{"doi":"10.3389/fnut.2025.1605769","title":"Plant-based dietary index and body weight in people with type 1 diabetes: a secondary analysis of a randomized clinical trial","abstract":"<jats:sec><jats:title>Objective</jats:title><jats:p>This secondary analysis tested the relationship of a plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI), with weight loss in adults with type 1 diabetes.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Fifty-eight adults with type 1 diabetes were randomized to follow an <jats:italic>ad libitum</jats:italic> low-fat vegan (<jats:italic>n</jats:italic> = 29) or a portion-controlled, energy-restricted diet (<jats:italic>n</jats:italic> = 29) for 12 weeks. Food records were analyzed and PDI indices were calculated. A repeated measure ANOVA, Spearman correlations, and a linear regression model were used for statistical analysis.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The PDI score increased on the vegan diet (<jats:italic>p</jats:italic> &amp;lt; 0.001) from 51.8 to 60.4, and did not change on the portion-controlled diet [effect size +6.0 (95% CI + 1.0 to +10.9); <jats:italic>p</jats:italic> = 0.02]; the hPDI increased on both diets, more on the vegan diet [effect size +9.1 (95% CI + 3.7 to +14.5); <jats:italic>p</jats:italic> = 0.002]; and uPDI increased on the vegan diet, and did not change on the portion-controlled diet [effect size +7.3 (95% CI + 1.9 to +12.7); <jats:italic>p</jats:italic> = 0.01]. Changes in PDI and hPDI scores correlated with changes in body weight [<jats:italic>r</jats:italic> = −0.35; <jats:italic>p</jats:italic> = 0.04 for PDI; and <jats:italic>r</jats:italic> = −0.52; <jats:italic>p</jats:italic> = 0.001 for hPDI], even after adjustment for changes in energy intake [<jats:italic>r</jats:italic> = −0.37; <jats:italic>p</jats:italic> = 0.04 for PDI; and <jats:italic>r</jats:italic> = −0.53; <jats:italic>p</jats:italic> = 0.001 for hPDI]. An increase in hPDI by 6.1 points was associated with a 1-kg weight loss (<jats:italic>p</jats:italic> = 0.01). There was no association between the changes in uPDI and changes in body weight (<jats:italic>r</jats:italic> = −0.07; <jats:italic>p</jats:italic> = 0.68).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The study results suggest that replacing animal foods with plant foods is an effective strategy for weight loss in adults with type 1 diabetes. The inclusion of “unhealthy” plant-based foods did not impair weight loss, and these benefits were independent of energy intake.</jats:p></jats:sec><jats:sec><jats:title>Clinical trial registration</jats:title><jats:p><jats:uri>ClinicalTrials.gov</jats:uri>, identifier NCT04944316.</jats:p></jats:sec>","journal":"Frontiers in Nutrition","year":2025,"id":597560,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1530909,"name":"Ilana Fischer","orcid":null,"position":1,"is_corresponding":false},{"id":1530910,"name":"Reagan Smith","orcid":null,"position":2,"is_corresponding":false},{"id":1530911,"name":"Joseph Himmelfarb","orcid":null,"position":3,"is_corresponding":false},{"id":1530912,"name":"Tatiana Znayenko-Miller","orcid":null,"position":4,"is_corresponding":false},{"id":502580,"name":"Richard Holubkov","orcid":"0000-0003-0431-3381","position":5,"is_corresponding":false},{"id":1530913,"name":"Neal D. Barnard","orcid":null,"position":6,"is_corresponding":false},{"id":1530908,"name":"Hana Kahleova","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Plant-based dietary index and body weight in people with type 1 diabetes: a secondary analysis of a randomized clinical trial","abstract":"<jats:sec><jats:title>Objective</jats:title><jats:p>This secondary analysis tested the relationship of a plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI), with weight loss in adults with type 1 diabetes.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Fifty-eight adults with type 1 diabetes were randomized to follow an <jats:italic>ad libitum</jats:italic> low-fat vegan (<jats:italic>n</jats:italic> = 29) or a portion-controlled, energy-restricted diet (<jats:italic>n</jats:italic> = 29) for 12 weeks. Food records were analyzed and PDI indices were calculated. A repeated measure ANOVA, Spearman correlations, and a linear regression model were used for statistical analysis.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The PDI score increased on the vegan diet (<jats:italic>p</jats:italic> &amp;lt; 0.001) from 51.8 to 60.4, and did not change on the portion-controlled diet [effect size +6.0 (95% CI + 1.0 to +10.9); <jats:italic>p</jats:italic> = 0.02]; the hPDI increased on both diets, more on the vegan diet [effect size +9.1 (95% CI + 3.7 to +14.5); <jats:italic>p</jats:italic> = 0.002]; and uPDI increased on the vegan diet, and did not change on the portion-controlled diet [effect size +7.3 (95% CI + 1.9 to +12.7); <jats:italic>p</jats:italic> = 0.01]. Changes in PDI and hPDI scores correlated with changes in body weight [<jats:italic>r</jats:italic> = −0.35; <jats:italic>p</jats:italic> = 0.04 for PDI; and <jats:italic>r</jats:italic> = −0.52; <jats:italic>p</jats:italic> = 0.001 for hPDI], even after adjustment for changes in energy intake [<jats:italic>r</jats:italic> = −0.37; <jats:italic>p</jats:italic> = 0.04 for PDI; and <jats:italic>r</jats:italic> = −0.53; <jats:italic>p</jats:italic> = 0.001 for hPDI]. An increase in hPDI by 6.1 points was associated with a 1-kg weight loss (<jats:italic>p</jats:italic> = 0.01). There was no association between the changes in uPDI and changes in body weight (<jats:italic>r</jats:italic> = −0.07; <jats:italic>p</jats:italic> = 0.68).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The study results suggest that replacing animal foods with plant foods is an effective strategy for weight loss in adults with type 1 diabetes. The inclusion of “unhealthy” plant-based foods did not impair weight loss, and these benefits were independent of energy intake.</jats:p></jats:sec><jats:sec><jats:title>Clinical trial registration</jats:title><jats:p><jats:uri>ClinicalTrials.gov</jats:uri>, identifier NCT04944316.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"40474900","pmcid":null,"openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1605769/pdf","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fnut.2025.1605769/full","host_type":"publisher"},{"url":"https://doaj.org/article/78aa6c944280419fb50b54f031e35306","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12137060","host_type":"repository"}],"fields_of_study":[],"mesh_terms":[],"keywords":["Body weight","Plant-based dietary index","diet quality","nutrition","plant-based","portion-controlled","type 1 diabetes","vegan"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-28T13:35:38.893135Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}