Cited by 452Nutritional Studies and DietDiet and metabolism studiesDiabetes, Cardiovascular Risks, and Lipoproteins

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A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial

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Barnard, Neal D, Cohen, Joshua, Jenkins, David JA, Turner-McGrievy, Gabrielle, Gloede, Lise, Green, Amber, Ferdowsian, Hope·2009·The American Journal of Clinical Nutrition

DOI 10.3945/ajcn.2009.26736hPMC PMC2677007

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Abstract

Background Low-fat vegetarian and vegan diets are associated with weight loss, increased insulin sensitivity, and improved cardiovascular health.Objective We compared the effects of a low-fat vegan diet and conventional diabetes diet recommendations on glycemia, weight, and plasma lipids.Design Free-living individuals with type 2 diabetes were randomly assigned to a low-fat vegan diet (n = 49) or a diet following 2003 American Diabetes Association guidelines (conventional, n = 50) for 74 wk. Glycated hemoglobin (Hb A(1c)) and plasma lipids were assessed at weeks 0, 11, 22, 35, 48, 61, and 74. Weight was measured at weeks 0, 22, and 74.Results Weight loss was significant within each diet group but not significantly different between groups (-4.4 kg in the vegan group and -3.0 kg in the conventional diet group, P = 0.25) and related significantly to Hb A(1c) changes (r = 0.50, P = 0.001). Hb A(1c) changes from baseline to 74 wk or last available values were -0.34 and -0.14 for vegan and conventional diets, respectively (P = 0.43). Hb A(1c) changes from baseline to last available value or last value before any medication adjustment were -0.40 and 0.01 for vegan and conventional diets, respectively (P = 0.03). In analyses before alterations in lipid-lowering medications, total cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet groups, respectively (P = 0.01); LDL cholesterol decreased by 13.5 and 3.4 mg/dL in the vegan and conventional groups, respectively (P = 0.03).Conclusions 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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Authors: Barnard, N. D., Cohen, J., Jenkins, D. J., Turner-McGrievy, G., Gloede, L., Green, A., & Ferdowsian, H.
Affiliations: University of North Carolina at Chapel Hill (US)
Corresponding author: Barnard, Neal D
ORCID: Barnard, Neal D
Cohen, Joshua
Jenkins, David JA
Ferdowsian, Hope
Venue: The American Journal of Clinical Nutrition
Publisher: Elsevier BV
Published: 2009-05
Volume: 89
Issue: 5
Pages: 1588S-1596S
ISSN: 0002-9165 (ISSN-L)
DOI: 10.3945/ajcn.2009.26736h
PMC: PMC2677007
OpenAlex: W2114345764
Cited by: 449
References: 66
Citations by year: 2026: 16 · 2025: 25 · 2024: 33 · 2023: 35 · 2022: 30 · 2021: 28 · 2020: 35 · 2019: 43 · 2018: 21 · 2017: 22 · 2016: 22 · 2015: 23 · 2014: 29 · 2013: 19 · 2012: 14
FWCI: 22.08
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 5056 d)
Locations: American Journal of Clinical Nutrition (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Diabetes Action Research and Education Foundation
George Washington University
Physicians Committee for Responsible Medicine
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 › Physiology (medical) › Diet and metabolism studies
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: vegetarian diet, HbA1c, glycemic control, weight loss, plasma lipids, LDL cholesterol, total cholesterol, lipid-lowering drugs
MeSH terms: Blood Glucose, Body Weight, Cholesterol, Diabetes Mellitus, Type 2, Dietary Fats, Glycated Hemoglobin, Humans, Lipoproteins, HDL, Lipoproteins, LDL, Time Factors, Diet, Vegetarian, Vitamin B 12, Weight Loss, Diet Records, Diet, Fat-Restricted, Dietary Supplements

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A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial

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