Elliot P Joslin said “ One of the first rules for the diabetic patient to learn is never to over-
eat.”
5
Most patients with T2D are either overweight, obese, or severely obese. Weight
Hamdy & Barakatun-Nisak
806
management is crucial for diabetes management in those patients. Any degree of
weight loss improves diabetes prognosis.
77,78
A modest weight reduction of 5% to
10% of the initial body weight is frequently recommended. This amount of weight
reduction is realistic and is clinically meaningful.
79,80
It has been shown to improve
Table 2
Summary of studies on dietary pattern for diabetes management
Diet-Style
Key Characteristic Inducing Benefits
Diabetes Management
Ref
Glucose
Insulin
CVD Risk
Mediterranean
diet
Rich in whole grains, olive oil, fruits,
vegetables, nuts, and legumes.
Low-to-moderate intake of dairy prod-
ucts, fish, poultry, and wine.
Low intake of red meat.
Very low sweets (only if desired).
Y
64,66,67
Y
69
Y
69
DASH
Rich in vegetables, fruits, whole grains,
poultry, fish, nuts, and low-fat dairy
products.
Low in red meat, sweets, and sugar-
containing beverages.
Emphasize keep saturated fats and so-
dium to a very minimum level.
Y
73
a
Y
99
Y
73
Vegetarian an
vegan
Vegan: eliminate all animal-derived
products.
Vegetarian: eliminate some animal
products, including lacto-avo (eat dairy
or egg only), pesco (eat fish, egg, or
dairy), semi (eat all but no red meat and
poultry).
b
Y
74
NA
NA
Dietary Guideline
for America
(AHEI)
AHEI is an index based on food and
nutrients to predict chronic disease risk.
High-quality diet is those rich in whole
grains, fruits, vegetables, nuts, le-
gumes, long-chain omega 3 fatty acids,
and PUFAs.
Low in sugar-sweetened beverages,
fruits juices, red meats, processed
meats, and foods high in sodium and
transfat.
Moderate alcohol consumption.
NA
Prudent/Paleo
Rich in whole grains, fruits, vegetables,
legumes, and vegetable fats.
Low in red meats, refined grains, and
sugared soft drinks.
NA
Lower
carbohydrates
diet
Low-to-moderate carbohydrate (<40%
carbohydrate from energy)
High in plant-based protein and fat.
Y
8,18,64
c
Y
18
c
Y
18
Abbreviations:
Y, reduced; AHEI, Alternate Healthy Eating Index; CVD, cardiovascular disease;
DASH, Dietary Approach to Stop Hypertension; NA, not available; PUFAs, polyunsaturated fatty
acids.
a
May reduce insulin levels.
99
b
Results were not consistent and cofounded by calorie-restricted diet that induced weight loss
in the study.
74
c
Individual study finding.
Nutrition in Diabetes
807
glycemic control and other diabetes-related outcomes, including reduced need for
antihyperglycemic medications. In the Action for Health in Diabetes (Look AHEAD)
study that included overweight and obese patients with T2D, participants in the inten-
sive lifestyle intervention arm had greater weight loss than those in the diabetes sup-
port and education arm (8.6% vs 0.7% at 1 year, 6.0% and 3.5% at 9.6 years of follow-
up).
77,81
This magnitude of weight reduction was associated with improvement in gly-
cemic control, CVD risk factors,
77,79
sleep apnea,
82
and urinary continence.
83
It was
also associated with reduction in medications used for diabetes and CVD risk man-
agement.
81
Additional benefits of weight reduction in the same study included
improvement in fitness and health-related quality of life.
84
Despite the impressive improvement in glycemic control and other diabetes-related
outcomes,
77
intensive lifestyle intervention did not show any pertinent benefit in
reducing cardiac events in comparison with the control group.
79
The unexpected
reduction in the incidence of cardiovascular events among US adults during the
same period might deteriorate the study power to detect its primary endpoint.
85
Increased use of cardio-protective drugs by the control group might also contribute
to the lack of difference between the 2 arms. Patients in the control group also lost
some weight probably after observing the announced short-term benefits of intensive
lifestyle intervention.
