Nutrition Guidelines for Diabetes Type 2 Patients, Joslin Diabetes Center

"Since obesity doesn't seem to be slowing down and the complications of diabetes are so serious, we were especially alarmed about the health of the American public. We felt the best way to impact the largest number of people was to strengthen our nutrition guidelines," said James L. Rosenzweig, M.D, head of Joslin's clinical guidelines committee. The team of physicians, dietitians, exercise physiologists and educators spent months reviewing the scientific literature to draw up new guidelines. "The search was on for guidelines that would improve insulin sensitivity, cardiovascular health and reduce body fat. And most importantly, we wanted to deliver a plan that makes clear what people need to do to achieve their goals," said Dr. Rosenzweig, who also is Director of Joslin's Disease Management Program and Assistant Professor of Medicine at Harvard Medical School.

The new guidelines recommend approximately 40 percent of a person's daily calories come from carbohydrates; 20 to 30 percent from protein ( unless the person has kidney disease ); 30-35 percent come from fat, ( mostly mono- and polyunsaturated fats ); and at least 20-35 grams of fiber. To initiate and continue weight reduction, a modest goal of one pound every one to two weeks is advised by reducing daily caloric intake by 250 to 500 calories. Total daily calories should not be less than 1,000 to 1,200 for women and 1,200 to 1,600 for men. A target of 60 to 90 minutes of modest intensity physical activity most days of the week with a minimum of 150-175 minutes/week is encouraged and should include cardiovascular, stretching and resistance activities to maintain or increase lean body mass.

Two out of three people in the U.S. are overweight or obese, resulting in a skyrocketing rate of type 2 diabetes that now affects at least 18.2 million Americans, including an increasing number of young people. An estimated 41 million Americans have pre-diabetes and are at risk of developing full-blown type 2 diabetes unless they lose weight and increase physical activity. Diabetes is a leading cause of heart disease, stroke, blindness, kidney disease, amputations and other complications.

"Setting the standards for diabetes treatment for more than 100 years, Joslin Diabetes Center's approach to diabetes management has always been to focus on the individual and not dictate a 'one size fits all' strategy. While these guidelines are very straightforward, Americans should meet with their healthcare team so they can adapt the guidelines to meet their personal needs," said Osama Hamdy, M.D., Ph.D., Clinical Director of Joslin's Obesity Program and an obesity researcher, who co-chaired the committee that developed the new guidelines.

"Eating smaller portions, modest carbohydrates and slightly more protein with careful selection of fat, protein and carbohydrate sources is the way to go if you are overweight or obese and have diabetes or pre-diabetes and normal kidney function. These recommendations can help people lose weight, have better diabetes control and prevent serious cardiovascular complications," Dr. Hamdy added.

Catherine Carver, M.S., A.N.P., C.D.E., Director, Educational Services and New Clinic Program Development, also co-chaired the workgroup that wrote the guidelines. Amy P. Campbell, M.S., R.D., C.D.E., Education Program Manager of Joslin's Affiliates Programs/Disease Management Program, also was integral to developing the guidelines.

Among the highlights of the new Joslin guidelines are the following recommendations:

Carbohydrate:

Approximately 40 percent of a person's daily calories should come from carbohydrate; the total should not be less than 130 grams daily. This is a significant change from Joslin's previous recommendations that promoted a higher carbohydrate intake. Scientific data show that reducing one's carbohydrate intake while simultaneously increasing healthier protein and fat choices may be a better approach to weight control. It may also help decrease cardiovascular disease in overweight people with type 2 diabetes. The best sources are fresh vegetables, fruits and beans. Whole grain foods are preferable to eating pasta, white bread, white potatoes and low fiber cereal. Fiber intake should be approximately 50 grams daily if that amount can be tolerated; a minimum of 20-35 grams per day is recommended and an external supplement may be needed. High-fiber foods include fruits, vegetables, whole grain cereals, breads, nuts and seeds.

