150763 Plant-based diet intervention for type 2 diabetes: Follow-up results from a randomized clinical trial

Monday, November 5, 2007

Neal D. Barnard, MD , Department of Medicine, George Washington University, Washington, DC
Joshua Cohen, MD , Department of Medicine, George Washington University, Washington, DC
David J.A. Jenkins, MD, PhD , University of Toronto, Toronto, ON, Canada
Gabrielle Turner-McGrievy, PHD, MS, RD , School of Public Health, University of North Carolina, Chapel Hill, NC
Hope Ferdowsian, MD, MPH , Washington Center for Clinical Research, Washington, DC
Diabetes prevalence is increasing at an alarming rate. Prevalence is lower, however, among populations following largely plant-based diets. We previously reported that, in a 22-week trial, a low-fat, vegan diet improved glycemic, lipid, and weight control in persons with type 2 diabetes. We now present final results after an additional year of study (74 weeks total). Individuals with type 2 diabetes were randomly assigned to a low-fat, vegan diet or a diet following American Diabetes Association (ADA) guidelines. Of 99 initial participants, 87 (42 vegan, 45 ADA) completed the full study. A1c changes from baseline to 74 weeks (or to the last value prior to any medication changes) were -0.40 (vegan, P=0.003) and +0.01 (ADA, P=0.47), between-group P=0.03. Among those who met dietary adherence criteria, A1c changes were -0.45 (vegan, N = 21) and -0.31 (ADA, N = 16), P=0.66. Among 74-week completers whose medications remained unchanged, A1c changes were -0.82 (vegan, n=14) and -0.21 (ADA, n=21), P=0.14. Total and LDL cholesterol changes from baseline to 74 weeks (or to last value prior to lipid-lowering medication changes) were: TC: -20.4 mg/dl (vegan), -6.8 mg/dl (ADA); P=0.01; LDL: -14.0 mg/dl (vegan), -3.4 mg/dl (ADA), P=0.03. Weight changes, based on 74-week or last available values, were -4.4 kg (vegan, P<0.0001) and -3.0 kg (ADA, P=0.0003); between-group P=0.25. In conclusion, in individuals with type 2 diabetes in a research setting, a low-fat, vegan diet led to sustained improvements in glycemic, lipid, and weight control.

Learning Objectives:
Quantify the effects of a low-fat, vegan diet and a diet based on American Diabetes Association guidelines on glycemic, lipid, and weight control. Describe the putative cellular mechanisms by which a low-fat, vegan diet improves glycemic control. List the basic guidelines for constructing a meal plan using such a diet.

Presenting author's disclosure statement:

Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Rodale Book on diet and diabetes Book publication

Any company-sponsored training? No
 Any institutionally-contracted trials related to this submission? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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