Dr Alan Barclay
New American Diabetes Association (ADA) nutrition guidelines for adults with diabetes.
The ADA has published its latest edition of the Nutrition Therapy Recommendations for the Management of Adults With Diabetes, the first major update in 5 years. Perhaps unsurprisingly, they are evolutionary rather than revolutionary.
One of the more important aspects of the ADA guidelines is their Goals of nutrition therapy. While they importantly set targets for common diabetes complications risk factors, they equally importantly put these into the context of the cultural aspects of food, eating and mealtimes.
After all, food is one of life’s pleasures whether you have diabetes or not – there is absolutely no point in avoiding any particular food or drink unless there’s good evidence to do so.
- “To address individual nutrition needs based on personal and cultural preferences, health literacy and numeracy, access to healthful food choices, willingness and ability to make behavioural changes, as well as barriers to change.”
- “To maintain the pleasure of eating by providing positive messages about food choices while limiting food choices only when indicated by scientific evidence.”
- “To provide the individual with diabetes with practical tools for day-to-day meal planning, rather than focusing on individual macronutrients, micronutrients, or single foods.”
One of the most debated issues over the past few millennia has been how much carbohydrate (sugars and starches), fat and protein can or should a person with diabetes eat? In line with its broader goals, the ADA states that:
In practice, this means that a person with diabetes should work with their dietitian and other members of their health-care team to nut out what is best for them as an individual, rather than follow the latest fad diet.
- “Evidence suggests that there is not an ideal percentage of calories from carbohydrate, protein, and fat for all people with diabetes; therefore, macronutrient distribution should be based on individualized assessment of current eating patterns, preferences, and metabolic goals.”
Recommendations for saturated (less than 10% of kilojoules/calories) and trans fat (as little as possible) and sodium (less than 2,300 mg/day) are the same as those for the general population.
Importantly for readers of GI News, the latest ADA Guidelines now incorporate specific recommendations for use of the glycemic load (GL = GI x grams available carbohydrate per serve) for the management of diabetes. This means that all of the evidence-based recommendations for the management of diabetes from the major diabetes organisations around the globe now advise people to use of the GI or GL as part of the nutritional management of diabetes, including the Canadian Diabetes Association and Diabetes UK.
Although it is possible to lower the GL of your diet by either eating a low carb diet, or by eating a moderate or even high carb diet but with more low GI foods, the scientific evidence about the benefits of low GL diets is based on studies where people ate moderate amounts of healthy low GI foods – carbohydrates were about 40–50% of their total calories (kilojoules).
Here’s how you can enjoy a low GL diet. Simply use the low GI swap it approach. Choose the food/drink within each food group/category that has the lowest GI value (and that is a healthy choice overall, of course). Because foods within a group/category by definition have similar macronutrient (carbohydrate, fat and protein) contents, by choosing the food with the lowest GI, in most cases you are also choosing the food with the lowest GL. You can use our new Simple Low GI Swaps tool on our updated website www.gisymbol.com.
The GI Symbol helps you identify healthy foods and drinks with both a lower GI and GL.
The GI Symbol, making healthy low GI choices easy choices
For more information about the GI Symbol Program
Dr Alan W Barclay, PhD
Chief Scientific Officer
Glycemic Index Foundation (Ltd)
Phone: +61 (0)2 9785 1037
Mob: +61 (0)416 111 046
Fax: +61 (0)2 9785 1037