Eating vegetables first may reduce risk of diabetic eye and kidney damage
Key Takeaway:
Eating vegetables first may reduce diabetes eye and kidney damage, but we cannot prove causality.
Study at a Glance
What was studied
A study of 832 adults with diabetes in Japan comparing eating patterns and complication rates
Study Type
Cross-Sectional
duration
Intervention
Vegetables-first eating pattern
Outcomes
Diabetic retinopathy incidence, Nephropathy progression
Funding
Non-Industry Sponsored
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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 Summary
| Intervention | Outcome | Measured Change | Study Effect |
|---|---|---|---|
 Vegetables-first eating pattern (Diet and Nutrition) |  Diabetic retinopathy incidence (Clinical Outcomes) | Decrease | Mixed |
Vegetables-first eating pattern (Diet and Nutrition) | Nephropathy progression (Clinical Outcomes) | Decrease | Strong |
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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
Journal Reference
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
Connected Evidence
Discover how this study fits into the broader diabetes evidence landscape.
This study contributes to evidence on Vegetables-first eating pattern and Kidney Function.
Related evidence relationships
Explore in Evidence ArchiveThis study contributes to the evidence on the following intervention–outcome relationships.
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Curated evidence collections and hubs this study is part of.
Kidney Function Evidence Hub
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Measures Kidney Function as a key outcome.
Vegetables-first eating pattern Evidence Hub
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Contributes to Vegetables-first eating pattern evidence base.
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All studies on Vegetables-first eating pattern and Nephropathy progression
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