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Implementing Medical Nutritional Therapy Through Dietary Patterns in Prevention and Treatment of Diabetes

  • Nutrition, Obesity and Diabetes (L Falque-Madrid and H Florez, Section Editors)
  • Published:
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Abstract

Purpose of the Review

To review the studies assessing dietary patterns for type 2 diabetes (T2D) treatment and prevention recently published.

Recent Findings

Different nutrients, foods, and dietary patterns have shown benefits in treatment and prevention of T2D. However, the implementation of nutritional strategies and making the information easily available to interested populations are a challenge.

Summary

The medical nutritional therapy recommendations included in the diabetes clinical practice guidelines were summarized, updated the studies reporting the effectiveness of dietary patterns on T2D, and proposed strategies to implement these recommendations in real-life scenarios. The conclusion is that there is not a unique dietary approach to prevent or treat T2D. Strategies should include the achievement and maintenance of a healthy weight and dietary intervention reducing carbohydrates to 30% of total calories. Interventions should be previously transculturalized and then implemented through simple tools such as the Transcultural Diabetes Nutrition Algorithm.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

  1. Pastors JG, Warshaw H, Daly A, Franz M, Kulkarni K. The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care. 2002;25(3):608–13.

    Article  PubMed  Google Scholar 

  2. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343–50.

    Article  PubMed  CAS  Google Scholar 

  3. Knowler WC, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374(9702):1677–86.

    Article  PubMed  Google Scholar 

  4. Hamdy O, Barakatun-Nisak MY. Nutrition in diabetes. Endocrinol Metab Clin N Am. 2016;45(4):799–817.

    Article  Google Scholar 

  5. Joslin EP. The treatment of diabetes mellitus. Can Med Assoc J. 1924;14(9):808–11.

    PubMed  PubMed Central  CAS  Google Scholar 

  6. Keys Aea. Coronary heart disease in seven countries. Circulation. 1970;41(1):186–95.

    Google Scholar 

  7. Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017;390(10107):2050–62.

    Article  PubMed  CAS  Google Scholar 

  8. Guasch-Ferre M, et al. Total and subtypes of dietary fat intake and risk of type 2 diabetes mellitus in the Prevencion con Dieta Mediterranea (PREDIMED) study. Am J Clin Nutr. 2017;105(3):723–35.

    Article  PubMed  CAS  Google Scholar 

  9. Augustin LS, et al. Glycemic index, glycemic load and glycemic response: an International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis. 2015;25(9):795–815.

    Article  PubMed  CAS  Google Scholar 

  10. ADA. Standards of medical care in diabete2013. Diabetes Care. 2013;36(Suppl 1):S11–66.

    Google Scholar 

  11. Gonzalez-Campoy JM, et al. Clinical practice guidelines for healthy eating for the prevention and treatment of metabolic and endocrine diseases in adults: cosponsored by the American Association of Clinical Endocrinologists/the American College of Endocrinology and the Obesity Society. Endocr Pract. 2013;19(Suppl 3):1–82.

    Article  PubMed  Google Scholar 

  12. Guzman JR, et al. Treatment of type 2 diabetes in Latin America: a consensus statement by the medical associations of 17 Latin American countries. Latin American Diabetes Association. Rev Panam Salud Publica. 2010;28(6):463–71.

    Article  PubMed  Google Scholar 

  13. Cheng AY. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Introduction. Can J Diabetes. 2013;37(Suppl 1):S1–3.

    Article  PubMed  Google Scholar 

  14. Aschner P. New IDF clinical practice recommendations for managing type 2 diabetes in primary care. Diabetes Res Clin Pract. 2017;132:169–70.

    Article  PubMed  Google Scholar 

  15. Garber AJ, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm—2018 executive summary. Endocr Pract. 2018;24(1):91–120.

    Article  PubMed  Google Scholar 

  16. Barnett AH. NICE draft type 2 diabetes guidelines: a cause for concern. Lancet Diabetes Endocrinol. 2015;3(6):403–5.

    Article  PubMed  Google Scholar 

  17. 2015 Diabetes types 1 and 2 evidence-based nutrition practice guideline. Academy of Nutrition and Dietetics. Accessed on May 2018. Available online: https://www.andeal.org/topic.cfm?menu=3253&cat=5595 .

  18. Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care. 2014;37(Suppl 1):S120–43.

    Article  PubMed  Google Scholar 

  19. Dworatzek PD, et al. Nutrition therapy. Can J Diabetes. 2013;37(Suppl 1):S45–55.

    Article  PubMed  Google Scholar 

  20. Salas-Salvado J, et al. The role of diet in the prevention of type 2 diabetes. Nutr Metab Cardiovasc Dis. 2011;21(Suppl 2):B32–48.

