Table 1. Nutrition Therapy Recommendations (continued)
Topic Recommendation
Optimal mix of
macronutrients
Evidence suggests that there is not an ideal percentage of calories
from carbohydrate, protein, and fat for all people with diabetes (B).
erefore, macronutrient distribution should be based on individual-
ized assessment of current eating patterns, preferences, and metabolic
goals. (E)
Eating patterns A variety of eating patterns (combinations of different foods or food
groups) are acceptable for the management of diabetes. Personal
preferences (e.g., tradition, culture, religion, health beliefs and
goals, economics) and metabolic goals should be considered when
recommending one eating pattern over another. (E)
Carbohydrates Evidence is inconclusive for an ideal amount of carbohydrate intake for
people with diabetes. erefore, collaborative goals should be developed
with the individual with diabetes. (C)
e amount of carbohydrates and available insulin may be the most
important factor influencing glycemic response aer eating and should
be considered when developing the eating plan. (A)
Monitoring carbohydrate intake, whether by carbohydrate counting
or experience-based estimation, remains a key strateg y in achieving
glycemic control. (B)
For good health, carbohydrate intake from vegetables, fruits, whole
grains, legumes, and dairy products should be advised over intake from
other carbohydrate sources, especially those that contain added fats,
sugars, or sodium. (B)
Glycemic index
and glycemic load
Substituting low-glycemic load foods for higher-glycemic load foods
may modestly improve glycemic control. (C)
Dietary fiber and
whole grains
People with diabetes should consume at least the amount of fiber and
whole grains recommended for the general public. (C)
Substitution of
sucrose for starch
While substituting sucrose-containing foods for isocaloric amounts
of other carbohydrates may have similar blood glucose effects,
consumption should be minimized to avoid displacing nutrient-dense
food choices. (A)
