{
  "abstract": "Objective\n\nThe aim of this study was to explore the effects of a low-fat plant-based diet on hepatocellular and intramyocellular lipids, advanced glycation end products (AGEs), insulin resistance, and beta-cell function in adults with type 2 diabetes.Research design and methods\n\nParticipants (n=25) were asked to follow a low-fat vegan diet for 16 weeks. Dual X-ray absorptiometry was used to measure body composition. Hepatocellular and intramyocellular lipids were quantified by ¹H magnetic resonance spectroscopy. Tissue accumulation of AGEs was measured using a skin fluorescence technique. Insulin resistance was assessed in a fasting state with the Homeostasis Model Assessment (HOMA-IR) index. Postprandial insulin sensitivity was assessed with the predicted insulin sensitivity index (PREDIM). Beta-cell function was calculated by a mathematical model after a standard meal, using C-peptide deconvolution.Results\n\nMean body weight decreased by 6.0 kg (95% CI -7.0 to -5.1; p<0.001), a 6.6% (95% CI -7.5 to -5.8) decrease relative to baseline. This was largely due to the reduction in fat mass (-4.2 kg, 95% CI -5.7 to -2.7; p<0.001). Visceral fat volume decreased by 290 cm³ (95% CI -467 to -114; p=0.003). Hepatocellular lipids decreased by 33.0% (95% CI -48.7 to -17.3; p<0.001). The AGE score decreased by 0.4 (95% CI -0.6 to -0.2; p=0.002). The HOMA-IR index, a measure of insulin resistance, fell (-2.5, 95% CI -4.1 to -0.9; p=0.004), whereas PREDIM, a measure of insulin sensitivity, increased on the vegan diet (+1.3 mg/min/kg, 95% CI +0.6 to +2.1; p=0.002). Several markers of beta-cell function improved on the vegan diet. Specifically, insulin secretion at 6 and 7 mmol/L glucose, beta-cell glucose sensitivity, rate sensitivity, and potentiation factor all increased.Conclusions\n\nOn an ad libitum low-fat plant-based (vegan) dietary intervention, the participants with type 2 diabetes experienced reductions in ectopic fat, particularly visceral and hepatocellular fat, improvements in insulin sensitivity, reductions in AGEs, and improvements in beta-cell function.Trial registration number\n\nNCT06106035.",
  "abstract_shown": true,
  "affiliations": [
    "Clinical Research, Physicians Committee for Responsible Medicine, Washington, District of Columbia, USA hana.kahleova@gmail.com.",
    "Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.",
    "Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.",
    "Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, USA.",
    "Clinical Research, Physicians Committee for Responsible Medicine, Washington, District of Columbia, USA.",
    "Metabolic Unit, ISIB-CNR, Padova, Italy.",
    "School of Medicine, University of Utah Health, Salt Lake City, Utah, USA.",
    "The George Washington University, Washington, District of Columbia, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hana Kahleova",
      "orcid": "0000-0003-0491-3993"
    },
    {
      "affs": [
        1
      ],
      "name": "Kitt Petersen"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Gerald I Shulman"
    },
    {
      "affs": [
        4
      ],
      "name": "Tatiana Znayenko-Miller"
    },
    {
      "affs": [
        2
      ],
      "name": "Sylvie Dufour"
    },
    {
      "affs": [
        4
      ],
      "name": "Haley Brennan"
    },
    {
      "affs": [
        4
      ],
      "name": "Cristina Maracine"
    },
    {
      "affs": [
        5
      ],
      "name": "Andrea Tura"
    },
    {
      "affs": [
        6
      ],
      "name": "Richard Holubkov"
    },
    {
      "affs": [
        4,
        7
      ],
      "name": "Neal D Barnard"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4paa73y2g5f0e.bib",
  "cited_by": 0,
  "doi": "10.1136/bmjdrc-2026-006472",
  "fulltext_url": "https://europepmc.org/articles/PMC13656109",
  "id": "4paa73y2g5f0e",
  "issns": [
    "2052-4897"
  ],
  "landing_url": "https://europepmc.org/article/MED/42850024",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2739|Nutritional Studies and Diet"
    ]
  ],
  "openalex": "W7220915253",
  "pdf_url": "https://europepmc.org/articles/PMC13656109?pdf=render",
  "pmcid": "PMC13656109",
  "pmid": "42850024",
  "published": "2026-10-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4paa73y2g5f0e.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:02Z",
      "native_id": "MED:42850024",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42850024"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Nutritional Studies and Diet",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Changes in ectopic lipids, insulin sensitivity, and beta cell function after a low-fat vegan diet in adults with type 2 diabetes: a 16-week single-arm clinical trial.",
  "title_text": "Changes in ectopic lipids, insulin sensitivity, and beta cell function after a low-fat vegan diet in adults with type 2 diabetes: a 16-week single-arm clinical trial.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:02Z",
  "url": "https://research.draconitic.com/paper/4paa73y2g5f0e",
  "venue": "BMJ open diabetes research & care",
  "versions": []
}