The Key to Better Health With Diabetes

By Cara Murez HealthDay Reporter

Adietrich in fresh veggies, fruit andfiberhas meaningful benefits for people withdiabetes, a new research review confirms.

Doctors have long recommended this kind of "low-glycemic" eating regimen to help patients manage theirdiabetesand keep bloodsugarlevels steady. The new review of findings from 29 different trials lends support for that advice.

"Although it was small, the effects were important," said study co-author Dr. John Sievenpiper, an associate professor of nutritional sciences and medicine at the University of Toronto. "I think it provides an opportunity for patients to help them achieve theirdiabetes treatmentgoals usingdiet," he added.

The trials reviewed in this study investigated the effects of a low-glycemic index/glycemic loaddietfor three or more weeks in 1,617 patients with type 1 ortype 2 diabetes．Most were middle-aged andoverweightorobese．他们的diabeteswas moderately controlled and they were using medication orinsulin．

Glycemic indexis a measure of how quickly different foods affect bloodsugarlevels.

Past research has found that low-glycemic index foods help keep bloodsugarlevels steady and reduce the risk ofheart diseasein people withdiabetes．

In this research review, low-glycemic diets were associated with lower bloodsugarlevels with a high degree of certainty of evidence.

With moderate certainty, thedietwas associated with reductions in fasting blood sugar, LDL ("bad")cholesterol, weight and a protein involved in inflammation.

The diets did not seem to affect blood levels ofinsulinandHDL("good")cholesterol, waist circumference or官网地址bwin, the review found.

Diet is a cornerstone ofdiabetestherapy, Sievenpiper said. Though patients in the reviewed studies were already on medications or insulin, adding in a low-glycemic diet later could also help, the evidence showed.

Laura Chiavaroli, a postdoctoral fellow at the University of Toronto, led the research review.

When it comes to choosing carbohydrates, she said people withdiabetesideally would choose whole and plant-based foods, including vegetables, fruit, legumes and whole grains.

"With the rise in popularity of plant-based diets right now, [this research] is coming out at a good time where people are a bit more aware of those kinds of foods," Chiavaroli said.

A big takeaway from the study is that all carbohydrates aren't created equal.

Sievenpiper said, "All carbohydrates aren't bad. And there's advantages to selecting lower-glycemic carbohydrates."

That includes scrapping refined grains in favor of whole grains with "sticky"fiber, such as oats and barley, he said. In its traditional form, aMediterranean diethas a low-glycemic index, he added.

The findings were published online Aug. 5 in theBMJ．

The research was done, in part, for an update to European Association for the Study of Diabetes' guidelines.

The American Association of Clinical Endocrinology is updating its guidelines, too, and the American Diabetes Association has included updates in its standards of care, according to Dr. Karl Nadolsky, assistant clinical professor at Michigan State University College of Human Medicine, in East Lansing.

Replacing food that's refined, processed and high-energy with whole foods will automatically result in a diet that's lower in glycemic index and energy intake, he said.

"Energy balance matters. We know that reducing our energy intake will helpobesityand … diseases liketype 2 diabetes," said Nadolsky, who was not involved in the study. "We know that Mediterranean-pattern diet, getting fat from nuts and seeds and all that stuff is better for cardiovascular risk and diabetes."

SLIDESHOW

Type 2 Diabetes: Signs, Symptoms, TreatmentsSee Slideshow

People may need individualized diets based on their circumstances. For example, Nadolsky said, an athlete with 5% body fat will have different needs than most, including more high-glycemic foods. Others may want to increase their consumption of plant-based foods, while sometimes eating high-quality fish or meat.

Replacing white bread, pizza crust, sugar-sweetenedbeveragesand baked goods with veggies, beans, legumes and fruit makes sense, he added.

"It's low-glycemic index, low-glycemic load. It's a lower energy intake. It has higher fiber, which they do talk about in this study," Nadolsky said. "So you end up getting all those benefits when you do that."

更多的信息

美国疾病控制中心Preventionhas more onmeal planning for people with diabetes.

SOURCES: John Sievenpiper, MD, PhD, associate professor, nutritional sciences and medicine, University of Toronto, and consultant physician, St. Michael's Hospital, Toronto; Laura Chiavaroli, PhD, postdoctoral fellow, University of Toronto, Canada; Karl Nadolsky, DO, assistant clinical professor, Michigan State University College of Human Medicine, East Lansing, and endocrinologist/obesitymedicine specialist, Spectrum Health, Grand Rapids, Mich.;BMJ, Aug. 5, 2021, online

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