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Nutrition Principles And Recommendations In Diabetes

Nutrition Principles And Recommendations In Diabetes

Medical nutrition therapy is an integral component of diabetes management and of diabetes self-management education. Yet many misconceptions exist concerning nutrition and diabetes. Moreover, in clinical practice, nutrition recommendations that have little or no supporting evidence have been and are still being given to persons with diabetes. Accordingly, this position statement provides evidence-based principles and recommendations for diabetes medical nutrition therapy. The rationale for this position statement is discussed in the American Diabetes Association technical review “Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications,” which discusses in detail the published research for each principle and recommendation (1). Historically, nutrition recommendations for diabetes and related complications were based on scientific knowledge, clinical experience, and expert consensus; however, it was often difficult to discern the level of evidence used to construct the recommendations. To address this problem, the 2002 technical review (1) and this position statement provide principles and recommendations classified according to the level of evidence available using the American Diabetes Association evidence grading system. However, the best available evidence must still take into account individual circumstances, preferences, and cultural and ethnic preferences, and the person with diabetes should be involved in the decision-making process. The goal of evidence-based recommendations is to improve diabetes care by increasing the awareness of clinicians and persons with diabetes about beneficial nutrition therapies. Because of the complexity of nutrition issues, it is recommended that a registered d Continue reading >>

The Role Of Diet In The Prevention Of Type 2 Diabetes

The Role Of Diet In The Prevention Of Type 2 Diabetes

Abstract Type 2 diabetes mellitus is an important preventable disease and a growing public health problem. Epidemiologic and interventional studies suggest that weight loss is the main driving force to reduce diabetes risk. Landmark clinical trials of lifestyle changes in subjects with prediabetes have shown that diet and exercise leading to weight loss consistently reduce the incidence of diabetes. However, from these studies it cannot be established whether dietary changes alone play a significant role in preventing diabetes. Here we review epidemiologic and clinical trial evidence relating nutrients, foods and dietary patterns to diabetes risk and the possible mechanisms involved. The differential effects of carbohydrate and fat quantity and quality, and those of specific foods and whole diets are discussed. Importantly, most dietary components influencing diabetes risk have similar effects on biomarkers of cardiovascular risk and inflammation. The conclusion is that there is no universal dietary strategy to prevent diabetes or delay its onset. Together with the maintenance of ideal body weight, the promotion of the so-called prudent diet (characterized by a higher intake of food groups that are generally recommended for health promotion, particularly plant-based foods, and a lower intake of red meat, meat products, sweets, high-fat dairy and refined grains) or a Mediterranean dietary pattern rich in olive oil, fruits and vegetables, including whole grains, pulses and nuts, low-fat dairy, and moderate alcohol consumption (mainly red wine) appears as the best strategy to decrease diabetes risk, especially if dietary recommendations take into account individual preferences, thus enabling long-time adherence. Continue reading >>

Nutrition Therapy Recommendations For The Management Of Adults With Diabetes

Nutrition Therapy Recommendations For The Management Of Adults With Diabetes

A healthful eating pattern, regular physical activity, and often pharmacotherapy are key components of diabetes management. For many individuals with diabetes, the most challenging part of the treatment plan is determining what to eat. It is the position of the American Diabetes Association (ADA) that there is not a “one-size-fits-all” eating pattern for individuals with diabetes. The ADA also recognizes the integral role of nutrition therapy in overall diabetes management and has historically recommended that each person with diabetes be actively engaged in self-management, education, and treatment planning with his or her health care provider, which includes the collaborative development of an individualized eating plan (1,2). Therefore, it is important that all members of the health care team be knowledgeable about diabetes nutrition therapy and support its implementation. This position statement on nutrition therapy for individuals living with diabetes replaces previous position statements, the last of which was published in 2008 (3). Unless otherwise noted, research reviewed was limited to those studies conducted in adults diagnosed with type 1 or type 2 diabetes. Nutrition therapy for the prevention of type 2 diabetes and for the management of diabetes complications and gestational diabetes mellitus is not addressed in this review. A grading system, developed by the ADA and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations (1) (Table 1). The level of evidence that supports each recommendation is listed after the recommendation using the letters A, B, C, or E. A table linking recommendations to evidence can be reviewed at Members of the Nutrition Recommendations Writing Group Committee d Continue reading >>

