Effect of a Brown Rice Based Vegan Diet and Conventional Diabetic Diet on Glycemic Control of Patients with Type 2 Diabetes: A 12-Week Randomized Clinical Trial Vegetarian diet, change in dietary patterns, and diabetes risk: a prospective study Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetes 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. Dietary strategies for patients with type 2 diabetes in the era of multi-approaches; review and results from the Dietary Intervention Randomized Controlled Trial (DIRECT). Toward improved management of NIDDM: A randomized, controlled, pilot intervention using a lowfat, vegetarian diet. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. Type of vegetarian diet, obesity and diabetes in adult Indian population Vegetarian diet-induced increase in linoleic acid in serum phospholipids is associated with improved insulin sensitivity in subjects with type 2 diabetes Ambulatory blood pressure and heart rate responses to vegetarian meals Effect of long-term intake of Asian food with different glycemic indices on diabetic control and protein conservation in type 2 diabetic patients. Can the Mediterranean diet lower HbA1c in type 2 diabetes? Results from a randomized cross-over study. Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Animal versus plant protein meals in individuals with type 2 diabetes and microalbuminuria: effects on renal, glycemic, and lipid parameters. Predominantly Vegetarian Diet in Patients with Incipient and Early Clinical Diabetic Nephropathy: Effects on Albumin Excretion Rate and Nutritional Status Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial. Dietary Intake of Total, Animal, and Vegetable Protein and Risk of Type 2 Diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL Study
Objective Several intervention studies have suggested that vegetarian or vegan diets have clinical benefits , particularly in terms of glycemic control , in patients with type 2 diabetes ( T2D ) ; however , no r and omized controlled trial has been conducted in Asians who more commonly depend on plant-based foods , as compared to Western population s. Here , we aim ed to compare the effect of a vegan diet and conventional diabetic diet on glycemic control among Korean individuals . Material s and Methods Participants diagnosed with T2D were r and omly assigned to follow either a vegan diet ( excluding animal-based food including fish ; n = 46 ) or a conventional diet recommended by the Korean Diabetes Association 2011 ( n = 47 ) for 12 weeks . HbA1c levels were measured at weeks 0 , 4 , and 12 , and the primary study endpoint was the change in HbA1c levels over 12 weeks . Results The mean HbA1c levels at weeks 0 , 4 , and 12 were 7.7 % , 7.2 % , and 7.1 % in the vegan group , and 7.4 % , 7.2 % , and 7.2 % in the conventional group , respectively . Although both groups showed significant reductions in HbA1C levels , the reductions were larger in the vegan group than in the conventional group ( -0.5 % vs. -0.2 % ; p-for-interaction = 0.017 ) . When only considering participants with high compliance , the difference in HbA1c level reduction between the groups was found to be larger ( -0.9 % vs. -0.3 % ) . The beneficial effect of vegan diets was noted even after adjusting for changes in total energy intake or waist circumference over the 12 weeks . Conclusion Both diets led to reductions in HbA1c levels ; however , glycemic control was better with the vegan diet than with the conventional diet . Thus , the dietary guidelines for patients with T2D should include a vegan diet for the better management and treatment . However , further studies are needed to evaluate the long-term effects of a vegan diet , and to identify potential explanations of the underlying mechanisms . Trial Registration CRiS Background / objectives Vegetarian diets are inversely associated with diabetes in Westerners but their impact on Asians — whose pathophysiology differ from Westerners — is unknown . We aim to investigate the association between a vegetarian diet , change in dietary patterns and diabetes risk in a Taiwanese Buddhist population . Methods We prospect ively followed 2918 non-smoking , non-alcohol drinking Buddhists free of diabetes , cancer , and cardiovascular diseases at baseline , for a median of 5 years , with 183 incident diabetes cases confirmed .  Diet was assessed through a vali date d food frequency question naire at baseline and a simple question naire during follow-ups .  