ADA Issues New Food and Diet Guidelines
In the January 2002 issue of Diabetes Care, the American Diabetes Association published revised guidelines for food and diet as it applies to both type 1 and type 2 diabetes. In its recommendations, the ADA laid out the following goals:
- For youth with type 1 diabetes, to provide adequate energy to ensure normal growth and development, integrate insulin regimens into usual eating and physical activity habits.
- For youth with type 2 diabetes, to facilitate changes in eating and physical activity habits that reduce insulin resistance and improve metabolic status.
- For pregnant and lactating women, to provide adequate energy and nutrients needed for optimal outcomes.
- For older adults, to provide for the nutritional and psychosocial needs of an aging individual.
- For individuals treated with insulin or insulin secretagogues, to provide self-management education for treatment (and prevention) of hypoglycemia, acute illnesses, and exercise-related blood glucose problems.
- For individuals at risk for diabetes, to decrease risk by encouraging physical activity and promoting food choices that facilitate moderate weight loss or at least prevent weight gain
Key among the new guidelines is the acknowledgement that the overall amount of carbohydrates is what matters, not the source. This change puts into policy what many have been practicing for some time, namely integrating sweets into meal plans.
In a section on children and adolescents, the ADA seems to be stepping away from the rigid "exchange plan" style of diet and instead suggesting a more normal meal plan:Withholding food or having a child eat consistently without an appetite for food in an effort to control blood glucose should be discouraged. ... Individualized food/meal plans and intensive insulin regimens can provide flexibility for children and adolescents with diabetes to accommodate irregular meal times and schedules, varying appetite, and varying activity levels.
This recommendation supports the use of carbohydrate counting, in which a child is given insulin to cover the food eaten, rather than being given food to cover insulin injected.
The recommendations stress the need to continue insulin and carbohydrate intake during illness, both for kids and adults.
The ADA again supports the use of the four FDA-approved sugar substitutes (saccharin, aspartame, acesulfame potassium, and sucralose) when used at levels established by the FDA.
Finally, the ADA recommends that people with diabetes receive nutrition counseling from a registered dietitian as part of their regular diabetes care.
For More Information
- Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications (Diabetes Care 2002 25: 202-212) (PDF format)
- Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications (Diabetes Care 2002 25: 202-212) (HTML format)
30 December 2001
Last Updated: Thursday August 29, 2002 20:59:48
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