The complexity of the diabetic diet plan can be overwhelming for just about anybody. Doctors and dietitians can no longer depend on pre-printed diet sheets or formulated meal patterns to provide the proper nutrition to people with diabetes. There is no such thing as the "ADA diet" or one specific diet for diabetes.
In fact the ADA recommends that the term "ADA diet" not be used because they no longer believe in any one single meal plan or a specific amount of nutrients needed each day. The old way of doing a diabetic diet plan in which a doctor determined levels of caloric intake based on percentages of carbohydrates, proteins, and fats is no longer used.
People with diabetes require an assessment by a registered dietitian to determine an appropriate nutrition prescription and plan for self management education. Diet orders such as that restrict or completely exclude sugar are not considered suitable because they do not reflect diabetes nutrition recommendations and pointlessly restrict sucrose. Such meal feed the false notion that simply restricting sucrose sweetened foods will improve blood glucose control.
A diabetic diet plan should be individualized, taking into consideration a person's usual eating habits and other lifestyle factors. Consistency within an eating pattern will result in lower glycosylated hemoglobin levels rather than following an arbitrary eating style. Nutrition recommendations for total fat, saturated fat, cholesterol, fiber, vitamins, and minerals are the same for individuals with diabetes as for the general population.
Recommendations are modified for protein, carbohydrates, sucrose, and alcohol because of the nature of diabetes in relation to carbohydrate metabolism or the effects of diabetic complications. Protein intake can range for 15% to 20% of daily calories from animal and vegetable protein sources. If the diabetic has nephropathy, lower intakes of protein may be warranted. Protein restrictions and other modifications needed for renal disease should be done by a registered dietitian who is familiar with creating diabetic diet plans.
Carbohydrate recommendations are individualized based on the person's eating habits and blood glucose and lipid goals. Blood glucose control is not impaired by the use of sucrose in the meal plan, but sucrose containing foods are substituted for other carbohydrates and foods and are not eaten in addition to the diet plan. Blood glucose levels are not affected by moderate alcohol use if the diabetes is well controlled. Any alcohol calories should be considered an addition to regular food or meals, and no food should be omitted.
Other related nutrient issues include the use of fructose and other nutritive and non-nutritive sweeteners. Although fructose creates a smaller rise in plasma glucose than sucrose and other carbohydrates, large amounts of fructose provide no advantage as a sweetener based on its negative effects on serum cholesterol and LDL-cholesterol levels.
Other nutritive sweeteners such as corn sweeteners, fruit juice or juice concentrate, honey, molasses, dextrose, and maltose affect glycemic response and caloric content in a manner similar to that of sucrose.
The sugar alcohols (sorbitol, mannitol, and xylitol) result in lower glycemic responses than other simple and complex carbohydrates, and ingesting large amounts may have a laxative effect.
Nonnutritive sweeteners approved for use by the food and drug administration, such as saccharin, aspartame, and Acesulfame K, are considered safe for consumption by people with diabetes. All these products have undergone rigorous testing and scrutiny before approval. All were shown to be safe when consumed by the general public, including people with diabetes, and during pregnancy.
For the diabetic following a set of dietary guidelines is a good starting point. But each diet needs to be customized to meet the each diabetic's nutritional needs. The one size fits all way planning a diabetes diet is no longer the best way to manage the affects of this disease.
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