NEW YORK (Reuters Health) - A diet that is low in fat, rich in fruits and vegetables and includes an occasional cookie or glass of wine can be as effective as some drugs when it comes to treating and preventing type 2 diabetes, the American Diabetes Association (ADA) said Thursday.

The updated nutrition guidelines, aimed at the estimated 16 million Americans with diabetes, reinforces the idea that it is the total amount of carbohydrates consumed in meals and snacks--not the source--that is the key to diabetes control.

Previously, it was believed that carbohydrates from cakes, cookies, pasta and potatoes caused dangerous spikes in blood glucose (sugar) levels.

It is true that these foods have a higher ``glycemic index,'' meaning they cause a faster rise in blood sugar compared with other carbohydrates such as whole wheat pasta or brown rice. But studies have not shown a significant benefit for low glycemic index diets over high glycemic index diets, the ADA states.

``We're still working on getting the message out about sugar and trying to explain that it's all foods they need to pay attention to, including fat and calories,'' Anne Daly, the ADA's president of Health Care and Education, said in an interview with Reuters Health.

For this reason, the guidelines do not support diets that focus on a food's potential to cause blood sugar to rise, which have not proven to be effective when it comes to controlling diabetes and may be difficult to maintain over the long term. Fad diets that severely restrict an entire category of food, such as low-carbohydrate, high-protein diets, have also not proven to be safe and effective over the long term. Not only are these diets potentially taxing to the kidneys of diabetic patients, the ADA notes; they also tend to be high in fat.

And high fat diets can increase the risk of heart and blood vessel disease, which is the most common complication of diabetes, Daly said.

The ADA advises patients to follow individualized eating plans designed by a dietitian. These plans should take into account a person's blood glucose, cholesterol level, blood pressure, weight and medical complications, in addition to lifestyle and food preferences.

Everyone, including people with diabetes, should eat fiber-rich foods such as whole grains, fruits, and vegetables because they contain vitamins, minerals and other beneficial nutrients, the ADA notes.

Protein from lean sources such as chicken and fish can account for up to 20% of a person's daily calorie intake, provided that his or her kidneys are functioning normally, and saturated fat and cholesterol should be limited, according to the ADA.

Men can consume up to two drinks a day, the ADA says, and women can enjoy one drink, defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of hard liquor. Alcohol should be consumed with food and not used as a substitute, the group recommends.

The guidelines also emphasize weight loss and physical activity, which have been shown to improve insulin sensitivity and help control blood sugar in overweight people with type 2 diabetes. Excess body weight is a major risk factor for diabetes.

In the US, an estimated 61% of American adults currently meet the scientific definition of overweight or obesity, US Surgeon General Dr. David Satcher announced earlier this month.SOURCE: Diabetes Care 2002;25:202-212.

Reference Source 89

For more information on how to prevent other diseases, use
PreventDisease.com's "Quick Prevention Resources".