OBJECTIVE -We sought to investigate whether a low-fat vegan diet improves glycemic control and cardiovascular risk factors in individuals with type 2 diabetes.RESEARCH DESIGN AND METHODS -Individuals with type 2 diabetes (n ϭ 99) were randomly assigned to a low-fat vegan diet (n ϭ 49) or a diet following the American Diabetes Association (ADA) guidelines (n ϭ 50). Participants were evaluated at baseline and 22 weeks.RESULTS -Forty-three percent (21 of 49) of the vegan group and 26% (13 of 50) of the ADA group participants reduced diabetes medications. Including all participants, HbA 1c (A1C) decreased 0.96 percentage points in the vegan group and 0.56 points in the ADA group (P ϭ 0.089). Excluding those who changed medications, A1C fell 1.23 points in the vegan group compared with 0.38 points in the ADA group (P ϭ 0.01). Body weight decreased 6.5 kg in the vegan group and 3.1 kg in the ADA group (P Ͻ 0.001). Body weight change correlated with A1C change (r ϭ 0.51, n ϭ 57, P Ͻ 0.0001). Among those who did not change lipid-lowering medications, LDL cholesterol fell 21.2% in the vegan group and 10.7% in the ADA group (P ϭ 0.02). After adjustment for baseline values, urinary albumin reductions were greater in the vegan group (15.9 mg/24h) than in the ADA group (10.9 mg/24 h) (P ϭ 0.013).CONCLUSIONS -Both a low-fat vegan diet and a diet based on ADA guidelines improved glycemic and lipid control in type 2 diabetic patients. These improvements were greater with a low-fat vegan diet.
Both diets were associated with sustained reductions in weight and plasma lipid concentrations. In an analysis controlling for medication changes, a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations. Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established. This trial was registered at clinicaltrials.gov as NCT00276939.
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