April 30, 2012

Nutrition Needed To Improve Diabetes Diet

Again, those wanting to make a name for themselves use a small study and publicize as widely as possible. This time it is in the name of nutrition. The study is faulty because there was not a control group or a blinded study. Another weakness or fault of the study was not publishing the criteria for selection of study participants. Yes, a few qualifications were mentioned, but these should not have been the only criteria in selection.

Yes, I am being very critical of most studies proclaiming this and that about what people with diabetes should be consuming. Saying that we should be eating a set number of daily servings of low glycemic index foods is not saying that the nutritional needs of an individual are being met or that this is what their body can tolerate. What irritates the worst is a one-size-fits-all mantra that everyone keeps promoting.

Low glycemic index foods can help manage blood glucose levels, but should be used as a guide only as just selecting this type of food can be nutritionally deficient and not the selection we may need for minimum nutrition goals. Yes, low glycemic index carbohydrates that are digested slowly, and are less likely to spike blood glucose levels than would carbohydrates with a high glycemic index may help blood glucose levels, but are they nutritious enough?

The article does say the participants also ate about 500 fewer daily calories and added vegetables, fruits and nuts, and seeds to their diet - all foods that are on the low end of the glycemic index. Again, no nutritional information is given nor are the combinations even discussed.

Carla Miller, associate professor of human nutrition at Ohio State University and lead author of the study stated, "I think we have enough data to say that consuming a low-glycemic-index diet has beneficial outcomes for people with diabetes." “That's a significant statement because no guidelines currently exist for consumption of low-glycemic-index foods,” she noted. “Some experts think a focus on the glycemic index in foods rather than carbohydrates and sugars is too complicated for patients with diabetes to follow. Miller doesn't think that's the case as long as patients receive adequate nutrition education - which was another finding of hers in a study published in 2009.”

What I find amusing is they talk a good line and have good ideas, yet they will not publish this nutritional information online for people to educate themselves. This would not put any money in their pockets like a study. They give us findings that we can be led to believe that good nutrition was taught and people were allowed to make variations in the diet to fit what their meter told them. I doubt this was allowed or even considered. The mantra was low glycemic index level foods and only this.  They also do not mention whether the nutritional level of the food participants were asked to consume were monitored. Yes, at the start of the study, all 35 participants completed a baseline assessment and participated in a five-week group nutrition intervention. No mention is made about the extent or type of nutrition information given, but I can imagine the bulk was about the glycemic index and very little else.

Another disturbing fact missing is that to be eligible, the participants had to have a hemoglobin A1c value of 7 percent or higher; however, I can find no evidence that of a comparative A1c at the completion of the trial. This is disturbing on so many levels. Did they require people with high level A1c's at the beginning to make sure that they would be less likely to complain about their high or higher A1c's at the end of the trial?

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