New dietary guidelines for diabetes released

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New dietary guidelines for diabetes released

By Suzanne Rostler

NEW YORK, Dec 27 (Reuters Health) - A diet that is low in fat, rich in

fruits and vegetables and includes an occasional cookie or glass of wine

can be as effective as some drugs when it comes to treating and

preventing type 2 diabetes, the American Diabetes Association (ADA) said

Thursday.

The updated nutrition guidelines, aimed at the estimated 16 million

Americans with diabetes, reinforces the idea that it is the total amount

of carbohydrates consumed in meals and snacks--not the source--that is

the key to diabetes control.

Previously, it was believed that carbohydrates from cakes, cookies,

pasta and potatoes caused dangerous spikes in blood glucose (sugar)

levels.

It is true that these foods have a higher " glycemic index, " meaning they

cause a faster rise in blood sugar compared with other carbohydrates

such as whole wheat pasta or brown rice. But studies have not shown a

significant benefit for low glycemic index diets over high glycemic

index diets, the ADA states.

" We're still working on getting the message out about sugar and trying

to explain that it's all foods they need to pay attention to, including

fat and calories, " Anne Daly, the ADA's president of Health Care and

Education, said in an interview with Reuters Health.

For this reason, the guidelines do not support diets that focus on a

food's potential to cause blood sugar to rise, which have not proven to

be effective when it comes to controlling diabetes and may be difficult

to maintain over the long term. Fad diets that severely restrict an

entire category of food, such as low-carbohydrate, high-protein diets,

have also not proven to be safe and effective over the long term. Not

only are these diets potentially taxing to the kidneys of diabetic

patients, the ADA notes; they also tend to be high in fat.

And high fat diets can increase the risk of heart and blood vessel

disease, which is the most common complication of diabetes, Daly said.

The ADA advises patients to follow individualized eating plans designed

by a dietitian. These plans should take into account a person's blood

glucose, cholesterol level, blood pressure, weight and medical

complications, in addition to lifestyle and food preferences.

Everyone, including people with diabetes, should eat fiber-rich foods

such as whole grains, fruits, and vegetables because they contain

vitamins, minerals and other beneficial nutrients, the ADA notes.

Protein from lean sources such as chicken and fish can account for up to

20% of a person's daily calorie intake, provided that his or her kidneys

are functioning normally, and saturated fat and cholesterol should be

limited, according to the ADA.

Men can consume up to two drinks a day, the ADA says, and women can

enjoy one drink, defined as 12 ounces of beer, 5 ounces of wine or 1.5

ounces of hard liquor. Alcohol should be consumed with food and not used

as a substitute, the group recommends.

The guidelines also emphasize weight loss and physical activity, which

have been shown to improve insulin sensitivity and help control blood

sugar in overweight people with type 2 diabetes. Excess body weight is a

major risk factor for diabetes.

In the US, an estimated 61% of American adults currently meet the

scientific definition of overweight or obesity, US Surgeon General Dr.

Satcher announced earlier this month.

SOURCE: Diabetes Care 2002;25:202-212.