Going Vegetarian

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Here at Diabetes Flashpoints, we’ve covered a variety of diet- and nutrition-related topics, from the ongoing low-carb controversy to vitamin pills, sweeteners, salt, and alcohol. But we’ve never before broached one particular subject that elicits curiosity — and strong feelings — from many people: vegetarian diets for people with diabetes. Studies show that vegetarian (meat-free) and vegan (meat-, egg-, and dairy-free) diets may have several benefits for people with diabetes, especially Type 2 diabetes. But are the diets tested in studies appealing to and sustainable for most people? And how does a vegetarian diet square with other dietary concerns that people with diabetes may have?

One often-cited study from 2006 compared a low-fat, low-sugar vegan diet with a standard diet based on the recommendations of the American Diabetes Association (ADA), which emphasizes fruits and vegetables, whole grains, low-fat dairy, and lean meat, fish, and poultry. Published in the journal Diabetes Care, the study randomly assigned 99 people with Type 2 diabetes to one of the two diets. All participants saw an advisor weekly, who encouraged them to stay on track and helped them with recipes and meal choices. This continued for 22 weeks.

At the end of the study, the vegan diet was found to be more beneficial in several ways. According to an ABC News article, 43% of participants who followed the vegan diet were able to reduce or eliminate their dose of insulin or another drug for diabetes, compared with 26% of those on the ADA diet. The vegan group saw an average drop in HbA1c of 1.23%, compared with a 0.38% drop in the ADA group. For those on the vegan diet, levels of LDL (low-density lipoprotein, or “bad”) cholesterol fell by 21% on average, versus 10% for those on the ADA diet. Members of the vegan group also lost an average of 14 pounds, compared with 7 pounds for the ADA group. Perhaps most surprisingly, the vegan diet — which did not limit portion sizes or count calories — was apparently easier to follow, as three participants in the vegan group dropped out of the study, versus eight in the ADA group.

There are, of course, any number of factors that may account for the benefits seen from following a particular diet. For a low-fat, low-sugar vegan diet, some or most of the observed benefits could be due to the lack of refined sugars or starches in the diet, the lack of animal protein or fat, or the lower overall level of calories it provides — without separating these elements, it’s impossible to say what benefit, if any, each one provides. Since many people with diabetes restrict carbohydrates in their diet, it could be useful to study how a standard low-carb diet compares with a high-fiber, low-sugar vegan diet in people with diabetes — or with a low-carb vegetarian or vegan diet. Just how useful such studies would be toward real-world recommendations is a matter of debate, as well. If, for example, a low-carb vegan diet were found to be most beneficial, how many people with diabetes could or would actually follow it?

Have you tried following a vegetarian or vegan diet? Did it have any beneficial effect on your diabetes, and did you find it to be sustainable? If you haven’t tried a vegetarian diet, are you open to the idea? Have you not tried it simply out of habit, or because you don’t foresee any benefit from it? Would you be willing to drastically change your diet to reduce or eliminate your use of insulin or another diabetes drug? On a more general note, should organizations like the American Diabetes Association take the likelihood of recommendations being followed into account when making them? Leave a comment below!

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