A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial
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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DOI：
10.3945/ajcn.2009.26736h
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发表时间：
2009-05-01
影响因子：
7.1
通讯作者：
Ferdowsian, Hope
中科院分区：
文献类型：
--
作者：
Barnard, Neal D.;Cohen, Joshua;Ferdowsian, Hope
背景资料：低脂素食和纯素饮食与减肥、增加胰岛素敏感性和改善心血管健康有关。目的：我们比较了低脂纯素饮食和传统糖尿病饮食建议对糖尿病、体重和血脂的影响。设计：自由生活的2型糖尿病患者被随机分配到低脂纯素饮食组（n = 49）或遵循2003年美国糖尿病协会指南的饮食组（常规组，n = 50）74 wk。在第0、11、22、35、48、61和74周评估糖化血红蛋白（Hb A（1c））和血脂。结果：两组间体重差异无统计学意义（纯素组为-4.4kg，常规饮食组为-3.0kg，P = 0.25），但体重下降与Hb A（1c）变化显著相关（r = 0.50，P = 0.001）。从基线到74 wk或最后可用值的Hb A（1c）变化，素食和常规饮食分别为-0.34和-0.14（P = 0.43）。素食和常规饮食组HbA（1c）从基线到最后一个可用值或任何药物调整前的最后一个值的变化分别为-0.40和0.01（P = 0.03）。在改变降脂药物前的分析中，素食和传统饮食组的总胆固醇分别降低了20.4和6.8 mg/dL（P = 0.01）;低密度脂蛋白胆固醇分别降低了13.5和3.4 mg/dL，素食组和传统组，结论：两种饮食均与体重和血浆脂质浓度的持续降低相关。在一项控制药物变化的分析中，低脂纯素饮食似乎比传统的糖尿病饮食建议更能改善血糖和血脂。观察到的差异是否为糖尿病的大血管或微血管并发症提供临床益处仍有待确定。本试验在clinicaltrials.gov上注册为NCT 00276939。Am J Clin Nutr 2009; 89（增刊）：1588 S-96 S。
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. Am J Clin Nutr 2009; 89(suppl): 1588S-96S.