Healthy Eating for the Prevention and Treatment of Metabolic and Endocrine Diseases in Adults
Publication Date: October 1, 2013
Last Updated: March 14, 2022
Recommendations
General Recommendations for Healthy Eating and Disease Prevention
All patients should be instructed on healthy eating and on proper meal planning by qualified health care professionals. (I, A)
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Essential macronutrients and micronutrients, fiber, and water should be provided by well-chosen foods and beverages that can be enjoyed and constitute a healthy eating pattern. Macronutrients should be recommended in the context of a calorie-controlled meal plan. (I, A)
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All patients should also be counseled on other ways to achieve a healthy lifestyle, including regular physical activity (150 minutes or more per week), ways to avoid a sedentary lifestyle, appropriate sleep time (6 or more hours every night), and budgeting time for recreation or play, stress reduction, and happiness. (I, A)
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Healthy Macronutrient Intake
In a healthy eating meal plan, carbohydrates should provide 45 to 65% of ingested energy, with due diligence to limit simple sugars or foods that have a high glycemic index (GI). Regardless of the macronutrient mix, total caloric intake must be appropriate for individual weight management goals. Patients should consume 6 to 8 servings of carbohydrates (one serving is 15 grams of carbohydrate) per day with at least half (3 to 4 servings) being from high-fiber, whole-grain products. (I, A)
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Consumption of fruits (especially berries) and vegetables (especially raw) (≥4.5 cups per day) will increase fiber, increase phytonutrient intake, and facilitate calorie control. (II, B)
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Patients should be instructed to consume whole grains in place of refined grains, which will add fiber and micronutrients to meals and help lower blood pressure (BP). (I, A)
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Protein from both plant and animal sources (15 to 35% of calories depending on total intake) can replace a portion of saturated fat and/or refined carbohydrates in the meal plan to help improve blood lipids and BP. (I, A)
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The meal plan should include a maximum of 6 ounces per day of reduced-fat animal protein to increase the nutrient-to-calorie ratio. (I, B)
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Reduced-fat dairy (2 to 3 servings per day) should be recommended as a source of high-quality protein for patients who are not intolerant or allergic to lactose because it lowers BP and helps reduce weight while also providing important micronutrients. (I, A)
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Plant protein (e.g., pulses, including beans, lentils, and some nuts; and certain vegetables, including broccoli, kale, and spinach) should be emphasized in meal planning, as it is not commonly consumed in Western meals; plant proteins confer many health benefits, including improved blood lipid levels and BP. (II, B)
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Patients should be counseled to consume unsaturated fats from liquid vegetable oils, seeds, nuts, and fish (including omega-3 fatty acids) in place of high-saturated fat foods (butter and animal fats), providing 25 to 35% of daily calories to reduce the risk for cardiovascular disease (CVD). (I, A)
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It should be recommended that patients consume natural foods high in monounsaturated fat, such as olive oil in the Mediterranean dietary pattern, since this is strongly associated with improved health outcomes. (I, A)
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It should be recommended that patients eat at least 2 servings of cold-water, fatty fish (such as salmon or mackerel) every week because they contain greater amounts of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). (II, B)
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Healthy Micronutrient Intake
With the exception of proven therapies for documented specific vitamin deficiency states or diseases, or pregnancy, there are insufficient data to recommend supplemental vitamin intake above the recommended dietary allowances (RDA). (IV, D)
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Vitamin E supplementation to decrease cardiovascular (CV) events or cancer is not recommended. (II, B)
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Lifelong regular follow-up and individualized therapy are recommended in diseases known to cause intestinal malabsorption (e.g., after malabsorptive bariatric surgery, ileo-colic resection, short bowel syndrome, celiac disease, inflammatory bowel disease, exocrine pancreatic insufficiency, CKD, and chronic liver disease) to detect and treat vitamin and mineral deficiencies. (II, B)
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Vitamin B12 levels should be checked periodically in older adults and patients on metformin therapy. (I, A)
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With the exception of early treatment of patients with neurologic symptoms, pernicious anemia, or malabsorptive bariatric surgery requiring parenteral (intramuscular or subcutaneous) vitamin B12 replacement, patients with vitamin B12 deficiency can generally be treated with oral vitamin B12 (1,000 μg per day of oral crystalline cobalamin) and may benefit from increasing the intake of vitamin B12 in food. (I, A)
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The prevalence of vitamin D deficiency and insufficiency warrants case finding by measurement of 25-hydroxyvitamin D (25[OH]D) levels in populations at risk, including institutionalized elderly patients, people with hyperpigmented skin, and people with obesity. (II, B)
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Older adults, people with increased skin pigmentation, and those exposed to insufficient sunlight should increase vitamin D intake from vitamin D-fortified foods and/or supplements to at least 800 to 1,000 international units (IU) daily. (I, A)
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Approach to Overweight and Obesity
Overweight and obesity should be managed as a long-term chronic disease. (I, A)
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Overweight and obesity should be managed using a multidisciplinary team approach. (I, A)
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Nutrition counseling for overweight and obesity should be aimed to decrease fat mass and also to correct adipose tissue dysfunction (adiposopathy). (I, A)
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Adult feeding behavior is solidly rooted from childhood, so it is important to counsel adult patients to include their families, especially their children, in healthy eating behavior changes. (II, B)
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Nutrition counseling should be culturally, linguistically, and educationally provided to meet individual patient needs. (IV, D)
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The weight-loss goal for overweight or obese patients is 5 to 10% of current body weight over the ensuing 6 to 12 months. This goal is perennial until an acceptable body mass index (BMI) is achieved. (I, A)
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Combined therapy utilizing a low-calorie meal plan (LCMP), increased physical activity, behavior therapy, and appropriate pharmacotherapy provides the most successful intervention for weight loss and weight maintenance and is also recommended as an adjunct to bariatric surgery. (II, A)
(Expert panel experience and consensus)
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Behavior Modification
Sustained behavior modification must be achieved for long-term success with weight management. Food and activity record-keeping should be recommended to help patients achieve the best results. (I, A)
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Behavioral group therapy is a cost-effective way of providing nutrition counseling to patients and should be incorporated into weight management treatment programs. (II, B)
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Use of portion-controlled prepackaged meals should be considered as a way to achieve a lower caloric intake. (I, A)
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Low-Calorie Meal Plans
When first treating a patient with overweight or obesity, emphasis should be placed on maintaining a healthy meal plan and avoiding fad diets while including food choices from all major food groups. (II, A)
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A healthy, LCMP with a deficit of 500 to 1,000 kcal/day should be an integral part of any program aimed at achieving a total weight-loss rate of 1 to 2 pounds/week (which may include lean muscle mass as well as fat mass weight loss). (I, A)
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All meal plans of <1,200 kcal/day should be carefully selected so that nutrient requirements are met. When particular food groups are severely restricted or omitted, the use of dietary supplements to meet nutrient requirements should be implemented. (IV, D)
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Very Low-Calorie Meal Plans
Very low-calorie meal plans (VLCMPs) (≤800 kcal/day or ~6 to 10 kcal/kg), which can produce weight losses up to 1.5 to 2.5 kg/week and up to 20 kg in 12 to 16 weeks, may be recommended for patients with a BMI >30 kg/m2 who have significant comorbidities or who have failed other nutritional approaches to weight loss. (II, B)
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VLCMP treatment requires nutritional supplementation and medical monitoring for complications, including electrolyte imbalances, hepatic transaminase elevation, and gallstone formation, and the duration of treatment should not exceed 12 to 16 weeks. (I, A)
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Nutritional Strategies for Excess Fat Mass and Adiposopathy
All patients at risk for CVD should implement healthy eating patterns, which provide calorie control, adequate nutrients, beneficial bioactive compounds, and result in weight loss or weight maintenance. (IV, D)
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To help control calorie intake, patients should eat meals that are low in energy density. (I, A)
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All patients should also be advised to increase caloric expenditure to at least 150 minutes of moderate-intensity activity every week (e.g., walking) or 75 minutes of vigorous-intensity activity every week (e.g., running). (I, A)
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Successful weight loss and maintenance to decrease CV risk must include both a change in meal plan as well as frequent physical activity. (I, A)
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Nutritional Strategies for Dyslipidemia
The therapeutic lifestyle changes (TLC) meal plan with viscous fiber and plant sterols and stanols is recommended for individuals with elevated low-density-lipoprotein cholesterol (LDL-C). (I, A)
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The Mediterranean meal plan (or a TLC meal plan that provides 30 to 35% of calories from total fat with an emphasis on mono- and polyunsaturated fatty acids [PUFAs]) is recommended for individuals who have abnormal non-LDL-C lipid values. (I, A)
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Nutritional Strategies for Hypertension
Attaining and maintaining a healthy body weight is recommended to prevent and treat hypertension. Obese and overweight individuals should accomplish a 10% weight loss to decrease their BP. (I, A)
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All patients should be counseled to adhere to the Dietary Approaches to Stop Hypertension (DASH) meal plan, which is high in fruits, vegetables, whole grains, and reduced-fat dairy. (I, A)
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Sodium intake should be reduced to <2,300 mg/day, and potassium intake should be increased to >4,700 mg/day with implementation of a DASH-type meal plan. (I, A)
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Sodium intake should be further reduced (<1,500 mg/day; or 3,800 mg/day of table salt) for people age 51 years and above, all people who are African American, regardless of age, and for patients who have hypertension, DM, or CKD. (I, A)
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Nutrient Sources That Should be Limited for Cardiovascular Health
Added sugars should be limited to <100 calories per day for women and <150 calories per day for men. (I, A)
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Sugar-sweetened beverage (SSB) intake should be reduced as an effective way to reduce added sugar intake. (II, B)
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Saturated fat intake should be limited to <7% for reduction of CVD risk. (I, A)
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It is recommended that processed red meat intake be limited to less than 2 servings per week and that lean or very lean red meat cuts be consumed while controlling for saturated fat intake. (II, B)
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Whole grain products should be substituted for refined grain products when possible, such that at least one-half of daily servings of grains are from whole grains. (II, B)
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Nutritional Recommendations Appropriate for Diabetes Mellitus
Patient Nutrition Education
Medical nutrition therapy provided by a physician, physician extender, registered dietician (RD), and/or certified diabetes educator (CDE) is recommended for all patients with DM. (I, A)
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Patients with DM who experience difficulty achieving glycemic targets should keep a personal food diary. (IV, D)
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Caloric and Protein Intake
Patients with DM should consume total daily calories at amounts sufficient to attain or maintain a normal BMI of 18.5 to 24.9 kg/m2, which is generally in the 15 to 30 kcal/kg/day range, depending on level of physical activity. (I, A)
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Patients with DM should consume protein in the 0.8 to 1.0 g/kg/day range, and protein should account for about 15 to 35% of the total calorie consumption for the day. (III, C)
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Carbohydrate Intake
Medical nutrition therapy should be implemented to control the glycemic response to meals and to achieve hemoglobin A1c (A1c) and blood glucose levels as close to the target range as possible without risk to the individual patient. (I, A)
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Carbohydrates should account for about 45 to 65% of the total calorie consumption for the day, including low-fat dairy products and sucrose. (III, C)
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Patients with DM should consume carbohydrate primarily from unprocessed carbohydrates, which are provided by a target of 8 to 10 servings per day of vegetables (particularly raw), fruits, and legumes, with due diligence to limit simple sugars or foods that have a high GI. (I, A)
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Regardless of the macronutrient mix, total caloric intake must be appropriate for individual weight management goals. Patients with DM should consume 20 to 35 g of fiber from raw vegetables and unprocessed grains (or about 14 g of fiber per 1,000 kcal ingested) per day (the same as the general population). (II, B)
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Patients with type 1 DM (T1DM), or insulin-treated type 2 DM (T2DM) should synchronize insulin dosing with carbohydrate intake. (I, A)
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Patients with T2DM treated with short-acting oral hypoglycemic agents (nateglinide, repaglinide) should also synchronize carbohydrate intake with administration of these medications. (I, A)
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Patients with DM may safely consume artificial sweeteners within the guidelines of the U.S. Food and Drug Administration (FDA). (IV, D)
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Fat Intake
For patients with DM, total fat intake should account for about 30% of the total daily calories. (II, B)
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Consumption of saturated fat should be less than 7% of total daily calories regardless of the serum total cholesterol level, and PUFAs should be up to 10% of the total daily calories (examples of food sources include vegetable oils high in n-6 PUFA, soft margarine, salad dressings, mayonnaise, and some nuts and seeds). (II, B)
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The n-3 PUFAs are most desirable, and dietary recommendations for EPA and DHA can be achieved with two or more servings of fresh fish per week. (II, B)
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In patients with DM, monounsaturated fatty acids (MUFAs) should be up to 15 to 20% of the total daily calories. (II, B)
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Dietary cholesterol should be less than 200 mg/day. (I, A)
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Patients with DM should avoid consumption of trans fats. (III, C)
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Other Nutritional Recommendations
There is insufficient evidence to specifically recommend a “low-GI” meal plan in patients with DM. (IV, D)
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There is insufficient evidence to support the routine use of antioxidants, chromium, magnesium, and/or vanadium in patients with DM. (III, C)
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Patients with DM who choose to drink alcohol should ingest it with food and limit intake to 2 servings per day for men or 1 serving per day for women. Alcohol intake should not be increased for any purported beneficial effect. (IV, D)
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There is insufficient evidence, based on long-term risks and benefits, to support the use of fad diets in patients with DM. (IV, D)
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Diabetes Mellitus Prevention
There is insufficient evidence to support nutrition changes to specifically prevent T1DM. (IV, D)
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However, women with a personal or family history of T1DM who may be HLA-DR3 and DR4 carriers should be counseled on the medical evidence suggesting that the use of infant formula derived from cow’s milk in the first 6 months of life increases a baby’s risk of T1DM by stimulating antibody formation to the beta-cells. (II, B)
