Practice Consideration
Dietary Guidelines and Diabetes
Dietary Guidelines
Heart health nutrition and regular exercise are recommended for glycemic control in individuals with type 2 diabetes. Current research recommends that macronutrient distribution and food-group intake be consistent with national dietary recommendations.
There are minor differences in international dietary guidelines, but the message is consistent worldwide: a fiber-rich, plant-based diet with whole-grains, fruit, vegetables, nuts and legumes, moderate servings of lean protein foods and daily intake of non- and low-fat dairy foods. It is generally recommended that fats be mono- and omega-3 polyunsaturated and that trans fats, such as the hydrogenated fat found in some snack and fried foods, be kept to less than one percent of total energy consumption. Those with diabetes benefit from an individualized diet and lifestyle approach that incorporates blood glucose monitoring and healthy eating, with consideration given to the quantity and type of carbohydrate consumed; and regular physical activity. Weight control and regular blood-pressure and blood-lipid monitoring are also recommended.(1,2-7)
Physical Activity
The exercise commonly recommended for adults is a minimum of 150 minutes of “moderate-intensity aerobic physical activity” per week. Some guidelines stipulate that exercise be undertaken daily; others at least three days a week, with no more than two days without exercise.(1,3,8) It is acceptable for the exercise to be accumulated in 10-minute increments. According to the WHO, the risk of type 2 diabetes can be reduced by 60 minutes of cumulative physical activity at not less than a “moderate” level on most days of the week.(4)
References
1. The Royal Australian College of General Practitioners and Diabetes Australia. General practice management of type 2 diabetes—2014–15. 2014; Accessed 13 September 2017. Available from: www.racgp.org.au/download/Documents/Guidelines/Diabetes/2014diabetesmanagement.pdf
2. Haase R, Swan W, Wedel N. Diabetes Mellitus Toolkit. Chicago, IL: Academy of Nutrition and Dietetics; 2011.
3. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Diabetes and Physical Activity: Your Exercise Prescription. 2014; 13 September 2017. Available from: http://guidelines.diabetes.ca/CDACPG/media/documents/patient-resources/diabetes-and-physical-activity-your-exercise-prescription-feb2014_1.pdf
4. World Health Organisation and Food and Agriculture Organization of the United Nations. 2002 WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases. 2003; Accessed 13 September 2017 Available from: www.fao.org/docrep/005/AC911E/ac911e00.htm
5. National Health and Medical Research Council. Australian Dietary Guidelines Canberra: Department of Health and Ageing; 2013. 13 September 2017. Available from: https://www.nhmrc.gov.au/_files_nhmrc/file/your_health/healthy/nutrition/n55a_australian_dietary_guidelines_summary_131014_1.pdf
6. Otten JJ, Hellwig JP, Meyers LD, eds. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC: National Academy of Sciences Press; 2006.
7. Gillespie SJ, Kulkarni KD, Daly AE. Using carbohydrate counting in diabetes clinical practice. J Am Diet Assoc. 1998; 98: 897-905.
8. American Diabetes Association. Standards of Medical Care in Diabetes 2017. Diabetes Care. 2017; 40 (Suppl. 1).
9. National Health and Medical Research Council. Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. 2013; Accessed 13 September 2017. Available from: www.nhmrc.gov.au/guidelines-publications/n57
Heart health nutrition and regular exercise are recommended for glycemic control in individuals with type 2 diabetes. Current research recommends that macronutrient distribution and food-group intake be consistent with national dietary recommendations.
There are minor differences in international dietary guidelines, but the message is consistent worldwide: a fiber-rich, plant-based diet with whole-grains, fruit, vegetables, nuts and legumes, moderate servings of lean protein foods and daily intake of non- and low-fat dairy foods. It is generally recommended that fats be mono- and omega-3 polyunsaturated and that trans fats, such as the hydrogenated fat found in some snack and fried foods, be kept to less than one percent of total energy consumption. Those with diabetes benefit from an individualized diet and lifestyle approach that incorporates blood glucose monitoring and healthy eating, with consideration given to the quantity and type of carbohydrate consumed; and regular physical activity. Weight control and regular blood-pressure and blood-lipid monitoring are also recommended.(1,2-7)
Physical Activity
The exercise commonly recommended for adults is a minimum of 150 minutes of “moderate-intensity aerobic physical activity” per week. Some guidelines stipulate that exercise be undertaken daily; others at least three days a week, with no more than two days without exercise.(1,3,8) It is acceptable for the exercise to be accumulated in 10-minute increments. According to the WHO, the risk of type 2 diabetes can be reduced by 60 minutes of cumulative physical activity at not less than a “moderate” level on most days of the week.(4)
References
1. The Royal Australian College of General Practitioners and Diabetes Australia. General practice management of type 2 diabetes—2014–15. 2014; Accessed 13 September 2017. Available from: www.racgp.org.au/download/Documents/Guidelines/Diabetes/2014diabetesmanagement.pdf
2. Haase R, Swan W, Wedel N. Diabetes Mellitus Toolkit. Chicago, IL: Academy of Nutrition and Dietetics; 2011.
3. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Diabetes and Physical Activity: Your Exercise Prescription. 2014; 13 September 2017. Available from: http://guidelines.diabetes.ca/CDACPG/media/documents/patient-resources/diabetes-and-physical-activity-your-exercise-prescription-feb2014_1.pdf
4. World Health Organisation and Food and Agriculture Organization of the United Nations. 2002 WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases. 2003; Accessed 13 September 2017 Available from: www.fao.org/docrep/005/AC911E/ac911e00.htm
5. National Health and Medical Research Council. Australian Dietary Guidelines Canberra: Department of Health and Ageing; 2013. 13 September 2017. Available from: https://www.nhmrc.gov.au/_files_nhmrc/file/your_health/healthy/nutrition/n55a_australian_dietary_guidelines_summary_131014_1.pdf
6. Otten JJ, Hellwig JP, Meyers LD, eds. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC: National Academy of Sciences Press; 2006.
7. Gillespie SJ, Kulkarni KD, Daly AE. Using carbohydrate counting in diabetes clinical practice. J Am Diet Assoc. 1998; 98: 897-905.
8. American Diabetes Association. Standards of Medical Care in Diabetes 2017. Diabetes Care. 2017; 40 (Suppl. 1).
9. National Health and Medical Research Council. Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. 2013; Accessed 13 September 2017. Available from: www.nhmrc.gov.au/guidelines-publications/n57
Updated September 13, 2017