Translating these findings into real-world practice settings is challenging. Patients
with T2D may not receive a comparable degree of support to promote weight loss
as participants in the Look AHEAD study due to limited time and resources.
86
Howev-
er, successful implementation of the Weight Achievement and Intensive Treatment
(Why WAIT) program at Joslin Diabetes Centre had shown the feasibility of successful
adoption of intensive lifestyle intervention in routine clinical practices.
87
The 12-week
multidisciplinary program has demonstrated 11.1% weight reduction sustained for
1 year in obese participants with T2D. This weight loss was associated with improved
glycemic control and reduction in cardiovascular risk factors. A small proportion of
participants were able to achieve partial or complete diabetes remission at 1 year.
78
To achieve a weight loss goal, structured modified dietary intervention with hypo-
caloric diet is recommended to create negative energy balance.
87
In the Why WAIT
program, the daily calorie goal was identified by reducing daily caloric intake by
approximately 250 to 500 calories and rounding it to the nearest level of 1200,
1500, or 1800 calories.
87
In general, most men consumed 1800 kcal/d and most
women consumed 1500 kcal/d with few exceptions (
Table 3
). As outlined previously,
DSNFs can be used as a meal replacement (MR) to enhance weight reduction.
53
MRs
Fig. 2. Difference in A1C response to various dietary patterns when compared with standard
diabetes nutrition guideline. (Data from Ajala O, English P, Pinkney J. Systematic review and
meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J
Clin Nutr 2013;97(3):505–16.)
Hamdy & Barakatun-Nisak
808
can be consumed in the form of ready-to-drink shakes, ready-to-mix powders, or
bars. The common nutrition information of the ready-to-drink shakes has been sum-
marized elsewhere.
53
MRs help patients to adhere to their energy-restricted meal
plan and control portion size. Frequency of MRs was also shown to be associated
with the magnitude of weight loss. In the Look AHEAD study, participants in the high-
est quartile or MR usage (
w2 per day) had a higher percentage of weight reduction
(11.2%) than the lowest quartile of usage (5.9%) at 1 year (
Fig. 3
).
88
In the Why
WAIT program, participants were instructed to consume 2 MRs (each of 190 calories)
and 2 snacks of 100 to 200 calories for their breakfast and lunch and a healthy choice
from dinner menus for 12 weeks. However, patients on MRs should carefully monitor
their blood glucose to reduce risk of hypoglycemia.
89
Weight reduction through a low-calorie diet is always associated with reduction in
several micronutrients, including B vitamins, iron, calcium, and magnesium, which
are essential for metabolism, energy, and bone health.
90
DSFs may maintain nutrient
adequacy during weight loss by calorie-restricted diets.
53
In an RCT, participants who
followed a low-calorie diet of only traditional food had a significantly lower level of 9
essential vitamins and minerals than those who used traditional food and DSF after
1 year despite equal macronutrient composition.
91
Table 3
Daily calorie needs for weight loss management
Gender
Weight Reduction
(kilocalorie/d)
Weight Maintenance
(kilocalorie/d)
Men
1800
1800–2200
Women
1500
1500–2000
Women height <150 cm (59 inches)
1200
1500
Data from Joslin Diabetes Centre, Joslin Clinic. Clinical nutrition guideline for overweight and
obese adults with type 2 diabetes, prediabetes or those at high risk of developing type 2 diabetes
08 07 2011. Boston: 2011. Available at:
https://www.joslin.org/bin_from_cms/Nutrition_Guidelines-
8.22.11(1).pdf
.
Fig. 3. Percentage reduction of body weight at 1 year based on the quartiles of meal re-
placements. (Data from Wadden TA, West DS, Neiberg RH, et al. One-year weight losses
in the Look AHEAD study: factors associated with success. Obesity (Silver Spring)
2009;17(4):713–22.)
Nutrition in Diabetes
809
Eating Plan for Type 1 Diabetes
Carbohydrate counting has been the mainstay for determining mealtime insulin re-
quirements in patients with type 1 diabetes.
12
It was initially thought that only carbo-
hydrates affect postprandial hyperglycemia; however, introduction of continuous
glucose monitoring showed that dietary fat, protein, and GI have a significant effect
on postprandial glycemic excursion.
