Food to the rescue: new federally funded study supports major shift in diet treatment for diabetes: it seems too simple to be true. But the numbers prove it beyond a shadow of a doubt. A low-fat vegan (no animal products) diet treats type 2 diabetes more effectively than the standard diabetes diet or oral medication.

Diabetes is not necessarily a one-way street. Recent studies have shown that persons with type 2 diabetes can improve and, in some cases, even reverse the disease by switching to an unrefined, vegan diet.

Funded by the National Institutes of Health and working with Georgetown University and the University of Toronto, a research team from the Physician's Committee for Responsible Medicine (PCRM) set about to compare two different diets: a high-fiber, low-fat, vegan diet; and the more commonly used American Diabetes Association (ADA) diet. They invited persons with non-insulin-dependent diabetes and their spouses or partners to follow one of the two diets for three months. Caterers prepared take-home lunches and dinners, so participants could simply heat up the food at home.

The vegan meals were made from unrefined vegetables, grains, beans, and fruits, with no refined ingredients such as vegetable oil, white flour, or white pasta. These meals averaged just 10 percent fat (as a percentage of calories) and 80 percent complex carbohydrate. They also offered 60-70 grams of fiber per day and had no cholesterol at all.

The comparison ADA diet contained somewhat more plant-based ingredients than the average American diet, but still relied on the conventional chicken and fish recipes. This diet was 30 percent fat and 50 percent carbohydrate. It provided about 30 grams of fiber and 200 milligrams of cholesterol per day.

Participants in both groups met two evenings per week for group sessions covering nutrition, cooking, and support.

Planning the Study

The researchers faced several challenges in planning the study. Would persons with diabetes--and their partners--volunteer for the study? Would they change their eating habits and maintain the study program for the full three months? Could they find caterers who would dependably prepare and deliver attractive vegan and ADA meals?

The first of these worries was quickly dispelled. On the very first day that their advertisement appeared in the newspaper, more than 100 people responded. The participants who were accepted for the study threw themselves into it with enthusiasm. One said, "I was amazed at how powerful the vegan diet was right from the beginning. The blood sugars and weight just started falling off."

Surprising Results

Some subjects were pleasantly surprised at how well they adapted to the experimental vegan diet. One said, "If anyone had told me 12 weeks ago that I would be satisfied with a totally vegetarian diet, I would not have believed it." Another participant needed more time to adjust: "In the beginning, it's not an easy diet. But I managed to lose--at last count--17 pounds. I am no longer on medication for diabetes, and I am no longer on medication for blood pressure. So, actually, it's been a very, very positive result for me."

Some found unexpected benefits: "My asthma has really improved," one reported enthusiastically. "I'm not taking as much asthma medicine because I can breathe better. The overall mental outlook on how I feel about myself as a diabetic is much more hopeful now, as I am self-sufficient with a diet that makes sense for me."

Vance, a study participant and former police officer who lives in the District of Columbia, saw his high blood sugar plunge rapidly into the normal range as he dropped 60 pounds. Nancy, another study subject, whose diabetes was worsening and not responding to intensified drug therapy, experienced a 42-pound weight loss and was able to discontinue one of her medications.

The Edge

The team found that both groups did an overall great job in adhering to their prescribed diets. However, the vegan group clearly had the edge in many of the results. Fasting blood sugars decreased 59 percent more in the vegan group than in the ADA group. And, while the vegans needed less medication to control their blood sugars, the ADA group needed just as much medicine as before. The vegans were taking less medicine, but were in better control.

While the ADA group lost, on average, an impressive eight pounds, the vegans saw their average weight drop nearly 16 pounds. Cholesterol levels also fell more substantially in the vegan group compared to the ADA group.

Diabetes can cause serious damage to the kidneys, resulting in protein loss in the urine. Several of the subjects already had significant protein loss at the beginning of the study, and the ADA group did not improve in this respect. In fact, their protein losses actually worsened somewhat over the 12 weeks of the study. The vegan group, on the other hand, had a large reduction in protein losses.

Major Departure

The vegan diet represents a major departure from current diabetes diets in that it places no limits on calories, carbohydrates, or portions. "The diet appears remarkably effective," says lead researcher Neal D. Barnard, M.D., PCRM president and adjunct associate professor of medicine at the George Washington University, "and all the side effects are good ones--especially weight loss and lower cholesterol. I hope this study will rekindle interest in using diet changes first, rather than prescription drugs."

TYPES OF DIABETES

TYPE 1, often called juvenile or insulin-dependent diabetes

TYPE 2, often called adult or non-insulin-dependent diabetes

GESTATIONAL, occurs during pregnancy

Lower Your Child's Risk

Although there is no way to prevent type 1 diabetes, there are certain steps you can take to lower a child's risk. In Caucasian populations, children who develop diabetes are more likely to have had cow's milk as an infant, and children who do not develop diabetes are more likely to have been exclusively breast fed. Therefore, some doctors recommend breast-feeding children who have parents or siblings with diabetes.

Amy Adams, M.S. and Jeremy Walston, M.D. www.genetichealth.com

FOODS TO INCLUDE

Fruits Eat unlimited amounts of most fruits.

Beans and Legumes Enjoy beans, peas, lentils, low-fat tofu, unsweetened soymilk, and fat-free soy foods such as veggie burgers and other meat alternatives.

Whole Grains Load up on carbohydrate-rich whole grains such as oatmeal, barley, couscous, rice; rye and pumpernickel breads; and pasta.

Vegetables Eat plenty of vegetables including low-glycemic ones such as yams and sweet potatoes, carrots, green beans, and cauliflower.

FOODS TO AVOID

Animal products Avoid red meat, poultry, fish, all dairy products (regular and fat-free), including cheese and eggs.

High-glycemic foods Foods high on the glycemic index increase blood sugar too rapidly. These include sugar, white bread, most cold cereals, and baking potatoes.

Added vegetable oils and other high-fat foods Keep added oils, oily toppings, fried foods, peanut butter, olives, and avocados to a minimum.

The Physician's Committee for Responsible Medicine is a nonprofit health organization that promotes preventive medicine and good nutrition. Visit them at www.pcrm.org.