Diet effects on clinical measures
| . | Vegan group (n = 49, except as noted) . | . | . | ADA group (n = 50, except as noted) . | . | . | . | P value . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| . | Baseline . | 22 weeks . | Change . | Baseline . | 22 weeks . | Change . | Effect size . | . | |||||
| Anthropometric and glycemic variables | |||||||||||||
| All participants | |||||||||||||
| A1C (%) | 8.0 ± 1.1 | 7.1 ± 1.0 | −1.0 ± 1.2* | 7.9 ± 1.0 | 7.4 ± 1.0 | −0.6 ± 1.1† | −0.4 (−0.9 to 0.1) | 0.09 | |||||
| Fasting plasma glucose (mmol/l) | 9.08 ± 2.95 | 7.11 ± 1.97 | −1.97 ± 2.68* | 8.90 ± 2.26 | 6.98 ± 1.91 | 1.92 ± 2.48* | −0.05 (−1.08 to 0.98) | 0.92 | |||||
| Fasting plasma glucose (mg/dl) | 163.5 ± 53.2 | 128.0 ± 35.5 | −35.5 ± 48.3* | 160.4 ± 40.7 | 125.8 ± 34.4 | −34.6 ± 44.7* | −0.9 (−19.5 to 17.6) | 0.92 | |||||
| Weight (kg) | 97.0 ± 22.9 | 91.1 ± 22.4 | −5.8 ± 4.4* | 99.3 ± 21.0 | 95.0 ± 20.9 | −4.3 ± 4.4* | −1.6 (−3.3 to 0.2) | 0.08 | |||||
| BMI (kg/m2) | 33.9 ± 7.8 | 31.8 ± 7.5 | −2.1 ± 1.5* | 35.9 ± 7.0 | 34.3 ± 7.3 | −1.5 ± 1.5* | −0.6 (−1.2 to 0.1) | 0.08 | |||||
| Waist (cm) | 110.8 ± 18.4 | 105.5 ± 18.1 | −5.3 ± 4.4* | 112.3 ± 14.9 | 109.5 ± 14.7 | −2.8 ± 4.7* | −2.5 (−4.3 to −0.7) | 0.008 | |||||
| Hip (cm) | 118.4 ± 17.8 | 114.5 ± 17.8 | −3.9 ± 3.4* | 121.3 ± 12.7 | 117.5 ± 12.2 | −3.8 ± 3.9* | −0.1 (−1.5 to 1.4) | 0.94 | |||||
| Waist-to-hip ratio (cm) | 0.94 ± 0.08 | 0.92 ± 0.07 | −0.02 ± 0.03‡ | 0.93 ± 0.07 | 0.93 ± 0.07 | 0.01 ± 0.04 | −0.02 (−0.03 to 0.01) | 0.003 | |||||
| Participants whose diabetes medications remained unchanged (n = 24 vegan, n = 33 ADA) | |||||||||||||
| A1C (%) | 8.07 ± 1.24 | 6.84 ± 0.84 | −1.23 ± 1.38† | 7.88 ± 0.93 | 7.50 ± 1.03 | −0.38 ± 1.11 | −0.85 (−1.51 to −0.19) | 0.01 | |||||
| Fasting plasma glucose (mmol/l) | 9.85 ± 2.95 | 7.12 ± 1.80 | 2.73 ± 3.05† | 8.90 ± 2.05 | 7.34 ± 2.05 | 1.57 ± 2.50‡ | −1.17 (−2.64 to 0.31) | 0.12 | |||||
| Fasting plasma glucose (mg/dl) | 177.4 ± 53.2 | 128.2 ± 32.4 | −49.2 ± 55.0† | 160.3 ± 37.0 | 132.2 ± 36.9 | −28.2 ± 45.0‡ | −21.1 (−47.6 to 5.5) | 0.12 | |||||