Incident cases of diabetes were ascertained through follow-up question naires , fasting glucose and HbA1C . Stratified Cox Proportional Hazards Regression was used to assess the effect of diets on risk of diabetes . Results Consistent vegetarian diet was associated with 35 % lower hazards ( HR : 0.65 , 95 % CI : 0.46 , 0.92 ) , while converting from a nonvegetarian to a vegetarian pattern was associated with 53 % lower hazards ( HR : 0.47 , 95 % CI : 0.30 , 0.71 ) for diabetes , comparing with nonvegetarians while adjusting for age , gender , education , physical activity , family history of diabetes , follow-up methods , use of lipid-lowering medications , and baseline BMI . Conclusion Vegetarian diet and converting to vegetarian diet may protect against diabetes independent of BMI among Taiwanese Aims The aim of this study was to compare the effects of calorie-restricted vegetarian and conventional diabetic diets alone and in combination with exercise on insulin resistance , visceral fat and oxidative stress markers in subjects with Type 2 diabetes . Methods A 24-week , r and omized , open , parallel design was used . Seventy-four patients with Type 2 diabetes were r and omly assigned to either the experimental group ( n = 37 ) , which received a vegetarian diet , or the control group ( n = 37 ) , which received a conventional diabetic diet . Both diets were isocaloric , calorie restricted ( -500 kcal/day ) . All meals during the study were provided . The second 12 weeks of the diet were combined with aerobic exercise . Participants were examined at baseline , 12 weeks and 24 weeks . Primary outcomes were : insulin sensitivity measured by hyperinsulinaemic isoglycaemic clamp ; volume of visceral and subcutaneous fat measured by magnetic resonance imaging ; and oxidative stress measured by thiobarbituric acid reactive substances . Analyses were by intention to treat . Results Forty-three per cent of participants in the experimental group and 5 % of participants in the control group reduced diabetes medication ( P < 0.001 ) . Body weight decreased more in the experimental group than in the control group [ –6.2 kg ( 95 % CI –6.6 to –5.3 ) vs. –3.2 kg ( 95 % CI –3.7 to –2.5 ) ; interaction group × time P = 0.001 ] . An increase in insulin sensitivity was significantly greater in the experimental group than in the control group [ 30 % ( 95 % CI 24.5–39 ) vs. 20 % ( 95 % CI 14–25 ) , P = 0.04 ] . A reduction in both visceral and subcutaneous fat was greater in the experimental group than in the control group ( P = 0.007 and P = 0.02 , respectively ) . Plasma adiponectin increased ( P = 0.02 ) and leptin decreased ( P = 0.02 ) in the experimental group , with no change in the control group . Vitamin C , superoxide dismutase and reduced glutathione increased in the experimental group ( P = 0.002 , P < 0.001 and P = 0.02 , respectively ) . Differences between groups were greater after the addition of exercise training . Changes in insulin sensitivity and enzymatic oxidative stress markers correlated with changes in visceral fat . Conclusions A calorie-restricted vegetarian diet had greater capacity to improve insulin sensitivity compared with a conventional diabetic diet over 24 weeks . The greater loss of visceral fat and improvements in plasma concentrations of adipokines and oxidative stress markers with this diet may be responsible for the reduction of insulin resistance . The addition of exercise training further augmented the improved outcomes with the vegetarian diet BACKGROUND Although vegan diets improve diabetes management , little is known about the nutrient profiles or diet quality of individuals with type 2 diabetes who adopt a vegan diet .  OBJECTIVE To assess the changes in nutrient intake and dietary quality among participants following a low-fat vegan diet or the 2003 American Diabetes Association dietary recommendations .  DESIGN A 22-week r and omized , controlled clinical trial examining changes in nutrient intake and diet quality . SUBJECTS/ SETTING Participants with type 2 diabetes ( n=99 ) in a free-living setting . RESEARCH DESIGN AND METHODS Participants were r and omly assigned to a low-fat vegan diet or a 2003 American Diabetes Association recommended diet . MAIN OUTCOME MEASURES Nutrient intake and Alternate Healthy Eating Index ( AHEI ) scores were collected at baseline and 22 weeks . STATISTICAL ANALYSES PERFORMED Between-group t tests were calculated for changes between groups and paired comparison t tests were calculated for changes within-group . Pearson 's correlation assessed relationship of AHEI score to hemoglobin A1c and body weight changes . RESULTS Both groups reported significant decreases in energy , protein , fat , cholesterol , vitamin D , selenium , and sodium intakes . The vegan group also significantly reduced reported intakes of vitamin B-12 and calcium , and significantly increased carbohydrate , fiber , total vitamin A activity , beta carotene , vitamins K and C , folate , magnesium , and potassium . The American Diabetes Association recommended diet group also reported significant decreases in carbohydrate and iron , but reported no significant increases . The vegan group significantly improved its AHEI score ( P<0.0001 ) , while the American Diabetes Association recommended diet group did not ( P=0.7218 ) . The difference in AHEI score at 22 weeks between groups was significant ( P<0.0001 ) . With both groups combined , AHEI score was negatively correlated with both changes in hemoglobin A1c value ( r=-0.24 , P=0.016 ) and weight ( r=-0.27 , P=0.007 ) . CONCLUSIONS Vegan diets increase intakes of carbohydrate , fiber , and several micronutrients , in contrast with the American Diabetes Association recommended diet . The vegan group improved its AHEI score whereas the American Diabetes Association recommended diet group 's AHEI score remained unchanged Dietary intervention is recognized as a key component in prevention and management of type 2 diabetes ( T2DM ) and the debate persists : which dietary strategy is most effective . In the Dietary Intervention R and omized Controlled Trial ( DIRECT ) 322 moderately obese participants were r and omized for 2 years to one of three diet groups : low-fat , Mediterranean and low-carbohydrate . Differential effects were observed in the sub-group of patients with T2DM at 24 months : participants r and omized to the Mediterranean diet , which had the highest intake of dietary fibers and unsaturated to saturated fat ratio , achieved greater significant improvements in fasting plasma glucose and insulin levels . Patients who were r and omized to the low-carbohydrate diet , which had the minimal intake of carbohydrates , achieved a significant reduction of hemoglobin A1C . Although improvements were observed in all groups , the low-fat diet was likely to be less beneficial in terms of glycemic control and lipid metabolism . Interpretation of results from different studies on dietary strategies may be complex since there is often no consistency in diet compositions , calorie restriction , intensity of intervention , dietary assessment or extent of adherence in the trial . Nevertheless , it seems that low fat restricted calorie diets are effective for weight loss and are associated with some metabolic benefits ; however , some recent trials have shown that low carbohydrate diets are as efficient in inducing weight loss and in some metabolic measures such as serum triglycerides and HDL-cholesterol may be even superior to low fat diets . When addressing the issue of diet quality rather than quantity applying the glycemic index may have some added benefits . Furthermore special features of the Mediterranean diet have apparent additional favorable effects for patients with T2DM OBJECTIVE To investigate whether glycemic and lipid control in patients with non-insulin-dependent diabetes ( NIDDM ) can be significantly improved using a low-fat , vegetarian ( vegan ) diet in the absence of recommendations regarding exercise or other lifestyle changes . METHODS Eleven subjects with NIDDM recruited from the Georgetown University Medical Center or the local community were r and omly assigned to a low-fat vegan diet ( seven subjects ) or a conventional low-fat diet ( four subjects ) . Two additional subjects assigned to the control group failed to complete the study . The diets were not design ed to be isocaloric . Fasting serum glucose , body weight , medication use , and blood pressure were assessed at baseline and biweekly thereafter for 12 weeks . Serum lipids , glycosylated hemoglobin , urinary albumin , and dietary macronutrients were assessed at baseline and 12 weeks . RESULTS Although the sample was intentionally small in accordance with the pilot study design , the 28 % mean reduction in fasting serum glucose of the experimental group , from 10.7 to 7.75 mmol/L ( 195 to 141 mg/dl ) , was significantly greater than the 12 % decrease , from 9.86 to 8.64 mmol/L ( 179 to 157 mg/dl ) , for the control group ( P < 0.05 ) . The mean weight loss was 7.2 kg in the experimental group , compared to 3 . 