    Article  PubMed  CAS  Google Scholar 

  21. Maghsoudi Z, Azadbakht L. How dietary patterns could have a role in prevention, progression, or management of diabetes mellitus? Review on the current evidence. J Res Med Sci. 2012;17(7):694–709.

    PubMed  PubMed Central  Google Scholar 

  22. • Salas-Salvadó J, et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care. 2011;34:14–9. This review summarizes the nutrients, foods, and dietary patterns showing a benefit in diabetes prevention, especially the Mediterranean diet pattern.

    Article  PubMed  Google Scholar 

  23. •• Jannasch F, Kroger J, Schulze MB. Dietary patterns and type 2 diabetes: a systematic literature review and meta-analysis of prospective studies. J Nutr. 2017;147(6):1174–82. This paper analyzes specifically dietary patterns and T2D through a meta-analysis suggesting that diets according to the Mediterranean, DASH, and AHEI patterns, although different in some components, have a strong potential for preventing T2D.

    Article  PubMed  CAS  Google Scholar 

  24. Salas-Salvado J, et al. Prevention of diabetes with Mediterranean diets: a subgroup analysis of a randomized trial. Ann Intern Med. 2014;160(1):1–10.

    Article  PubMed  Google Scholar 

  25. Esposito K, Maiorino MI, Ceriello A, Giugliano D. Prevention and control of type 2 diabetes by Mediterranean diet: a systematic review. Diabetes Res Clin Pract. 2010;89(2):97–102.

    Article  PubMed  CAS  Google Scholar 

  26. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90.

    Article  PubMed  CAS  Google Scholar 

  27. Esposito K, Maiorino MI, Ciotola M, di Palo C, Scognamiglio P, Gicchino M, et al. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial. Ann Intern Med. 2009;151(5):306–14.

    Article  PubMed  Google Scholar 

  28. Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr. 2013;97(3):505–16.

    Article  PubMed  CAS  Google Scholar 

  29. Schwingshackl L, Hoffmann G. Diet quality as assessed by the healthy eating index, the alternate healthy eating index, the dietary approaches to stop hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies. J Acad Nutr Diet. 2015;115(5):780–800. e5

    Article  PubMed  Google Scholar 

  30. Shirani F, Salehi-Abargouei A, Azadbakht L. Effects of Dietary Approaches to Stop Hypertension (DASH) diet on some risk for developing type 2 diabetes: a systematic review and meta-analysis on controlled clinical trials. Nutrition. 2013;29(7–8):939–47.

    Article  PubMed  Google Scholar 

  31. Azadbakht L, Fard NRP, Karimi M, Baghaei MH, Surkan PJ, Rahimi M, et al. Effects of the Dietary Approaches to Stop Hypertension (DASH) eating plan on cardiovascular risks among type 2 diabetic patients: a randomized crossover clinical trial. Diabetes Care. 2011;34(1):55–7.

    Article  PubMed  CAS  Google Scholar 

  32. Wu PY, Huang CL, Lei WS, Yang SH. Alternative health eating index and the dietary guidelines from American Diabetes Association both may reduce the risk of cardiovascular disease in type 2 diabetes patients. J Hum Nutr Diet. 2016;29(3):363–73.

    Article  PubMed  CAS  Google Scholar 

  33. Davis NJ, Tomuta N, Schechter C, Isasi CR, Segal-Isaacson CJ, Stein D, et al. Comparative study of the effects of a 1-year dietary intervention of a low-carbohydrate diet versus a low-fat diet on weight and glycemic control in type 2 diabetes. Diabetes Care. 2009;32(7):1147–52.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  34. Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015;31(1):1–13.

    Article  PubMed  CAS  Google Scholar 

  35. Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA, et al. Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. Am J Clin Nutr. 2015;102(4):780–90.

    Article  PubMed  CAS  Google Scholar 

  36. Liu S, Serdula M, Janket SJ, Cook NR, Sesso HD, Willett WC, et al. A prospective study of fruit and vegetable intake and the risk of type 2 diabetes in women. Diabetes Care. 2004;27:2993–6.

    Article  PubMed  Google Scholar 

  37. Villegas R, Shu XO, Gao YT, Yang G, Elasy T, Li H, et al. Vegetable but not fruit consumption reduces the risk of type 2 diabetes in Chinese women. J Nutr. 2008;138:574–80.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  38. Priebe MG, et al. Whole grain foods for the prevention of type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008;1:CD006061.

    Google Scholar 

  39. Thomas D, Elliott EJ. Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. Cochrane Database Syst Rev. 2009;i:CD006296.

    Google Scholar 

  40. Matusheski, N.V., S. Bidel, and J. Tuomilehto. Coffee and type 2 diabetes risk Chapter 8 in Coffee emerging health effects and disease prevention. Ed. Chu, Y.F. Wiley-Blackwell. John Wiley & Sons. 2012: p. 141–179.

