Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density (HND) diet


Objective: The purpose of this study was to provide an initial assessment of the effectiveness of the high nutrient density (HND) diet on glycemic control and cardiovascular risk factors in participants with type 2 diabetes. Design: This was a retrospective case series study. Participants were 13 adult type 2 diabetic U.S. women and men between the ages of 30 - 80 years old. Glycosylated hemoglobin (HbA1C), lipid profile, blood pressure, BMI, and medication requirements before and after commencement of the HND diet were compared. Results: After a median length on the HND diet of 7 months, the mean HbA1C dropped from 8.2% to 5.8% (p = 0.002), with sixty-two percent of participants reaching normoglycemic levels (HbA1C < 6.0%). There was a substantial reduction in mean blood pressure for hypertensive participants (n=10) from a pre-intervention level of 148/87 mmHg to 121/74 mmHg (p = 0.0004 for systolic blood pressure, p = 0.01 for diastolic blood pressure). Triglycerides significantly decreased from a mean of 171 mg/dl to a mean of 103 mg/dl (p = 0.02). The HDL increased significantly from 48.3 mg/dl to 54.6 mg/dl (p = 0.03). The mean number of medications dropped from 4 to 1 (p = 0.0006). Conclusions: The HND diet was very effective in controlling glycemic levels and cardiovascular risk factors in 13 participants with type 2 diabetes. Therefore, there is a well-justified need for further study with the HND diet.