Fat:

Approximately 30 to 35 percent of a person's daily calories should come from fat. Most should come from mono- and polyunsaturated fats, such as olive oil, canola oil, nuts, seeds and fish ( especially those high in omega-3 fatty acids, such as salmon, mackerel, lake trout, herring and sardines ). Foods that are high in saturated fat, such as beef, pork, lamb and high-fat dairy products ( cream cheese, whole milk ) should be eaten in small amounts. Foods that are high in trans fats such as fast foods, commercially baked goods, crackers, cookies and some margarines should be avoided. Cholesterol intake should be less than 300 mg daily; or less than 200 mg in people with an LDL ( "bad" ) cholesterol that is more than 100 mg/dL.

Protein:

While anyone with signs of kidney disease should consult their provider before increasing the daily amount of protein, approximately 20 to 30 percent of a person's total calories should come from protein. This is a higher percentage than Joslin recommended in the past. Scientific data reveal that eating more protein helps people feel "full" and thus causes people to eat less calories overall. Protein also helps to maintain lean body mass during weight loss. Examples of protein include fish, skinless chicken or turkey, nonfat or lowfat dairy products and legumes such as kidney beans, black beans, chick peas and lentils.

Weight Loss Guidelines:

A modest weight loss of one pound every one to two weeks is advised. Reducing daily calories should be by 250 to 500 calories; total daily calories should not be less than 1,000 to 1,200 for women and 1,200 to 1,600 for men. Weight loss is different for each person and should be continued until a person reaches a target body mass index, or BMI ( ask your provider about how to obtain this measurement. ) Meal replacements, such as shakes, bars and ready-to-mix powders that match these guidelines can be helpful for some people. Blood glucose patterns often change with these types of replacements and thus people should monitor their blood glucose.

Physical Activity Guidelines: Physical activity is extremely important to a weight loss plan. A minimum of 150 to 175 minutes of moderate intensity physical activity is recommended. Examples of this include walking, biking, swimming and dancing. A target of 60 to 90 minutes most days of the week is encouraged. Physical activity should be a mix of cardiovascular, stretching and resistance activities to maintain or increase lean body mass.

About Joslin Diabetes Center

Joslin Diabetes Center, dedicated to conquering diabetes in all of its forms, is the global leader in diabetes research, care and education. Founded in 1898, Joslin is an independent nonprofit institution affiliated with Harvard Medical School. Joslin research is a team of more than 300 people at the forefront of discovery aimed at preventing and curing diabetes. Joslin Clinic, affiliated with Beth Israel Deaconess Medical Center in Boston, the nationwide network of Joslin Affiliated Programs, and the hundreds of Joslin educational programs offered each year for clinicians, researchers and patients, enable Joslin to develop, implement and share innovations that immeasurably improve the lives of people with diabetes. As a nonprofit, Joslin benefits from the generosity of donors in advancing its mission.

Editor's Note: To schedule an appointment with a member of Joslin Clinic's Nutrition Staff, call ( 617 ) 732-2440. For more information on Joslin, call 1-800-JOSLIN-1 or visit http://www.joslin.org.

Note: Here is a link to a pdf containing the new nutrition guidelines on Joslin's website

Contact: Marjorie Dwyer
marjorie.dwyer@joslin.harvard.edu
617-732-2415
Joslin Diabetes Center
http://www.joslin.org/main.shtml

Published on:
2005-04-08

Terms | Privacy | Contact us | Site Map | Links

Sitemap 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61
62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91
92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151
152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181
182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211
212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241
242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271
272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301
302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331
332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361
362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391
392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421
422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451
452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481
482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511
512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541
542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571
572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601
602 603 604 605 606 607 608 609 610 611 612 613 614

This website disclaims any content found in these news releases or articles. Issuers of news releases or articles are solely responsible for the accuracy of their content. If you have any questions regarding information in these news releases, please contact the issuers of the press releases.
© Copyright @ 2005. All rights Reserved. Use of our service is protected by our Privacy policy and Terms of Service.