92
Consumption of a high-fat meal results in sustained late postprandial hyperglyce-
mia. This effect is caused by delayed gastric emptying, which in turn delays peak post-
prandial glycemic excursion.
93
Adding 35 g of fat (approximately 7 teaspoons)
increased postprandial plasma glucose by 2.3 mmol/L at 5 hours. Wolpert and col-
leagues
94
observed that 50 g fat (10 teaspoons) caused significant hyperglycemia
over 5 hours even when additional insulin was injected. Protein intake also induces
a late excursion in postprandial plasma glucose. However, its effect varies according
Fig. 4. Clinical application on the effect of fat, protein, and glycemic index on postprandial
glycemic control. (Data from Bell KJ, Smart CE, Steil GM, et al. Impact of fat, protein, and
glycemic index on postprandial glucose control in type 1 diabetes: implications for intensive
diabetes management in the continuous glucose monitoring era. Diabetes Care
2015;38(6):1008–15.)
Hamdy & Barakatun-Nisak
810
to the amount of concomitant carbohydrates.
92
Adding 35 g protein (
w1 oz) to 30 g
carbohydrates (2 carbs exchanges) increased blood glucose concentration by
2.6 mmol/L at 5 hours.
95
Eating 12.5 to 50.0 g (0.5–1.5 oz) of protein alone did not
affect postprandial glycemia. However, increasing protein intake to 75 to 100 g
(2.5–3.3 oz) significantly increased postprandial plasma glucose.
96
Thus, a meal
high in fat and protein may require a higher insulin dose to control late postprandial
hyperglycemia than a lower fat and protein meal even if combined with the same
amount of carbohydrates.
94–96
At a similar amount of carbohydrates, a low GI meal results in lower glycemic
response than a high GI meal.
92
Studies suggested that risk of mild hypoglycemia
may increase when low GI food is ingested in comparison with high GI food.
97,98
For this reason, more upfront insulin may be needed to cater the effect of higher GI
food.
97,98
These observations indicate that the premeal insulin dose should be adjusted based
on the overall meal composition rather than on only calculating the carbohydrate con-
tent of the meal.
92
The empirical approach for clinical application on the effects of fat,
protein, and GI on postprandial glycemic excursion, adapted from Bell and col-
leagues,
92
is shown in
Fig. 4
.
FUTURE CONSIDERATION
Although macronutrient composition of diet is important, it is difficult to separately
examine the effects of individual dietary components on plasma glucose because
diet is a complex entity with extensive interaction between foods. This is highly rele-
vant, as people eat food rather than individual nutrients, such as carbohydrate, pro-
tein, or fat for diabetes management.
REFERENCES
1.
Evert AB, Boucher JL, Cypress M, et al. Nutrition therapy recommendations for
the management of adults with diabetes. Diabetes Care 2013;36(11):3821–42
.
2.
Allen F. Studies concerning diabetes. J Am Med Assoc 1914;LXIII(11):939
.
3.
Hockaday TDR. Should the diabetic diet be based on carbohydrate of fat restric-
tion?. In: Turner M, Thomas B, editors. Nutrition and diabetes. London : Libbey;
1981. p. 23–32
.
4.
Joslin EP. The Treatment of Diabetes Mellitus. Can Med Assoc J 1924;14(9):
808–11
.
5.
Joslin EP. 5th edition. A diabetic manual for the mutual use of doctor and patient,
vol. 26. Philadelphia: Lea & Febiger; 1934
.
6.
Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for car-
diovascular disease: the Framingham study. Diabetes Care 1979;2(2):120–6
.
7.
Oza-Frank R, Cheng YJ, Narayan KMV, et al. Trends in nutrient intake among
adults with diabetes in the United States: 1988-2004. J Am Diet Assoc 2009;
109(7):1173–8
.
8.
Feinman RD, Pogozelski WK, Astrup A, et al. Dietary carbohydrate restriction as
the first approach in diabetes management: critical review and evidence base.
Nutrition 2014;31(1):1–13
.
9.
Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes,
and obesity: a comprehensive review. Circulation 2016;133(2):187–225
.
10.
Ley SH, Hamdy O, Mohan V, et al. Prevention and management of type 2 dia-
betes: dietary components and nutritional strategies. Lancet 2014;383(9933):
1999–2007
.
