Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Gabrielle M. Turner-McGrievy, M.S., R.D.: University of North Carolina Neal D. Barnard, M.D.: George Washington University (GWU) Joshua Cohen, M.D.: GWU David J.A. Jenkins, M.D., Ph.D., D.Sc.: University of Toronto Lise Gloede, R.D., C.D.E.: Nutrition Coaching, LLC Amber A. Green, R.D.: Physicians Committee for Responsible Medicine JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Background While vegan diets improve diabetes management, little is known about the nutrient profiles or diet quality of individuals with type 2 diabetes adopting a vegan diet. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Objective The objective of this study was to assess the changes in nutrient intake and dietary quality among participants following a low-fat vegan diet or the 2003 American Diabetes Association (ADA) dietary recommendations. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Methods In this 22-week randomized, controlled clinical trial, participants with type 2 diabetes (n = 99) were randomly assigned to a low-fat vegan diet or a 2003 ADA diet. Nutrient intake and Alternate Healthy Eating Index (AHEI) were measured at baseline and 22-weeks. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Results-Within Group: Vegan Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Within Group: Vegan The vegan group reduced mean reported intakes of: energy protein fat (total, saturated, monounsaturated, polyunsaturated, and trans) cholesterol vitamins D and B-12, calcium, selenium, and sodium The vegan group increased mean reported intake of: carbohydrate soluble and insoluble fiber total vitamin A activity beta-carotene vitamins C and K, folate, magnesium, and potassium JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Within Group: ADA The ADA group reported significant reductions in: energy carbohydrate protein fat (total, saturated, monounsaturated, polyunsaturated, and trans) cholesterol vitamin D, iron, selenium, and sodium The ADA group reported no significant increases in intake of any measured nutrient. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Between Groups The vegan group reduced its reported mean intakes of the following to a greater degree than did the ADA group: -total fat -trans fat -saturated fat -MUFA -protein -cholesterol -vitamin D JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Results-Between Groups Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Between Groups The vegan group significantly increased intakes and the ADA group decreased or had no change in intakes of the following nutrients: carbohydrate soluble and insoluble fiber total vitamin A activity and beta-carotene folate magnesium iron potassium JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Results-Between Groups Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Between Groups Both groups increased vitamin C but the vegan group increased it to a greater degree than did the ADA group. The ADA group reduced sodium intake to a greater degree, compared to the vegan group. There were no significant differences in changes in the following nutrients between groups: energy PUFA vitamins E, K, B-6, and B-12 calcium, zinc, or selenium JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Results-Alternate Healthy Eating Index Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Alternate Healthy Eating Index The vegan group significantly improved its overall AHEI score, while the ADA group did not (P < 0.001). Vegan group (n = 49) ADA group (n =50) Mean Effect Size (Lower CL to Upper CL) P-value for Difference Between Groups Baseline 22-weeks Difference Total AHEI Score 31.6 ± 11.8 54.1 ± 17.92 22.5 ± 18.7*** 35.1 ± 10.1 34.2 ± 17.9 -0.9 ± 18.12 3.5 (16.1 to 30.8) <0.0001 *** for P < 0.001 for within-group changes. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Conclusion Vegan diets increase intakes of carbohydrate, fiber, and several micronutrients, in contrast with the ADA diet. The vegan group improved its AHEI score whereas the ADA group’s AHEI score remained unchanged. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008