***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Plant-based diets have been recommended to reduce the risk of type 2 diabetes ( T2D ) . However , not all plant foods are necessarily beneficial . We examined the association of an overall plant-based diet and hypothesized healthful and unhealthful versions of a plant-based diet with T2D incidence in three prospect i ve cohort studies in the US . Methods and Findings We included 69,949 women from the Nurses ’ Health Study ( 1984–2012 ) , 90,239 women from the Nurses ’ Health Study 2 ( 1991–2011 ) , and 40,539 men from the Health Professionals Follow-Up Study ( 1986–2010 ) , free of chronic diseases at baseline .  Dietary data were collected every 2–4 y using a semi-quantitative food frequency question naire . Using these data , we created an overall  plant-based diet index  ( PDI ) , where plant foods received positive scores , while animal foods ( animal fats , dairy , eggs , fish/seafood , poultry/red meat , miscellaneous animal-based foods ) received reverse scores . We also created a healthful plant-based diet index ( hPDI ) , where healthy plant foods ( whole grains , fruits , vegetables , nuts , legumes , vegetable oils , tea/coffee ) received positive scores , while less healthy plant foods ( fruit juices , sweetened beverages , refined grains , potatoes , sweets/desserts ) and animal foods received reverse scores . Lastly , we created an unhealthful plant-based diet index ( uPDI ) by assigning positive scores to less healthy plant foods and reverse scores to healthy plant foods and animal foods . We documented 16,162 incident T2D cases during 4,102,369 person-years of follow-up . In pooled multivariable-adjusted analysis , both PDI and hPDI were inversely associated with T2D ( PDI : hazard ratio [ HR ] for extreme deciles 0.51 , 95 % CI 0.47–0.55 , p trend < 0.001 ; hPDI : HR for extreme deciles 0.55 , 95 % CI 0.51–0.59 , p trend < 0.001 ) . The association of T2D with PDI was considerably attenuated when we additionally adjusted for body mass index ( BMI ) categories ( HR 0.80 , 95 % CI 0.74–0.87 , p trend < 0.001 ) , while that with hPDI remained largely unchanged ( HR 0.66 , 95 % CI 0.61–0.72 , p trend < 0.001 ) . uPDI was positively associated with T2D even after BMI adjustment ( HR for extreme deciles 1.16 , 95 % CI 1.08–1.25 , p trend < 0.001 ) . Limitations of the study include self-reported diet assessment , with the possibility of measurement error , and the potential for residual or unmeasured confounding given the observational nature of the study design . Conclusions Our study suggests that plant-based diets , especially when rich in high- quality plant foods , are associated with substantially lower risk of developing T2D . This supports current recommendations to shift to diets rich in healthy plant foods , with lower intake of less healthy plant and animal foods OBJECTIVE To study the relationship between dietary intake and the development of  type 2 diabetes among Chinese adults . DESIGN A prospect i ve cohort study . Dietary assessment was carried out using a vali date d FFQ . Principal component analysis was used to identify dietary patterns . Dietary glycaemic load and variety of snacks were also calculated . SETTING A hospital-based centre at the Queen Mary Hospital in Hong Kong SAR , China . SUBJECTS A total of 1010 Chinese adults aged 25 - 74 years who participated in a territory-wide dietary and cardiovascular risk factor prevalence survey in 1995 - 1996 were followed up for 9 - 14 years for the development of diabetes . RESULTS A total of 690 ( 68·3 % ) individuals completed follow-up during 2005 - 2008 and seventy-four cases of diabetes were identified over the follow-up period . Four dietary patterns were identified ( ' more snacks and drinks ' , ' more vegetables , fruits and fish ' , ' more meat and milk products ' and ' more refined grains ' ) . After adjustment for age , sex , BMI , waist-to-hip ratio , smoking , alcohol intake , participation in exercise/sports and family history of diabetes , the more vegetables , fruits and fish pattern was associated with a 14 % lower risk ( OR per 1 sd increase in score = 0·76 ; 95 % CI 0·58 , 0·99 ) , whereas the more meat and milk products pattern was associated with a 39 % greater risk of diabetes ( OR per 1 sd increase in score = 1·39 ; 95 % CI 1·04 , 1·84  ) . Dietary glycaemic load , rice intake , snack intake and variety of snacks were not independently associated with diabetes . CONCLUSIONS The more vegetables , fruits and fish pattern was associated with reduced risk and the more meat and milk products pattern was associated with an increased risk of diabetes Aims The aim of this study was to compare the effects of calorie-restricted vegetarian and conventional diabetic diets alone and in combination with exercise on insulin resistance , visceral fat and oxidative stress markers in subjects with Type 2 diabetes . Methods A 24-week , r and omized , open , parallel design was used . Seventy-four patients with Type 2 diabetes were r and omly assigned to either the experimental group ( n = 37 ) , which received a vegetarian diet , or the control group ( n = 37 ) , which received a conventional diabetic diet . Both diets were isocaloric , calorie restricted ( -500 kcal/day ) . All meals during the study were provided . The second 12 weeks of the diet were combined with aerobic exercise . Participants were examined at baseline , 12 weeks and 24 weeks . Primary outcomes were : insulin sensitivity measured by hyperinsulinaemic isoglycaemic clamp ; volume of visceral and subcutaneous fat measured by magnetic resonance imaging ; and oxidative stress measured by thiobarbituric acid reactive substances . Analyses were by intention to treat . Results Forty-three per cent of participants in the experimental group and 5 % of participants in the control group reduced diabetes medication ( P < 0.001 ) . Body weight decreased more in the experimental group than in the control group [ –6.2 kg ( 95 % CI –6.6 to –5.3 ) vs. –3.2 kg ( 95 % CI –3.7 to –2.5 ) ; interaction group × time P = 0.001 ] . An increase in insulin sensitivity was significantly greater in the experimental group than in the control group [ 30 % ( 95 % CI 24.5–39 ) vs. 20 % ( 95 % CI 14–25 ) , P = 0.04 ] . A reduction in both visceral and subcutaneous fat was greater in the experimental group than in the control group ( P = 0.007 and P = 0.02 , respectively ) . Plasma adiponectin increased ( P = 0.02 ) and leptin decreased ( P = 0.02 ) in the experimental group , with no change in the control group . Vitamin C , superoxide dismutase and reduced glutathione increased in the experimental group ( P = 0.002 , P < 0.001 and P = 0.02 , respectively ) . Differences between groups were greater after the addition of exercise training . Changes in insulin sensitivity and enzymatic oxidative stress markers correlated with changes in visceral fat . Conclusions A calorie-restricted vegetarian diet had greater capacity to improve insulin sensitivity compared with a conventional diabetic diet over 24 weeks . The greater loss of visceral fat and improvements in plasma concentrations of adipokines and oxidative stress markers with this diet may be responsible for the reduction of insulin resistance . The addition of exercise training further augmented the improved outcomes with the vegetarian diet More than 25 % of the U.S. population aged 65 years has diabetes mellitus ( hereafter referred to as diabetes ) , 1 and the aging of the overall population is a significant driver of the diabetes epidemic . Although the burden of diabetes is often described in terms of its impact on working-age adults , diabetes in older adults is linked to higher mortality , reduced functional status , and increased risk of institutionalization . 2 Older adults with diabetes are at substantial risk for both acute and chronic microvascular and cardiovascular complications of the disease . Despite having the highest prevalence of diabetes of any age-group , older persons and /or those with multiple comorbidities have often been excluded from r and omized controlled trials of treatments— and treatment targets— for diabetes and its associated conditions . Heterogeneity of health status of older adults ( even within an age range ) and the dearth of evidence from clinical trials present challenges to determining st and ard intervention strategies that fit all older adults . To address these issues , the American Diabetes Association ( ADA ) convened a Consensus Development Conference on  Diabetes and Older Adults ( defined as those aged 65 years ) in February 2012 . Following a series of scientific presentations by experts in the field , the writing group independently developed this consensus