8 kg for the control group ( P < 0.005 ) . Of six experimental group subjects on oral hypoglycemic agents , medication use was discontinued in one and reduced in three . Insulin was reduced in both experimental group patients on insulin . No patient in the control group reduced medication use . Differences between the diet groups in the reductions of serum cholesterol and 24-h microalbuminuria did not reach statistical significance ; however , high-density lipoprotein concentration fell more sharply ( 0.20 mmol/L ) in the experimental group than in the control group ( 0.02 mmol/L ) ( P < 0.05 ) . CONCLUSION The use of a low-fat , vegetarian diet in patients with NIDDM was associated with significant reductions in fasting serum glucose concentration and body weight in the absence of recommendations for exercise . A larger study is needed for confirmation 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 r and omly 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 clinical trials.gov as NCT00276939 Background To investigate the prevalence of obesity and diabetes among adult men and women in India consuming different types of vegetarian diets compared with those consuming non-vegetarian diets .  Methods We used cross-sectional data of 156,317 adults aged 20–49 years who participated in India ’s third National Family Health Survey ( 2005–06 ) . Association between types of vegetarian diet ( vegan , lacto-vegetarian , lacto-ovo vegetarian , pesco-vegetarian , semi-vegetarian and non-vegetarian ) and self-reported diabetes status and measured body mass index ( BMI ) were estimated using multivariable logistic regression adjusting for age , gender , education , household wealth , rural/urban residence , religion , caste , smoking , alcohol use , and television watching . Results Mean BMI was lowest in pesco-vegetarians ( 20.3 kg/m2 ) and vegans ( 20.5 kg/m2 ) and highest in lacto-ovo vegetarian ( 21.0 kg/m2 ) and lacto-vegetarian ( 21.2 kg/m2 ) diets . Prevalence of diabetes varied from 0.9 % ( 95 % CI : 0.8 - 1.1 ) in person consuming lacto-vegetarian , lacto-ovo vegetarian ( 95 % CI:0.6 - 1.3 ) and semi-vegetarian ( 95 % CI:0.7 - 1.1 ) diets and was highest in those persons consuming a pesco-vegetarian diet ( 1.4 % ; 95 % CI:1.0 - 2.0 ) . Consumption of a lacto- ( OR:0.67;95 % CI:0.58 - 0.76;p < 0.01 ) , lacto-ovo ( OR:0.70 ; 95 % CI:0.51 - 0.96;p = 0.03 ) and semi-vegetarian ( OR:0.77 ; 95 % CI:0.60 - 0.98 ; p = 0.03 ) diet was associated with a lower likelihood of diabetes than a non-vegetarian diet in the adjusted analyses . Conclusions In this large , nationally representative sample of Indian adults  , lacto- , lacto-ovo and semi-vegetarian diets were associated with a lower likelihood of diabetes . These findings may assist in the development of interventions to address the growing burden of overweight/obesity and diabetes in Indian population . However , prospect i ve studies with better measures of dietary intake and clinical measures of diabetes are needed to clarify this relationship BACKGROUND AND AIMS : Fatty acids are important cellular constituents that may affect many metabolic processes relevant for the development of diabetes and its complications . We showed previously that vegetarian diet leads to greater increase in metabolic clearance rate of glucose ( MCR ) than conventional hypocaloric diet . The aim of this secondary analysis was to explore the role of changes in fatty acid composition of serum phospholipids in diet- and exercise-induced changes in MCR in subjects with type 2 diabetes ( T2D ) . METHODS : Subjects with T2D ( n=74 ) were r and omly assigned into a vegetarian group ( VG , n=37 ) following vegetarian diet or a control group ( CG , n=37 ) following a conventional diet . Both diets were calorie restricted ( −500 kcal day–1 ) . Participants were examined at baseline , 12 weeks of diet intervention and 24 weeks ( subsequent 12 weeks of diet were combined with aerobic exercise ) . The fatty acid composition of serum phospholipids was measured by gas liquid chromatography . MCR was measured by hyperinsulinemic isoglycemic clamp . Visceral fat ( VF ) was measured by magnetic resonance imaging . RESULTS : Linoleic acid ( LA ; 18:2n6 ) increased in VG ( P=0.04 ) , whereas it decreased in CG ( P=0.04 ) in response to dietary interventions . It did not change significantly after the addition of exercise in either group ( group × time P<0.001 ) . In VG , changes in 18:2n6 correlated positively with changes in MCR ( r=+0.22 ; P=0.04 ) and negatively with changes in VF ( r=−0.43 ; P=0.01 ) . After adjustment for changes in body mass index , the association between 18:2n6 and MCR was no longer significant . The addition of exercise result ed in greater changes of phospholipid fatty acids composition in VG than in CG . CONCLUSION : We demonstrated that the insulin-sensitizing effect of a vegetarian diet might be related to the increased