Nutrition in Diabetes
811
11.
Identifying patients at risk: ADA’s definitions for nutrition screening and nutrition
assessment. J Am Diet Assoc 1994;94(8):838–9
.
12.
American Diabetes Association. 3. Foundations of care and comprehensive med-
ical evaluation. Diabetes Care 2016;39(Suppl 1):S23–35
.
13.
Pastors JG, Warshaw H, Daly A, et al. The evidence for the effectiveness of medical
nutrition therapy in diabetes management. Diabetes Care 2002;25(3):608–13
.
14.
Franz MMJ, Powers MA, Leontos C, et al. The evidence for medical nutrition ther-
apy for type 1 and type 2 diabetes in adults. J Am Diet Assoc 2010;110(12):
1852–89
.
15.
Wheeler ML, Dunbar SA, Jaacks LM, et al. Macronutrients, food groups, and eating
patterns in the management of diabetes: a systematic review of the literature, 2010.
Diabetes Care 2012;35(2):434–45 [systematic review and meta-analyses]
.
16. Joslin Diabetes Centre, Joslin Clinic. Clinical nutrition guideline for overweight
and obese adults with type 2 diabetes, prediabetes or those at high risk of devel-
oping type 2 diabetes 08 07 2011. Boston: 2011. Available at:
https://www.joslin.
org/bin_from_cms/Nutrition_Guidelines-8.22.11(1).pdf
.
17.
Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Ca-
nadian Diabetes Association clinical practice guidelines for the prevention and
management of diabetes in Canada. Can J Diabetes 2013;37(Suppl 1):S1–212
.
18.
Tay J, Luscombe-Marsh ND, Thompson CH, et al. Comparison of low- and high-
carbohydrate diets for type 2 diabetes management: a randomized trial. Am J
Clin Nutr 2015;102(4):780–90
.
19.
Jenkins DJA, Kendall CWC, McKeown-Eyssen G, et al. Effect of a low-glycemic
index or a high-cereal fiber diet on type 2 diabetes: a randomized trial. JAMA
2008;300(23):2742–53
.
20.
Ma Y, Olendzki BC, Merriam PA, et al. A randomized clinical trial comparing low-
glycemic index versus ADA dietary education among individuals with type 2 dia-
betes. Nutrition 2008;24(1):45–56
.
21.
Barakatun Nisak MY, Ruzita AT, Norimah AK, et al. Improvement of dietary quality
with the aid of a low glycemic index diet in Asian patients with type 2 diabetes
mellitus. J Am Coll Nutr 2010;29(3):161–70
.
22.
Slavin J, Green H. Dietary fibre and satiety. Nutr Bull 2007;32(s1):32–42
.
23.
Post RE, Mainous AG, King DE, et al. Dietary fiber for the treatment of type 2 dia-
betes mellitus: a meta-analysis. J Am Board Fam Med 2012;25(1):16–23
.
24.
Stanhope KL, Schwarz JM, Keim NL, et al. Consuming fructose-sweetened, not
glucose-sweetened, beverages increases visceral adiposity and lipids and de-
creases insulin sensitivity in overweight/obese humans. J Clin Invest 2009;
119(5):1322–34
.
25.
Gardner C, Wylie-Rosett J, Gidding SS, et al. Nonnutritive sweeteners: current
use and health perspectives: a scientific statement from the American Heart As-
sociation and the American Diabetes Association. Diabetes Care 2012;35(8):
1798–808
.
26. USDA. Scientific report of the 2015 dietary guidelines advisory committee. Diet
Guidel Advis Comm; 2015. Available at:
https://health.gov/dietaryguidelines/
2015-scientific-report/
.
27.
Fox CS, Golden SH, Anderson C, et al. Update on prevention of cardiovascular
disease in adults with type 2 diabetes mellitus in light of recent evidence: a sci-
entific statement from the American Heart Association and the American Dia-
betes Association. Diabetes Care 2015;38(9):1777–803
.
28.
de Souza RJ, Mente A, Maroleanu A, et al. Intake of saturated and trans unsatu-
rated fatty acids and risk of all cause mortality, cardiovascular disease, and type
Hamdy & Barakatun-Nisak
812
2 diabetes: systematic review and meta-analysis of observational studies. BMJ
2015;351:h3978
.
