BackgroundMedical nutrition therapy is recognized as an important treatment option in type 2 diabetes. Most guidelines recommend eating a diet with a high intake of fiber-rich food including fruit. This is based on the many positive effects of fruit on human health. However some health professionals have concerns that fruit intake has a negative impact on glycemic control and therefore recommend restricting the fruit intake. We found no studies addressing this important clinical question. The objective was to investigate whether an advice to reduce the intake of fruit to patients with type 2 diabetes affects HbA1c, bodyweight, waist circumference and fruit intake.MethodsThis was an open randomized controlled trial with two parallel groups. The primary outcome was a change in HbA1c during 12 weeks of intervention. Participants were randomized to one of two interventions; medical nutrition therapy + advice to consume at least two pieces of fruit a day (high-fruit) or medical nutrition therapy + advice to consume no more than two pieces of fruit a day (low-fruit). All participants had two consultations with a registered dietitian. Fruit intake was self-reported using 3-day fruit records and dietary recalls. All assessments were made by the “intention to treat” principle.ResultsThe study population consisted of 63 men and women with newly diagnosed type 2 diabetes. All patients completed the trial. The high-fruit group increased fruit intake with 125 grams (CI 95%; 78 to 172) and the low-fruit group reduced intake with 51 grams (CI 95%; -18 to −83). HbA1c decreased in both groups with no difference between the groups (diff.: 0.19%, CI 95%; -0.23 to 0.62). Both groups reduced body weight and waist circumference, however there was no difference between the groups.ConclusionsA recommendation to reduce fruit intake as part of standard medical nutrition therapy in overweight patients with newly diagnosed type 2 diabetes resulted in eating less fruit. It had however no effect on HbA1c, weight loss or waist circumference. We recommend that the intake of fruit should not be restricted in patients with type 2 diabetes.Trial registrationhttp://www.clinicaltrials.gov; Identifier: NCT01010594.

Medical nutrition therapy was associated with reduction of the fetal weight in women with GDM and the weight decreases with length of treatment. Birth weight above 4 kg was as prominent in the non-diabetic women as in the women with GDM without MNT.

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Background: Different attempts have been made to improve nutritional care and food intake in hospital inpatients. One way may be to improve the individual customisation of meals and meal time points. This pilot study compared the food concept FoodCare consisting of customised meals served on demand and standardised meals served at fixed time points concerning energy and protein intake in medical inpatients. Method: A pilot study including medical lung inpatients at a Danish regional hospital. The control group received a set menu with limited choices served at fixed times. The intervention group received a menu of customised dishes prepared by food professionals and served on demand. Results: Twelve patients were included in the control group and 26 patients in the intervention group. In the intervention group, the tendency showed an increased energy (8.8 ± 2.7 MJ (mean ± SD) compared with the control group of 7.3 ± 2.0 MJ, p=0.10) and protein intake (74 ± 26 grams compared with the control group of 60 ± 18 (mean ± SD) grams, p=0.08). Conclusion: This pilot study demonstrated that a self-selected menu served on demand may potentially increase energy and protein intake in medical inpatients. The concept should be further tested in a randomised control trial with a sufficient sample size.

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