{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:57:10Z","timestamp":1791467830495,"version":"4.3.4"},"reference-count":50,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"unspecified","delay-in-days":37,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 DK045735"],"award-info":[{"award-number":["P30 DK045735"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 DK135645"],"award-info":[{"award-number":["R01 DK135645"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016441","name":"Physicians Committee for Responsible Medicine","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100016441","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2026,9,18]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design and methods<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:sup>1<\/jats:sup>\n                      H 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean body weight decreased by 6.0 kg (95% CI \u22127.0 to \u22125.1; p&lt;0.001), a 6.6% (95% CI \u22127.5 to \u22125.8) decrease relative to baseline. This was largely due to the reduction in fat mass (\u22124.2 kg, 95% CI \u22125.7 to \u22122.7; p&lt;0.001). Visceral fat volume decreased by 290 cm\n                      <jats:sup>3<\/jats:sup>\n                      (95% CI \u2212467 to \u2212114; p=0.003). Hepatocellular lipids decreased by 33.0% (95% CI \u221248.7 to \u221217.3; p&lt;0.001). The AGE score decreased by 0.4 (95% CI \u22120.6 to \u22120.2; p=0.002). The HOMA-IR index, a measure of insulin resistance, fell (\u22122.5, 95% CI \u22124.1 to \u22120.9; p=0.004), whereas PREDIM, a measure of insulin sensitivity, increased on the vegan diet (+1.3\u2009mg\/min\/kg, 95% CI +0.6\u2009to +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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06106035\">NCT06106035<\/jats:ext-link>\n                      .\n         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