29.
O’Sullivan TA, Hafekost K, Mitrou F, et al. Food sources of saturated fat and the
association with mortality: a meta-analysis. Am J Public Health 2013;103(9):
e31–42 [systematic review and meta-analyses]
.
30.
McEwen B, Morel-Kopp M-C, Tofler G, et al. Effect of omega-3 fish oil on cardio-
vascular risk in diabetes. Diabetes Educ 2010;36(4):565–84
.
31.
Rizos EC, Ntzani EE, Bika E, et al. Association between omega-3 fatty acid sup-
plementation and risk of major cardiovascular disease events: a systematic re-
view and meta-analysis. JAMA 2012;308(10):1024–33 [systematic review and
meta-analyses]
.
32.
Lee JSW, Auyeung TW, Leung J, et al. The effect of diabetes mellitus on age-
associated lean mass loss in 3153 older adults. Diabet Med 2010;27(12):1366–71
.
33.
Leenders M, Verdijk LB, van der Hoeven L, et al. Patients with type 2 diabetes
show a greater decline in muscle mass, muscle strength, and functional capacity
with aging. J Am Med Dir Assoc 2013;14(8):585–92
.
34.
Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss:
the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol
2014;2(10):819–29
.
35.
Paddon-Jones D, Rasmussen BB. Dietary protein recommendations and the pre-
vention of sarcopenia. Curr Opin Clin Nutr Metab Care 2009;12(1):86–90
.
36.
KDOQI. KDOQI Clinical practice guidelines and clinical practice recommenda-
tions for diabetes and chronic kidney disease. Am J Kidney Dis 2007;49(2
Suppl 2):S12–154
.
37.
Tuttle KR, Bakris GL, Bilous RW, et al. Diabetic kidney disease: a report from an
ADA Consensus Conference. Diabetes Care 2014;37(10):2864–83
.
38.
Modification of Diet in Renal Disease (MDRD) Study Group, Levey AS, Adler S,
et al. Effects of dietary protein restriction on the progression of moderate renal
disease in the Modification of Diet in Renal Disease Study. J Am Soc Nephrol
1996;7(12):2616–26 [Erratum appears in J Am Soc Nephrol 1997;8(3):493]
.
39.
Pan Y, Guo LL, Jin HM. Low-protein diet for diabetic nephropathy: a meta-
analysis of randomized controlled trials. Am J Clin Nutr 2008;88(3):660–6 [sys-
tematic review and meta-analyses]
.
40.
Nezu U, Kamiyama H, Kondo Y, et al. Effect of low-protein diet on kidney function
in diabetic nephropathy: meta-analysis of randomised controlled trials. BMJ
Open 2013;3(5) [pii:e002934]. [systematic review and meta-analyses]
.
41.
Hamdy O, Horton ES. Protein content in diabetes nutrition plan. Curr Diab Rep
2011;11(2):111–9
.
42.
Mooradian A, Morley J. Micronutrient status in diabetes mellitus. Am J Clin Nutr
1987;45(5):877–95
.
43.
Forrest KYZ, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in
US adults. Nutr Res 2011;31(1):48–54
.
44.
Mitri J, Muraru MD, Pittas AG. Vitamin D and type 2 diabetes: a systematic review.
Eur J Clin Nutr 2011;65(9):1005–15 [systematic review and meta-analyses]
.
45.
Herrmann M, Sullivan DR, Veillard A-S, et al. Serum 25-hydroxyvitamin D: a pre-
dictor of macrovascular and microvascular complications in patients with type 2
diabetes. Diabetes Care 2015;38(3):521–8
.
46.
Mitri J, Pittas AG. Vitamin D and diabetes. Endocrinol Metab Clin North Am 2014;
43(1):205–32 [systematic review and meta-analyses]
.
Nutrition in Diabetes
813
47.
Kositsawat J, Freeman VL, Gerber BS, et al. Association of A1C levels with
vitamin D status in U.S. adults: data from the National Health and Nutrition Exam-
ination Survey. Diabetes Care 2010;33(6):1236–8
.
48.
