Vegetarian Nutrition

VN: Type 2 Diabetes (2009)

Type 2 Diabetes (Adults) and Vegetarian Nutrition

• Intervention
  Is the therapeutic use of a vegetarian diet effective for reducing blood glucose levels among adults with diabetes?

  • Conclusion

    No studies report an increase in blood glucose levels, however the findings are mixed regarding the effectiveness a vegetarian diet to decrease blood glucose levels. The therapeutic use of a vegetarian diet may be effective in decreasing blood glucose among adults with type 2 diabetes.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Is the therapeutic use of a vegetarian diet effective for reducing symptoms of diabetes in adults with diabetes?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006 Aug;29(8):1777-83.
      • Bhumisawasdi J, Vanna O, Surinpang N. The self-reliant system for alternative care of diabetes mellitus patients--experience macrobiotic management in Trad Province. J Med Assoc Thai. 2006 Dec; 89 (12): 2,104-2,115.
      • Burke LE, Hudson AG, Warziski MT, Styn MA, Music E, Elci OU, Sereika SM. Effects of a vegetarian diet and treatment preference on biochemical and dietary variables in overweight and obese adults: a randomized clinical trial. Am J Clin Nutr. 2007 Sep; 86 (3): 588-596.
      • Burke LE, Styn MA, Steenkiste AR, Music E, Warziski M, Choo J. A randomized clinical trial testing treatment preference and two dietary options in behavioral weight management: preliminary results of the impact of diet at six months: PREFER study. Obesity (Silver Spring). 2006 Nov; 14 (11): 2,007-2,017.
      • Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA 2005; 293: 43-53.
      • de Mello VD, Zelmanovitz T, Perassolo MS, Azevedo MJ, Gross JL. Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria. Am J Clin Nutr. 2006 May; 83 (5): 1,032-1,038.
      • Stephenson TJ, Setchell KDR, Kendall CWC, Jenkins DJA, Anderson JW, Fanti P. Effect of soy protein-rich diet on renal function in young adults with insulin-dependent diabetes mellitus. Clin Nephrol. 2005; 64: 1-11. 
  • Search Plan and Results: VN: Vegetarian Nutrition and Type 2 Diabetes 2008
     
  How does the therapeutic use of a vegetarian diet compare to omnivorous therapeutic diets for lowering blood glucose levels among adults with diabetes?

  • Conclusion

    The therapeutic use of a vegetarian diet is neither better nor worse for lowering blood glucose than omnivorous therapeutic diets in adults with diabetes.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Is the therapeutic use of a vegetarian diet effective for reducing symptoms of diabetes in adults with diabetes?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006 Aug;29(8):1777-83.
      • Bhumisawasdi J, Vanna O, Surinpang N. The self-reliant system for alternative care of diabetes mellitus patients--experience macrobiotic management in Trad Province. J Med Assoc Thai. 2006 Dec; 89 (12): 2,104-2,115.
      • Burke LE, Hudson AG, Warziski MT, Styn MA, Music E, Elci OU, Sereika SM. Effects of a vegetarian diet and treatment preference on biochemical and dietary variables in overweight and obese adults: a randomized clinical trial. Am J Clin Nutr. 2007 Sep; 86 (3): 588-596.
      • Burke LE, Styn MA, Steenkiste AR, Music E, Warziski M, Choo J. A randomized clinical trial testing treatment preference and two dietary options in behavioral weight management: preliminary results of the impact of diet at six months: PREFER study. Obesity (Silver Spring). 2006 Nov; 14 (11): 2,007-2,017.
      • Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA 2005; 293: 43-53.
      • de Mello VD, Zelmanovitz T, Perassolo MS, Azevedo MJ, Gross JL. Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria. Am J Clin Nutr. 2006 May; 83 (5): 1,032-1,038.
      • Stephenson TJ, Setchell KDR, Kendall CWC, Jenkins DJA, Anderson JW, Fanti P. Effect of soy protein-rich diet on renal function in young adults with insulin-dependent diabetes mellitus. Clin Nephrol. 2005; 64: 1-11. 
  • Search Plan and Results: VN: Vegetarian Nutrition and Type 2 Diabetes 2008
     
  Is the therapeutic use of a vegetarian diet effective for reducing A1c levels in adults with diabetes?

  • Conclusion

    Based on very limited evidence (a single study), the therapeutic use of a low-fat vegan diet may be effective for decreasing A1c levels in adults with diabetes (in part because of decreases in weight associated with a low-fat vegan diet).

