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.
8 affiliations
- 1Clinical Research, Physicians Committee for Responsible Medicine, Washington, District of Columbia, USA [email protected].
- 2Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
- 3Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
- 4Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, USA.
- 5Clinical Research, Physicians Committee for Responsible Medicine, Washington, District of Columbia, USA.
- 6Metabolic Unit, ISIB-CNR, Padova, Italy.
- 7School of Medicine, University of Utah Health, Salt Lake City, Utah, USA.
- 8The George Washington University, Washington, District of Columbia, USA.
Abstract
Objective
The 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
Participants (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
Mean 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
On 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
NCT06106035.
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BibTeX
@article{kahleova2026changes,
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.}},
author = {Hana Kahleova and Kitt Petersen and Gerald I Shulman and Tatiana Znayenko-Miller and Sylvie Dufour and Haley Brennan and Cristina Maracine and Andrea Tura and Richard Holubkov and Neal D Barnard},
journal = {BMJ open diabetes research \& care},
year = {2026},
month = oct,
doi = {10.1136/bmjdrc-2026-006472},
url = {https://europepmc.org/article/MED/42850024},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - 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.
AU - Hana Kahleova
AU - Kitt Petersen
AU - Gerald I Shulman
AU - Tatiana Znayenko-Miller
AU - Sylvie Dufour
AU - Haley Brennan
AU - Cristina Maracine
AU - Andrea Tura
AU - Richard Holubkov
AU - Neal D Barnard
PY - 2026
DA - 2026/10/08
JO - BMJ open diabetes research & care
DO - 10.1136/bmjdrc-2026-006472
UR - https://europepmc.org/article/MED/42850024
AB - Objective The 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 Participants (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 Mean 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 On 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 NCT06106035.
SN - 2052-4897
ER -