Seida JC, Mitri J, Colmers IN, et al. Clinical review: Effect of vitamin D3 supple-
mentation on improving glucose homeostasis and preventing diabetes: a system-
atic review and meta-analysis. J Clin Endocrinol Metab 2014;99(10):3551–60
[systematic review and meta-analyses]
.
49.
Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the peri-
operative nutritional, metabolic, and nonsurgical support of the bariatric surgery
patient–2013 update: cosponsored by American Association of Clinical Endocri-
nologists, the Obesity Society, and American Society for Metabolic & Bariatric
Surgery. Endocr Pract 2013;19(2):337–72
.
50.
Schweiger C, Weiss R, Berry E, et al. Nutritional deficiencies in bariatric surgery
candidates. Obes Surg 2010;20(2):193–7
.
51.
Flancbaum L, Belsley S, Drake V. Preoperative nutritional status of patients under-
going Roux-en-Y gastric bypass for morbid obesity. J Gastrointest Surg 2006;
10(7):1033–7
.
52.
Elia M, Ceriello A, Laube H, et al. Enteral nutritional support and use of diabetes-
specific formulas for patients with diabetes: a systematic review and meta-anal-
ysis. Diabetes Care 2005;28(9):2267–79 [systematic review and meta-analyses]
.
53.
Hamdy O, Zwiefelhofer D. Weight management using a meal replacement strat-
egy in type 2 diabetes. Curr Diab Rep 2010;10(2):159–64
.
54.
Vanschoonbeek K, Lansink M, van Laere KMJ, et al. Slowly digestible carbohy-
drate sources can be used to attenuate the postprandial glycemic response to
the ingestion of diabetes-specific enteral formulas. Diabetes Educ 2009;35(4):
631–40
.
55.
van Loon LJC, Kruijshoop M, Menheere PPCA, et al. Amino acid ingestion
strongly enhances insulin secretion in patients with long-term type 2 diabetes.
Am J Clin Nutr 2003;26(3):625–30
.
56.
Mortensen LS, Hartvigsen ML, Brader LJ, et al. Differential effects of protein quality
on postprandial lipemia in response to a fat-rich meal in type 2 diabetes: compari-
son of whey, casein, gluten, and cod protein. Am J Clin Nutr 2009;90(1):41–8
.
57.
Ceriello A. Postprandial hyperglycemia and diabetes complications: is it time to
treat? Diabetes 2004;54(1):1–7
.
58.
Vilsbøll T, Krarup T, Deacon CF, et al. Reduced postprandial concentrations of
intact biologically active glucagon-like peptide 1 in type 2 diabetic patients. Dia-
betes 2014;50(March 2001):609–13
.
59.
Flint A, Raben A, Astrup A, et al. Glucagon-like peptide 1 promotes satiety and
suppresses energy intake in humans. J Clin Invest 1998;101(3):515–20
.
60.
Hamdy O, Ernst FR, Baumer D, et al. Differences in resource utilization between
patients with diabetes receiving glycemia-targeted specialized nutrition vs stan-
dard nutrition formulas in U.S. hospitals. JPEN J Parenter Enteral Nutr 2014;38(2
Suppl):86S–91S
.
61.
Gosmanov AR, Umpierrez GE. Medical nutrition therapy in hospitalized patients
with diabetes. Curr Diab Rep 2012;12(1):93–100
.
62.
de Luis D a, Izaola O, Aller R, et al. A randomized clinical trial with two enteral
diabetes-specific supplements in patients with diabetes mellitus type 2: meta-
bolic effects. Eur Rev Med Pharmacol Sci 2008;12:261–6
.
63.
Mozaffarian D, Appel LJ, Van Horn L. Components of a cardioprotective diet: new
insights. Circulation 2011;123(24):2870–91
.
Hamdy & Barakatun-Nisak
814
64.
Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different di-
etary approaches to the management of type 2 diabetes. Am J Clin Nutr 2013;
97(3):505–16 [systematic review and meta-analyses]
.
65.
American Diabetes Association. Evidence-based nutrition principles and recom-
mendations for the treatment and prevention of diabetes and related complica-
tions. Diabetes Care 2002;25(Suppl 1):S50–60
.
66.
