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APHA Scientific Session and Event Listing

Recorded presentation

Neal D. Barnard, MD¹, Joshua Cohen, MD¹, David J.A. Jenkins, MD, PhD², and Gabrielle Turner-McGrievy, MS, RD³. (1) Department of Medicine, George Washington University, 5100 Wisconsin Avenue, Suite 400, Washington, DC 20016, 202-686-2210, ext 303, nbarnard@pcrm.org, (2) University of Toronto, 150 College Street, Room 339, Toronto, ON M5S 3E2, Canada, (3) School of Public Health, University of North Carolina, 5100 Wisconsin Avenue, Suite 400, Washington, DC 20016

Type 2 diabetes is often devastating. However, preliminary evidence suggests that low-fat, plant-based diets greatly improve glycemic control. In a controlled trial, we randomly assigned 99 individuals with type 2 diabetes to a low-fat, vegan diet or a diet following American Diabetes Association (ADA) guidelines. Glycosylated hemoglobin (A1c), plasma lipids, urinary albumin, and body weight were assessed at baseline and 22 weeks. Medications were reduced, primarily due to hypoglycemia, in 21/49 vegan and 13/50 ADA participants. A clinically significant improvement, defined as either an A1c reduction of Ан1 point or any diabetes medication reduction, occurred in 69% of vegan-group and 46% of ADA-group participants (P = 0.02). Among all participants, without regard to medication changes, A1c fell 0.96 percentage points in the vegan group and 0.56 points in the ADA group (P = 0.089). Among medication-stable participants, A1c fell 1.23 points in the vegan group and 0.38 points in the ADA group (P = 0.01). Body weight fell 6.5 kg in the vegan group and 3.1 kg in the ADA group (P < 0.001). Among participants whose lipid-lowering agents remained unchanged, total cholesterol fell 17.6% in the vegan group and 9.7% in the ADA group (P = 0.0125). LDL cholesterol fell 21.2% in the vegan group and 9.3% in the ADA group (P = 0.023). Baseline-adjusted urinary albumin changes were greater in the vegan group (-15.9 mg/24h vs -10.9 mg/24h, P = 0.013). In conclusion, a low-fat, vegan diet is highly effective for glycemic, lipid, and weight control in type 2 diabetes, compared with a diet following ADA guidelines.

Learning Objectives:

• Describe four significant clinical improvements observed with the intervention diet.
• Articulate the basic nutritional guidelines for a low-fat, vegan diet used for type 2 diabetes.
• Describe the differences in outcome between the intervention diet and a diet following current American Diabetes Association guidelines.

Keywords: Diabetes, Nutrition

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation