I do have to wonder when the different medical groups are going to become unified in their recommendations for daily dietary fiber intake. I see different ranges quite often. One group orders 31 grams of fiber for everyone, another claims that women only need 25 grams, and men need 38 grams of daily dietary fiber. Most seem to recommend within this range, but I have seen more precise suggestions based on age and other factors.
Do we need standardization? It would seem wise as too many medical groups recommend on one number fits all. They do not specify what age range they are talking about or even if there are other factors involved in the determination. I am not sure whose recommendation to use. People may have their own opinion, but I find the best table for dietary fiber is this table by the World Health Organization and you can find it here. You may wish to bookmark it for future reference. It does account for children and the table is about one third down the page.
The recommendation (2nd page) from the Mayo Clinic does not account for children for which I fault the National Academy of Sciences' Institute of Medicine, and Mayo Clinic for using the IOM table which does not take into consideration fiber levels for children. The IOM does say that age 50 and younger for women the amount of daily dietary fiber should be 25 grams and for women age 51 and older the need drops to 21 grams. For men age 50 and younger the amount of daily dietary fiber should be 38 grams and for men age 51 and older the need decreases to 30 grams.
Dietary fiber is sometimes referred to as bulk or roughage. Dietary fiber is found in plants, fruits, vegetables, and grains plus part of a heart-healthy diet. It adds bulk and the full feeling quicker which helps control weight, aids digestion and makes bowel movements easier.
Dietary fiber is of two types – soluble and insoluble. Insoluble fiber facilitates easier movement through you digestive system and increases stool bulk. Soluble fiber dissolves in water and forms a gel-like material. This helps lower blood cholesterol and glucose levels. The amount of each type of fiber varies by plant foods. This is why everyone recommends eating a wide variety of high fiber foods.
Benefits of a proper level of fiber in your diet are many and this is the reason for making this known over and over to people. Of course, the correct amount of fiber in your diet makes bowel movement easier and can help with preventing loose stools and for some people it may provide assistance from irritable bowel syndrome. Other benefits of a proper fiber diet is that it may lower your risk of developing hemorrhoids, and possibly other colon diseases.
I was intending to have a two part series, but upon closer reading of the study I had in mind, I decided to let you read it here. I do not like studies that try to factualize estimated values of cardiovascular risks and have a cardiologist state that the “results of this study make a lot of sense”. This to me just invalidates the purpose of studies and indicates that what they were after did not come to be fact. It indicates that the study was inconclusive.
You need to read this just to see an example of what lengths they will go to to justify a poor study.
April 19, 2011
April 18, 2011
New AACE Guidelines Emphasize Individualized Care
I know why many diabetes professional groups fear recommending that individuals strive to attain lower HbA1c's; however, I have to disagree with the way they do it. Here the American Association of Clinical Endocrinology (AACE) does recommend individualized care plans at least. They get very shy when it comes to recommending anything lower that an A1c of 6.5 for fear of hypoglycemic episodes. This is standard practice among the diabetes professionals.
The comprehensive individualized care plans for patients with Type 1 and Type 2 diabetes was developed by a panel of 23 leading diabetes experts. They wisely set the care plans to account for the patients' risk for complications, other chronic health conditions, and the psychological, social, and economic status. Because of that fact that they are concerned about the safety of people being able to achieve an A1c of 6.5 all recommendations emphasize taking into account a patients risk for development of severe hypoglycemia.
For once the recommendations do take into account the use of technologies such as insulin pumps, and continuous glucose monitoring. They they surprise me with adding the importance of other conditions that sometimes may not be obvious to the treating physicians – sleep and breathing disturbances and depression. These conditions have been neglected to the detriment of diabetes patients in the past.
Now if they will take this information and work to alleviate sleep disorders, sleep apnea, and minimize depression, this could work to make life a lot better for people with diabetes. Other factors missing from the guidelines is handling other illnesses such as the occasional cold, flu, and other common maladies.
The guidelines do stress hyperglycemia but also the associated cardiovascular risk factors. Also in the guidelines is the recommendation for comprehensive diabetes lifestyle management education at the time of diagnosis and to continue this throughout the time the person has diabetes. Other topics of the education is medical nutrition therapy, physical activity, not using tobacco, and importance of adequate sleep.
I applaud the latest guidelines as far as they go. It seems that individualized care plans should include other objectives. No provisions have been made for those of us desiring to attain lower A1c goals. So again the diabetes professionals are ignoring many patients that can and do work to attain A1c goals lower than 6.5. So it is still up to us to work independently of these medical professionals who have no desire to support us in achieving better health, avoiding complications, and in general doing better that others in our treatment of diabetes.
Why do I say we have to work independently? I am slowly discovering that the diabetes medical professionals are working to reduce the time spent with us, stopping continuing education for us, and just praising us and ushering us out of the office. This is a shame that the guidelines do not make provisions for those of us that wish to attain A1c's lower than 6.5.
Then our medical insurance companies take these results and are searching for ways to cut testing supplies, necessary related tests, and other procedures because we work to have better health. We must fight an uphill battle with no support from either group and chances that in the drive to curtail rising medical costs, we will be discriminated against and have necessary medical support withheld in the name of health care rationing. Just does not seem fair.
Read the two articles here and here.
The comprehensive individualized care plans for patients with Type 1 and Type 2 diabetes was developed by a panel of 23 leading diabetes experts. They wisely set the care plans to account for the patients' risk for complications, other chronic health conditions, and the psychological, social, and economic status. Because of that fact that they are concerned about the safety of people being able to achieve an A1c of 6.5 all recommendations emphasize taking into account a patients risk for development of severe hypoglycemia.
For once the recommendations do take into account the use of technologies such as insulin pumps, and continuous glucose monitoring. They they surprise me with adding the importance of other conditions that sometimes may not be obvious to the treating physicians – sleep and breathing disturbances and depression. These conditions have been neglected to the detriment of diabetes patients in the past.
Now if they will take this information and work to alleviate sleep disorders, sleep apnea, and minimize depression, this could work to make life a lot better for people with diabetes. Other factors missing from the guidelines is handling other illnesses such as the occasional cold, flu, and other common maladies.
The guidelines do stress hyperglycemia but also the associated cardiovascular risk factors. Also in the guidelines is the recommendation for comprehensive diabetes lifestyle management education at the time of diagnosis and to continue this throughout the time the person has diabetes. Other topics of the education is medical nutrition therapy, physical activity, not using tobacco, and importance of adequate sleep.
I applaud the latest guidelines as far as they go. It seems that individualized care plans should include other objectives. No provisions have been made for those of us desiring to attain lower A1c goals. So again the diabetes professionals are ignoring many patients that can and do work to attain A1c goals lower than 6.5. So it is still up to us to work independently of these medical professionals who have no desire to support us in achieving better health, avoiding complications, and in general doing better that others in our treatment of diabetes.
Why do I say we have to work independently? I am slowly discovering that the diabetes medical professionals are working to reduce the time spent with us, stopping continuing education for us, and just praising us and ushering us out of the office. This is a shame that the guidelines do not make provisions for those of us that wish to attain A1c's lower than 6.5.
Then our medical insurance companies take these results and are searching for ways to cut testing supplies, necessary related tests, and other procedures because we work to have better health. We must fight an uphill battle with no support from either group and chances that in the drive to curtail rising medical costs, we will be discriminated against and have necessary medical support withheld in the name of health care rationing. Just does not seem fair.
Read the two articles here and here.
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