  41. Baliunas DO, Taylor BJ, Irving H, Roerecke M, Patra J, Mohapatra S, et al. Alcohol as a risk factor for type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2009;32:2123–32.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  42. Via MA, Mechanick JI. Nutrition in type 2 diabetes and the metabolic syndrome. Med Clin N Am. 2016;100(6):1285–302.

    Article  PubMed  Google Scholar 

  43. Davis C, et al. Definition of the Mediterranean diet; a literature review. Nutrients. 2015;7(11):5459.

    Article  CAS  Google Scholar 

  44. Serra-Majem L, Roman B, Estruch R. Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev. 2006;64(2 Pt 2):S27–47.

    Article  PubMed  Google Scholar 

  45. Giugliano D, Esposito K. Mediterranean diet and metabolic diseases. Curr Opin Lipidol. 2008;19(1):63–8.

    PubMed  CAS  Google Scholar 

  46. Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010;170(17):1566–75.

    PubMed  CAS  Google Scholar 

  47. Hamdy O, Mottalib A, Morsi A, el-Sayed N, Goebel-Fabbri A, Arathuzik G, et al. Long-term effect of intensive lifestyle intervention on cardiovascular risk factors in patients with diabetes in real-world clinical practice: a 5-year longitudinal study. BMJ Open Diabetes Res Care. 2017;5(1):e000259.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Wing RR, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145–54.

    Article  PubMed  CAS  Google Scholar 

  49. Aguiar Sarmento R, Peçanha Antonio J, Lamas de Miranda I, Bellicanta Nicoletto B, Carnevale de Almeida J. Eating patterns and health outcomes in patients with type 2 diabetes. J Endocr Soc. 2018;2(1):42–52.

    Article  PubMed  Google Scholar 

  50. Shi Z, Zhen S, Zimmet PZ, Zhou Y, Zhou Y, Magliano DJ, et al. Association of impaired fasting glucose, diabetes and dietary patterns with mortality: a 10-year follow-up cohort in Eastern China. Acta Diabetol. 2016;53(5):799–806.

    Article  PubMed  CAS  Google Scholar 

  51. Reeds J, Mansuri S, Mamakeesick M, Harris SB, Zinman B, Gittelsohn J, et al. Dietary patterns and type 2 diabetes mellitus in a first nations community. Can J Diabetes. 2016;40(4):304–10.

    Article  PubMed  Google Scholar 

  52. Zhang M, Zhu Y, Li P, Chang H, Wang X, Liu W, et al. Associations between dietary patterns and impaired fasting glucose in Chinese men: a cross-sectional study. Nutrients. 2015;7(9):8072–89.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  53. Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA, et al. Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. Am J Clin Nutr. 2015;102(4):780–90.

    Article  PubMed  CAS  Google Scholar 

  54. Paula TP, Viana LV, Neto ATZ, Leitão CB, Gross JL, Azevedo MJ. Effects of the DASH diet and walking on blood pressure in patients with type 2 diabetes and uncontrolled hypertension: a randomized controlled trial. J Clin Hypertens (Greenwich). 2015;17(11):895–901.

    Article  Google Scholar 

  55. Giordano M, Ciarambino T, Castellino P, Cataliotti A, Malatino L, Ferrara N, et al. Long-term effects of moderate protein diet on renal function and low-grade inflammation in older adults with type 2 diabetes and chronic kidney disease. Nutrition. 2014;30(9):1045–9.

    Article  PubMed  CAS  Google Scholar 

  56. Saslow LR, Kim S, Daubenmier JJ, Moskowitz JT, Phinney SD, Goldman V, et al. A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. PLoS One. 2014;9(4):e91027.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  57. Hsu CC, Jhang HR, Chang WT, Lin CH, Shin SJ, Hwang SJ, et al. Associations between dietary patterns and kidney function indicators in type 2 diabetes. Clin Nutr. 2014;33(1):98–105.

    Article  PubMed  CAS  Google Scholar 

  58. Jeppesen C, Bjerregaard P, Jorgensen ME. Dietary patterns in Greenland and their relationship with type 2 diabetes mellitus and glucose intolerance. Public Health Nutr. 2014;17(2):462–70.

    Article  PubMed  Google Scholar 

  59. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279–90.

    Article  PubMed  CAS  Google Scholar 

  60. Nieto-Martínez R, González-Rivas JP, Florez H, Mechanick JI. Transcultural endocrinology: adapting type-2 diabetes guidelines on a global scale. Endocrinol Metab Clin N Am. 2016;45(4):967–1009.

    Article  Google Scholar 

  61. Franz MJ, Monk A, Barry Bea. Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus: a randomized, controlled clinical trial. J Am Diet Assoc. 1995;95:1009–17.