| Weight (kg) | 102.4 ± 23.6 | 95.9 ± 22.4 | −6.5 ± 4.3* | 100.0 ± 19.4 | 96.9 ± 19.1 | −3.1 ± 3.4* | −3.4 (−5.5 to −1.4) | 0.001 | |||||
| BMI (kg/m2) | 36.1 ± 7.5 | 33.8 ± 7.2 | −2.3 ± 1.5* | 36.0 ± 5.8 | 34.9 ± 5.9 | −1.1 ± 1.2* | −1.2 (−1.9 to −0.5) | 0.001 | |||||
| Waist (cm) | 115.3 ± 17.9 | 110.3 ± 17.8 | −5.0 ± 3.7* | 113.3 ± 13.1 | 111.0 ± 13.5 | −2.3 ± 4.2‡ | −2.7 (−4.8 to −0.5) | 0.017 | |||||
| Hip (cm) | 123.3 ± 17.4 | 119.1 ± 17.3 | −4.1 ± 2.8* | 121.7 ± 12.1 | 118.6 ± 11.6 | −3.1 ± 3.3* | −1.0 (−2.7 to 0.7) | 0.23 | |||||
| Waist-to-hip ratio (cm) | 0.94 ± 0.08 | 0.93 ± 0.07 | −0.01 ± 0.03 | 0.93 ± 0.07 | 0.94 ± 0.08 | 0.00 ± 0.04 | −0.02 (−0.03 to 0.00) | 0.10 | |||||
| Renal variable | |||||||||||||
| Urinary albumin/24 h | 33.0 ± 51.8 | 14.6 ± 17.8 | −18.4 ± 39.0‡ | 55.0 ± 263.1 | 43.7 ± 212.0 | −11.3 ± 53.9 | −7.1 (−25.9 to 11.7) | 0.45 | |||||
| With albumin >30 mg/24 h (m) | 12 | 5 | −7 | 8 | 6 | −2 | NA | NA | |||||
| Blood pressure (n = 48 vegan, n = 50 ADA) (mmHg)§ | |||||||||||||
| Systolic | 123.8 ± 17.1 | 120.0 ± 18.3 | −3.8 ± 12.6‖ | 122.9 ± 15.1 | 119.4 ± 16.5 | −3.6 ± 13.7 | −0.2 (−5.5 to 5.1) | 0.93 | |||||
| Diastolic | 77.9 ± 11.1 | 72.8 ± 10.2 | −5.1 ± 8.3* | 80.0 ± 10.5 | 76.7 ± 11.1 | −3.3 ± 8.8‖ | −1.8 (−5.2 to 1.6) | 0.30 | |||||
| All participants | |||||||||||||
| Total cholesterol (mg/dl) | 187.0 ± 37.4 | 159.3 ± 31.9 | −27.7 ± 28.5* | 198.9 ± 44.0 | 174.6 ± 36.2 | −24.2 ± 30.5* | −3.5 (−15.3 to 8.3) | 0.56 | |||||
| HDL cholesterol (mg/dl) | 52.3 ± 19.7 | 47.3 ± 16.9 | −5.0 ± 7.1* | 49.8 ± 14.5 | 46.6 ± 11.8 | −3.2 ± 11.0‖ | −1.8 (−5.5 to 1.9) | 0.34 | |||||
| Non-HDL cholesterol (mg/dl) | 134.7 ± 39.2 | 112.0 ± 31.9 | −22.7 ± 28.2* | 149.0 ± 44.1 | 128.0 ± 35.0 | −21.0 ± 31.5* | −1.7 (−13.6 to 10.2) | 0.78 | |||||
| Total cholesterol/HDL (mg/dl) | 4.0 ± 1.6 | 3.7 ± 1.2 | −0.3 ± 0.9‖ | 4.3 ± 1.7 | 3.9 ± 1.2 | −0.4 ± 1.2‖ | −0.0 (−0.4 to 0.4) | 0.92 | |||||
| LDL cholesterol (n = 49 vegan, n = 48 ADA) (mg/dl)¶ | 104.4 ± 32.9 | 88.0 ± 27.8 | −16.4 ± 30.6† | 118.5 ± 41.5 | 103.1 ± 33.3 | −15.4 ± 25.1* | −1.0 (−12.3 to 10.3) | 0.86 | |||||
