TOPLINE:
A low-fat vegan diet — high in fiber and carbohydrates and moderate in protein — reduces insulin requirement, increases insulin sensitivity, and improves glycemic control in individuals with type 1 diabetes (T1D) compared with a conventional portion-controlled diet.
METHODOLOGY: The effects of a low-fat vegan diet (without carbohydrate or portion restriction) were compared with those of a conventional portion-controlled, carbohydrate-controlled diet in 58 patients with T1D (age, ≥ 18 years) who had been receiving stable insulin treatment for the past 3 months. Participants were randomly assigned to receive either the vegan diet (n=29), comprising vegetables, grains, legumes, and fruits, or the portion-controlled diet (n=29), which reduced daily energy intake by 500-1000 kcal/d in participants with overweight while maintaining a stable carbohydrate intake. The primary clinical outcomes were insulin requirement (total daily dose of insulin), insulin sensitivity, and glycemic control (A1c). Other assessments included the blood lipid profile, blood urea nitrogen, blood urea nitrogen-to-creatinine ratio, and body weight. TAKEAWAY: The study was completed by 18 participants in the vegan-diet group and 17 in the portion-controlled group. In the vegan group, the total daily dose of insulin decreased by 12.1 units/d (P=.007) and insulin sensitivity increased by 6.6 g of carbohydrate per unit of insulin on average (P=.002), with no significant changes in the portion-controlled diet group. Participants on the vegan diet had lower levels of total and low-density lipoprotein cholesterol and blood urea nitrogen and a lower blood urea nitrogen-to-creatinine ratio (P for all <.001), whereas both vegan and portion-controlled groups had lower A1c levels. Body weight decreased by 5.2 kg (P <.001) in the vegan group; there were no significant changes in the portion-controlled group. For every 1-kg weight loss, there was a 2.16-unit decrease in the insulin total daily dose and a 0.9-unit increase in insulin sensitivity. IN PRACTICE:
“This study provides substantial support for a low-fat vegan diet that is high in fiber and carbohydrates, low in fat, and moderate in protein” and suggests the potential therapeutic use of this diet in type 1 diabetes management, the authors wrote.
SOURCE:
The study led by Hana Kahleova, MD, PhD, Physicians Committee for Responsible Medicine, Washington, DC, was published in Clinical Diabetes.
LIMITATIONS:
Dietary intake was recorded on the basis of self-reported data. A higher attrition rate was observed due to meal and blood glucose monitoring. The findings may have limited generalizability as the study participants comprised those seeking help for T1D.
DISCLOSURES:
The study was supported by the Physicians Committee for Responsible Medicine and a grant from the Institute for Technology in Healthcare. Some authors reported receiving compensation, being cofounders of a coaching program, writing books, providing nutrition coaching, giving lectures, or receiving royalties and honoraria from various sources.
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