The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
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
Open accessAbstract
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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Very low-fat patterns are characterized predominantly by having ≤10% energy from fat. 37,[39][40][41]57,58”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [57]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger
Stunkard, A. J., & Messick, S. (1985) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(85)90010-8 · Cited by 4,687 · cited 2×
“Restraint, disinhibition, and hunger, as reported using the Eating Inventory instrutment (10), indicating changes from baseline to 22”
BackgroundMethodBantle (2008) · doi:10.2337/dc08-s061 · Cited by 1,795
Intensive Lifestyle Changes for Reversal of Coronary Heart Disease
Ornish, D. (1998) · JAMA · doi:10.1001/jama.280.23.2001 · Cited by 1,730 · cited 2×
“Vegetarian and vegan diets have demonstrated efficacy in the management of cardiovascular disease (22), weight problems (26), and diabetes (4).”
BackgroundFranz, M. J., Bantle, J. P., Beebe, C. A., Brunzell, J. D., Chiasson, J.-L., Garg, A., Holzmeister, L. A., Hoogwerf, B., Mayer-Davis, E., Mooradian, A. D., et al. (2002) · Diabetes Care · doi:10.2337/diacare.25.1.148 · Cited by 1,165
Sources of data for developing and maintaining a nutrient database.
Schakel, S., Sievert, Y. A., & Buzzard, I. M. (1988) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(21)07997-9 · Cited by 757 · cited 2×
“0, Food and Nutrient Database 35, 2004, Nutrition Coordinating Center, University of Minnesota, Minneapolis) (9) and reported instances of poor dietary adherence to the RDs responsible for the initial dietary instruction for additional dietary counseling as needed.”
BackgroundInfluentialDevelopment and Validation of the Food‐Craving Inventory
White, M. A., Whisenhunt, B. L., Williamson, D. A., Greenway, F. L., & Netemeyer, R. G. (2002) · Obesity Research · doi:10.1038/oby.2002.17 · Cited by 471 · cited 5×
“Cravings, as reported using the Food-Craving Inventory (12), indicating changes from baseline to 22 weeks and from baseline to 74”
BackgroundMethodInfluentialBarnard, N. D., Cohen, J., Jenkins, D. J. A., Turner-McGrievy, G., Gloede, L., Jaster, B., Seidl, K., Green, A. A., & Talpers, S. (2006) · Diabetes Care · doi:10.2337/dc06-0606 · Cited by 468
Self-citationPosition of the American Dietetic Association and Dietitians of Canada: Vegetarian diets
(2003) · Journal of the American Dietetic Association · doi:10.1053/jada.2003.50142 · Cited by 414
Assessment of Group Versus Individual Diabetes Education
Rickheim, P., Weaver, T. W., Flader, J. L., & Kendall, D. M. (2002) · Diabetes Care · doi:10.2337/diacare.25.2.269 · Cited by 400
Johansson, G. K., Wikman, Å., Åhrén, A.-M., Hallmans, G., & Johansson, I. (2001) · Public Health Nutrition · doi:10.1079/phn2001124 · Cited by 389 · cited 1×
“Dietary intake was based on self-report, which is vulnerable to distortion based on participants’ tendency to provide socially desirable responses and to underreporting, especially in individuals with higher body mass indexes (28).”
BackgroundSadur, C. N., Moline, N., Costa, M., Michalik, D., Mendlowitz, D. R., Roller, S., Watson, R., Swain, B. E., Selby, J. V., & Javorski, W. C. (1999) · Diabetes Care · doi:10.2337/diacare.22.12.2011 · Cited by 349 · cited 1×
“Attrition was low in older individuals (6% in a 10-week study [2] and 8% in a 6-month study [14]), and higher in a California Health Maintenance Organization study (15% at 5 months) (15), a Costa Rican study (19% at 12 weeks) (16), two Minneapolis studies (18% [17] and 46% [18], both at 6 months), and an urban Atlanta…”
BackgroundFRANZ, M. J., MONK, A., BARRY, B., McCLAIN, K., WEAVER, T., COOPER, N., UPHAM, P., BERGENSTAL, R., & MAZZE, R. S. (1995) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(95)00276-6 · Cited by 289
Improving self-care among older patients with type II diabetes: The “sixty something…” Study
Glasgow, R. E., Toobert, D. J., Hampson, S. E., Brown, J., Lewinsohn, P. M., & Donnelly, J. (1992) · Patient Education and Counseling · doi:10.1016/0738-3991(92)90102-o · Cited by 219 · cited 1×
“04 Service occupation 3 (6) 7 (14) Technical, sales, administrative 16 (33) 18 (36) Professional or managerial 15 (31) 21 (42) Retired 15 (31) 4 (8) Years since diabetes diagnosis”
Type 2 diabetes and the vegetarian diet
Jenkins, D. J., Kendall, C. W., Marchie, A., Jenkins, A. L., Augustin, L. S., Ludwig, D. S., Barnard, N. D., & Anderson, J. W. (2003) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/78.3.610s · Cited by 209 · cited 4×
“0-74 wks 5 (5-6) 5 (5-6) 0 (0 to 11) 5 (4-6) 5 (4-6) 0 (0 to 11) 0.”
BackgroundInfluentialSelf-citationMiller, C. K., Edwards, L., Kissling, G., & Sanville, L. (2002) · Preventive Medicine · doi:10.1006/pmed.2001.0985 · Cited by 194
Goldhaber‐Fiebert, J. D., Goldhaber-Fiebert, S. N., Tristán, M. L., & Nathan, D. M. (2003) · Diabetes Care · doi:10.2337/diacare.26.1.24 · Cited by 163 · cited 1×
“Attrition was low in older individuals (6% in a 10-week study [2] and 8% in a 6-month study [14]), and higher in a California Health Maintenance Organization study (15% at 5 months) (15), a Costa Rican study (19% at 12 weeks) (16), two Minneapolis studies (18% [17] and 46% [18], both at 6 months), and an urban Atlanta…”
BackgroundA Two‐Year Randomized Weight Loss Trial Comparing a Vegan Diet to a More Moderate Low‐Fat Diet
Turner‐McGrievy, G. M., Barnard, N. D., & Scialli, A. R. (2007) · Obesity · doi:10.1038/oby.2007.270 · Cited by 143 · cited 1×
“Vegetarian and vegan diets have demonstrated efficacy in the management of cardiovascular disease (22), weight problems (26), and diabetes (4).”
BackgroundSelf-citationZiemer, D. C., Berkowitz, K. J., Panayioto, R. M., El-Kebbi, I. M., Musey, V. C., Anderson, L. A., Wanko, N. S., Fowke, M. L., Brazier, C. W., Dunbar, V. G., et al. (2003) · Diabetes Care · doi:10.2337/diacare.26.6.1719 · Cited by 68 · cited 1×
“Attrition was low in older individuals (6% in a 10-week study [2] and 8% in a 6-month study [14]), and higher in a California Health Maintenance Organization study (15% at 5 months) (15), a Costa Rican study (19% at 12 weeks) (16), two Minneapolis studies (18% [17] and 46% [18], both at 6 months), and an Urban Atlanta…”
BackgroundBarnard, N., Scialli, A., Turner-McGrievy, G. M., & Lanou, A. (2004) · Journal of Cardiopulmonary Rehabilitation (JCR) · doi:10.1097/00008483-200407000-00004 · Cited by 61
Self-citationWilson, D., Bogacz, J. P., Forsythe, C. M., Turk, P. J., Lane, T. L., Gates, R. C., & Brandt, D. (1993) · Clinical Chemistry · doi:10.1093/clinchem/39.10.2090 · Cited by 57 · cited 6×
“04 Service occupation 3 (6) 7 (14) Technical, sales, administrative 16 (33) 18 (36) Professional or managerial 15 (31) 21 (42) Retired 15 (31) 4 (8) Years since diabetes diagnosis”
BackgroundMethodInfluentialTurner‐McGrievy, G. M., Barnard, N. D., Scialli, A. R., & Lanou, A. J. (2004) · Nutrition · doi:10.1016/j.nut.2004.05.005 · Cited by 54 · cited 1×
“These changes are similar to those reported in earlier studies using low-fat vegan diets (13).”
ResultSelf-citationAcceptability of a Therapeutic Low-Fat, Vegan Diet in Premenopausal Women
Barnard, N. D., Scialli, A. R., Bertron, P., Hurlock, D., & Edmonds, K. (2000) · Journal of Nutrition Education · doi:10.1016/s0022-3182(00)70590-5 · Cited by 35
Self-citationAdherence and Acceptability of a Low-Fat, Vegetarian Diet Among Patients With Cardiac Disease
Barnard, N. D., Scherwitz, L. W., & Ornish, D. M. (1992) · Journal of Cardiopulmonary Rehabilitation · doi:10.1097/00008483-199211000-00009 · Cited by 30 · cited 1×
“In a study of a program of lifestyle changes for reversing coronary atherosclerosis, there were no identifiable differences in the acceptability of a low-fat, vegetarian diet, compared to the diets followed by control participants referred to their physicians for cardiac care (21).”
BackgroundSelf-citation
Research works printed but not linked: 5
- 2008, Nutrition recommendations and interventions for diabetes, Diabetes Care, 31, S61
- Ziemer, 2003, 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, 26, 1719, 10.2337/diacare.26.6.1719 · DOI · Paper page
- Barnard, 2000, Acceptability of a therapeutic low-fat, vegan diet in premenopausal women, J Nutr Educ, 32, 314, 10.1016/S0022-3182(00)70590-5 · DOI
- Barnard, 2004, 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, 24, 229, 10.1097/00008483-200407000-00004 · DOI
- Smith, 1999, Young adults remain on vegetarian diet longer than on weight loss diets, Ann Behav Med, 21, S90
Cited by
Sorted by citations
Ajala, O., English, P., & Pinkney, J. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.042457 · Cited by 821
“Additional analysis at 18 mo (29) showed an advantage of vegetarian diets in terms of glycemic control and lipid profile but not in weight loss (48).”
BackgroundBarnard, N. D., Cohen, J., Jenkins, D. J., Turner-McGrievy, G., Gloede, L., Green, A., & Ferdowsian, H. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.26736h · Cited by 449
“The acceptability of low-fat vegetarian and vegan diets has been shown to be similar to that of other therapeutic diets in studies of individuals with cardiovascular disease (8), young women with dysmenorrhea (9), overweight but otherwise healthy postmenopausal women (10), and the current study population (30).”
Self-citationA Comprehensive Review of the Benefits of and the Barriers to the Switch to a Plant-Based Diet
Fehér, A., Gazdecki, M., Véha, M., Szakály, M., & Szakály, Z. (2020) · Sustainability · doi:10.3390/su12104136 · Cited by 362
The Evidence for Medical Nutrition Therapy for Type 1 and Type 2 Diabetes in Adults
Franz, M. J., Powers, M. A., Leontos, C., Holzmeister, L. A., Kulkarni, K. D., Monk, A. M., Wedel, N., & Gradwell, E. (2010) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2010.09.014 · Cited by 324
Can We Say What Diet Is Best for Health?
Katz, D. L., & Meller, S. (2014) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-032013-182351 · Cited by 378
Metadata
- 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.
- 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)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 (medical) › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