proportion of LA in serum phospholipids Objectives : To determine the effects of a vegetarian diet on daytime ambulatory ( Accutracker ) blood pressures and heart rates , and to relate these to the estimated peak in plasma glucose to determine whether low-glycaemic-index diets reduce sympathetic activity in response to differences in postpr and ial glucose and insulin . Design : The subjects were matched for age and body mass index and r and omly assigned to one of two parallel diet groups . Setting : Clinical . Participants : Twenty-one normotensive non-vegetarian male hospital workers volunteered for the study and 20 completed it . Intervention : After 2 weeks of baseline measurement the subjects followed an omnivorous or a lacto-ovovegetarian diet for 6 weeks . Main outcome measures : Daytime ambulatory blood pressures and heart rate , and postbreakfast catecholamines , insulin and glucose . Results : Ambulatory systolic blood pressure and heart rates were lower in the vegetarian group during the working day . The prepr and ial rise in diastolic pressure was attenuated on the vegetarian diet . There were no differences in plasma catecholamine , glucose or insulin levels sample d after breakfast on the two dietary regimes . Conclusions : The blood pressure-lowering effect of a lacto-ovovegetarian diet , which occurs throughout the working day , is associated with lower heart rates , suggesting a central nervous or cardiac mechanism . The possibility that the lower glycaemic index of a lacto-ovovegetarian diet has some effect needs to be investigated further in relation to major meal-times and studied in both normotensive and hypertensive subjects The study was carried out in 10 females with type 2 diabetes aged 32 - 60 yrs . All of them were receiving weight-maintaining diets composed of 12 per cent protein , 30 per cent fat and 58 per cent carbohydrate . The only difference among all study -diets was the types of complex carbohydrate used . High-glycemic diet ( HG ) or low glycemic diet ( LG ) consisted mainly of glutinous rice or mungbean noodles and the intermediate-glycemic diet ( DM ) was solely white rice . After the metabolic evaluation of the baseline diet ( BL ) , each subject was placed on DM and followed r and omly by HG and LG or vice versa for 4 weeks each . The diurnal plasma glucose levels tended to be lowest after LG . The integrated plasma glucose levels among all diets were not different . The integrated insulin levels after DM and LG did not differ but they were lower than HG and BL . Long-term ingestion of all test-diets spilt less urinary glucose than BL , the lowest was LG . HbA1 levels and nitrogen balance after all diets were better than BL , the best was LG . It was concluded that in addition to strict dietary control , ingestion of mungbean noodles ( a low glycemic diet ) without increasing fiber intake , can improve diabetic control and protein conservation in type 2 diabetes BACKGROUND AND AIMS To investigate the impact of a diet modeled on the traditional Cretan Mediterranean diet on metabolic control and vascular risk in type 2 diabetes . METHODS AND RESULTS Twenty-seven subjects ( 47 - 77 yrs ) with type 2 diabetes were r and omly assigned to consume either the intervention diet ad libitum or their usual diet for 12 weeks and then cross over to the alternate diet . Most of the meals and staple foods for the intervention diet were provided . Lipids , glycemic variables , blood pressure , homocysteine , C-reactive protein , plasma carotenoids and body composition ( anthropometry and dual energy X-ray absorptiometry ) were assessed at baseline , and at the end of both diet periods . Dietary adherence was monitored using plasma carotenoid and fatty acid ( FA ) analysis , complemented by diet diaries . Compared with usual diet , on the ad libitum Mediterranean intervention diet glycosylated haemoglobin fell from 7.1 % ( 95 % CI : 6.5 - 7.7 ) to 6.8 % ( 95 % CI : 6.3 - 7.3 ) ( p=0.012 ) and diet quality improved significantly [ plant : animal ( g/day ) food ratio increased from 1.3 ( 95 % CI : 1.1 - 1.5 ) to 5.4 ( 95 % CI : 4.3 - 6.6 ) ( p<0.001 ) ] , plasma lycopene and lutein/zeaxanthin increased ( 36 % and 25 % , respectively ) , plasma saturated and trans FAs decreased , and monounsaturated FAs increased . CONCLUSION A traditional moderate-fat Mediterranean diet improves glycemic control and diet quality in men and women with well-controlled type 2 diabetes , without adverse effects on weight BACKGROUND Although obesity is the most important risk factor for type 2 diabetes , evidence is emerging that certain foods and dietary factors may be associated with diabetes . To examine the association between major dietary patterns and risk of type 2 diabetes mellitus in a cohort of women . METHODS We prospect ively assessed the associations between major dietary patterns  and  risk of type 2 diabetes in women .  