Nutrition In Patients With Diabetes

Nutrition In Patients With Diabetes

Author: Fazia Mir, MD; Chief Editor: George T Griffing, MD more... Diabetes is a chronic illness that requires a holistic approach in terms of care to prevent both acute and long-term complications. Nutritional management for diabetic patients has been evolving for 100 years as the pathophysiological basis of the complications incurred from diabetes becomes more explicit. Medical nutrition therapy is extremely important for diabetic patients and prediabetic patients so that adequate glycemic control can be achieved. One-on-one consultations with a registered dietician well-versed in diabetic nutrition are most preferable, as has been shown in studies performed in Pakistan [ 1 ] and Hungary, [ 2 ] which proved the utility of a dietician in improving dietary adherence. Nutrition counseling should be sensitive to the personal needs of the patient and how much effort the patient is willing to put in to making the change to eating appropriately. Medical nutrition therapy for diabetics can be divided into (1) dietary interventions and (2) physical activity. Lifestyle and dietary modifications form the cornerstone of therapy in type 2 diabetic patients (insulin resistance). In type 1 diabetic patients , who have an insulin deficiency, a balance between insulin and nutrition needs to be obtained for optimal glycemic control. [ 3 ] Nutrition for diabetic patients can be further divided into prevention and continual management of glycemic control. Prevention is more for individuals at risk for developing diabetes and for type 2 diabetic patients than for patients who have already developed complications, in order to prevent further progression. The goals of nutrition in prevention are as follows: Primary prevention Identification of the population at high risk (body mass index [ Continue reading >>

Evidence-based Diabetes Nutrition Therapy Recommendations Are Effective: The Key Is Individualization

Evidence-based Diabetes Nutrition Therapy Recommendations Are Effective: The Key Is Individualization

Marion J Franz,1 Jackie L Boucher,2 Alison B Evert3 1Nutrition Concepts by Franz, Inc., Minneapolis, MN, 2Minneapolis Heart Institute Foundation, Minneapolis, MN, 3Diabetes Care Center, University of Washington Medical Center, Seattle, WA, USA Abstract: Current nutrition therapy recommendations for the prevention and treatment of diabetes are based on a systematic review of evidence and answer important nutrition care questions. First, is diabetes nutrition therapy effective? Clinical trials as well as systematic and Cochrane reviews report a ~1%2% lowering of hemoglobin A1c values as well as other beneficial outcomes from nutrition therapy interventions, depending on the type and duration of diabetes and level of glycemic control. Clinical trials also provide evidence for the effectiveness of nutrition therapy in the prevention of diabetes. Second, are weight loss interventions important and when are they beneficial? Modest weight loss is important for the prevention of type 2 diabetes and early in the disease process. However, as diabetes progresses, weight loss may or may not result in beneficial glycemic and cardiovascular outcomes. Third, are there ideal percentages of macronutrients and eating patterns that apply to all persons with diabetes? There is no ideal percentage of macronutrients and a variety of eating patterns has been shown to be effective for persons with diabetes. Treatment goals, personal preferences (eg, tradition, culture, religion, health beliefs, economics), and the individual's ability and willingness to make lifestyle changes must all be considered by clinicians and/or educators when counseling and educating individuals with diabetes. A healthy eating pattern emphasizing nutrient-dense foods in appropriate portion sizes, regular physical acti Continue reading >>

Diabetes Diet, Eating, & Physical Activity

Diabetes Diet, Eating, & Physical Activity

Nutrition and physical activity are important parts of a healthy lifestyle when you have diabetes. Along with other benefits, following a healthy meal plan and being active can help you keep your blood glucose level, also called blood sugar, in your target range. To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine, if you take any. What you choose to eat, how much you eat, and when you eat are all important in keeping your blood glucose level in the range that your health care team recommends. Becoming more active and making changes in what you eat and drink can seem challenging at first. You may find it easier to start with small changes and get help from your family, friends, and health care team. Eating well and being physically active most days of the week can help you keep your blood glucose level, blood pressure, and cholesterol in your target ranges prevent or delay diabetes problems feel good and have more energy What foods can I eat if I have diabetes? You may worry that having diabetes means going without foods you enjoy. The good news is that you can still eat your favorite foods, but you might need to eat smaller portions or enjoy them less often. Your health care team will help create a diabetes meal plan for you that meets your needs and likes. The key to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts your meal plan outlines. The food groups are vegetables nonstarchy: includes broccoli, carrots, greens, peppers, and tomatoes starchy: includes potatoes, corn, and green peas fruits—includes oranges, melon, berries, apples, bananas, and grapes grains—at least half of your grains for the day should be whole grains includes wheat, rice, oats, co Continue reading >>

