Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report
For the first time in 2019, The American Diabetes Association endorses a low-carbohydrate and a very-low carbohydrate approach in nutrition therapy for Diabetes. They also include Prediabetes in the recommendations for the first time, which expands coverage of the recommendations to 50-60 % of the population.
Also noting:
Relaxing of recommendation for extensive salt restriction
Confusing discussion on the health impact of various fats, probably due to the well-known points of view of several of the authors. Other analyses have exonerated saturated fat and/or not shown reduction in mortality from substitution of polyunsaturates for saturated fats. Most studies have shown mortality benefit from replacing carbohydrates with saturated fats
As in previous versions, there are still extensive conflicts of interest disclosed (so called “duality”) on the part of the authors
Evert AB, Dennison M, Gardner CD, Garvey WT, Lau KHK, MacLeod J, et al. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care [Internet]. 2019 Apr 18;dci190014. Available from: care.diabetesjournals.org/lookup/doi/10.2337/dci19-0014
“For people with type 2 diabetes or prediabetes, low-carbohydrate eating plans show potential to improve glycemia and lipid outcomes for up to 1 year”
Studies by Saslow, et al and Hallberg, et al, referenced for the first time
Relaxation of sodium restriction
Relaxation of fat restriction
Significant conflicts of interest still present
Source: American Diabetes Association. 5. Lifestyle management: Standards of Medical Care in Diabetesd2019. Diabetes Care 2019;42(Suppl. 1):S46–S60, Used under license: www.diabetesjournals .org/content/license
References:
62. Saslow LR, Daubenmier JJ, Moskowitz JT, et al. Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. Nutr Diabetes 2017;7:304
63. Hallberg SJ, McKenzie AL, Williams PT, Bhanpuri NH, Peters AL, Campbell WW, et al. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Ther [Internet]. 2018 Apr [cited 2019 Apr 2];9(2):583–612. Available from: www.ncbi.nlm.nih.gov/pubmed/29417495
