care and guided by a recipe book, Healing Diabetes and Other Lifestyle Disease: Cooking Africa’s Plant-Based Whole Foods. The recipe book includes 80 affordable recipes and a sample 7-day meal plan from the program.
Healthy Plant-Based Eating in South Africa
To understand what unfolded during the healthy plant-based eating challenge, the Physicians Association for Nutrition (PAN) South Africa and North-West University conducted a multiple-case study including 10 of its participants. Through interviews with participants and their physicians, the research unpacks unique perspectives on how the challenge impacted their health and fit into their daily lives.
Says Dr. Nanine Wyma, Managing Director of PAN South Africa, “There is not enough scientific evidence on how healthy plant-based eating may benefit South Africans. The article represents a significant step forward in exploring plant-based dietary approaches for diabetes and other chronic diseases in South Africa.”
Dr. Christi Niesing, Senior Lecturer at North-West University, supported the research as an explorative foundation for future investigations, “Understanding the multi-layered contextual factors which influence the behaviour change of individuals greatly supports the development of subsequent health promotion interventions.”
Participants found it difficult to adapt to the plant-based diet during the first week. Thereafter, they experienced remarkable health benefits. The plant-based dietary approach improved their blood sugar control, and some were able to reduce medications or come off of them entirely. Participants also lost weight and abdominal circumference and gained psychological benefits.
Professor Andrew Robinson, Public Health Physician and Principal Investigator of the study expressed, “I was so impressed how this simple intervention empowered patients to take control of their own health.”
“The importance of this study is that it suggests that it may be possible to reverse T2DM with nutritional interventions in South Africa. Health promotion interventions which mitigate the economic impact of the noncommunicable disease pandemic will be an integral component of the success of the NHI. More local research must be done to properly inform the steps our health services must take to implement necessary effective health promotion interventions at every level,” he continued.
“Seeing what [plant-based eating] can do in terms of chronic disease management, this was very powerful,” said a physician who monitored participants of the challenge. The physicians were positive about the plant-based dietary approach, and described it as “very powerful” in its potential to manage chronic disease. The positive health outcomes also sparked genuine interest among local healthcare clinics and healthcare workers.
The Reality of Plant-Based Diets in South Africa
Health may be a powerful motivator for dietary change, but food choices are influenced by a number of contextual factors – personal, interpersonal, organisational, cultural and healthcare systems. South African food environments still largely promote animal-based diets, making it difficult to access a diversity of fruits, vegetables and healthy plant-based meals. PAN South Africa hopes that the research improves health promotion and promotes the understanding of plant-based nutrition among South African healthcare professionals.
“It was interesting to see how little health professionals knew about the healing potential and power of a plant-based diet. It will be difficult to shift towards lifestyle interventions that challenge the current curative approach to chronic non-communicable, as there are huge financial interests in the pharmaceuticalisation of healthcare,” added Professor Andrew Robinson.
There are indeed socio-economic challenges to normalising this dietary programme. Among the factors that may thwart the adoption of plant-based nutrition are the lifestyle precepts of South African society, where the everyday use of animal products is still entrenched. Meat consumption patterns have increased in South Africa, as recently as within one generation. The consumption of animal products is firmly rooted in South African culture and across ethnic groups. Eating a plant-based diet is starkly in contrast with this standard and may provoke disagreement and acrimony when challenged.
Furthermore, future doctors and dieticians are not adequately trained in plant-based nutrition on a university level. A survey of South African health science students found that 74 percent of medical students felt they don’t learn enough about nutrition and disease, and 67 percent of dietetic students were requiring more information on plant-based diets. This represents a significant gap in the competencies of South African physicians to address lifestyle-related illnesses such as diabetes.
If you’d like to better address your lifestyle habits in the treatment of a T2DM diagnosis, talk to your doctor or dietician about eating a plant-based diet. Reference the plant-based friendly healthcare providers database for South Africa to find a suitable professional, and sign up for the ProVeg Veggie Challenge for guidance and eating plans for a whole month of following a plant-based diet. Healthcare professionals can sign up for a nutritional journal series for further information.
About PAN South Africa:
The Physicians Association for Nutrition (PAN) South Africa is a national office of the non-profit organisation PAN International. PAN South Africa works with health science students, healthcare professionals, and policymakers to raise awareness of the power of whole-food, plant-based nutrition for health promotion and disease prevention.
About ProVeg South Africa:
ProVeg South Africa is the local branch of ProVeg International. ProVeg is an international food awareness organisation working to transform the global food system by replacing conventional animal-based products with plant-based and cultured alternatives.
ProVeg works with international decision-making bodies, governments, food producers, investors, the media, and the general public to help the world transition to a society and economy that are less dependent on animal agriculture and more sustainable for humans, animals, and the planet.
ProVeg has permanent-observer status with the UNFCCC, is accredited with UNEA, and has received the United Nations’ Momentum for Change Award.
About UBUNTU Wellness:
UBUNTU Wellness is a social impact holistic health and education ‘healthy vegan’ organisation dedicated to creating “Wellness for All”. Embracing the African philosophy of ubuntu, which emphasises the interconnectedness of all people, animals and the planet, they offer a variety of services and training including a medical spa, wellness retreats, workshops, and community-based programs. Their approach is integrative, combining traditional healing practices with modern wellness techniques to support individuals in achieving transformational holistic health and harmony.
UBUNTU Wellness – Ian MacFarlane – Director:
[email protected]; +27 82 929 2544