Huo R, Du T, Xu Y, et al. Effects of Mediterranean-style diet on glycemic control,
weight loss and cardiovascular risk factors among type 2 diabetes individuals: a
meta-analysis. Eur J Clin Nutr 2015;69(11):1200–8 [systematic review and
meta-analyses]
.
67.
Esposito K, Maiorino MI, Bellastella G, et al. A journey into a Mediterranean diet
and type 2 diabetes: a systematic review with meta-analyses. BMJ Open 2015;
5(8):e008222 [systematic review and meta-analyses]
.
68.
Yao B, Fang H, Xu W, et al. Dietary fiber intake and risk of type 2 diabetes: a dose-
response analysis of prospective studies. Eur J Epidemiol 2014;29(2):79–88
.
69.
Estruch R, Ros E, Salas-Salvado´ J, et al. Primary prevention of cardiovascular
disease with a Mediterranean diet. N Engl J Med 2013;368(14):1279–90
.
70.
Jacobs DR, Gross MD, Tapsell LC. Food synergy: an operational concept for un-
derstanding nutrition. Am J Clin Nutr 2009;89(5):1543S–8S
.
71.
Howard BV, Van Horn L, Hsia J, et al. Low-fat dietary pattern and risk of cardio-
vascular disease: the Women’s Health Initiative Randomized Controlled Dietary
Modification Trial. JAMA 2006;295(6):655–66
.
72.
Clark AL. Use of the Dietary Approaches to Stop Hypertension (DASH) eating
plan for diabetes management. Diabetes Spectr 2012;25(4):244–52
.
73.
Azadbakht L, Fard NRP, Karimi M, et al. Effects of the Dietary Approaches to Stop
Hypertension (DASH) eating plan on cardiovascular risks among type 2 diabetic
patients: a randomized crossover clinical trial. Diabetes Care 2011;34(1):55–7
.
74.
Yokoyama Y, Barnard ND, Levin SM, et al. Vegetarian diets and glycemic control
in diabetes: a systematic review and meta-analysis. Cardiovasc Diagn Ther 2014;
4(5):373–82
.
75.
Barnard ND, Cohen J, Jenkins DJA, et al. A low-fat vegan diet and a conventional
diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk
clinical trial. Am J Clin Nutr 2009;89(5):1588S–96S
.
76.
Barnard ND, Scialli AR, Turner-McGrievy G, et al. The effects of a low-fat, plant-
based dietary intervention on body weight, metabolism, and insulin sensitivity.
Am J Med 2005;118(9):991–7
.
77.
Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascu-
lar risk factors in individuals with type 2 diabetes mellitus: four-year results of the
Look AHEAD trial. Arch Intern Med 2010;170(17):1566–75
.
78.
Mottalib A, Sakr M, Shehabeldin M, et al. Diabetes remission after nonsurgical
intensive lifestyle intervention in obese patients with type 2 diabetes.
J Diabetes Res 2015;2015:468704
.
79.
Wing RR, Bolin P, Brancati FL, et al. Cardiovascular effects of intensive lifestyle
intervention in type 2 diabetes. N Engl J Med 2013;369(2):145–54
.
80.
Hamdy O. Nonsurgical diabetes weight management: be prepared for sustain-
able and practical interventions. Curr Diab Rep 2011;11(2):75–6
.
81.
The Look AHEAD Research Group. Reduction in weight and cardiovascular dis-
ease risk factors in individuals with type 2 diabetes: one-year results of the Look
AHEAD trial. Diabetes Care 2007;30(6):1374–83
.
Nutrition in Diabetes
815
82.
Foster GD, Borradaile KE, Sanders MH, et al. A randomized study on the effect of
weight loss on obstructive sleep apnea among obese patients with type 2 dia-
betes: the Sleep AHEAD study. Arch Intern Med 2009;169(17):1619–26
.
83.
Phelan S, Kanaya AM, Subak LL, et al. Weight loss prevents urinary incontinence
in women with type 2 diabetes: results from the Look AHEAD trial. J Urol 2012;
187(3):939–44
.
84.
Rubin RR, Wadden TA, Bahnson JL, et al. Impact of intensive lifestyle intervention
on depression and health-related quality of life in type 2 diabetes: the Look
AHEAD Trial. Diabetes Care 2014;37(6):1544–53
.
