Study participants on the low-fat vegan diet showed dramatic improvement in four disease markers: blood sugar control, cholesterol reduction, weight control, and kidney function. The randomized controlled trial was conducted by doctors and dieticians with the Physicians Committee for Responsible Medicine (PCRM), the George Washington University, and the University of Toronto with funding from the National Institutes of Health and the Diabetes Action Research and Education Foundation.

The vegan diet represents a major departure from current diabetes diets, in that it placed no limits on calories, carbohydrates, or portions. "The diet appears remarkably effective, and all the side effects are good ones--especially weight loss and lower cholesterol," says lead researcher Neal D. Barnard, M.D., PCRM president and adjunct associate professor of medicine at the George Washington University. "I hope this study will rekindle interest in using diet changes first, rather than prescription drugs."

Diabetes rates have climbed rapidly in recent years, and more than 20 million Americans now have the disease, which is linked to kidney failure, blindness, and cardiovascular disease.

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After six hours, researchers found the meal high in saturated fat had diminished the protective qualities of HDL, allowing more inflammatory agents to accumulate in the arteries than had been present before the volunteers ate. The polyunsaturated meal, however, seemed to boost the anti-inflammatory abilities of the body's good cholesterol, with the researchers finding fewer inflammatory agents in the arteries than before the volunteers ate.

"In putting this all together," Dr. Nicholls said, "we have a difference between the two meals regarding a number of factors that influence the early stages of plaque formation. We have a situation where consumption of a single meal containing a high level of saturated fat is associated with impairment of vascular reactivity and impairment of a normal protective property of HDL. In contrast, consumption of a meal high in polyunsaturated fat results in HDL that is more protective.

"It is a small study," he concluded, "but I think the findings have broad implication because diet and exercise are the cornerstones of all strategies for preventing heart disease."

Robert Vogel, MD, a cardiologist and professor of medicine at the University of Maryland Medical Center, did not participate in the research, but agrees it provides "one more nail in the coffin" against eating diets high in saturated fat.

"This study helps to flesh out just why we shouldn't eat too much saturated fat," Dr. Vogel said. "Traditionally, we think of unhealthy foods as raising cholesterol or raising blood pressure, but this demonstrates that depending on what you eat, you can actually change the effect of HDL - typically thought of as 'good' cholesterol - from protective to detrimental. This opens up new insights and avenues for research."

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