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Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis.
Cardiovasc Diagn Ther 2014; 4(5):373-82CD

Abstract

INTRODUCTION

Previous studies have suggested an association between vegetarian diets and improvements in glycemic control in diabetes, although this relationship is not well established. No meta-analysis of these studies has been performed.

METHODS

To conduct a systematic review and meta-analysis of controlled clinical trials examining the association between vegetarian diets and glycemic control in type 2 diabetes.

DATA SOURCE

The electronic databases Medline, Web of Science, Excerpta Medica Database (EMBASE), and Cochrane Central Register of Controlled Trials were searched for articles published in any language through December 9, 2013.

STUDY SELECTION

The following criteria were used for study inclusion: (I) age of participants >20 years; (II) vegetarian diet as intervention; (III) mean difference in hemoglobin A1c (HbA1c) and/or fasting blood glucose levels used as outcomes; and (IV) controlled trials, duration ≥4 weeks. Exclusion criteria were: (I) not an original investigation; (II) duplicate samples; (III) diabetes other than type 2; (IV) multiple interventions; and (V) uncontrolled studies.

DATA EXTRACTION AND SYNTHESIS

The data collected included study design, baseline population characteristics, dietary data, and outcomes. Data were pooled using a random-effects model.

MAIN OUTCOMES AND MEASURES

Differences in HbA1c and fasting blood glucose levels associated with vegetarian diets were assessed.

RESULTS

Of 477 studies identified, six met the inclusion criteria (n=255, mean age 42.5 years). Consumption of vegetarian diets was associated with a significant reduction in HbA1c [-0.39 percentage point; 95% confidence interval (CI), -0.62 to -0.15; P=0.001; I(2)=3.0; P for heterogeneity =0.389], and a non-significant reduction in fasting blood glucose concentration (-0.36 mmol/L; 95% CI, -1.04 to 0.32; P=0.301; I(2)=0; P for heterogeneity =0.710), compared with consumption of comparator diets.

CONCLUSIONS

Consumption of vegetarian diets is associated with improved glycemic control in type 2 diabetes. PROSPERO registration number is CRD42013004370.

Authors+Show Affiliations

1 Graduate School of Media and Governance, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan ; 2 Department of Medicine, The George Washington University School of Medicine, Washington, DC, USA ; 3 Physicians Committee for Responsible Medicine, Washington, DC, USA ; 4 Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan ; 5 Health Science Laboratory, Graduate School of Media and Governance, Faculty of Environment and Information Studies, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan.1 Graduate School of Media and Governance, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan ; 2 Department of Medicine, The George Washington University School of Medicine, Washington, DC, USA ; 3 Physicians Committee for Responsible Medicine, Washington, DC, USA ; 4 Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan ; 5 Health Science Laboratory, Graduate School of Media and Governance, Faculty of Environment and Information Studies, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan.1 Graduate School of Media and Governance, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan ; 2 Department of Medicine, The George Washington University School of Medicine, Washington, DC, USA ; 3 Physicians Committee for Responsible Medicine, Washington, DC, USA ; 4 Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan ; 5 Health Science Laboratory, Graduate School of Media and Governance, Faculty of Environment and Information Studies, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan.1 Graduate School of Media and Governance, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan ; 2 Department of Medicine, The George Washington University School of Medicine, Washington, DC, USA ; 3 Physicians Committee for Responsible Medicine, Washington, DC, USA ; 4 Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan ; 5 Health Science Laboratory, Graduate School of Media and Governance, Faculty of Environment and Information Studies, Keio University, 5322 Endo, Fujisawa, Kanagawa, 252-0882, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25414824

Citation

Yokoyama, Yoko, et al. "Vegetarian Diets and Glycemic Control in Diabetes: a Systematic Review and Meta-analysis." Cardiovascular Diagnosis and Therapy, vol. 4, no. 5, 2014, pp. 373-82.
Yokoyama Y, Barnard ND, Levin SM, et al. Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis. Cardiovasc Diagn Ther. 2014;4(5):373-82.
Yokoyama, Y., Barnard, N. D., Levin, S. M., & Watanabe, M. (2014). Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis. Cardiovascular Diagnosis and Therapy, 4(5), pp. 373-82. doi:10.3978/j.issn.2223-3652.2014.10.04.
Yokoyama Y, et al. Vegetarian Diets and Glycemic Control in Diabetes: a Systematic Review and Meta-analysis. Cardiovasc Diagn Ther. 2014;4(5):373-82. PubMed PMID: 25414824.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis. AU - Yokoyama,Yoko, AU - Barnard,Neal D, AU - Levin,Susan M, AU - Watanabe,Mitsuhiro, PY - 2014/09/06/received PY - 2014/10/08/accepted PY - 2014/11/22/entrez PY - 2014/11/22/pubmed PY - 2014/11/22/medline KW - Type 2 diabetes KW - diet KW - plant-based diets KW - vegan KW - vegetarian SP - 373 EP - 82 JF - Cardiovascular diagnosis and therapy JO - Cardiovasc Diagn Ther VL - 4 IS - 5 N2 - INTRODUCTION: Previous studies have suggested an association between vegetarian diets and improvements in glycemic control in diabetes, although this relationship is not well established. No meta-analysis of these studies has been performed. METHODS: To conduct a systematic review and meta-analysis of controlled clinical trials examining the association between vegetarian diets and glycemic control in type 2 diabetes. DATA SOURCE: The electronic databases Medline, Web of Science, Excerpta Medica Database (EMBASE), and Cochrane Central Register of Controlled Trials were searched for articles published in any language through December 9, 2013. STUDY SELECTION: The following criteria were used for study inclusion: (I) age of participants >20 years; (II) vegetarian diet as intervention; (III) mean difference in hemoglobin A1c (HbA1c) and/or fasting blood glucose levels used as outcomes; and (IV) controlled trials, duration ≥4 weeks. Exclusion criteria were: (I) not an original investigation; (II) duplicate samples; (III) diabetes other than type 2; (IV) multiple interventions; and (V) uncontrolled studies. DATA EXTRACTION AND SYNTHESIS: The data collected included study design, baseline population characteristics, dietary data, and outcomes. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES: Differences in HbA1c and fasting blood glucose levels associated with vegetarian diets were assessed. RESULTS: Of 477 studies identified, six met the inclusion criteria (n=255, mean age 42.5 years). Consumption of vegetarian diets was associated with a significant reduction in HbA1c [-0.39 percentage point; 95% confidence interval (CI), -0.62 to -0.15; P=0.001; I(2)=3.0; P for heterogeneity =0.389], and a non-significant reduction in fasting blood glucose concentration (-0.36 mmol/L; 95% CI, -1.04 to 0.32; P=0.301; I(2)=0; P for heterogeneity =0.710), compared with consumption of comparator diets. CONCLUSIONS: Consumption of vegetarian diets is associated with improved glycemic control in type 2 diabetes. PROSPERO registration number is CRD42013004370. SN - 2223-3652 UR - https://www.unboundmedicine.com/medline/citation/25414824/full_citation L2 - https://doi.org/10.3978/j.issn.2223-3652.2014.10.04 DB - PRIME DP - Unbound Medicine ER -