Eating vegetables first may reduce risk of diabetic eye and kidney damage
Last updated May 16, 2026
Key finding
Eating vegetables first may reduce diabetes eye and kidney damage, but we cannot prove causality.
This study looked at whether eating vegetables before other foods affects diabetes complications. Researchers surveyed 832 adults with diabetes in Japan about their eating habits. About half ate vegetables first, while others had no particular order or ate protein or carbs first. People who ate vegetables first had lower rates of eye damage and kidney problems compared to those with no eating pattern. The link was strongest for kidney damage, with about 50% lower odds. No clear connection was found for nerve damage or heart disease. Because this study only observed patterns at one point in time, it cannot prove that eating vegetables first prevents complications.
Quick read
Study at a glance
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EvidenceScore™
Moderate
Study type
Cross-Sectional
Risk of bias
Some Concerns
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
Eating vegetables first may reduce diabetes eye and kidney damage, but we cannot prove causality.
Published in
Journal Reference
Publication details and source links for this paper.
Imataka K, Ida S, Tanaka T, Azuma K, Murata K. The Habit of Eating Vegetables First Is Linked with a Lower Risk of Diabetic Retinopathy and Nephropathy: Cross-Sectional Study in Japanese Diabetic Patients. Diabetes Metab Syndr Obes. 2026;19:555812. doi:10.2147/DMSO.S555812
Main Effects
Kidney damage → ↓ (strong association, 53% lower odds)
Eye damage → ↓ (moderate association, 36% lower odds)
Nerve damage and heart disease → → (no clear link)
Evidence Suggest
- Eating vegetables first at meals may be linked to lower risk of eye and kidney damage in people with diabetes
- The connection appears strongest for kidney damage, with roughly half the risk compared to no eating pattern
- The study design cannot prove cause and effect, so the link may reflect other healthy behaviors rather than the eating pattern itself
Who this applies to
Adults with type 1 or type 2 diabetes, particularly those in Asian populations where meals are naturally structured with vegetables as separate dishes
Keep in Mind
The study design cannot prove eating vegetables first prevents complications; the cause and effect relationship is uncertain
Between the Lines
- Cannot prove eating pattern caused fewer complications
- Eating habits were self-reported, not observed
- Conducted in Japan; may not apply elsewhere
- Blood sugar after meals was not measured
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