Glucose Intolerance and Insulin Resistance

People with diabetes (both non-insulin-dependent and insulin-dependent) or with impaired glucose tolerance have a higher risk of CHD than people with normal glucose tolerance.34 Some of this association is due to the coexistence of glucose intolerance with low HDL cholesterol, high blood pressure, and obesity, but hyperglycemia also increases CHD risk independently of these other risk factors.42

Vegetarian diets do not have a well-defined effect on glucose tolerance. Western vegetarian diets generally include more low glycemic index foods, such as legumes and fruit, than non-vegetarian Western diets and might therefore reduce the incidence of glucose intolerance. Snowdon and Phillips43 found that self-reported diabetes was less prevalent among vegetarian than among non-vegetarian Seventh-Day Adven-tists, and that diabetes was only half as common as a cause of death among Seventh-Day Adventists, as compared with the American population as a whole. However, Asian vegetarians from the Indian subcontinent suffer a high incidence of diabetes, despite eating relatively large amounts of legumes. It is possible that a vegetarian diet high in complex carbohydrates has some protective effect against glucose intolerance and diabetes, but other factors such as energy intake, physical activity, and genotype may play more important roles in determining the risk of these conditions.

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