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Cited by 155Nutritional Studies and DietDiabetes Management and EducationDiet and metabolism studies

A Low-Fat Vegan Diet Elicits Greater Macronutrient Changes, but Is Comparable in Adherence and Acceptability, Compared with a More Conventional Diabetes Diet among Individuals with Type 2 Diabetes

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Barnard, Neal D., Gloede, Lise, Cohen, Joshua, Jenkins, David J.A., Turner-McGrievy, Gabrielle, Green, Amber A., Ferdowsian, Hope·2009·Journal of the American Dietetic Association
DOI 10.1016/j.jada.2008.10.049PMC PMC2680723
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Abstract

Background Although therapeutic diets are critical to diabetes management, their acceptability to patients is largely unstudied.Objective To quantify adherence and acceptability for two types of diets for diabetes.Design Controlled trial conducted between 2004 and 2006.Subjects/setting Individuals with type 2 diabetes (n=99) at a community-based research facility. Participants were randomly assigned to a diet following 2003 American Diabetes Association guidelines or a low-fat, vegan diet for 74 weeks.Main outcome measures Attrition, adherence, dietary behavior, diet acceptability, and cravings.Statistical analyses For nutrient intake and questionnaire scores, t tests determined between-group differences. For diet-acceptability measures, the related samples Wilcoxon sum rank test assessed within-group changes; the independent samples Mann-Whitney U test compared the diet groups. Changes in reported symptoms among the groups was compared using chi(2) for independent samples.Results All participants completed the initial 22 weeks; 90% (45/50) of American Diabetes Association guidelines diet group and 86% (42/49) of the vegan diet group participants completed 74 weeks. Fat and cholesterol intake fell more and carbohydrate and fiber intake increased more in the vegan group. At 22 weeks, group-specific diet adherence criteria were met by 44% (22/50) of members of the American Diabetes Association diet group and 67% (33/49) of vegan-group participants (P=0.019); the American Diabetes Association guidelines diet group reported a greater increase in dietary restraint; this difference was not significant at 74 weeks. Both groups reported reduced hunger and reduced disinhibition. Questionnaire responses rated both diets as satisfactory, with no significant differences between groups, except for ease of preparation, for which the 22-week ratings marginally favored the American Diabetes Association guideline group. Cravings for fatty foods diminished more in the vegan group at 22 weeks, with no significant difference at 74 weeks.Conclusions Despite its greater influence on macronutrient intake, a low-fat, vegan diet has an acceptability similar to that of a more conventional diabetes diet. Acceptability appears to be no barrier to its use in medical nutrition therapy.

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  1. [19]Ziemer DC Berkowitz KJ Panayioto RM El-Kebbi IM Musey VC Anderson LA Wanko NS Fowke ML Brazier CW Dunbar VG Slocum W Bacha GM Gallina DL Cook CB Phillips LS A simple meal plan emphasizing healthy food choices is as effective as an exchange-based meal plan for urban African Americans with type 2 diabetes Diabetes Care 2003 26 1719 1724 12766100
  2. [24]Barnard ND Scialli AR Turner-McGrievy GM Lanou AJ Acceptability of a very-low-fat, vegan diet compares favorably to a more moderate low-fat diet in a randomized, controlled trial J Cardiopulm Rehab 2004 24 229 235 15286527

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Authors
Barnard, N. D., Gloede, L., Cohen, J., Jenkins, D. J. A., Turner-McGrievy, G., Green, A. A., & Ferdowsian, H.
Affiliations
  • Physicians Committee for Responsible Medicine (US)
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Barnard, Neal D.
ORCID
Venue
Journal of the American Dietetic Association
Publisher
Elsevier BV
Published
2009-02
Volume
109
Issue
2
Pages
263-272
ISSN
0002-8223 (ISSN-L)
DOI
10.1016/j.jada.2008.10.049
PMC
PMC2680723
OpenAlex
W2153632139
Cited by
154
References
23
Citations by year
2026: 3 · 2025: 7 · 2024: 13 · 2023: 11 · 2022: 10 · 2021: 15 · 2020: 7 · 2019: 13 · 2018: 11 · 2017: 8 · 2016: 5 · 2015: 8 · 2014: 11 · 2013: 6 · 2012: 7
FWCI
8.74
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Dietetic Association (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5r01dk059362-02)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK059362-01A2, R01 DK059362)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
Keywords
type 2 diabetes, vegan diet, low-fat diet, dietary adherence, diet acceptability, macronutrient intake, dietary restraint, hunger, food cravings, American Diabetes Association guidelines, medical nutrition therapy, dietary fat and cholesterol
MeSH terms
Adult, Aged, Aged, 80 and over, Blood Glucose, Cholesterol, Dietary, Diabetes Mellitus, Type 2, Diet, Diabetic, Diet, Reducing, Dietary Carbohydrates, Dietary Fats, Dietary Fiber, Dietary Proteins, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Obesity, Patient Acceptance of Health Care, Patient Compliance, Surveys and Questionnaires, Diet, Vegetarian, Weight Loss, Chi-Square Distribution, Treatment Outcome, Patient Satisfaction, Diet, Fat-Restricted

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