Gabrielle M. Turner-McGrievy, M.S., R.D.: University of North Carolina

1. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Gabrielle M. Turner-McGrievy, M.S., R.D.: University of North Carolina Neal D. Barnard, M.D.: George Washington University (GWU) Joshua Cohen, M.D.: GWU David J.A. Jenkins, M.D., Ph.D., D.Sc.: University of Toronto Lise Gloede, R.D., C.D.E.: Nutrition Coaching, LLC Amber A. Green, R.D.: Physicians Committee for Responsible Medicine JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

2. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks • While vegan diets improve diabetes management, little is known about the nutrient profiles or diet quality of individuals with type 2 diabetes adopting a vegan diet. Background JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

3. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks • The objective of this study was to assess the changes in nutrient intake and dietary quality among participants following a low-fat vegan diet or the 2003 American Diabetes Association (ADA) dietary recommendations. Objective JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

4. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Methods • In this 22-week randomized, controlled clinical trial, participants with type 2 diabetes (n = 99) were randomly assigned to a low-fat vegan diet or a 2003 ADA diet. • Nutrient intake and Alternate Healthy Eating Index (AHEI) were measured at baseline and 22-weeks. JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

5. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Within Group: Vegan • The vegan group reduced mean reported intakes of: • energy • protein • fat (total, saturated, monounsaturated, polyunsaturated, and trans) • cholesterol • vitamins D and B-12, calcium, selenium, and sodium • The vegan group increased mean reported intake of: • carbohydrate • soluble and insoluble fiber • total vitamin A activity • beta-carotene • vitamins C and K, folate, magnesium, and potassium JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

6. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Within Group: ADA • The ADA group reported significant reductions in: • energy • carbohydrate • protein • fat(total, saturated, monounsaturated, polyunsaturated, and trans) • cholesterol • vitamin D, iron, selenium, and sodium • The ADA group reported no significant increases in intake of any measured nutrient. JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

7. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Between Groups • The vegan group reduced its reported mean intakes of the following to a greater degree than did the ADA group: • -total fat • -trans fat • -saturated fat • -MUFA • -protein • -cholesterol • -vitamin D JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

8. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Between Groups • The vegan group significantly increased intakes and the ADA group decreased or had no change in intakes of the following nutrients: • carbohydrate • soluble and insoluble fiber • total vitamin A activity and beta-carotene • folate • magnesium • iron • potassium JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

9. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Between Groups • Both groups increased vitamin C but the vegan group increased it to a greater degree than did the ADA group. • The ADA group reduced sodium intake to a greater degree, compared to the vegan group. • There were no significant differences in changes in the following nutrients between groups: • energy • PUFA • vitamins E, K, B-6, and B-12 • calcium, zinc, or selenium JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

10. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Results-Alternate Healthy Eating Index • The vegan group significantly improved its overall AHEI score, while the ADA group did not (P < 0.001). *** for P < 0.001 for within-group changes. JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008

11. Changes In Nutrient Intake And Dietary Quality Among Participants With Type 2 Diabetes Following A Low-fat Vegan Diet Or A Conventional Diabetes Diet For 22 Weeks Conclusion • Vegan diets increase intakes of carbohydrate, fiber, and several micronutrients, in contrast with the ADA diet. • The vegan group improved its AHEI score whereas the ADA group’s AHEI score remained unchanged. JOURNAL OF THEAMERICAN DIETETICASSOCIATION Turner-McGrievy, G, et al. J Am Diet Assoc. 108 (10), Oct. 2008