J Acad Nutr Diet. 2018 Jun;118(6):1072-1079. doi: 10.1016/j.jand.2017.11.017. Epub 2018 Feb 15.
In research settings, plant-based (vegan) eating plans improve diabetes management, typically reducing weight, glycemia, and low-density lipoprotein (LDL) cholesterol concentrations to a greater extent than has been shown with portion-controlled eating plans.
The study aimed to test whether similar benefits could be found using weekly nutrition classes in a typical endocrinology practice, hypothesizing that a vegan eating plan would improve glycemic control, weight, lipid concentrations, blood pressure, and renal function and would do so more effectively than a portion-controlled eating plan.
In a 20-week trial, participants were randomly assigned to a low-fat vegan or portion-controlled eating plan.
PARTICIPANTS/SETTING: Individuals with type 2 diabetes treated in a single endocrinology practice in Washington, DC, participated (45 starters, 40 completers).
Participants attended weekly after-hours classes in the office waiting room. The vegan plan excluded animal products and added oils and favored low-glycemic index foods. The portion-controlled plan included energy intake limits for weight loss (typically a deficit of 500 calories/day) and provided guidance on portion sizes.
Body weight, hemoglobin A1c (HbA1c), plasma lipids, urinary albumin, and blood pressure were measured.
For normally distributed data, t tests were used; for skewed outcomes, rank-based approaches were implemented (Wilcoxon signed-rank test for within-group changes, Wilcoxon two-sample test for between-group comparisons, and exact Hodges-Lehmann estimation to estimate effect sizes).
Although participants were in generally good metabolic control at baseline, body weight, HbA1c, and LDL cholesterol improved significantly within each group, with no significant differences between the two eating plans (weight: -6.3 kg vegan, -4.4 kg portion-controlled, between-group P=0.10; HbA1c, -0.40 percentage point in both groups, P=0.68; LDL cholesterol -11.9 mg/dL vegan, -12.7 mg/dL portion-controlled, P=0.89). Mean urinary albumin was normal at baseline and did not meaningfully change. Blood pressure changes were not significant.
Weekly classes, integrated into a clinical practice and using either a low-fat vegan or portion-controlled eating plan, led to clinical improvements in individuals with type 2 diabetes.
在研究环境中，植物性（素食）饮食计划改善糖尿病管理，通常更能减轻体重、降低血糖和低密度脂蛋白（LDL）胆固醇浓度，效果优于控制份量的饮食计划。
本研究旨在测试在典型内分泌学实践中，每周营养课程是否能带来类似的益处，假设素食饮食计划能改善血糖控制、体重、血脂浓度、血压和肾功能，且效果优于控制份量的饮食计划。
在一项 20 周的试验中，参与者被随机分配到低脂素食或控制份量的饮食计划中。
参与者/设置：在华盛顿特区的一家内分泌诊所接受治疗的 2 型糖尿病患者参与了此项研究（45 名开始者，40 名完成者）。
参与者参加每周下班后在办公室候诊室举行的课程。素食计划排除动物产品并添加油，并偏向于低升糖指数的食物。控制份量的计划包括体重减轻的能量摄入量限制（通常每天 500 卡路里的热量不足），并提供份量大小的指导。
体重、糖化血红蛋白（HbA1c）、血浆脂质、尿白蛋白和血压。
对于正态分布数据，使用 t 检验；对于偏态结果，采用基于等级的方法（Wilcoxon 符号秩检验用于组内变化，Wilcoxon 两样本检验用于组间比较，以及精确 Hodges-Lehmann 估计用于估计效应大小）。
尽管参与者在基线时的代谢控制通常较好，但两组的体重、HbA1c 和 LDL 胆固醇均显著改善，两种饮食计划之间无显著差异（体重：素食组-6.3kg，控制份量组-4.4kg，组间 P=0.10；HbA1c，两组均下降 0.40 个百分点，P=0.68；LDL 胆固醇，素食组-11.9mg/dL，控制份量组-12.7mg/dL，P=0.89）。基线时平均尿白蛋白正常，无明显变化。血压变化无显著意义。
每周课程整合到临床实践中，无论是采用低脂素食还是控制份量的饮食计划，都能改善 2 型糖尿病患者的临床状况。