The Diabetes Diet

The Diabetes Diet

What's the best diet for diabetes? Whether you’re trying to prevent or control diabetes, your nutritional needs are virtually the same as everyone else, so no special foods are necessary. But you do need to pay attention to some of your food choices—most notably the carbohydrates you eat. While following a Mediterranean or other heart-healthy diet can help with this, the most important thing you can do is to lose a little weight. Losing just 5% to 10% of your total weight can help you lower your blood sugar, blood pressure, and cholesterol levels. Losing weight and eating healthier can also have a profound effect on your mood, energy, and sense of wellbeing. Even if you’ve already developed diabetes, it’s not too late to make a positive change. By eating healthier, being more physically active, and losing weight, you can reduce your symptoms or even reverse diabetes. The bottom line is that you have more control over your health than you may think. The biggest risk for diabetes: belly fat Being overweight or obese is the biggest risk factor for type 2 diabetes. However, your risk is higher if you tend to carry your weight around your abdomen as opposed to your hips and thighs. A lot of belly fat surrounds the abdominal organs and liver and is closely linked to insulin resistance. You are at an increased risk of developing diabetes if you are: A woman with a waist circumference of 35 inches or more A man with a waist circumference of 40 inches or more Calories obtained from fructose (found in sugary beverages such as soda, energy and sports drinks, coffee drinks, and processed foods like doughnuts, muffins, cereal, candy and granola bars) are more likely to add weight around your abdomen. Cutting back on sugary foods can mean a slimmer waistline as well as a lowe Continue reading >>

Diabetic Diet: Foods That Raise Your Blood Sugar Levels

Diabetic Diet: Foods That Raise Your Blood Sugar Levels

There is no single diabetes diet, meal plan, or diet that is diabetes-friendly that can serve as a correct meal plan for all patients with diabetes (type 2, gestational, or type 1 diabetes). Glycemic index, carbohydrate counting, the MyPlate method, and the TLC diet plan are all methods for determining healthy eating habits for diabetes management. The exact type and times of meals on a diabetic meal plan depend upon a person's age and gender, how much exercise you get and your activity level, and the need to gain, lose, or maintain optimal weight. Most diabetic meal plans allow the person with diabetes to eat the same foods as the rest of the family, with attention to portion size and timing of meals and snacks. Eating a high-fiber diet can help improve blood cholesterol and blood sugar levels in patients with type 2 diabetes. Glycemic index is a way to classify carbohydrates in terms of the amount that they raise blood sugar. High glycemic index foods raise blood sugar more than lower index foods. Some patients with type 2 use supplements as complementary medicine to treat their disease. However, there is limited evidence on the effectiveness of supplements in treating the disease. A diabetes meal plan (diabetes diet) is a nutritional guide for people with diabetes that helps them decide when to consume meals and snacks as well as what type of foods to eat. There is no one predetermined diabetes diet that works for all people with diabetes. The goal of any diabetic meal plan is to achieve and maintain good control over the disease, including control of blood glucose and blood lipid levels as well as to maintaining a healthy weight and good nutrition. Health care professionals and nutritionists can offer advice to help you create the best meal plan to manage your diabe Continue reading >>

Diabetic Diet

Diabetic Diet

If you have diabetes, your body cannot make or properly use insulin. This leads to high blood glucose, or blood sugar, levels. Healthy eating helps keep your blood sugar in your target range. It is a critical part of managing your diabetes, because controlling your blood sugar can prevent the complications of diabetes. A registered dietitian can help make an eating plan just for you. It should take into account your weight, medicines, lifestyle, and other health problems you have. Healthy diabetic eating includes Limiting foods that are high in sugar Eating smaller portions, spread out over the day Being careful about when and how many carbohydrates you eat Eating a variety of whole-grain foods, fruits and vegetables every day Eating less fat Limiting your use of alcohol Using less salt NIH: National Institute of Diabetes and Digestive and Kidney Diseases Continue reading >>