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Dunaief, D. , Fuhrman, J. , Dunaief, J. and Ying, G. (2012) Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density (HND) diet. Open Journal of Preventive Medicine, 2, 364-371. doi: 10.4236/ojpm.2012.23053.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Nathan, D.M., Buse, J.B., Davidson, M.B., Ferrannini, E., Holman, R.R., Sherwin, R. and Zinman, B. (2008) American diabetes association; European association for study of diabetes medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy. Diabetes Care, 32, 193-203. doi:10.2337/dc08-9025
[2] Saydah, S.H., Fradkin, J. and Cowie, C. (2004) Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. Journal of the American Medical Association, 291, 335-342. doi:10.1001/jama.291.3.335
[3] Montonen, J., Knekt, P., H?rk?nen, T., J?rvinen, R., Heli?vaara, M., Aromaa, A. and Reunanen, A. (2005) Dietary patterns and the incidence of type 2 diabetics. American Journal of Epidemiology, 161, 219-227. doi:10.1093/aje/kwi039
[4] Yl?nen, K., Alfthan, G., Groop, L., Saloranta, C., Aro, A., Virtanen, S.M. and the Botnia Research Group (2003) Dietary intakes and plasma concentrations of carotenoids and tocopherols in relation to glucose metabolism in subjects at high risk of type 2 diabetes: The Botnia dietary study. American Journal of Clinical Nutrition, 77, 1434-1441.
[5] Jenkins, D.J., Kendall, C.W., Marchie, A., Jenkins, A.L., Augustin, L.S., Ludwig, D.S., Barnard, N.D. and Anderson J.W. (2003) Type 2 diabetes and the vegetarian diet. American Journal of Clinical Nutrition, 78, 610S-616S.
[6] Bourn, D.M., Mann, J.I., McSkimming, B.J., Waldron, M.A. and Wishart, J.D. (1994) Impaired glucose tolerance and NIDDM: Does lifestyle intervention program have an effect? Diabetes Care, 17, 1311-1319. doi:10.2337/diacare.17.11.1311
[7] Ford, E.S. and Mokdad, A.H. (2001) Fruit and vegetable consumption and diabetes mellitus incidence among US adults. Preventive Medicine, 32, 33-39. doi:10.2337/diacare.17.11.1311
[8] Giammarioli, S., Filesi, C., Vitale, B., Cantagallo, A., Dragoni, F. and Sanzini, E. (2004) Effect of high intakes of fruit and vegetables on redox status in type 2 onset diabetes: A pilot study. International Journal for Vitamin and Nutrition Research, 74, 313-320. doi:10.1024/0300-9831.74.5.313
[9] Vasdev, S., Gill, V. and Singal P. (2007) Role of advanced glycation end products in hypertension and atherosclerosis: Therapeutic implications. Cell Biochemistry and Biophysics, 49, 48-63. doi:10.1007/s12013-007-0039-0
[10] Cervantes-Laurean, D., Schramm, D.D., Jacobson, E.L., Halaweish, I., Bruckner, G.G. and Boissonneault, G.A. (2006) Inhibition of advanced glycation end product formation on collagen by rutin and its metabolites. Journal of Nutritional Biochemistry, 17, 531-540. doi:10.1016/j.jnutbio.2005.10.002
[11] Benetou, V., Trichopoulou, A., Orfanos, P., Naska, A., Lagiou, P., Boffetta, P. and Trichopoulos, D. (2008) Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. British Journal of Cancer, 99, 191-195. doi:10.1038/sj.bjc.6604418
[12] Martinez-Gonzalez, M.A., de la Fuente-arrillaga, C., Nunez-Cordoba, J.M., Basterra-Gortari, F.J., Beunza, J.J., Vazquez, Z., Benito, S., Tortosa, A. and Bes-Rastrollo, M. (2008) Adherence to Mediterranean diet and risk of developing diabetes: Prospective cohort study. British Medical Journal, 336, 1348-1351. doi:10.1136/bmj.39561.501007.BE
[13] Trichopoulou, A. and Lagiou, P. (2007) Healthy traditional Mediterranean diet: An expression of culture, history, and lifestyle. Nutrition Reviews, 55, 383-389. doi:10.1111/j.1753-4887.1997.tb01578.x
[14] Lanou, A.J. (2009) Should dairy be recommended as part of a healthy vegetarian diet? Counterpoint. American Journal of Clinical Nutrition, 89, 1638S-1642S. doi:10.3945/ajcn.2009.26736P
[15] Kris-Etherton, P.M., Hu, F.B., Ros, E. and Sabaté J. (2008) The role of tree nuts and peanuts in prevention of coronary heart disease. Journal of Nutrition, 138, 1746S- 1751S.
[16] Jiang, R., Manson, J.E., Sampfer, M.J., Liu, S., Willett, W.C. and Hu, F.B. (2002) Nut and peanut butter consumption and risk of type 2 diabetes in women. Journal of the American Medical Association, 288, 2554-2560. doi:10.1001/jama.288.20.2554
[17] Sabate, J. and Ang, Y. (2009) Nuts and health outcomes: New epidemiologic evidence. American Journal of Clinical Nutrition, 89, 1643S-1648S. doi:10.3945/ajcn.2009.26736Q
[18] Albert, C.M., Gaziano, J.M., Willett, W.C. and Manson, J.E. (2002) Nut consumption and decreased risk of sud- den cardiac death in the Physicians’ Health Study. Archives of Internal Medicine, 162, 1382-1387.
[19] Hu, F.B., Stampfer, M.J., Manson, J.E., Rimm, E.B., Colditz, G.A., Rosner, B.A., Speizer, F.E., Hennekens, C.H. and Willett, W.C. (1998) Frequent nut consumption and risk of coronary heart disease in women: Prospective cohort study. British Medical Journal, 317, 1341-1345. doi:10.1136/bmj.317.7169.1341
[20] Sabate, J. (1999) Nut consumption, vegetarian diets, ischemic heart disease risk and all-cause mortality: Evidence from epidemiologic studies. American Journal of Clinical Nutrition, 70, 500S-503S.
[21] Li, T.Y., Brennan, A.M., Weddick, N.M., Mantzoros, C., Rifai, N. and Hu, F.B. (2009) Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with Type 2 Diabetes. Journal of Nutrition, 139, 1333-1338. doi:10.3945/jn.108.103622
[22] Jenkins, D.J., Hu, F.B., Tapsell, L.C., Josse, A.R. and Kendall, C.W. (2008) Possible benefit of nuts in Type 2 diabetes. Journal of Nutrition, 138, 1752S-1756S.
[23] American Diabetes Association (2008) Standards of medical care in diabetes-2008. Diabetes Care, 31, S12- S54. doi:10.2337/dc08-S012
[24] Chobanian, A., Bakris, G., Black, H.R., Cushman, W.C., Green, L.A., Izzo, J.L. Jr., Jones, D.W., Materson, B.J., Oparil, S, Wright, J.T., Jr., Roccella, E.J. and the National High Blood Pressure Education Program Coordinating Committee (2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Journal of the American Medical Associ-ation, 289, 2560-2571. doi:10.1001/jama.289.19.2560
[25] Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Journal of the American Medical Association, 285, 2486-2497. doi:10.1001/jama.285.19.2486
[26] Classification of overweight and obesity by BMI, waist circumference, and associated diseaserRisks (2009)
[27] Barnard, N.D., Cohen, J., Jenkins, D.J., Turner-McGrievy, G., Gloede, .L, Jaster, B., Seidl, K., Green, A.A. and Talpers, S. (2006) A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care, 29, 1777-1783. doi:10.2337/dc06-0606
[28] Barnard, N.D., Cohen, J., Jenkins, D.J., Turner-McGrievy, G., Gloede, L., Green, A. and Ferdowsian, H. (2009) A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: A randomized, controlled, 74-wk clinical trial. American Journal of Clinical Nutrition, 89, 1588S-1596S. doi:10.3945/ajcn.2009.26736H
[29] Arca, M., Montali, A., Valiante, S., Campagna, F., Pigna, G., Paoletti, V., Antonini, R., Barilla, F., Tanilli, G., Vestri, A. and Gaudio, C. (2007) Usefulness of atherogenic dys-lipidemia for predicting cardiovascular risk in patients with angiographically defined coronary artery disease. American Journal of Cardiology, 100, 1511-1516. doi:10.1016/j.amjcard.2007.06.049
[30] National Diabetes Statistics 2007 (2008) Internet accessed 25 May 2009.

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