85.
Gerstein HC. Do lifestyle changes reduce serious outcomes in diabetes? N Engl J
Med 2013;369(2):189–90
.
86.
Forman-Hoffman V, Little A, Wahls T. Barriers to obesity management: a pilot
study of primary care clinicians. BMC Fam Pract 2006;7:35
.
87.
Hamdy O. Diabetes weight management in clinical practice—the why WAIT
model. US Endocrinol 2008;4(2):49–54
.
88.
Wadden TA, West DS, Neiberg RH, et al. One-year weight losses in the Look
AHEAD study: factors associated with success. Obesity (Silver Spring) 2009;
17(4):713–22
.
89.
Hamdy O, Goebel-Fabbri A, Carver C, et al. Why WAIT program: a novel model
for diabetes weight management in routine clinical practice. Obes Manag 2008;
4(4):176–83
.
90.
Gardner CD, Kim S, Bersamin A, et al. Micronutrient quality of weight-loss diets
that focus on macronutrients: results from the A TO Z study. Am J Clin Nutr
2010;92(2):304–12
.
91.
Ashley JM, Herzog H, Clodfelter S, et al. Nutrient adequacy during weight loss
interventions: a randomized study in women comparing the dietary intake in a
meal replacement group with a traditional food group. Nutr J 2007;6(1):12
.
92.
Bell KJ, Smart CE, Steil GM, et al. Impact of fat, protein, and glycemic index on
postprandial glucose control in type 1 diabetes: implications for intensive dia-
betes management in the continuous glucose monitoring era. Diabetes Care
2015;38(6):1008–15 [systematic review and meta-analyses]
.
93.
Lodefalk M, Aman J, Bang P. Effects of fat supplementation on glycaemic
response and gastric emptying in adolescents with type 1 diabetes. Diabet
Med 2008;25(9):1030–5
.
94.
Wolpert HA, Atakov-Castillo A, Smith SA, et al. Dietary fat acutely increases
glucose concentrations and insulin requirements in patients with type 1 diabetes:
implications for carbohydrate-based bolus dose calculation and intensive dia-
betes management. Diabetes Care 2013;36(4):810–6
.
95.
Smart CEM, Evans M, O’Connell SM, et al. Both dietary protein and fat increase
postprandial glucose excursions in children with type 1 diabetes, and the effect is
additive. Diabetes Care 2013;36(12):3897–902
.
96. Paterson MA, Smart C, McElduff P, et al. Influence of pure protein on postprandial
blood blucose levels in individuals with type 1 diabetes mellitus. In: 2014 Confer-
ence
ADA.
Diabetes
2014;63:A15.
Available
at:
http://www.mdlinx.com/
endocrinology/conference-abstract.cfm/16262/?conf_id
534530&searchstring5
&coverage_day
50&nonus50&page52
.
97.
Mohammed NH, Wolever TMS. Effect of carbohydrate source on post-prandial
blood glucose in subjects with type 1 diabetes treated with insulin lispro. Dia-
betes Res Clin Pract 2004;65(1):29–35
.
Hamdy & Barakatun-Nisak
816
98.
Nansel TR, Gellar L, McGill A. Effect of varying glycemic index meals on blood
glucose control assessed with continuous glucose monitoring in youth with type
1 diabetes on basal-bolus insulin regimens. Diabetes Care 2008;31(4):695–7
.
99.
Shirani F, Salehi-Abargouei A, Azadbakht L. Effects of Dietary Approaches to
Stop Hypertension (DASH) diet on some risk for developing type 2 diabetes: a
systematic review and meta-analysis on controlled clinical trials. Nutrition 2013;
29(7–8):939–47 [systematic review and meta-analyses]
.
Nutrition in Diabetes
817
Document Outline - Nutrition in Diabetes
- Key points
- Introduction
- Medical nutrition therapy for diabetes management
- Specific nutrition plans for patients with diabetes
- Nutrition Strategies for Weight Reduction in Type 2 Diabetes
- Eating Plan for Type 1 Diabetes
- Future consideration
- References
150>
Dostları ilə paylaş: |