report to address the following questions IMPORTANCE Red meat consumption has been consistently associated with an increased risk of  type 2 diabetes mellitus ( T2DM ) . However , whether changes in red meat intake are related to subsequent T2DM risk remains unknown . OBJECTIVE To evaluate the association between changes in red meat consumption during a 4-year period and subsequent 4-year risk of T2DM in US adults . DESIGN AND SETTING Three prospect i ve cohort studies in US men and women . PARTICIPANTS We followed up 26,357 men in the Health Professionals Follow-up Study ( 1986 - 2006 ) , 48,709 women in the Nurses ' Health Study ( 1986 - 2006 ) , and 74,077 women in the Nurses ' Health Study II ( 1991 - 2007 ) .  Diet was assessed by vali date d food frequency question naires and up date d every 4 years . Time-dependent Cox proportional hazards regression models were used to calculate hazard ratios with adjustment for age , family history , race , marital status , initial red meat consumption , smoking status , and initial and changes in other lifestyle factors ( physical activity , alcohol intake , total energy intake , and diet quality ) . Results across cohorts were pooled by an inverse variance-weighted , fixed-effect meta- analysis . MAIN OUTCOMES AND MEASURES Incident T2DM cases vali date d by supplementary question naires . RESULTS During 1,965,824 person-years of follow-up , we documented 7540 incident T2DM cases . In the multivariate-adjusted models , increasing red meat intake during a 4-year interval was associated with an elevated risk of T2DM during the subsequent 4 years in each cohort ( all P < .001 for trend ) . Compared with the reference group of no change in red meat intake , increasing red meat intake of more than 0.50 servings per day was associated with a 48 % ( pooled hazard ratio , 1.48 ; 95 % CI , 1.37 - 1.59 ) elevated risk in the subsequent 4-year period , and the association was modestly attenuated after further adjustment for initial body mass index and concurrent weight gain ( 1.30 ; 95 % CI , 1.21 - 1.41 ) . Reducing red meat consumption by more than 0.50 servings per day from baseline to the first 4 years of follow-up was associated with a 14 % ( pooled hazard ratio , 0.86 ; 95 % CI , 0.80 - 0.93 ) lower risk during the subsequent entire follow-up through 2006 or 2007 . CONCLUSIONS AND RELEVANCE Increasing red meat consumption over time is associated with an elevated subsequent risk of T2DM , and the association is partly mediated by body weight . Our results add further evidence that limiting red meat consumption over time confers benefits for T2DM prevention Background Type 2 diabetes ( T2D ) is one of the most psychologically dem and ing chronic medical illness in adult . Comorbidity between diabetes and depression is quite common , but most studies were based on developed country sample . Limited data exists to document biopsychosocial predictors of depressive symptoms in Ethiopian patients . Therefore , the aim of the study was to describe the association of depressive symptoms and T2D and explore the potential underlying associated biopsychosocial risk factors . Methods Institution based cross-sectional study was conducted on 276 patient with T2D at diabetic clinic , Black Lion General Specialized Hospital in Ethiopia . Patients were selected using systematic r and om sampling technique . Depressive symptoms score , which constructed from a vali date d nine-item Patient Health Question naire ( PHQ-9 ) , was an outcome variable . Finally , significant associated factors were identified using multiple linear regression analysis with backward elimination procedure . Statistical Package for Social Science ( SPSS ) version 22.0 ( IBM SPSS Corp. ) was used to perform all analysis . Results Total of 264 patient data was analyzed with 95.7 % response rate . Patients mean ( SD ) current age and 
    Output:
    
Plant-based diets were associated with significant improvement in emotional well-being , physical well-being , depression , quality of life , general health , HbA1c levels , weight , total cholesterol and low-density lipoprotein cholesterol , compared with several diabetic associations ' official guidelines and other comparator diets .
Plant-based diets can significantly improve psychological health , quality of life , HbA1c levels and weight and therefore the management of diabetes