ADA Report Recommends Individualized Eating Plans for those with Diabetes

A new report from the American Diabetes Association (ADA) finds there is no particular “diet” for those with diabetes and instead recommends individualized eating plans to meet each person’s goals.

The new guidance document was produced by a national panel of 14 distinguished professionals with nutrition expertise. The group included registered dietitian nutritionists, certified diabetes educators, endocrinologists, a primary care physician and a patient advocate, who answered a national call for experts.

The Consensus Report panel performed a comprehensive review of more than 600 key nutrition manuscripts published from 2014 through 2018.

The resulting recommendations focus on key areas of nutrition management and guidelines to achieve optimal diabetes management, reduce complications, and improve quality of life for adults with Type 1 or Type 2 diabetes or prediabetes.

“‘What can I eat?’ is the number one question asked by people with diabetes and prediabetes when diagnosed,” says the ADA’s chief scientific, medical and mission officer, Dr. William T. Cefalu. “This new Consensus Report reflects the ADA’s continued commitment to evidence-based guidelines that are achievable and meet people where they are and recommends an individualized nutrition plan for every person with diabetes or prediabetes.”

Cefalu adds the importance of this consensus also lies in the fact it was authored by a group of experts who are extremely knowledgeable about numerous eating patterns, including vegan, vegetarian and low carb.

Some of the key guidelines and highlights in the report include:

Emphasizes that there is not one, single recommended nutrition plan for all people with diabetes given the broad spectrum of people affected by diabetes and prediabetes, as well as other factors, such as cultural preferences, food availability and socioeconomic factors.
Evidence suggests there is no ideal percentage of calories from carbohydrate, protein, and fat for all people with diabetes or at-risk for diabetes, and a variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes and prediabetes.
Macronutrient distribution should be personalized based on an individualized assessment of current eating patterns, preferences and metabolic goals.
Prior to this Consensus Report, the presence of obesity in Type 1 diabetes was not specifically addressed. The panel determined that similar to Type 2 diabetes, the presence of obesity with type 1 diabetes can worsen insulin resistance, glycemic variability, microvascular disease complications, and cardiovascular risk factors. Therefore, weight management has been recommended as an essential component of care for people with Type 1 diabetes who have overweight or obesity.
For purposes of weight loss, the ability to maintain and sustain an eating plan that results in an energy deficit, irrespective of macronutrient composition or eating pattern, is critical for success.

Cefalu concludes the latest evidence indicates there is no one, single nutrition plan to be recommended for every person with diabetes due to the broad variability of diabetes for each individual, as well as other life factors such as cultural backgrounds, personal preferences, other health conditions, access to healthy foods and socioeconomic status.

He says reassessing an individual’s nutritional plan is particularly important during significant life and health status changes and includes nutrition counseling and guidance to achieve overall improved health and wellness that supports appropriate weight management, reducing diabetes complications and improving quality of life.

“Working with a team of health providers including a registered dietitian or certified diabetes educator is fundamental to effectively managing diabetes and prediabetes,” Cefalu adds.

The new report is an update to the ADA’s 2014 Position Statement on nutrition therapy for adults with diabetes and has been incorporated into the ADA’s Standards of Medical Care in Diabetes—2019 as a Living Standards Update.

The full report can be accessed here.

American Diabetes Association.