Effects of lacto-vegetarian and vegan diets on glycemic responses and metabolite profiles in healthy adults: a randomized trial using continuous glucose monitoring and targeted metabolomics
Zhu, X., Gayathri, R., Sriram Manasa, V., Abirami, K., Bhupathiraju, S. N., Mohan Anjana, R., Givens, D. I.
It is advisable to refer to the publisher's version if you intend to cite from this work. See Guidance on citing. To link to this item DOI: 10.1016/j.clnu.2025.04.018 Abstract/SummaryBackground Our previous studies have demonstrated that dairy products protect against type 2 diabetes (T2D) and improve cardiometabolic health outcomes. Given that continuous glucose monitoring (CGM) and metabolomics analysis capture different aspects of T2D, this study investigated the effects of dairy and non-dairy products on the glycemic and metabolite profiles in healthy adults following lacto-vegetarian and vegan diets. Methods A parallel randomized feeding trial with 30 participants compared isoenergetic vegan and lacto-vegetarian diets. All participants wore CGM sensors for 14 days to track glucose concentrations. Anthropometric and biochemical characteristics were also measured. In a subgroup of 13 individuals, fasting and postprandial blood samples were collected on days 1 and 15 for metabolomics analysis. Results Our CGM data showed higher mean glucose concentrations in the vegan group over 14 days compared to the lacto-vegetarian group (p = 0.0399), after adjusting for age, sex, body mass index, and baseline glucose concentrations. Metabolomics analysis from day 1 to day 15 showed increased postprandial phenylalanine (Phe; p = 0.0189) in the vegan group, while the lacto-vegetarian group showed increased acetyl carnitine (C2; p = 0.00704) and decreased argininosuccinic acid (p = 0.0149). Conclusions Our pilot CGM data suggest a lacto-vegetarian diet may offer better glycemic control, potentially explained by our preliminary metabolomics findings. The increased Phe observed in the vegan group may be explained by a hypothetical mechanism in which higher glucose induces oxidative stress, whereas the increased C2 from dairy in the lacto-vegetarian group may protect against oxidative stress, contributing to lower glucose concentrations. However, larger, longer-term studies with more diverse populations, along with in vitro investigations into biomolecular mechanisms, are needed to confirm these findings.
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