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Is the therapeutic use of a vegetarian diet effective for reducing symptoms of diabetes in adults with diabetes?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006 Aug;29(8):1777-83.
      • Bhumisawasdi J, Vanna O, Surinpang N. The self-reliant system for alternative care of diabetes mellitus patients--experience macrobiotic management in Trad Province. J Med Assoc Thai. 2006 Dec; 89 (12): 2,104-2,115.
      • Burke LE, Hudson AG, Warziski MT, Styn MA, Music E, Elci OU, Sereika SM. Effects of a vegetarian diet and treatment preference on biochemical and dietary variables in overweight and obese adults: a randomized clinical trial. Am J Clin Nutr. 2007 Sep; 86 (3): 588-596.
      • Burke LE, Styn MA, Steenkiste AR, Music E, Warziski M, Choo J. A randomized clinical trial testing treatment preference and two dietary options in behavioral weight management: preliminary results of the impact of diet at six months: PREFER study. Obesity (Silver Spring). 2006 Nov; 14 (11): 2,007-2,017.
      • Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA 2005; 293: 43-53.
      • de Mello VD, Zelmanovitz T, Perassolo MS, Azevedo MJ, Gross JL. Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria. Am J Clin Nutr. 2006 May; 83 (5): 1,032-1,038.
      • Stephenson TJ, Setchell KDR, Kendall CWC, Jenkins DJA, Anderson JW, Fanti P. Effect of soy protein-rich diet on renal function in young adults with insulin-dependent diabetes mellitus. Clin Nephrol. 2005; 64: 1-11. 
  • Search Plan and Results: VN: Vegetarian Nutrition and Type 2 Diabetes 2008
     
  How does the therapeutic use of a vegetarian diet compare to omnivorous therapeutic diets for lowering A1c levels among adults with diabetes?

  • Conclusion

    Based on very limited evidence (a single study), the therapeutic use of a low-fat vegan diet may be more effective than omnivorous therapeutic diets for decreasing A1c levels in adults with diabetes, especially among those with no diabetes medication changes.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Is the therapeutic use of a vegetarian diet effective for reducing symptoms of diabetes in adults with diabetes?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006 Aug;29(8):1777-83.
      • Bhumisawasdi J, Vanna O, Surinpang N. The self-reliant system for alternative care of diabetes mellitus patients--experience macrobiotic management in Trad Province. J Med Assoc Thai. 2006 Dec; 89 (12): 2,104-2,115.
      • Burke LE, Hudson AG, Warziski MT, Styn MA, Music E, Elci OU, Sereika SM. Effects of a vegetarian diet and treatment preference on biochemical and dietary variables in overweight and obese adults: a randomized clinical trial. Am J Clin Nutr. 2007 Sep; 86 (3): 588-596.
      • Burke LE, Styn MA, Steenkiste AR, Music E, Warziski M, Choo J. A randomized clinical trial testing treatment preference and two dietary options in behavioral weight management: preliminary results of the impact of diet at six months: PREFER study. Obesity (Silver Spring). 2006 Nov; 14 (11): 2,007-2,017.
      • Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA 2005; 293: 43-53.
      • de Mello VD, Zelmanovitz T, Perassolo MS, Azevedo MJ, Gross JL. Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria. Am J Clin Nutr. 2006 May; 83 (5): 1,032-1,038.
      • Stephenson TJ, Setchell KDR, Kendall CWC, Jenkins DJA, Anderson JW, Fanti P. Effect of soy protein-rich diet on renal function in young adults with insulin-dependent diabetes mellitus. Clin Nephrol. 2005; 64: 1-11. 
  • Search Plan and Results: VN: Vegetarian Nutrition and Type 2 Diabetes 2008
     
  Is the therapeutic use of a vegetarian diet effective for improving insulin levels in adults with diabetes?

  • Conclusion

    While none of the studies identified for analysis focused on patients with diabetes, limited evidence indicates that a vegetarian diet may be effective for decreasing insulin levels in adults.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Is the therapeutic use of a vegetarian diet effective for reducing symptoms of diabetes in adults with diabetes?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006 Aug;29(8):1777-83.
      • Bhumisawasdi J, Vanna O, Surinpang N. The self-reliant system for alternative care of diabetes mellitus patients--experience macrobiotic management in Trad Province. J Med Assoc Thai. 2006 Dec; 89 (12): 2,104-2,115.
      • Burke LE, Hudson AG, Warziski MT, Styn MA, Music E, Elci OU, Sereika SM. Effects of a vegetarian diet and treatment preference on biochemical and dietary variables in overweight and obese adults: a randomized clinical trial. Am J Clin Nutr. 2007 Sep; 86 (3): 588-596.
      • Burke LE, Styn MA, Steenkiste AR, Music E, Warziski M, Choo J. A randomized clinical trial testing treatment preference and two dietary options in behavioral weight management: preliminary results of the impact of diet at six months: PREFER study. Obesity (Silver Spring). 2006 Nov; 14 (11): 2,007-2,017.
      • Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA 2005; 293: 43-53.
      • de Mello VD, Zelmanovitz T, Perassolo MS, Azevedo MJ, Gross JL. Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria. Am J Clin Nutr. 2006 May; 83 (5): 1,032-1,038.
      • Stephenson TJ, Setchell KDR, Kendall CWC, Jenkins DJA, Anderson JW, Fanti P. Effect of soy protein-rich diet on renal function in young adults with insulin-dependent diabetes mellitus. Clin Nephrol. 2005; 64: 1-11. 
  • Search Plan and Results: VN: Vegetarian Nutrition and Type 2 Diabetes 2008