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Diabetes

05 August 2019

No 'one-size-fits-all' diet for diabetics, expert panel says

There is no ideal percentage of calories from carbohydrates, proteins and fats for diabetics – each person is different.

There is no one right diet for people with diabetes, and patients should instead have personalised nutrition plans, a new American Diabetes Association (ADA) report says.

There simply is no ideal percentage of calories from carbohydrates, proteins and fats. And combinations of different foods or food groups are acceptable for the management of diabetes and pre-diabetes, the report added.

Weight management essential

"'What can I eat?' is the number one question asked by people with diabetes and pre-diabetes when diagnosed," said Dr William Cefalu, chief scientific, medical and mission officer at the ADA. "This new consensus report reflects the ADA's continued commitment to evidence-based guidelines that are achievable and meet people where they are."

As with type 2 diabetes, being obese with type 1 diabetes can worsen insulin resistance, blood sugar levels, microvascular disease complications and heart disease risk factors. Therefore, weight management should be an essential component of care for people with type 1 diabetes who are overweight or obese, as it is for those with type 2 diabetes, the report said.

General recommendations on nutrition plans include: emphasis on non-starchy vegetables; minimising added sugars and refined grains; eating whole, unprocessed foods as much as possible; replacing sugary beverages with water as often as possible; and replacing saturated fats with unsaturated fats.

Research suggests that medical nutrition therapy for adults with type 2 diabetes can achieve haemoglobin A1c reductions similar to or greater than what could be expected with medications, according to the report.

Haemoglobin A1c is a test used to check blood sugar levels over a period of time.

The report was prepared by a panel of 14 experts, and published online in the journal Diabetes Care.

No single nutrition plan

The panel reviewed more than 600 studies published between 2014 and 2018 to produce the new nutrition guidelines.

"The importance of this consensus also lies in the fact it was authored by a group of experts who are extremely knowledgeable about numerous eating patterns, including vegan, vegetarian and low-carb," Cefalu added.

"As detailed by the latest evidence, there is no one single nutrition plan to be recommended for every person with diabetes due to the broad variability of diabetes for each individual, as well as other life factors such as cultural backgrounds, personal preferences, other health conditions, access to healthy foods and socioeconomic status," Cefalu said.

"The ADA strongly encourages an individualised approach that includes regular review of nutrition status for all people living with diabetes," he said. "Reassessment of an individual's nutritional plan is particularly important during significant life and health status changes," Cefalu concluded.

Image credit: iStock

 

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Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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