Dietary information was collected in 1984 , 1986 , 1990 , and 1994 from 69,554 women aged 38 to 63 years without a history of diabetes , cardiovascular disease , or cancer in 1984 . We conducted factor analysis and identified 2 major dietary patterns : " prudent " and " Western . " We then calculated pattern scores for each participant and examined prospect ively the associations between dietary pattern scores and type 2 diabetes risks . RESULTS The prudent pattern was characterized by higher intakes of fruits , vegetables , legumes , fish , poultry , and whole grains , while the Western pattern included higher intakes of red and processed meats , sweets and desserts , french fries , and refined grains . During 14 years of follow-up , we identified 2699 incident cases of type 2 diabetes .  After adjusting for potential confounders , we observed a relative risk for diabetes of 1.49 ( 95 % confidence interval [ CI ] , 1.26 - 1.76 , P for trend , < .001 ) when comparing the highest to lowest quintiles of the Western pattern . Positive associations were also observed between type 2 diabetes and red meat and other processed meats . The relative risk for diabetes for every 1-serving increase in intake is 1.26 ( 95 % CI , 1.21 - 1.42 ) for red meat , 1.38 ( 95 % CI , 1.23 - 1.56 ) for total processed meats , 1.73 ( 95 % CI , 1.39 - 2.16 ) for bacon , 1.49 ( 95 % CI , 1.04 - 2.11 ) for hot dogs , and 1.43 ( 95 % CI , 1.22 - 1.69 ) for processed meats . CONCLUSION The Western pattern , especially a diet higher in processed meats , may increase the risk of type 2 diabetes in women OBJECTIVE To determine , for individuals with type 2 diabetes and microalbuminuria , the effects of 6 weeks of meals containing plant-based protein ( PP ) versus meals with predominantly animal-based protein ( AP ) on renal function and secondarily on glycemia , lipid levels , and blood pressure . RESEARCH DESIGN AND METHODS In a r and omized crossover trial , we compared 6 weeks of meals containing only PP with meals containing primarily AP ( 60 % animal , 40 % plant ) in 17 subjects with type 2 diabetes and microalbuminuria treated with diet and /or oral antidiabetic agents .  Protein content was equivalent to the average American diet , and calories provided weight maintenance . Nutrients were equivalent between the two diets . Meals were prepared and packaged by a metabolic kitchen staff and were sent home weekly . At the beginning and end of each 6-week period , subjects were studied for 36 h on a metabolic unit . RESULTS There were no significant differences between diets for glomerular filtration rate , renal plasma flow , albumin excretion rate , total cholesterol , HDL cholesterol , triglyceride area under the curve ( AUC ) , glucose and insulin AUC , HbA(1c , ) blood pressure , or serum amino acids . For both diets , at the end of the treatment periods as compared with baseline , total cholesterol was significantly lower ( PP and AP : from 4.75 to 4.34 mmol/l , P < 0.01 ) , HbA(1c ) had significantly improved ( PP : from 8.1 to 7.5 % , P < 0.01 ; AP : from 7.9 to 7.4 % , P < 0.01 ) , and diastolic blood pressure was significantly lower ( PP : from 83 to 80 mmHg , P < 0.02 ; AP : from 82 to 78 , P < 0.02 ) . CONCLUSIONS There is no clear advantage for the recommendation of diets containing only PP rather than diets containing protein that is primarily animal-based for individuals with type 2 diabetes and microalbuminuria . There are , however , potential lipid , glycemic , and blood pressure benefits for following a carefully constructed , weight-maintaining , healthy diet , regardless of protein source Several studies have suggested that dietary protein quality may be an important determinant in the natural history of renal disease . We have therefore studied the effects of a predominantly vegetarian diet in eight patients with Type 1 diabetes mellitus and an albumin excretion rate ( AER ) in excess of 30 μg min−1 . The AER was measured after an 8‐week run‐in period on the patient 's usual diet , and again after 8 weeks of a predominantly vegetarian diet in which the proportion of vegetable protein was supplemented in order to minimize the reduction in total dietary protein intake . The median fractional albumin clearance fell during the study from an initial value of 188 times 10−4 ( range 58–810 times 10−4 ) at the end of the run‐in period to 87 times 10−4 ( 23–829 times 10−4 ) at the end of the period on low animal protein diet ( difference 79 times 10−4 ( 95 % Cl 9–149 times 10−4 ) , p < 0.05 ) . The AER then returned to values similar to those obtained at the beginning of the study after a further 8 weeks in those patients returning to their usual diet . No significant changes in blood glucose control or in arterial pressure were observed . A predominantly vegetarian diet may therefore have important beneficial effects on diabetic nephropathy without the need for a heavily restricted total protein intake BACKGROUND Legumes , including beans , chickpeas , and lentils , are among the lowest glycemic index ( GI ) foods and have been recommended in national diabetes mellitus ( DM ) guidelines . Yet , to our knowledge , they have never been used specifically to lower the GI of the diet . We have therefore undertaken a study of low-GI foods in type 2 DM with a focus on legumes in the intervention . METHODS A total of 121 participants with type 2 DM were r and omized to either a low-GI legume diet that encouraged participants to increase legume intake by at least 1 cup per day , or to increase insoluble fiber by consumption of whole wheat products , for 3 months . The primary outcome was change in hemoglobin A1c ( HbA1c ) values with calculated coronary heart disease ( CHD ) risk score as a secondary outcome . RESULTS The low-GI legume diet reduced HbA1c values by -0.5 % ( 95 % CI , -0.6 % to -0.4 % ) and the high wheat fiber diet reduced HbA1c values by -0.3 % ( 95 % CI , -0.4 % to -0.2 % ) . The relative reduction in HbA1c values after the low-GI legume diet was greater than after the high wheat fiber diet by -0.2 % ( 95 % CI , -0.3 % to -0.1 % ; P < .001 ) . The respective CHD risk reduction on the low-GI legume diet was -0.8 % ( 95 % CI , -1.4 % to -0.3 % ; P = .003 ) , largely owing to a greater relative reduction in systolic blood pressure on the low-GI legume diet compared with the high wheat fiber diet ( -4.5 mm Hg ; 95 % CI , -7.0 to -2.1 mm Hg ; P < .001 ) . CONCLUSION Incorporation of legumes as part of a low-GI diet improved both glycemic control and reduced calculated CHD risk score in type 2 DM OBJECTIVE Dietary recommendations are focused mainly on relative dietary fat and carbohydrate content in relation to diabetes risk . Meanwhile , high-protein diets may contribute to disturbance of glucose metabolism , but evidence from prospect i ve studies is scarce . We examined the association among dietary total , vegetable , and animal protein intake and  diabetes incidence and whether consuming 5 energy % from protein at the expense of 5 energy % from either carbohydrates or fat was associated with diabetes risk . RESEARCH DESIGN AND METHODS A prospect i ve cohort study was conducted among 38,094 participants of the European Prospect i ve Investigation into Cancer and Nutrition (EPIC)-NL study .  Dietary protein intake  was measured with a vali date d food frequency question naire .  Incident diabetes was verified against medical records . RESULTS During 10 years of follow-up , 918 incident cases of diabetes were documented . Diabetes risk increased with higher total protein ( hazard ratio 2.15 [ 95 % CI 1.77–2.60 ] highest vs. lowest quartile ) and animal protein ( 2.18 [ 1.80–2.63 ] ) intake . Adjustment for confounders did not material ly change these results . Further adjustment for adiposity measures attenuated the associations . Vegetable protein was not related to diabetes . Consuming 5 energy % from total or animal protein at the expense of 5 energy % from carbohydrates or fat increased diabetes risk . CONCLUSIONS Diets high in animal protein are associated with an increased diabetes risk . Our findings also suggest a similar association for total protein itself instead of only animal sources . Consumption of energy from protein at the expense of energy from either carbohydrates or fat may similarly increase diabetes risk . This finding indicates that accounting for protein content in dietary recommendations for diabetes prevention may be useful
Consumption of vegetarian diets is associated with improved glycemic control in type 2 diabetes .
INTRODUCTION Previous studies have suggested an association between vegetarian diets and improvements in glycemic control in diabetes , although this relationship is not well established .
No meta- analysis of these studies has been performed .
METHODS To conduct a systematic review and meta- analysis of controlled clinical trials examining the association between  vegetarian diets  and  glycemic control in type 2 diabetes .