Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report

Abstract

This Consensus Report is intended to provide clinical professionals with evidencebased guidance about individualizing nutrition therapy for adults with diabetes or prediabetes. Strong evidence supports the efficacy and cost-effectiveness of nutrition therapy as a component of quality diabetes care, including its integration into the medical management of diabetes; therefore, it is important that all members of the health care team know and champion the benefits of nutrition therapy and key nutrition messages. Nutrition counseling that works toward improving or maintaining glycemic targets, achieving weight management goals, and improving cardiovascular risk factors (e.g., blood pressure, lipids, etc.) within individualized treatment goals is recommended for all adults with diabetes and prediabetes. Though it might simplify messaging, a "one-size-fits-all" eating plan is not evident for the prevention or management of diabetes, and it is an unrealistic expectation given the broad spectrum of people affected by diabetes and prediabetes, their cultural backgrounds, personal preferences, co-occurring conditions (often referred to as comorbidities), and socioeconomic settings in which they live. Research provides clarity on many food choices and eating patterns that can help people achieve health goals and quality of life. The American Diabetes Association (ADA) emphasizes that medical nutrition therapy (MNT) is fundamental in the overall diabetes management plan, and the need for MNT should be reassessed frequently by health care providers in collaboration with people with diabetes across the life span, with special attention during times of changing health status and life stages (1-3). This Consensus Report now includes information on prediabetes, and previous ADA nutrition position statements, the last of which was published in 2014 (4), did not. Unless otherwise noted, the research reviewed was limited to those studies conducted in adults diagnosed with prediabetes, type 1 diabetes, and/or type 2 diabetes. Nutrition therapy for children with diabetes or women with gestational diabetes mellitus is not addressed in this review but is covered in other ADA publications, specifically Standards of Medical Care in Diabetes (5,6).

Valuable Food Molecules with Potential Benefits for Human Health

“…In this report, there are no amendments related to soy consumption for diabetic patients. The only specific remark is for patients with diabetic kidney disease and macroalbuminuria, who can change to a more soy-based source of protein in order to improve the cardiovascular disease risk factors but proteinuria is not altered [175].…”

Weight maintenance interventions for people with type 2 diabetes mellitus: A systematic review protocol

“…with a focus on promoting physical activity and healthier eating habits) will be included, along with pharmacological treatments (e.g. lipase inhibitors such as orlistat) and nutrition therapies targeting the modi cation of nutrient or whole-food intake (as de ned by the American Diabetes Association; [27]). Pharmacological treatments must be approved as a weight loss drug by a regulatory agency (e.g.…”

Kohlenhydratrestriktion bei Typ-2-Diabetes aus Sicht des Präventivmediziners

“…In den gerade aktualisierten Ernährungsempfehlungen der American Diabetes Association (ADA) heißt es dazu wörtlich: "Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences. For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic medications is a priority, reducing overall carbohydrate intake with low-or very low-carbohydrate eating plans is a viable approach" [3].…”