Beans & Diabetes

Diabetes is becoming more common across the world as the overweight and obesity epidemic continues. Eating a variety of legumes, including beans, as part of a healthful diet may be valuable not only in the prevention but also management of diabetes.

Beans are rich in complex carbohydrates, dietary fiber, and protein, which gives them a low glycemic index.  This makes them an ideal food for the management of insulin resistance and diabetes. Beans also provide protein that is low in fat and saturated fat as well as important vitamins and minerals in the diet.  Numerous studies show that consuming a low glycemic index diet may be protective against developing diabetes, while consuming a high glycemic index/load may increase the risk. Beans are an important food for individuals striving to manage blood sugars.

In the Health Professionals Study and Nurses Health Study, a 37-40% increase in Type 2 diabetes was found in individuals with the highest glycemic intake compared to those having the lowest glycemic index intake. (Salmeron & Ascherio, 1997; Salmeron & Manson, 1997) In a cohort from the Nurses Health study II, an increased risk of diabetes was also found in young and middle aged women when comparing highest vs. lowest quintiles for glycemic index. (Schulze, 2004)

Krishnan et al (2007) examined differences in glycemic indices and risk of type-2 diabetes with a group of US black women. After 8 years of follow-up, they found a positive association for diabetes in women consuming higher glycemic index diets, which was surprisingly stronger in normal weight women with a BMI <25. In a study of older Australians, researchers reported an increased risk of type-2 diabetes in women < 70 years of age consuming higher glycemic index carbohydrates (Barclay, 2006). Lastly, in a cohort of middle-aged Chinese women, individuals in the highest quintile for glycemic index and glycemic load and with a BMI > 25 had an increased risk of type-2 diabetes.

Two epidemiologic studies have looked at the relationship between legume intake and risk of type-2 diabetes. A study of middle-aged Chinese women reported a 38% reduced risk in the incidence of type-2 diabetes for women in the highest quintile (65 g/day) of total legume intake (soybeans, peanuts, and other legumes) compared to those in the lowest quintile (12.3 g/day) (Villegas, 2008).

The ability of low glycemic index carbohydrates to decrease risk of type-2 diabetes may be related to lower post-prandial (post meal) release of glucose and insulin coupled to improvements in insulin sensitivity. (Willett, 2002) High glycemic index foods are known to cause rapid rises in blood glucose and insulin following a meal. Chronic consumption of high glycemic load diets may in turn lead to down-regulation or desensitization of receptors for insulin, eventually contributing to insulin resistance. (Augustin, 2002) The body initially adjusts to higher circulating glucose by increasing insulin secretion from the pancreas. However, in susceptible individuals over time, insulin resistance combined with exhaustion of insulin producing cells will eventually lead to Type 2 diabetes. (Augustin, 2002; Ludwig, 2002)

An important area of research in the field of diabetes is looking at the effect that certain foods have on blood sugars after a meal (postprandial). More than 30 published postprandial studies have compared dry beans or other pulse products to carbohydrate controls like potatoes, rice, white bread, pasta, grains, and glucose. The majority of these studies (~83%) found significant reductions in postprandial peak glucose or area under the curve (AUC) compared to the control.

A meta-analysis of randomized controlled longer term experimental trials found that when eaten on their own, pulses including cooked dry beans significantly lowered fasting blood glucose and insulin levels.  In studies where treatments were bean-containing high-fiber or low-glycemic diets, glycosylated hemoglobin (HbA1c) was significantly lowered. In fact, the reduction in HbA1c seen in people with Type 2 diabetes (~0.48%) was comparable to that achieved by oral medications. (Sievenpipe, 2009)

Dry bean consumption also has been shown to have beneficial effects on risk factors for diabetes (including reducing total cholesterol, LDL-cholesterol, triglycerides, and increasing HDL-cholesterol) and has been associated with decreased body weight (Anderson, 2002). Important dietary behaviors, including regular consumption of low glycemic index foods like beans, may be beneficial in the prevention and management of Type 2 diabetes.

References

Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC. Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. Jama-Journal of the American Medical Association. 1997;277(6):472-477.

Schulze MB, Liu SM, Rimm EB, Manson JE, Willett WC, Hu FB. Glycemic index, glycemic load, and dietary fiber intake and incidence of Type 2 diabetes in younger and middle-aged women. American Journal Of Clinical Nutrition. 2004;80(2):348-356.

Krishnan S, Rosenberg L, Singer M, et al. Glycemie index, glycemie load, and cereal fiber intake and risk of Type 2 diabetes in US black women. Archives Of Internal Medicine. 2007;167(21):2304-2309.

Barclay AW, Brand-Miller JC, Mitchell P. Macronutrient intake, glycaemic index and glycaemic load of older Australian subjects with and without diabetes: baseline data from the Blue Mountains Eye Study. British Journal Of Nutrition. 2006;96(1):117-123.

Villegas R, Gao YT, Yang G, et al. Legume and soy food intake and the incidence of Type 2 diabetes in the Shanghai Women’s Health Study. American Journal Of Clinical Nutrition. 2008;87(1):162-167.

Willett W, Manson J, Liu SM. Glycemic index, glycemic load, and risk of Type 2 diabetes. American Journal of Clinical Nutrition. 2002;76(1):274S-280S.

Augustin LS, Franceschi S, Jenkins DJA, Kendall CWC, La Vecchia C. Glycemic index in chronic disease: a review. European Journal of Clinical Nutrition. 2002;56(11):1049-1071.

Ludwig DDS. The glycemic index – Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Jama-Journal of the American Medical Association. 2002;287(18):2414-2423.

Sievenpiper, J. L., Kendall, C. W., Esfahani, A., Wong, J. M., Carleton, A. J., Jiang, H. Y., Bazinet, R. P., Vidgen, E., & Jenkins, D. J. (2009). Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia, 52, 1479-1495.

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