| VLDL cholesterol (n = 47 vegan, n = 47 ADA) (mg/dl) | 26.2 ± 14.4 | 23.0 ± 10.2 | −3.2 ± 10.0‖ | 26.8 ± 13.8 | 22.3 ± 10.0 | −4.4 ± 12.4‖ | 1.2 (−3.4 to 5.8) | 0.60 | |||||
| Triglycerides (mg/dl) | 148.1 ± 112.5 | 119.7 ± 56.0 | −28.5 ± 80.0‖ | 158.1 ± 133.1 | 132.9 ± 114.4 | −25.1 ± 124.7 | −3.3 (−45.2 to 38.6) | 0.87 | |||||
| Log triglycerides | 2.08 ± 0.28 | 2.03 ± 0.21 | −0.05 ± 0.17‖ | 2.11 ± 0.25 | 2.05 ± 0.23 | −0.07 ± 0.20‖ | 0.02 (−0.05 to 0.09) | 0.61 | |||||
| Participants with no changes to lipid-controlling medications (n = 39 vegan, n = 41 ADA, except as noted) | |||||||||||||
| Total cholesterol (mg/dl) | 190.5 ± 36.8 | 156.9 ± 25.1 | −33.5 ± 21.5* | 194.9 ± 40.9 | 175.9 ± 36.2 | −19.0 ± 28.5* | −14.5 (−25.8 to −3.2) | 0.01 | |||||
| HDL cholesterol (mg/dl) | 54.6 ± 21.0 | 48.6 ± 18.4 | −6.0 ± 6.8* | 49.2 ± 15.5 | 46.4 ± 12.2 | −2.8 ± 11.6 | −3.2 (−7.5 to 1.1) | 0.14 | |||||
| Non-HDL cholesterol (mg/dl) | 135.9 ± 38.4 | 108.3 ± 25.6 | −27.6 ± 21.1* | 145.7 ± 42.9 | 129.4 ± 35.9 | −16.3 ± 30.1‖ | −11.3 (−22.9 to 0.3) | 0.05 | |||||
| Total cholesterol/HDL (mg/dl) | 3.9 ± 1.5 | 3.6 ± 1.2 | −0.3 ± 0.6‡ | 4.4 ± 1.8 | 4.0 ± 1.3 | −0.3 ± 1.2 | −0.0 (−0.4 to 0.4) | 0.98 | |||||
| LDL cholesterol (n = 39 vegan, n = 39 ADA) (mg/dl)¶ | 107.3 ± 34.3 | 84.6 ± 22.5 | −22.6 ± 22.0* | 115.3 ± 40.4 | 104.6 ± 33.7 | −10.7 ± 23.3‖ | −11.9 (−22.2 to −1.7) | 0.02 | |||||
| VLDL cholesterol (n = 38 n = vegan, 38 ADA) (mg/dl) | 26.6 ± 15.4 | 23.1 ± 10.9 | −3.5 ± 10.5‖ | 25.5 ± 13.2 | 21.7 ± 9.0 | −3.8 ± 12.1 | 0.4 (−4.8 to 5.6) | 0.89 | |||||
| Triglycerides (mg/dl) | 140.3 ± 89.1 | 118.2 ± 57.3 | −22.2 ± 58.5‖ | 157.4 ± 143.0 | 134.6 ± 122.9 | −22.8 ± 134.3 | 0.6 (−45.9 to 47.2) | 0.98 | |||||
| Log triglycerides | 2.06 ± 0.28 | 2.02 ± 0.22 | −0.04 ± 0.16 | 2.11 ± 0.25 | 2.05 ± 0.24 | −0.06 ± 0.21 | 0.02 (−0.1 to 0.1) | 0.68 | |||||
| . | Vegan group (n = 49, except as noted) . | . | . | ADA group (n = 50, except as noted) . | . | . | . | P value . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| . | Baseline . | 22 weeks . | Change . | Baseline . | 22 weeks . | Change . | Effect size . | . | |||||