Sugars And Starch In The Nutritional Management Of Diabetes Mellitus

Sugars And Starch In The Nutritional Management Of Diabetes Mellitus

Nutritional recommendations, long recognized as an important aspect of diabetes mellitus treatment, have also been an area of persistent controversy, particularly regarding the proportions and types of carbohydrate and fat. This review addresses the role of sugars within medical nutrition therapy for diabetes mellitus. Nutritional recommendations for diabetes mellitus treatment were revised recently. The new guidelines do not specifically restrict intake of sugars, although general recommendations are made for including fiber, whole grains, vegetables, and fruits within dietary selections containing starches. For carbohydrates, the principle focus is on overall caloric amounts. In type 1 diabetes the most effective approach to the control of postprandial hyperglycemia continues to be adjustment of premeal doses of insulin on the basis of carbohydrate counting. In type 2 diabetes, in addition to a focus on caloric content of carbohydrate, consideration continues to be given to the role of the glycemic index as a determinant of postprandial hyperglycemia and overall metabolic control. Nevertheless, consensus recommendations do not support widespread use of the glycemic index. An area of some change is a more clear endorsement of including monounsaturated fatty acids. Current recommendations are that monounsaturated fatty acids and carbohydrates combined should provide 6070% of daily energy intake, with individual flexibility in the respective proportions, whereas intake of saturated fats is limited to < 10% of energy intake. This new emphasis reflects greater awareness of the importance of responding to individual and cultural dietary preferences and the need to address treatment of both hyperglycemia and dyslipidemia in diabetes mellitus. Continue reading >>

Diabetes | Diabetic Diet - Nutritionist Resource

Diabetes | Diabetic Diet - Nutritionist Resource

Also known as insulin-dependent diabetes, type 1 diabetes is an autoimmune disease. The immune system attacks the healthy cells, in this case, the pancreas, preventing it from producing the insulin needed to regulate blood sugar levels. Type 1 commonly develops in people under the age of 40 and will typically require regular insulin injections to regulate sugar levels and manage the condition. Usually, symptoms develop quickly (over days or weeks) in young people. In adults, the symptoms of diabetes will take longer to develop, often over a number of months. While symptoms will vary from person to person, common symptoms of type 1 diabetes include: going to the toilet more than usual, particularly at night The lack of insulin in the body means the glucose (sugar) in the blood isnt being used for energy, and so, symptoms occur. Because there is excess glucose in the blood, the body will work to try to remove it in any way it can, such as through your urine. If you are experiencing any of the above symptoms or are worried about your health, it is important you visit a medical professional. Early diagnosis is key - the earlier you get diagnosed, the earlier you can treat and manage the condition. Type 2 diabetes is when the body doesnt produce enough insulin to function properly, or the cells in the body arent reacting to the insulin as they should. The most common form of diabetes, it is often associated with obesity. Previously, type 2 diabetes was typically diagnosed in older people, yet it is becoming more common in younger people, too. Symptoms are similar to those of type 1. However, the signs and symptoms of type 2 diabetes arent always as obvious, developing slowly, over a number of years. Because symptoms appear more mild and gradual, many people go years without Continue reading >>

Effect Of Diet On Type 2 Diabetes Mellitus: A Review

Effect Of Diet On Type 2 Diabetes Mellitus: A Review

Go to: Introduction Diabetes mellitus (DM) was first recognized as a disease around 3000 years ago by the ancient Egyptians and Indians, illustrating some clinical features very similar to what we now know as diabetes.1 DM is a combination of two words, “diabetes” Greek word derivative, means siphon - to pass through and the Latin word “mellitus” means honeyed or sweet. In 1776, excess sugar in blood and urine was first confirmed in Great Britain.2,3 With the passage of time, a widespread knowledge of diabetes along with detailed etiology and pathogenesis has been achieved. DM is defined as “a metabolic disorder characterized by hyperglycemia resulting from either the deficiency in insulin secretion or the action of insulin.” The poorly controlled DM can lead to damage various organs, especially the eyes, kidney, nerves, and cardiovascular system.4 DM can be of three major types, based on etiology and clinical features. These are DM type 1 (T1DM), DM type 2 (T2DM), and gestational DM (GDM). In T1DM, there is absolute insulin deficiency due to the destruction of β cells in the pancreas by a cellular mediated autoimmune process. In T2DM, there is insulin resistance and relative insulin deficiency. GDM is any degree of glucose intolerance that is recognized during pregnancy. DM can arise from other diseases or due to drugs such as genetic syndromes, surgery, malnutrition, infections, and corticosteroids intake.5-7 T2DM factors which can be irreversible such as age, genetic, race, and ethnicity or revisable such as diet, physical activity and smoking.8, 9 Continue reading >>

