DIETARY GUIDELINES FOR PEOPLE WITH DIABETES

As discussed in this month’s What’s New? the American Diabetes Association publishes evidence-based recommendations for the management of diabetes each year. While not published annually, Diabetes Canada and DiabetesUK also regularly conduct systematic literature reviews and publish evidence-based recommendations for the nutritional management of diabetes (1-5).

It’s important to note that all organisations recommend that people with diabetes or those at risk should be referred for individualized medical nutrition therapy (MNT) provided by an Accredited Practising/Registered Dietitian.

While the wording varies, all essentially state that there is no single eating pattern recommended for all people with diabetes, and that macronutrient (protein, fat and carbohydrate) distribution can be flexible, within recommended ranges, and should depend on individual treatment goals and food preferences. Overall, they recommend food-based dietary patterns that emphasize key nutrition principles like the regular consumption of non-starchy vegetables, whole fruits, legumes, whole grains, nuts/seeds, and lower-fat dairy products and minimize consumption of processed meats, sugar-sweetened beverages and refined grains/starches. Examples of healthy eating patterns for diabetes include Mediterranean-style, vegetarian, vegan, low-fat, low-carbohydrate, low-energy and very low-energy.

Overarching principles include:

• Promoting healthy eating patterns, emphasizing a variety of nutrient-dense foods in appropriate sizes to improve overall health and to improve glycated haemoglobin (HbA1c), blood pressure, cholesterol and triglycerides and aid in achieving and maintaining body weight.
• Individualize nutrition needs based on personal and cultural preferences, health literacy, and access to healthy food choices.
• For those using exogenous insulin, focus on matching insulin doses with meal composition through carbohydrate counting.

Diabetes-specific dietary guidelines are published by major diabetes associations around the world on a regular basis and overall, they all provide very similar recommendations, because they are based on the same high-quality scientific evidence. The overall benefits of healthy eating can often equal those achieved with pharmacological interventions without the unwanted side effects.

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