Advisor(s)
Courtney Peterson
Committee Member(s)
Barbara Gower
Jose Fernandez
Laura Rogers
Timothy Garvey
School
School of Health Professions
Document Type
Dissertation
Department (new version)
Nutrition Sciences
Date of Award
1-6-2025
Abstract
Type 2 diabetes (T2D) is a global health and economic concern. Safe and effective treatments for T2D, including dietary approaches, are limited. Additionally, it remains unclear whether dietary carbohydrate quality or quantity matters more for managing T2D. Most nutrient-dense carbohydrate quality sources—such as fruit, vegetables, legumes, and whole grains—come from plant foods and are recommended for people with T2D by the American Diabetes Association. Furthermore, when these food groups are combined into a dietary pattern, a whole-food, plant-based (WFPB) diet is created. However, few studies have tested the effects of a WFPB diet or carbohydrate-rich food groups in people with T2D. Therefore, the objective of this dissertation is to investigate whether WFPB diets can improve cardiometabolic health in adults with T2D. First, we tested the effects of a WFPB diet and exercise in adults with T2D compared to standard medical care (SMC). Second, we examined the effects of a fruit-rich Mediterranean diet on glycemic control in weight-stable adults with T2D. Third, we examined the effects of such a diet on ectopic fat and cardiovascular disease risk factors in weight-stable adults with T2D. First, we found that a WFPB diet and exercise was superior to SMC at reducing HbA1c, inflammation, body weight, and waist circumference while also reducing T2D and cardiovascular medications. The WFPB diet also induced T2D remission in some patients. Second, we found that a fruit-rich Mediterranean diet improved glycemic control in 90% of participants, reduced antihyperglycemic medication use in 75% of participants who were on T2D medications at baseline, and induced non-diabetic glucose levels in 30% of participants even after medication cessation. However, participants’ 24-hour mean glucose levels worsened before getting better. Third, a fruit-rich Mediterranean diet substantially lowered blood pressure, while increasing triglycerides and HDL cholesterol. The diet did not change liver or pancreatic fat, though liver fat transiently increased before decreasing back to baseline. Collectively, this dissertation shows that high-carbohydrate, WFPB diets provide cardiometabolic beneficial effects and may be able to induce T2D remission in some patients.
ProQuest ID
Recommended Citation
Hanick, Cody, "Effects Of Whole-Food, Plant-Centered Diets On Glycemic Control, Medication Use, Ectopic Fat, And Cardiovascular Health In Adults With Type 2 Diabetes" (2025). All ETDs from UAB. 7291.
https://digitalcommons.library.uab.edu/etd-collection/7291