| Anthropometric and glycemic variables | |||||||||||||
| All participants | |||||||||||||
| A1C (%) | 8.0 ± 1.1 | 7.1 ± 1.0 | −1.0 ± 1.2* | 7.9 ± 1.0 | 7.4 ± 1.0 | −0.6 ± 1.1† | −0.4 (−0.9 to 0.1) | 0.09 | |||||
| Fasting plasma glucose (mmol/l) | 9.08 ± 2.95 | 7.11 ± 1.97 | −1.97 ± 2.68* | 8.90 ± 2.26 | 6.98 ± 1.91 | 1.92 ± 2.48* | −0.05 (−1.08 to 0.98) | 0.92 | |||||
| Fasting plasma glucose (mg/dl) | 163.5 ± 53.2 | 128.0 ± 35.5 | −35.5 ± 48.3* | 160.4 ± 40.7 | 125.8 ± 34.4 | −34.6 ± 44.7* | −0.9 (−19.5 to 17.6) | 0.92 | |||||
| Weight (kg) | 97.0 ± 22.9 | 91.1 ± 22.4 | −5.8 ± 4.4* | 99.3 ± 21.0 | 95.0 ± 20.9 | −4.3 ± 4.4* | −1.6 (−3.3 to 0.2) | 0.08 | |||||
| BMI (kg/m2) | 33.9 ± 7.8 | 31.8 ± 7.5 | −2.1 ± 1.5* | 35.9 ± 7.0 | 34.3 ± 7.3 | −1.5 ± 1.5* | −0.6 (−1.2 to 0.1) | 0.08 | |||||
| Waist (cm) | 110.8 ± 18.4 | 105.5 ± 18.1 | −5.3 ± 4.4* | 112.3 ± 14.9 | 109.5 ± 14.7 | −2.8 ± 4.7* | −2.5 (−4.3 to −0.7) | 0.008 | |||||
| Hip (cm) | 118.4 ± 17.8 | 114.5 ± 17.8 | −3.9 ± 3.4* | 121.3 ± 12.7 | 117.5 ± 12.2 | −3.8 ± 3.9* | −0.1 (−1.5 to 1.4) | 0.94 | |||||
| Waist-to-hip ratio (cm) | 0.94 ± 0.08 | 0.92 ± 0.07 | −0.02 ± 0.03‡ | 0.93 ± 0.07 | 0.93 ± 0.07 | 0.01 ± 0.04 | −0.02 (−0.03 to 0.01) | 0.003 | |||||
| Participants whose diabetes medications remained unchanged (n = 24 vegan, n = 33 ADA) | |||||||||||||
| A1C (%) | 8.07 ± 1.24 | 6.84 ± 0.84 | −1.23 ± 1.38† | 7.88 ± 0.93 | 7.50 ± 1.03 | −0.38 ± 1.11 | −0.85 (−1.51 to −0.19) | 0.01 | |||||
| Fasting plasma glucose (mmol/l) | 9.85 ± 2.95 | 7.12 ± 1.80 | 2.73 ± 3.05† | 8.90 ± 2.05 | 7.34 ± 2.05 | 1.57 ± 2.50‡ | −1.17 (−2.64 to 0.31) | 0.12 | |||||
| Fasting plasma glucose (mg/dl) | 177.4 ± 53.2 | 128.2 ± 32.4 | −49.2 ± 55.0† | 160.3 ± 37.0 | 132.2 ± 36.9 | −28.2 ± 45.0‡ | −21.1 (−47.6 to 5.5) | 0.12 | |||||
| Weight (kg) | 102.4 ± 23.6 | 95.9 ± 22.4 | −6.5 ± 4.3* | 100.0 ± 19.4 | 96.9 ± 19.1 | −3.1 ± 3.4* | −3.4 (−5.5 to −1.4) | 0.001 | |||||
| BMI (kg/m2) | 36.1 ± 7.5 | 33.8 ± 7.2 | −2.3 ± 1.5* | 36.0 ± 5.8 | 34.9 ± 5.9 | −1.1 ± 1.2* | −1.2 (−1.9 to −0.5) | 0.001 | |||||
