ResearchCurrent ResearchA 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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Participants
The overall study methods have been previously described (4). Briefly, individuals with type 2 diabetes, defined by a fasting plasma glucose concentration ≥126 mg/dL (≥7.0 mmol/L) on two occasions or a prior physician's diagnosis of type 2 diabetes with the use of hypoglycemic medications for at least 6 months, were recruited through newspaper advertisements in the Washington, DC, area in two cohorts (October through December 2004 and October through December 2005), to complete the 74-week
Participants
Of 1,049 individuals initially screened by telephone, 99 met study criteria and were randomly assigned to the ADbA guidelines (n=50) or vegan (n=49) diet groups. The reasons for exclusion were hemoglobin A1c values outside the required range (n=201), failure to meet other participation criteria (n=279), inability to attend scheduled meetings (n=187), failure to keep interview appointment (n=153), reluctance to change diet (n=72), and other or unspecified (n=58). The sample was predominantly
Discussion
In this group of self-selected research volunteers, those assigned to a low-fat vegan diet reported major changes in nutrient intake that largely persisted for 74 weeks. Reductions in reported fat, saturated fat, and cholesterol intake and increases in carbohydrate and fiber intake were greater in the vegan group, compared with the ADbA guidelines group. These changes are similar to those reported in earlier studies using low-fat vegan diets (13). Neither diet was associated with increases in
Conclusions
Among individuals with type 2 diabetes in a research study, a low-fat vegan diet led to greater reductions in fat, saturated fat, and cholesterol intake and greater increases in fiber and complex carbohydrate intake, compared with a diet following 2003 ADbA guidelines, but was not viewed as less acceptable. Acceptability to patients should not be viewed as a barrier to its clinical use. The vegan diet requires marginally more initial effort, but was experienced as less constraining initially,
N. D. Barnard is with the Department of Medicine, George Washington University, Washington, DC, and founder and president of the Physicians Committee for Responsible Medicine, Washington, DC
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N. D. Barnard is with the Department of Medicine, George Washington University, Washington, DC, and founder and president of the Physicians Committee for Responsible Medicine, Washington, DC
J. Cohen is with the Department of Medicine, George Washington University School of Medicine, Washington, DC
A. A. Green is a staff dietitian, Physicians Committee for Responsible Medicine, Washington, DC
L. Gloede is with Nutrition Coaching, LLC, Arlington, VA
D. J. A. Jenkins is with the Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, and Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Canada
G. Turner-McGrievy is with the Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill
H. Ferdowsian is with the Department of Medicine, George Washington School of Medicine, Washington, DC, and is director of research policy, Physicians Committee for Responsible Medicine, Washington, DC
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