Type 2 diabetes: Flavonoid-rich diets may help lower risk

Share on Pinterest Recent research has linked flavonoid-rich foods and beverages, such as black and green tea, to a lower risk of type 2 diabetes. Image credit: Stefania Pelfini, La Waziya Photography/Getty Images. New research has revealed that increasing the consumption of flavonoid-rich foods can significantly reduce the risk of developing type 2 diabetes.

This form of diabetes is a growing public health concern, affecting over 400 million people worldwide and contributing to over 1 million deaths annually, according to the World Health Organization (WHO).

Researchers analysed data from 113,097 participants in the UK Biobank, finding that a diet high in flavonoids, particularly from foods like berries, apples and tea, is linked to improved insulin sensitivity and reduced diabetes risk. A new study, published in Nutrition & Diabetes , examined the connection between a flavonoid-rich diet and the onset of type 2 diabetes within a large population in the United Kingdom. Adopting a diet rich in plant-based foods is already known to decrease the risk of type 2 diabetes. However, plants are abundant in various polyphenolic compounds that differ in their bioavailability and bioactivity. Flavonoids, a category of polyphenolic compounds, are divided into six main subclasses: flavanones, flavones, flavan-3-ols, flavonols, anthocyanins, and isoflavones. There is some evidence to suggest that a higher intake of flavonoids may lead to greater insulin sensitivity and an improved blood lipid profile.

Investigating flavonoid intake and type 2 diabetes risk The new study involved 113,097 participants from the UK Biobank, a large-scale, population-based cohort study that recruited over 500,000 adults in the UK between 2006 and 2010. The participants’ flavonoid intake was assessed through two or more 24-hour dietary surveys, which were analysed using the United States Department of Agriculture databases. Ten flavonoid-rich foods were chosen based on average daily consumption. A Flavodiet Score (FDS) was calculated by summing the servings of these ten foods. Statistical analyses, accounting for potential confounders, were performed to assess the relationship between dietary flavonoid intake and the development of type 2 diabetes. The study found that higher consumption of flavonoid-rich foods was more common among female participants, older individuals, those who were physically active and those with higher educational levels. The average daily flavonoid intake was 805.7 milligrams. Among the flavonoid subclasses, polymers — including proanthocyanidins — and flavan-3-ols were the most significant contributors, accounting for 67% and 22% of the total intake, respectively. Tea was the primary source for these subclasses. Flavones, mainly derived from peppers, contributed the least to total flavonoid intake. When analyzing the association between flavonoid intake and the risk of developing type 2 diabetes, the study adjusted for participants’ demographic and lifestyle characteristics. It found that a higher Flavodiet Score (FDS) — equivalent to consuming six servings of flavonoid-rich foods per day — was linked to a 28% lower risk of developing type 2 diabetes compared to a lower FDS of one serving per day. The study found that each additional daily serving of flavonoid-rich foods reduces diabetes risk by 6%, 4 servings of black or green tea per day were linked to a 21% lower risk, 1 serving a day of berries was associated with a 15% lower diabetes risk, and 1 serving per day of apples was associated with a 12% lower risk.

Flavonoids reduce inflammation, aid blood sugar control The analysis identified body mass index (BMI), insulin-like growth factor 1 (IGF-1), C-reactive protein, cystatin C, urate, gamma-glutamyl transferase (GGT) and alanine aminotransferase (ALT) as potential mediators. The findings suggest that a flavonoid-rich diet positively impacts weight management, glucose metabolism, inflammation and kidney and liver functions, contributing to the reduced risk of type 2 diabetes. Flavonoids, especially anthocyanins, flavan-3-ols, and flavonols, enhance insulin secretion and signalling, and improve glucose transport and metabolism. However, the study’s findings may not be generalisable to non-European populations as the study population consisted of middle-aged British adults. Two experts, not involved in this research, spoke to Medical News Today about its findings. Megan Hilbert, RDN, a registered dietitian specialising in gut health nutrition and the gut-brain axis, told MNT that “these findings help to confirm a lot of what we understand about the pathophysiology of type 2 diabetes.” “This study confirms flavonoids impact on this, due to flavonoids’ ability to help reduce inflammation and even help those with high intakes maintain a healthy weight,” she explained. “These findings show that flavonoid intake can help lower excess adipose tissue which can be pro-inflammatory, as well as reduce adipose tissue that surrounds smooth muscle tissue, allowing for more blood glucose to be absorbed by said muslce cells,” Hilbert added. “These changes help allow the body to process blood sugars more effectively, leading to a reduced risk in developing type 2 diabetes,” she said. “What I really enjoyed about this study is that different flavonoids were compared and the data showed certain flavonoids to have a larger impact on reductions in diabetes, and certain foods in particular seemed to have a more protective effect than others. These specific findings can play a huge role in educating patients on dietary recommendations.” – Megan Hilbert, RDN Kelsey Costa, MS, RDN, a registered dietitian nutritionist and founder of Dietitian Insights, agreed, noting that “given flavonoids’ well-documented anti-diabetic effects , the results of the present study are not surprising. According to Costa, flavonoids’ role in blood sugar control may also explain their link to lower diabetes risk: “Flavonoids may help prevent and manage diabetes and its complications by regulating glucose metabolism, enhancing insulin signaling and secretion and liver enzyme activity, reducing oxidative stress, and optimizing lipid profiles, which together improve obesity, blood sugar levels, chronic inflammation, and kidney and liver function.” “However, the large UK Biobank cohort and substantial follow-up add further evidence to support flavonoids’ protective role in preventing type 2 diabetes,” she cautioned.

Why it is important to control for alcohol use In addition, she highlighted that the “scientific community continues to uncover the harmful effects of alcohol consumption, including its association with systemic inflammation, weight gain, and disturbances in fat metabolism, which can ultimately contribute to the development of type 2 diabetes.” “Therefore, I am pleased that this study accounted for the total alcohol intake of participants when examining the relationship between flavonoid consumption and type 2 diabetes risk in their initial assessment and then reassessed the data by excluding red wine from the flavonoid diet score to determine if the results would differ,” Costa told us. She further noted that “[t]his approach allowed them to isolate the effects of flavonoids without the influence of alcohol and show that the protective association between flavonoid intake and type 2 diabetes risk remained significant without any red wine consumption.” “We’re finding out that consuming no alcohol is better for your health across the board, with several studies highlighting that even moderate alcohol consumption can lead to detrimental health effects, so it’s essential to account for alcohol intake when assessing the impact of other dietary factors.” – Kelsey Costa, RDN