Diabetes And Nutrition

Diabetes And Nutrition

People who have diabetes have too much sugar in their blood. Managing diabetes means managing your blood sugar level. What you eat is closely connected to the amount of sugar in your blood. The right food choices will help you control your blood sugar level. Path to improved health Eating well is one of the primary things you can do to help control diabetes. Do I have to follow a special diet? There isn’t one specific “diabetes diet.” Your doctor can work with you to design a meal plan. A meal plan is a guide that tells you what kinds of food to eat at meals and for snacks. The plan also tells you how much food to have. For most people who have diabetes (and those without, too), a healthy diet consists of: 40% to 60% of calories from carbohydrates. 20% calories from protein. 30% or fewer calories from fat. Your diet should also be low in cholesterol, low in salt, and low in added sugar. Can I eat any sugar? Yes. In recent years, doctors have learned that eating some sugar doesn’t usually cause problems for most people who have diabetes — as long as it is part of a balanced diet. Just be careful about how much sugar you eat and try not to add sugar to foods. What kinds of foods can I eat? In general, at each meal you may have: 2 to 5 choices (or up to 60 grams) of carbohydrates. 1 choice of protein. A certain amount of fat. Talk to your doctor or dietitian for specific advice. Carbohydrates. Carbohydrates are found in fruits, vegetables, beans, dairy foods, and starchy foods such as breads. Try to have fresh fruits rather than canned fruits, fruit juices, or dried fruit. You may eat fresh vegetables and frozen or canned vegetables. Condiments such as nonfat mayonnaise, ketchup, and mustard are also carbohydrates. Protein. Protein is found in meat, poultry, fish Continue reading >>

The Prevention And Control The Type-2 Diabetes By Changing Lifestyle And Dietary Pattern

The Prevention And Control The Type-2 Diabetes By Changing Lifestyle And Dietary Pattern

Go to: INTRODUCTION Diabetes mellitus or type-2 diabetes, is one of the major non-communicable and fastest growing public health problems in the world, is a condition difficult to treat and expensive to manage. It has been estimated that the number of diabetes sufferers in the world will double from the current value of about 190 million to 325 million during the next 25 years.[1,2,3] Individuals with type-2 diabetes are at a high risk of developing a range of debilitating complications such as cardiovascular disease, peripheral vascular disease, nephropathy, changes to the retina and blindness that can lead to disability and premature death. It also imposes important medical and economic burdens. Genetic susceptibility and environmental influences seem to be the most important factors responsible for the development of this condition. However, a drastic increase of physical inactivity, obesity, and type-2 diabetes has been recently observed. The fact indicates that obesity and physical inactivity may constitute the main reasons for the increasing burden of diabetes in the developed world.[4,5,6,7,8,9,10] Fortunately, because environmental factors are modifiable, disease manifestation from these factors is largely preventable. Diet is one of the major factors now linked to a wide range of diseases including diabetes. The amount and type of food consumed is a fundamental determinant of human health. Diet constitutes a crucial aspect of the overall management of diabetes, which may involve diet alone, diet with oral hypoglycemic drugs, or diet with insulin.[11,12,13,14,15] Diet is individualized depending on age, weight, gender, health condition, and occupation etc. The dietary guidelines as used in this review are sets of advisory statements that give quick dietary advic Continue reading >>

What's New In Nutrition For Adults With Diabetes?

What's New In Nutrition For Adults With Diabetes?

What's new in nutrition for adults with diabetes? Nwankwo, Robin MPH, RD, CDE; Funnell, Martha MS, RN, CDE, FAADE Patients with diabetes often get conflicting advice on how to plan meals in order to reach their glycemic targets and weight goals. Implement these evidence-based guidelines to set them on the path to personalized nutrition. In the Department of Learning Health Sciences at University of Michigan Medical School in Ann Arbor, Mich., Robin Nwankwo is the research coordinator and Martha Funnell is an associate research scientist. Ms. Funnell is also an editorial board member for Nursing2016. Acknowledgment: Supported in part by Grant Number P30DK092926 (MCDTR) from the National Institute of Diabetes and Digestive and Kidney Diseases. Ms. Nwankwo receives grants from Eli Lilly and Healthsense and is a pump trainer for Animas. She serves on the national committee and on the local leadership board of the American Diabetes Association and as co-chair of the CDC's advisory board. Previously, she received a grant from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. The authors and planners have disclosed no other potential conflicts of interest, financial or otherwise. All people with diabetes should be on a diabetic or American Diabetes Association (ADA) diet. White potatoes and other white foods are bad carbs that people with diabetes should avoid. Sweets, foods made with sugar, fried foods, and alcohol are also off-limits. Everyone who takes insulin should count carbs. Everyone with diabetes should follow sodium restrictions. Many adults with diabetes ask, What can I eat? Unfortunately, they're often given the incorrect advice listed above. So what can you tell your patients about how to plan meals in order to r Continue reading >>

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