| Waist (cm) | 115.3 ± 17.9 | 110.3 ± 17.8 | −5.0 ± 3.7* | 113.3 ± 13.1 | 111.0 ± 13.5 | −2.3 ± 4.2‡ | −2.7 (−4.8 to −0.5) | 0.017 | |||||
| Hip (cm) | 123.3 ± 17.4 | 119.1 ± 17.3 | −4.1 ± 2.8* | 121.7 ± 12.1 | 118.6 ± 11.6 | −3.1 ± 3.3* | −1.0 (−2.7 to 0.7) | 0.23 | |||||
| Waist-to-hip ratio (cm) | 0.94 ± 0.08 | 0.93 ± 0.07 | −0.01 ± 0.03 | 0.93 ± 0.07 | 0.94 ± 0.08 | 0.00 ± 0.04 | −0.02 (−0.03 to 0.00) | 0.10 | |||||
| Renal variable | |||||||||||||
| Urinary albumin/24 h | 33.0 ± 51.8 | 14.6 ± 17.8 | −18.4 ± 39.0‡ | 55.0 ± 263.1 | 43.7 ± 212.0 | −11.3 ± 53.9 | −7.1 (−25.9 to 11.7) | 0.45 | |||||
| With albumin >30 mg/24 h (m) | 12 | 5 | −7 | 8 | 6 | −2 | NA | NA | |||||
| Blood pressure (n = 48 vegan, n = 50 ADA) (mmHg)§ | |||||||||||||
| Systolic | 123.8 ± 17.1 | 120.0 ± 18.3 | −3.8 ± 12.6‖ | 122.9 ± 15.1 | 119.4 ± 16.5 | −3.6 ± 13.7 | −0.2 (−5.5 to 5.1) | 0.93 | |||||
| Diastolic | 77.9 ± 11.1 | 72.8 ± 10.2 | −5.1 ± 8.3* | 80.0 ± 10.5 | 76.7 ± 11.1 | −3.3 ± 8.8‖ | −1.8 (−5.2 to 1.6) | 0.30 | |||||
| All participants | |||||||||||||
| Total cholesterol (mg/dl) | 187.0 ± 37.4 | 159.3 ± 31.9 | −27.7 ± 28.5* | 198.9 ± 44.0 | 174.6 ± 36.2 | −24.2 ± 30.5* | −3.5 (−15.3 to 8.3) | 0.56 | |||||
| HDL cholesterol (mg/dl) | 52.3 ± 19.7 | 47.3 ± 16.9 | −5.0 ± 7.1* | 49.8 ± 14.5 | 46.6 ± 11.8 | −3.2 ± 11.0‖ | −1.8 (−5.5 to 1.9) | 0.34 | |||||
| Non-HDL cholesterol (mg/dl) | 134.7 ± 39.2 | 112.0 ± 31.9 | −22.7 ± 28.2* | 149.0 ± 44.1 | 128.0 ± 35.0 | −21.0 ± 31.5* | −1.7 (−13.6 to 10.2) | 0.78 | |||||
| Total cholesterol/HDL (mg/dl) | 4.0 ± 1.6 | 3.7 ± 1.2 | −0.3 ± 0.9‖ | 4.3 ± 1.7 | 3.9 ± 1.2 | −0.4 ± 1.2‖ | −0.0 (−0.4 to 0.4) | 0.92 | |||||
| LDL cholesterol (n = 49 vegan, n = 48 ADA) (mg/dl)¶ | 104.4 ± 32.9 | 88.0 ± 27.8 | −16.4 ± 30.6† | 118.5 ± 41.5 | 103.1 ± 33.3 | −15.4 ± 25.1* | −1.0 (−12.3 to 10.3) | 0.86 | |||||
| VLDL cholesterol (n = 47 vegan, n = 47 ADA) (mg/dl) | 26.2 ± 14.4 | 23.0 ± 10.2 | −3.2 ± 10.0‖ | 26.8 ± 13.8 | 22.3 ± 10.0 | −4.4 ± 12.4‖ | 1.2 (−3.4 to 5.8) | 0.60 | |||||
| Triglycerides (mg/dl) | 148.1 ± 112.5 | 119.7 ± 56.0 | −28.5 ± 80.0‖ | 158.1 ± 133.1 | 132.9 ± 114.4 | −25.1 ± 124.7 | −3.3 (−45.2 to 38.6) | 0.87 | |||||
