Search Weight Loss Topics:

Diabetic diet – Wikipedia, the free encyclopedia

Posted: May 22, 2015 at 7:51 am

Diabetic diet refers to the diet that is recommended for people with diabetes mellitus. There is much controversy regarding what that diet should consist of. The diet most often recommended is high in dietary fiber, especially soluble fiber, but low in fat (especially saturated fat) and low in sugar. Recommendations of the fraction of total calories to be obtained from carbohydrate are generally in the range of 40 to 65%, but recommendations can vary as widely as from 16 to 75% .[1] People with diabetes may be encouraged to reduce their intake of carbohydrates that have a high glycemic index (GI), although this is also controversial.[2] (In cases of hypoglycemia, they are advised to have food or drink that can raise blood glucose quickly, such as lucozade, followed by a long-acting carbohydrate (such as rye bread) to prevent risk of further hypoglycemia.) However, others question the usefulness of the glycemic index and recommend high-GI foods like potatoes and rice. It has been claimed that oleic acid has a slight advantage over linoleic acid in reducing plasma glucose.[3]

There has been long history of dietary treatment of diabetes mellitus dietary treatment of diabetes mellitus was used in Egypt since 3,500 B.C., and was used in India by Sushruta and Charaka more than 2000 years ago. In the eighteenth century, John Rollo argued that calorie restriction in the diabetic diet could reduce glycosuria in diabetes. However, more modern history of the diabetic diet may begin with Frederick Madison Allen, who, in the days before insulin was discovered, recommended that people with diabetes ate only a low-calorie diet to prevent ketoacidosis from killing them. This was an approach which did not actually cure diabetes but merely extended life by a limited period. The first use of insulin by Frederick Banting in 1922 changed things, and at last allowed patients more flexibility in their eating.

In the 1950s, the American Diabetes Association, in conjunction with the U.S. Public Health Service, introduced the "exchange scheme". This allowed people to swap foods of similar nutritional value (e.g. carbohydrate) for another, so, for example, if wishing to have more than normal carbohydrates for dessert, one could cut back on potatoes in one's first course. The exchange scheme was revised in 1976, 1986 and 1995.[4]

However, not all diabetes dietitians today recommend the exchange scheme. Instead, they are likely to recommend a typical healthy diet: one high in fiber, with a variety of fruit and vegetables, and low in both sugar and fat, especially saturated fat. A diet that is high in plant fibre was recommended by James Anderson (Anderson & Ward, 1979; cited in Murray & Pizzorno, 1990). This may be understood as continuation of the work of Denis Burkitt and Hugh Trowell on dietary fibre,[5] which in turn, may be understood as a continuation of the work of Price (Murray & Pizzorno, 1990). It is still recommended that people with diabetes consume a diet that is high in dietary fiber.

In 1976, Nathan Pritikin opened a centre where patients were put on programme of diet and exercise (the Pritikin Program). This diet is high on carbohydrates and fibre, with fresh fruit, vegetables, and whole grains. A study at UCLA in 2005 showed that it brought dramatic improvement to a group of people with diabetes or pre-diabetes in only three weeks, so that about half no longer met the criteria for the disease.[6][7][8][9]

On the other hand, in 1983, Richard K. Bernstein began treating people with diabetes and pre-diabetes successfully with a very low carbohydrate diet, avoiding fruit, added sugar, and starch. Both the Pritikin approach and the Bernstein approach prescribe exercise.

An approach that has been popular with some people with type one diabetes mellitus since 2000 is known as DAFNE (Dose Adjustment for Normal Eating). This approach involves estimating how much carbohydrates there will be in a meal and modifying the amount of insulin one injects before meal accordingly. An equivalent approach has for people with type two diabetes mellitus is known as DESMOND, which stands for Diabetes Education and Self-Management for On-Going and Newly Diagnosed (diabetes). DAFNE has its own newsletter and has received recommendation.[10]

The American Diabetes Association in 1994 recommended that 6070% of caloric intake should be in the form of carbohydrates. As mentioned above, this is controversial, with some researchers claiming that 40%[11] or even less is better, while others claim benefits for a high-fiber, 75% carbohydrate diet.[12]

An article summarizing the view of the American Diabetes Association[13] contains the statement: "Sucrose-containing foods can be substituted for other carbohydrates in the meal plan or, if added to the meal plan, covered with insulin or other glucose-lowering medications. Care should be taken to avoid excess energy intake." Sucrose does not increase glycemia more than the same number of calories taken as starch[citation needed]. It is not recommended to use fructose as a sweetener. Benefits may be obtained by consumption of dietary fibre in conjunction with carbohydrate; as Francis (1987) points out, evidence suggests that carbohydrate consumed with dietary fiber will have a less major impact on glycemic rise than the same amount of carbohydrate consumed alone.

What has not generally been included in diabetic diet recommendations is the variation in effect from different carbohydrates. It has been recommended that carbohydrates eaten by people with diabetes should be complex carbohydrates.

Read more:
Diabetic diet - Wikipedia, the free encyclopedia


Search Weight Loss Topics: