Informed food choices and dietary eating habits are essential to fighting diseases and maintaining a healthy lifestyle. Unhealthy menu items, such as sugar-sweetened beverages and highly processed food, can lead to weight gain, obesity, prediabetes and type 2 diabetes, all of which are risk factors for cardiovascular disease (CVD). Their increasing consumption is now leading to an increase in the number of persons with CVD.
Prediabetes and type 2 diabetes have increased dramatically over several decades in parallel with the increase in obesity (which now is over 40% of adults across all ages). Over half of Americans have prediabetes (hemoglobin A1c 5.7–6.4%) or type 2 diabetes (hemoglobin A1c ≥6.5% or on diabetes medication). These numbers have tripled since 1990.
For National Nutrition Month® 2024, we’re going to highlight some of the key points and resources for pre-diabetic and diabetic patients when it comes to Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and Type 2 Diabetes and Nutrition Interventions in Adults with Diabetic Foot Ulcers.
Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and Type 2 Diabetes – (Low-Carb Diet for Any Budget):
For patients managing type 2 diabetes, metabolic syndrome, high blood pressure, or obesity, a low-carb diet can be a game-changer. A low-carb approach can be both effective and healthy, improving markers like blood pressure, blood sugar, and metabolism.
Here are some basics for patients interested in adopting a low-carb lifestyle:
- Emphasize protein, healthy fats, and non-starchy vegetables
- Limit or eliminate sugary and starchy foods, as well as refined, processed options
- Eat only when hungry and stop when satisfied to promote satiety
- Monitor glucose levels and adjust diet and medication as needed
Common Low-carb Eating Patterns:
| Eating Pattern | Total Carbs (grams/day) | Meat | Poultry | Fish & Shellfish | Eggs | Tofu |
|---|---|---|---|---|---|---|
| Very Low-carb Keto | ≤30 | No Limit | No Limit | No Limit | No Limit | – |
| Low-carb Keto | 30–50 | No Limit | No Limit | No Limit | No Limit | – |
| Mediterranean | 50–150 | No Limit | No Limit | No Limit | No Limit | No Limit |
| Paleo | 50–150 | No Limit | No Limit | No Limit | No Limit | – |
| Primal | 50–150 | No Limit | No Limit | No Limit | No Limit | – |
| Vegetarian | 100–150 | – | – | – | No Limit | No Limit |
| Eating Pattern | Total Carbs (grams/day) | Non-Starchy Veggies | Starchy Veggies | Leafy Greens | Berries | Fruit | Grains |
|---|---|---|---|---|---|---|---|
| Very Low-carb Keto | ≤30 | 1 cup | – | 2 cups | – | – | – |
| Low-carb Keto | 30–50 | 2 cups | 1 cup | 2 cups | 1/2 cup | 1 cup | – |
| Mediterranean | 50–150 | 3 cups | 1 cup | No limit | 1 cup | 1 cup | 2 svgs |
| Paleo | 50–150 | 3 cups | 1 cup | No limit | 1/2 cup | 1/2 cup | – |
| Primal | 50–150 | 3 cups | 1 cup | No limit | – | – | – |
| Vegetarian | 100–150 | No limit | No limit | No limit | 1 cup | 1 cup | 4 svgs |
Tips on counting carbs, general eating principles, medication management, recipes and more can all be found in the Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and Type 2 Diabetes Pocket Guide.
Additional Resources:
- Studies of low-carb for obesity: www.phcuk.org/rcts
- Studies of low-carb for Type 2 diabetes: www.phcuk.org/t2d
- Nutrition Network Research Database: https://nutrition-network.org/references-resource/
Nutrition Interventions in Adults with Diabetic Foot Ulcers
Patients grappling with diabetic foot ulcers (DFUs) face unique challenges when it comes to their dietary needs. Educating these individuals about the importance of proper nutrition and the role it plays in wound healing can make a world of difference in their outcomes.
Collaboration between clinicians and patients is key here. When patients are empowered with the knowledge to make informed decisions about their diets, we see improvements come not only in HbA1c levels but also in quality of life and adherence to treatment plans.
Some key points to emphasize include:
- Proper hydration and tracking daily glucose targets
- Consistency in meal timing and portion sizes
- Incorporating oral nutrition supplements as needed
- Focusing on whole grain foods and plenty of fiber to stabilize blood sugar levels
Navigating Shared Decision-Making:
| Average Daily Targets | Men | Women |
|---|---|---|
| Calories | 2,500 | 2,000 |
| Hydration | 6-8 cups | 6-8 cups |
| ONS | 2 servings | 2 servings |
| Protein | 0.5-1 g per pound of body weight | 0.5-1 g per pound of body weight |
| Carbs | 60-75 g | 45-60 g |
| Arginine | 4.5 g | 4.5 g |
| Glutamine | 20-40 g | 20-40 g |
| HMB | 3 g | 3 g |
| Zinc | 11 mg | 8 mg |
| Vitamin A | 900 mcg | 700 mcg |
| Vitamin B12 | 2.4 mcg | 2.4 mcg |
| Vitamin C | 90 mg | 75 mg |
| Vitamin D | 15-20 mcg | 15-20 mcg |
| Vitamin E | 15 mg | 15 mg |
The Nutrition Interventions in Adults with Diabetic Foot Ulcers contains the full guideline, designed to accomplish the difficult goal of improved outpatient nutrition to support the healing DFU wound.
Additional Resources for Recipes and More:
- www.cdc.gov/diabetes/managing/eat-well.html
- http://www.nutrition.gov/topics/diet-and-health-conditions/diabetes
- www.diabetes.org/healthy-living/recipes-nutrition/understanding-carbs/carb-counting-and-diabetes
- http://www.diabetesfoodhub.org/
- http://www.eatright.org/health/diseases-and-conditions/diabetes
In conclusion, the journey to better health begins with education and empowerment. By equipping ourselves and our patients with the knowledge and resources we need to make informed food choices, patients can take control of their health and pave the way for a brighter, healthier future. Working together, we can make National Nutrition Month® 2024 a turning point in the fight against chronic disease.
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