| Log triglycerides | 2.08 ± 0.28 | 2.03 ± 0.21 | −0.05 ± 0.17‖ | 2.11 ± 0.25 | 2.05 ± 0.23 | −0.07 ± 0.20‖ | 0.02 (−0.05 to 0.09) | 0.61 | |||||
| Participants with no changes to lipid-controlling medications (n = 39 vegan, n = 41 ADA, except as noted) | |||||||||||||
| Total cholesterol (mg/dl) | 190.5 ± 36.8 | 156.9 ± 25.1 | −33.5 ± 21.5* | 194.9 ± 40.9 | 175.9 ± 36.2 | −19.0 ± 28.5* | −14.5 (−25.8 to −3.2) | 0.01 | |||||
| HDL cholesterol (mg/dl) | 54.6 ± 21.0 | 48.6 ± 18.4 | −6.0 ± 6.8* | 49.2 ± 15.5 | 46.4 ± 12.2 | −2.8 ± 11.6 | −3.2 (−7.5 to 1.1) | 0.14 | |||||
| Non-HDL cholesterol (mg/dl) | 135.9 ± 38.4 | 108.3 ± 25.6 | −27.6 ± 21.1* | 145.7 ± 42.9 | 129.4 ± 35.9 | −16.3 ± 30.1‖ | −11.3 (−22.9 to 0.3) | 0.05 | |||||
| Total cholesterol/HDL (mg/dl) | 3.9 ± 1.5 | 3.6 ± 1.2 | −0.3 ± 0.6‡ | 4.4 ± 1.8 | 4.0 ± 1.3 | −0.3 ± 1.2 | −0.0 (−0.4 to 0.4) | 0.98 | |||||
| LDL cholesterol (n = 39 vegan, n = 39 ADA) (mg/dl)¶ | 107.3 ± 34.3 | 84.6 ± 22.5 | −22.6 ± 22.0* | 115.3 ± 40.4 | 104.6 ± 33.7 | −10.7 ± 23.3‖ | −11.9 (−22.2 to −1.7) | 0.02 | |||||
| VLDL cholesterol (n = 38 n = vegan, 38 ADA) (mg/dl) | 26.6 ± 15.4 | 23.1 ± 10.9 | −3.5 ± 10.5‖ | 25.5 ± 13.2 | 21.7 ± 9.0 | −3.8 ± 12.1 | 0.4 (−4.8 to 5.6) | 0.89 | |||||
| Triglycerides (mg/dl) | 140.3 ± 89.1 | 118.2 ± 57.3 | −22.2 ± 58.5‖ | 157.4 ± 143.0 | 134.6 ± 122.9 | −22.8 ± 134.3 | 0.6 (−45.9 to 47.2) | 0.98 | |||||
| Log triglycerides | 2.06 ± 0.28 | 2.02 ± 0.22 | −0.04 ± 0.16 | 2.11 ± 0.25 | 2.05 ± 0.24 | −0.06 ± 0.21 | 0.02 (−0.1 to 0.1) | 0.68 | |||||
Data are means ± SD unless otherwise indicated. Listed P values are for comparisons of between-group (vegan vs. ADA) changes (baseline to 22 weeks).
P < 0.0001,
P < 0.001,
P < 0.01, and
P < 0.05 for within-group changes.
Blood pressure was not determined on one vegan group participant due to equipment failure.
When triglycerides exceeded 400 mg/dl, LDL was calculated via direct-LDL; two ADA-group individuals were excluded due to lack of sufficient plasma samples. SI conversion: to convert HDL, LDL, and total cholesterol to mmol/l, multiply by 0.0259; for tryiglycerides, multiply by 0.0113.