Nutritional Recommendations and Principles for Individuals With Diabetes Mellitus

I n 1979, the Committee on Food and Nutrition of the American Diabetes Association published a special report titled "Principles of Nutrition and Dietary Recommendations for Individuals With Diabetes Mellitus." Publication of the report was prompted by new and emerging information regarding effects of diet on blood glucose concentration in diabetic people and by information relating aberrations of blood lipid levels, particularly cholesterol, with atherosclerosis in the general population. Since 1979, much new information has been generated in the field of nutrition for management of diabetes. Questions have arisen as to the optimal carbohydrate, protein, and fat intake; the use of fiber; the role of the glycemic index and its relation to food exchanges; and the value of eicosapentanoic acid or fish oil. The 1980s also witnessed a transformation in the approach to nutrition education. Health care should be provided by a team of professionals, with each member of the team contributing a particular area of expertise. Ever-growing recognition of the needs of minority populations has dictated closer inspection of these requirements and a need to formulate new and more relevant approaches. This report updates the original principles and recommendations, based on information accumulated since 1979, and the evolving patterns of nutritional management. Nutritional recommendations for people with diabetes are similar to those of the American Heart Association, the National Cancer Institute (American Cancer Society), the Nutritional Committee for Recommendations for Children With Diabetes of the Amer-