In Summary

After reviewing the available evidence, it is the ADA’s position that there is no standard meal plan or eating pattern that is effective universally for all people with diabetes.1

In order to be effective, nutrition therapy should be individualized for each person based on his or her individual health goals; personal and cultural preferences; health literacy and numeracy; access to healthful choices; and readiness, willingness, and ability to change.

Nutrition interventions should emphasize a variety of minimally processed nutrient-dense foods in appropriate portion sizes as part of a healthful eating pattern.

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Marion J. Franz,  MS, RD, LD, CDE, is a nutrition/health consultant with Nutrition Concepts by Franz, Inc. For over 20 years she was the Director of Nutrition and Health Professional Education at the International Diabetes Center, Minneapolis.

The Grain Foods Foundation seeks to advance public understanding of the beneficial role grain-based foods play in a healthful diet. Follow them on Twitter @GrainFoods and Facebook.

References

  1. Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, Neumiller JJ, Nwankwo R, Verdi CL, Urbanski P, Yancy Jr, WS. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care 2013;36:3821-3842.
  2. Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press, 2002.
  3. Vitolins MZ, Anderson AM, Delahanty L, et al; Look AHEAD Research Group. Action for Health in Diabetes (Look AHEAD) trial: baseline evaluation of selected nutrients and food group intake. J Am Diet Assoc 2009;109:1367-1375.
  4. Delahanty LM, Nathan DM, Lachin JM, et al for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. Association of diet with glycated hemoglobin during intensive treatment of type 1 diabetes in the Diabetes Control and Complications Trial. Am J Clin Nutr 2009;89:518-524.
  5. Eeley EA, Stratton IM, Hadden DR, Turner RC, Holman RR: UKPDS:18. Estimated dietary intake in type 2 diabetic patients randomly assigned to diet, sulphonylurea or insulin therapy: UK Prospective Diabetes Study Group. Diabet Med 1996;13:656-662. 
  6. Iqbbal N, Venter ML, Moore RH,   Effects of a low-intensity intervention that prescribed a low-carbohydrate vs. a low-fat diet in obese, diabetic participants. Obesity (Silver Spring) 2010;18:1733-1738.
  7. Xu J, Eilat-Adar S, Loria CM et al. Macronutrient intake and glycemic control in a population-based sample of American Indians with diabetes: The Strong Heart study. Am J Clin Nutr 2009;89:518-524.
  8. Wheeler ML, Dunbar SA, Jaacks LM, et al. Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010. Diabetes Care 2012;35:434-445.
  9. Estadella D, da Penha Oller do Nascimento CM, Oyama LM, Riberio EB, Damaso AR, de Piano A. Lipotoxicity: effects of dietary saturated and trans fatty acids. Mediators Inflamm 2013;137579. doi: 10.1155/2013/137579.
  10. Riserus U. Fatty acids and insulin sensitivity. Curr Opin Clin Nutr Metab Care 2008;11:100-105.
  11. Lee JS, Pinnamaneni SK, Eo SJ, et al. Saturated, but not n-6 polyunsaturated fatty acids induce insulin resistance; role of intramuscular accumulation of lipid metabolites. J Appl Physiol 2006;100:1467-1476.
  12. Rosenfalck AM, Almdal T, Viggers L, Madsbad S, Hilssted J. A low-fat diet improves peripheral sensitivity in patients with type 1 diabetes. Diabetes Med 2006;23:384-392.
  13. Accurso A, Bernstein RK, Dahlqvist A, et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for critical appraisal. Nutr Metab (Lond) 2008;5:9-16.
  14. Nordmann AJ, Nordmann A, Briel M, et al. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 2008;166:285-293
  15. Franz MJ. The obesity paradox and diabetes. Diabetes Spectrum 2013;26:145-150
  16. Davis NJ, Tomuta N, Schechter C, Isasi CR, Segal-Isaacson CJ, Stein D, Zonszein JZ, Wylie-Rosett J: Comparative study of the effects of a 1-year dietary intervention of a low-carbohydrate diet versus a low-fat diet on weight and glycemic control in type 2 diabetes. Diabetes Care 32:1147-1152, 2009
  17. Larson RN, Mann NJ, Maclean E, Shaw JE: The effect of a high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12 month randomized controlled trial. Diabetologia 2011;54:731-740
  18. Ard JD, Grambow SC, Liu D, Sientz CA, Kraus WE, Svetkey LP, PREMIER study. The effect of the PREMIER interventions on insulin sensitivity. Diabetes Care 2004;27:340-347
  19. Howard BV, Van Horn L, Hsia J, et al. Low fat dietary patterns and risk of cardiovascular disease. The Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 2006;295:656-666.
  20. Bessesen DH. The role of carbohydrate in insulin resistance. J Nutr 2001;131:2782S-2786S.
  21. Assali AR, Ganor A, Beigel Y, Shafer Z, Hershcovici T, Fainaru M. Insulin resistance in obesity: body-weight or energy balance. J Endocrinol 2001;171:293-298
  22. Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpoole PW. Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care 2003;26:557-562
  23. American Diabetes Association. Standards for medical care in diabetes—2014. Diabetes Care 2014;37(Suppl 1):S14-S80.
  24. Brunzell C. Nutrition therapy for diabetes and celiac disease. In: American Diabetes Association Guide to Nutrition Therapy for Diabetes, Second Edition. Franz MJ, Evert AB, eds. Alexandria, VA: American Diabetes Association; 2012, pp 319-339

Topics:

Diabetes Diet and Nutrition Type 1 Diabetes Type 2 Diabetes