Welcome! This is written primarily for people with Type 2 Diabetes. Some information covers all types of diabetes. Always keep a positive attitude is my motto.
I am a person with diabetes type 2 and write about my experiences and research. Please discuss medical problems with your doctor. Please do not click on the advertisers that have attached to certain words in this section. They are not authorized and are robbing me by doing so.
July 12, 2014
Nutrition for People with Diabetes
In covering the new nutrition guidelines (a PDF file) from the ADA (American Diabetes Association) from last October, I was more than a little harsh because of the registered
dietitians on the guideline committee. Yes, the guidelines are
developed by a select committee of nutrition experts and the
guidelines are evidence-based. Much of the evidence is from
randomized clinical trials, but some is called expert opinion or
expert consensus if we are to believe that is possible in dietary
nutrition. When many of the authors of the ADA nutrition guidelines
are beholden to Big Food and Big Ag, one must wonder if personal
'expert' opinions were not injected in the guidelines.
There are some new concepts not in
prior guidelines. This may be the most positive aspect to come out
of the 2013 guidelines.
Eating patterns. This has not
been discussed in guidelines before and for people with diabetes,
this is a milestone in change. Be recognizing that there are many
types of eating patterns, this makes individualizing a meal plan more
realistic. The types of meal plans include:
• The DASH (Dietary Approaches to
Stop Hypertension) eating plan • The Mediterranean-style eating
plan • Vegetarian and vegan diets • Low-fat diets •
This allows room for other eating plans
and making people with diabetes feel more relaxed about their food
plan. Just because a friend may like a vegan diet, does not mean
that your personal preferences have to be the same. It is your
personal food plan that is important to you. It will make your likes
and dislikes, cultural background, religion, economic situation, and
glycemic goals more important for your eating pattern.
Macronutrients. These are
carbohydrate, protein, and fat.
Carbohydrate – I have been one to
criticize the American Diabetes Association for promoting high
carbohydrate diets, but I need to consider that with the new
guidelines that their promotion has changed.
Until I see the Academy for Nutrition
and Dietetics (AND) stop promoting Big Food, the people with type 2
diabetes will still need to be very careful in what the registered
dietitians are promoting in the number of carbohydrates they
recommend. Many are still promoting 60 grams of carbohydrates for
each meal and 15 to 25 grams of carbohydrates for snacks. One that I
heard about recently was promoting almost 280 grams of carbohydrates
per day. Most of us with type 2 diabetes cannot consume that many
and will gain weight rapidly doing this.
Many of the registered dietitians have
switched to promoting percentages to mask the number of carbohydrates
they are promoting. They have been recommending that it is up to the
individual, but they still promote a higher percentage of
carbohydrates. With most type 2 diabetes patients needing to lose
weight (about 85 percent), reducing the number or percentage of
carbohydrates consumed is the most efficient method and if possible
adding exercise to this.
Another trick dietitian's use is
alternating between grams of carbohydrates and percentage of
carbohydrates to confuse those they are supposedly teaching. But
more often, they are just issuing mandates and mixing the terms in to
make it sound like they are individualizing the treatment for you.
The two following paragraphs are
typical examples of the language used to make the type 2 patient
think they are doing what is best for them.
a considerable amount of space in these recommendations devoted to
lower-carb eating plans and some of the research does, indeed, show
positive effects of lower-carb eating patterns, particularly in terms
of weight loss. However, the authors of the guideline do point out
that one of the downsides with low-carb diets is that there isn’t a
standard definition of “low carb.” The authors describe “very
low” carbohydrate intake as being from 21 grams to 70 grams of
carbohydrate per day and “moderate” carbohydrate intake as
comprising between 30% and 40% of total calories. But there’s no
general consensus about this.”
recommendations also, for the first time, recommend limiting the
intake of sugar-sweetened beverages. Monitoring carbohydrate intake,
whether by counting carbs or watching portions, is still considered
an effective means of controlling blood glucose. And substituting
low-glycemic-index carbohydrate for high-glycemic-index carbohydrate
may modestly improve glycemic control.”
Since there are no existing guidelines
for the different carbohydrate levels, I only offer these as a suggestion from a previous blog. If you believe differently, I have
no objection, but please be consistent and follow your personal
chart. I will have more in the next blog for protein and fat.