Table 1. Nutrition Therapy Recommendations (continued)
Topic Recommendation
Fructose Fructose consumed as "free fructose" (i.e., naturally occurring in foods
such as fruit) may result in better glycemic control compared with
isocaloric intake of sucrose or starch (B), and free fructose is not likely to
have detrimental effects on triglycerides as long as intake is not excessive
(>12% energ y). (C)
People with diabetes should limit or avoid intake of SSBs (from any
caloric sweetener including high fructose corn syrup and sucrose) to
reduce risk for weight gain and worsening of cardiometabolic risk
profile. (B)
NNSs and
hypocaloric
sweeteners
Use of NNSs has the potential to reduce overall calorie and carbohydrate
intake if substituted for caloric sweeteners without compensation by
intake of additional calories from other food sources. (B)
Protein For people with diabetes and no evidence of diabetic kidney disease,
evidence is inconclusive to recommend an ideal amount of protein intake
for optimizing glycemic control or improving one or more CVD risk
measures. erefore, goals should be individualized. (C)
For people with diabetes and diabetic kidney disease (either micro- or
macroalbuminuria), reducing the amount of dietary protein below usual
intake is not recommended because it does not alter glycemic measures,
cardiovascular risk measures, or the course of GFR decline. (A)
In individuals with type 2 diabetes, ingested protein appears to increase
insulin response without increasing plasma glucose concentrations.
erefore, carbohydrate sources high in protein should not be used to
treat or prevent hypoglycemia. (B)
Total fat Evidence is inconclusive for an ideal amount of total fat intake for people
with diabetes. erefore, goals should be individualized (C). Fat quality
appears to be far more important than quantity. (B)
MUFAs/PUFAs In people with type 2 diabetes, a Mediterranean-style, MUFA-rich
eating pattern may benefit glycemic control and CVD risk factors and
can therefore be recommended as an effective alternative to a lower-fat,
higher-carbohydrate eating pattern. (B)
