For most diabetics, a high-carbohydrate/low-fat diet has long been one of the most important methods of combating their condition. But according to new guidelines from the American Diabetes Association (ADA), sufferers may now choose a high-monounsaturated diet instead.
Dr Abhimanyu Garg, professor of internal medicine and chief of nutrition and metabolic diseases at UT Southwestern Medical Center at Dallas, served on the expert panel of 12 convened by the ADA which formulated the new evidence-based guidelines. Dr Garg's research showing the benefits of a high-monounsaturated fat diet was instrumental in leading to the change in guidelines.
"In the past a diet rich in carbohydrates and low in fats was recommended to all patients with diabetes," Dr Garg said. "We found that a diet rich in monounsaturated fatty acids led to improvement in HDL (high-density lipoprotein) cholesterol, triglycerides and most importantly, diabetes control."
He continued: "Now diabetics can choose a diet rich in carbohydrates or a diet rich in monounsaturated fats. We can now offer them a choice, which they are more likely to stick to and are more compliant with,"
The new guidelines say that foods containing carbohydrates from whole grains, fruits, vegetables and low-fat milk should be included in a healthy diet and that the total amount of carbohydrates in meals or snacks is more important than the source or type.
They also say that diabetics do not need to avoid sucrose (table sugar) or sucrose-containing foods and that non-nutritive sweeteners are safe when consumed within the acceptable daily intake levels established by the Food and Drug Administration.
The ADA's panel of experts looked at evidence form numerous studies which showed that sucrose did not negatively affect glucose control any more than starch or other carbohydrate-containing foods. However, it recommended that diabetics continue to steer clear of foods containing large quantities of sugar, and that they should instead opt for carbohydrate sources such as fruit and vegetables.
"If you get your carbohydrates from fruits, vegetables and grains, then there are other beneficial substances that are not included in sugar. If you compare the nutritional value of an apple to an equal amount of sugar, an apple would be more beneficial," Dr Garg said.
Dr Garg's research also led to the panel recommending a higher intake of fibre. His studies showed that a high intake of dietary fibre, mostly from fruits and vegetables, lowered blood glucose levels by 10 per cent in individuals who consumed 50 grams of fibre in their daily diet. The high-fibre diet also decreased insulin in the blood and lowered blood lipid concentrations.
The new guidelines also suggest that carbohydrate and monounsaturated fat intake should account for 60 to 70 per cent of calorie intake, while 15 to 20 per cent of caloric intake should come from protein.
Carbohydrate food sources recommended by the panel include whole grains, fruits, vegetables and low-fat milk. Olive, canola and peanut oils, as well as avocados and some nuts, are rich in monounsaturated fats. According to the new guidelines, less than 10 per cent of caloric intake should come from saturated fats.
A dietary cholesterol intake of less than 300 milligrams a day is recommended, and trans-unsaturated fatty acids should be minimised, according to the panel. Polyunsaturated fats should account for 10 per cent of caloric intake.