by JeffN » Mon Jun 24, 2019 2:28 pm
I agree with you.
While there are no standard definitions of reversal yet (yes, even this is controversial), one should at least have numbers which have improved and are now good to excellent numbers. And in regard to blood sugars, that would be an A1c 5.6 or less, or at least under 6. After all, treatment goals are under 7. And a blood sugar under 100, if not at least under 126 (pre diabetes)
A few other points
- I am always concerned when a study attributes its benefit to a vegan diet without being very specific in regard to what about the vegan diet made the difference. Just eliminating animal products is not enough.
- Those on the vegan diet averaged 36 mg of cholesterol per 1000 calories, or about 50 mg/day so the diet wasn't even vegan. Even their definition of dietary adherence to the vegan group allowed the vegan group to not be vegan.
"For statistical purposes, dietary adherence for the vegan group was defined by 3 criteria: 1) the absence of meat, poultry, fish, dairy, or egg intake in any 24-h recalls, 3-d dietary records, or incidentally at any point; 2) saturated fat ≤5% and total fat ≤25% of energy on 3-d dietary records at 22 and 74 wk; and 3) mean daily cholesterol intake ≤50 mg on 3-d dietary records at 22 and 74 wk. Adherence for the conventional diet group was defined, based on the 22- and 74-wk 3-d dietary records, as 1) mean daily energy intake ≤200 kcal in excess of the prescribed intake and 2) saturated fat ≤10% of energy. Individuals who attended <10 of the first 22 weekly sessions were also considered nonadherent on either diet. These adherence criteria were used for descriptive purposes (not for participant teaching) and were not used in the primary outcome analysis."
When defining the details of a vegan diet to someone, do you allow for the intake of cholesterol? If so, where do they think the allowed cholesterol would come from? And, consider that, only 67% in the “vegan” group meet the “vegan” adherence criteria at 22 weeks and only 51% at 74 weeks.
- Both diets dropped caloric intake about 420 cal/day which is a 24% drop and both groups lost weight with the vegan group losing a little more.
- The vegan group doubled their intake of fruits and veggies.
Now, when I first saw this study and read through, I said, it is clear the "vegan" group ate less calories, much less fat, much more fiber and much more fruits and vegetables. This means they also lowered the energy density of their diet too (less fat, more low density foods). All of these are very good things. These are all the reasons they did somewhat better and would be expected, vegan or not.
In the discussion, this gets one sentence
"Much of the effect of the intervention diets on glycemia appears to be mediated by weight reduction. However, the 2 diets appear to have altered energy intake by different mechanisms. Although overweight individuals in the conventional diet group were prescribed an explicit energy deficit, a low-fat vegan diet typically elicits significant weight loss in the absence of prescribed energy intake limits (2). This is likely because reduced dietary fat and increased dietary fiber reduce dietary energy density (15, 16)."
Yet the conclusion makes no mention of these things and instead states....
"In conclusion, in individuals with type 2 diabetes participating in a research study, both a low-fat vegan diet and a diet based on 2003 ADA guidelines facilitated long-term weight reduction. In analyses controlling for medication changes, the vegan diet appeared to be more effective for control of glycemia and plasma lipid concentrations. Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established."
So, the Vegan Diet was not very effective (as those who often refer to this study claim), and not very vegan either.
In Health
Jeff