From vegconomist.com
A recent secondary analysis of a randomised clinical trial published in Frontiers in Nutrition examined the effects of plant-based diets on body weight among adults with type 1 diabetes. Conducted by researchers at the Physicians Committee for Responsible Medicine, the study evaluated how different categories of plant-based foods impacted weight loss compared to a portion-controlled diet.
“Our research shows that replacing animal products with plant-based foods […] benefits people with type 1 diabetes who are looking to lose weight”
The trial involved 58 adults with type 1 diabetes, randomised to either an ad libitum low-fat vegan diet or a portion-controlled, energy-restricted diet over 12 weeks. The vegan diet excluded all animal products and placed no restrictions on calorie or carbohydrate intake. The portion-controlled diet focused on caloric reduction for overweight participants and maintained consistent carbohydrate consumption.
Dietary intake was assessed using the Plant-based Dietary Index (PDI) framework, which categorizes plant foods into healthful (hPDI)—including fruits, vegetables, whole grains, legumes, nuts, oils, coffee, and tea—and unhealthful (uPDI)—including fruit juices, sugar-sweetened beverages, refined grains, potatoes, and sweets. Scores in these categories reflect the relative consumption of respective foods.
Participants following the vegan diet increased overall PDI and hPDI scores significantly, while their uPDI scores also rose. In contrast, the portion-controlled group showed no significant change in PDI or uPDI but experienced a modest increase in hPDI. Notably, vegan diet participants increased intake of legumes, whole grains, and fruits, but reduced consumption of vegetable oils and nuts, whereas the portion-controlled group increased whole grain intake only.
Significant weight loss for vegan group
Weight loss averaged 5.2 kilograms (approximately 11 pounds) in the vegan group, with no significant weight change in the portion-controlled group. Statistical analysis showed a correlation between increases in PDI and hPDI scores and reductions in body weight, even after adjusting for changes in energy intake. No such relationship was observed for changes in uPDI.
Lead author Hana Kahleova, MD, PhD, noted: “Our research shows that replacing animal products with plant-based foods—even so-called ‘unhealthy’ ones, as defined by the plant-based diet index—benefits people with type 1 diabetes who are looking to lose weight.
“Whether you have an orange and oatmeal for breakfast or orange juice and toasted white bread, either option is a better choice for weight loss than eggs and cottage cheese.”
Previous findings from the primary trial reported that the vegan diet improved insulin sensitivity, reduced insulin requirements, enhanced glycaemic control, and improved cholesterol and kidney function in the same patient group.
The study’s design included weekly dietary counselling by registered dietitians, and participants recorded all meals via a digital tracking tool. Physical activity and medication regimens were kept stable during the intervention.
Weight loss without calorie restriction
The analysis found no association between changes in plant-based dietary indices and total energy intake, suggesting that the weight loss observed was independent of caloric restriction. Researchers pointed out that while some plant-based “unhealthful” foods did not negatively impact weight loss, consumption of vegetable oils and nuts—categorized as healthful—declined in the vegan group, which may have contributed to weight reduction.
This study adds to existing literature on diet and type 1 diabetes, demonstrating that substitution of animal products with plant foods can produce weight loss without caloric limits, irrespective of the perceived healthfulness of specific plant-based foods.
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