New Dietary Guidelines From the American Diabetes Association Address Glycemic Index

DENVER, March 25 /PRNewswire/ -- With 16 million Americans currently suffering from diabetes and millions more at risk, the American Diabetes Association (ADA) has updated its dietary guidelines not only to help those with diabetes manage their condition, but also to help those at risk prevent or delay the onset of this dangerous disease. The 2002 guidelines are based on an exhaustive review of nearly 700 scientific articles and are presented in a format that distinguishes recommendations based on the strength of the scientific evidence behind them.

Among other things, the guidelines address the usefulness of the glycemic index in managing and/or preventing diabetes. The glycemic index, or GI, is a measurement of the effect that a food has on blood sugar. Specifically, the ability of a food to raise blood sugar level within 2 to 3 hours after eating. Some dietitians have used GI as a tool for developing meal plans for diabetes and weight loss for many years. GI pertains primarily to dietary carbohydrates, rather than protein or fats.

After an extensive review of the literature, the ADA concluded that, for people with diabetes, the total amount of carbohydrate in meals and snacks, rather than the type, determines the blood sugar (glycemic) response.

There is a great deal of confusion regarding the concept of the glycemic index, a term that is increasingly appearing in media coverage of popular diet books, as well as in discussions of national health issues such as diabetes, obesity and heart disease. "I am pleased the American Diabetes Association report examined the evidence on the issue of the glycemic index," commented Ann Coulston, MS, RD, Nutrition Consultant. "There is a lot of misunderstanding about GI and it is easy to misuse the concept." "For example, some people use it inappropriately to malign wholesome foods such as potatoes and rice. In fact, there is no data showing any adverse effect from eating these starches, which are staples of the diet not only in America but in much of the world," Coulston said.

In examining all the existing research on the effects of high glycemic index diets versus low glycemic index diets in type 2 diabetes, the ADA found that in the vast majority of studies, a high GI diet had no adverse effect on measures of blood glucose or blood lipids (e.g. cholesterol). Conversely, a low GI diet provided no convincing evidence of long-term benefit. Type 2 diabetes is the most common form of diabetes, where the body either does not produce enough insulin or the cells ignore insulin. Insulin is necessary for the body to be able to use glucose.

Anne Daly, President of Health Care and Education for the ADA, explained, "Glycemic response has been shown to depend on many factors. Any carbohydrate can be part of a mixed meal, even sugar. The total dietary pattern and the total amount of carbohydrate is more important than the individual GI of any single food."

The recommendations provided in the ADA Guidelines are consistent with nutrition recommendations from all other major organizations, including the United States Department of Agriculture, the American Heart Association, the National Cholesterol Education Program, the American Institute for Cancer Research and the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: to eat plenty of whole grains, fruits and vegetables and to replace saturated fats with monounsaturated fats and omega-3 polyunsaturated fats. Such eating patterns have been shown in dozens of studies to reduce risk for major chronic diseases.

These new ADA Guidelines are designed to achieve the following goals for diabetic individuals: 1. maintain blood glucose levels in the normal range; 2. maintain a blood lipid profile that reduces risk of cardiovascular disease; 3. maintain healthy blood pressure levels; 4. prevent and treat obesity; and 5. promote healthy food choices and physical activity. For people who do not have diabetes but may be at risk, the ADA encourages increased physical activity along with the same dietary pattern. This winning combination of nutrition and exercise may aid in weight loss, which is the leading risk factor for type 2 diabetes in the U.S.

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