    Article  PubMed  CAS  Google Scholar 

  62. Szucs TD, Stoffel AW. Nutrition and health—why payors should get involved. Nutrition. 2016;32(5):615–6.

    Article  PubMed  Google Scholar 

  63. Mechanick JI, Marchetti AE, Apovian C, Benchimol AK, Bisschop PH, Bolio-Galvis A, et al. Diabetes-specific nutrition algorithm: a transcultural program to optimize diabetes and prediabetes care. Curr Diab Rep. 2012;12(2):180–94.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  64. Mechanick JI, et al. American Association of Clinical Endocrinologists and American College of Endocrinology protocol for standardized production of clinical practice guidelines, algorithms, and checklists—2014 update and the AACe G4G program. Endocr Pract. 2014;20(7):692–702.

    Article  PubMed  Google Scholar 

  65. Su HY, et al. Transculturalization of a diabetes-specific nutrition algorithm: Asian application. Curr Diab Rep. 2012;12(2):213–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  66. Joshi SR, Mohan V, Joshi SS, Mechanick JI, Marchetti A. Transcultural diabetes nutrition therapy algorithm: the Asian Indian application. Curr Diab Rep. 2012;12:204–12.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Hussein Z, Hamdy O, Chin Chia Y, Lin Lim S, Kumari Natkunam S, Hussain H, et al. Transcultural diabetes nutrition algorithm: a Malaysian application. Int J Endocrinol. 2013;2013:679396.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Gougeon R, et al. The transcultural diabetes nutrition algorithm: a Canadian perspective. Int J Endocrinol. 2014;151068(10):16.

    Google Scholar 

  69. Nieto-Martínez R, Hamdy O, Marante D, Marulanda M, Marchetti A, Hegazi R, et al. Transcultural diabetes nutrition algorithm (tDNA): Venezuelan application. Nutrients. 2014;6(4):1333–63.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  70. Galvis AB, et al. Transcultural diabetes nutrition algorithm: the Mexican application. J Diabetes Metab. 2014;5(9):1–10. https://doi.org/10.4172/2155-6156.1000423.

    Article  Google Scholar 

  71. Moura F, Salles J, Hamdy O, Coutinho W, Baptista D, Benchimol A, et al. Transcultural diabetes nutrition algorithm: Brazilian application. Nutrients. 2015;7(9):7358–80.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  72. Hamdy O, Marchetti A, Hegazi RA, Mechanick JI. The transcultural diabetes nutrition algorithm toolkit: survey and content validation in the United States, Mexico, and Taiwan. Diabetes Technol Ther. 2014;16(6):378–84.

    Article  PubMed  Google Scholar 

  73. Chee WSS, Gilcharan Singh HK, Hamdy O, Mechanick JI, Lee VKM, Barua A, et al. Structured lifestyle intervention based on a trans-cultural diabetes-specific nutrition algorithm (tDNA) in individuals with type 2 diabetes: a randomized controlled trial. BMJ Open Diabetes Res Care. 2017;5(1):e000384.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Nieto-Martínez R. Recomendaciones nutricionales para la poblacion venezolana. Med Interna. 2015;31(3):134–6.

    Google Scholar 

  75. Infante-García MM, et al. Baja Adherencia a la Dieta Mediterránea en la Región de los Andes de Venezuela. Med Interna (Caracas). 2017;33(3):162–3.

    Google Scholar 

  76. Bonaccio M, Bes-Rastrollo M, de Gaetano G, Iacoviello L. Challenges to the Mediterranean diet at a time of economic crisis. Nutr Metab Cardiovasc Dis. 2016;26(12):1057–63.

    Article  PubMed  CAS  Google Scholar 

  77. Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995;61(6 Suppl):1402S–6S.

    Article  PubMed  CAS  Google Scholar 

  78. Hensrud DD. Converting knowledge to action, chapter 7. Mayo Clinic on healthy weight. 1st ed. New York, N.Y.: Kensington Publishing Corporation; 2000. p. 77–104.

    Google Scholar 

  79. Hassanein M, al-Arouj M, Hamdy O, Bebakar WMW, Jabbar A, al-Madani A, et al. Diabetes and Ramadan: practical guidelines. Diabetes Res Clin Pract. 2017;126:303–16.

    Article  PubMed  Google Scholar 

  80. DAR Diabetes & Ramadan. Accessed on June 2018. Available online: https://www.daralliance.org/daralliance/.

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Correspondence to Ramfis Nieto-Martínez.

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Ramfis Nieto-Martínez, Juan P. González-Rivas, and María M. Infante-García declare no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Nutrition, Obesity and Diabetes

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Nieto-Martínez, R., González-Rivas, J.P. & Infante-García, M.M. Implementing Medical Nutritional Therapy Through Dietary Patterns in Prevention and Treatment of Diabetes. Curr Geri Rep 7, 125–136 (2018). https://doi.org/10.1007/s13670-018-0243-3

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