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Patients at high risk for the development of T2DM should implement lifestyle interventions to achieve a minimum of 7% weight loss followed by weight maintenance, and a minimum of 150 minutes of weekly physical activity, similar in intensity to brisk walking. (I, A)
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Nutritional Recommendations Appropriate for Chronic Kidney Disease
General Approach
Patients with CKD should have a meal plan low in protein, sodium, potassium, and phosphorus, which slows the progression of kidney disease. (I, A)
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All patients with CKD should receive nutrition education by qualified health care professionals. (I, A)
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Protein Requirements
In CKD stages 1, 2, or 3, protein intake should be limited to 12 to 15% of daily calorie intake or 0.8 g of high-biological-value (HBV) protein/kg body weight/day. (I, A)
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In CKD stage 4, protein intake should be reduced to 10% of daily calorie intake or 0.6 g of high-quality protein/kg body weight/day, provided an essential amino acid (EAA) deficiency does not occur. (I, A)
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For nondialyzed CKD patients with a glomerular filtration rate (GFR) <25 mL/min, 0.6 g of protein/kg body weight/day should be prescribed, with at least 50% of the protein intake from HBV sources to ensure a sufficient amount of EAAs. (I, A)
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For patients with CKD stage 5 or patients on renal replacement therapy (RRT), protein intake should be 1.3 g/kg/day (peritoneal dialysis) or 1.2 g/kg/day (hemodialysis). (I, A)
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Urinary protein losses in the nephrotic syndrome should be replaced, and a low-normal protein dietary reference intake (DRI) of 0.8 to 1.0 g/kg body weight/day should be recommended. (III, C)
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Patients with CKD stages 1, 2, or 3 should ingest 35 kcal/kg body weight/day in order to maintain neutral nitrogen balance and to prevent catabolism of stored proteins for energy needs. (II, B)
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Patients with CKD and a GFR <25 mL/min should ingest 35 kcal/kg body weight/day if they are younger than age 60 years or 30 to 35 kcal/kg body weight/day if they are age 60 years or above. (II, B)
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Phosphate intake should be limited to 800 mg/day for patients with stage 3, 4, or 5 CKD. (I, A)
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Electrolytes
All patients with CKD, regardless of CKD stage, should limit sodium intake to 2.0 g/day. (I, A)
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When potassium levels are elevated, potassium intake (including salt substitutes) should be limited to 2 to 3 g/day. (I, A)
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When diarrhea or vomiting is present, potassium intake should be liberalized and provided with meals that include a variety of fruits, vegetables, and grains. (IV, D)
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All patients with CKD and hyperphosphatemia should get 2,000 mg/day of total calcium intake (binders plus calcium in meals). (I, A)
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All patients with CKD who have hyperphosphatemia and secondary hyperparathyroidism should be treated with oral vitamin D to bring the total serum 25(OH)D level to greater than 30 ng/mL. (I, A)
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If the intact parathyroid hormone (PTH) level remains elevated above treatment goal despite a serum 25(OH)D level higher than 30 ng/mL, treatment with an active form of vitamin D is indicated. (I, A)
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Patients with stage 3, 4, or 5 CKD should receive oral ferrous sulfate, 325 mg three times a day, in order to maintain transferrin saturation >20% and serum ferritin >100 ng/mL. (I, A)
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Renal Replacement Therapy
For patients with end-stage kidney disease (ESKD) on RRT, potassium intake should be limited to 3 to 4 g/day (peritoneal dialysis) or 2 to 3 g/day (hemodialysis). (I, A)
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Patients with DM and ESKD who are on RRT should be routinely queried regarding their eating habits, home glucose monitoring, and frequency and severity of hypoglycemia. (III, C)
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Nutritional Recommendations Appropriate for Bone Health
Calcium
Total elemental calcium intake should be 1,000 mg/day for premenopausal women and men and 1,200 to 1,500 mg/day for postmenopausal women, preferentially from food sources. (I, A)
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Excessive amounts of elemental calcium intake, in the range of 2,000 mg/day, may increase the risk of kidney stones and other side effects and should therefore be actively discouraged. (I, A)
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A calcium intake greater than 1,500 mg/day is associated with an increased risk of advanced prostate cancer and should be discouraged. (II, B)
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Calcium supplements should be used if a patient’s meal plan does not provide adequate calcium intake. (I, A)
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Calcium citrate should be recommended instead of calcium carbonate for patients with achlorhydria, history of gastric surgery, and those being treated with proton-pump inhibitors or H2-receptor blockers. (II, B)
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For best absorption, calcium supplements should be limited to no more than 500 mg of elemental calcium per dose, since there is decreasing absorption with increasing doses. (I, A)
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A 24-hour urine calcium collection should be measured in patients with osteoporosis or patients at risk for bone loss in order to check calcium adequacy and test for hypercalciuria or malabsorption. (II, B)
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Vitamin D
Serum 25(OH)D should be measured in individuals at risk for vitamin D deficiency (e.g., elderly, institutionalized, or malnourished patients) and in those with known osteopenia or osteoporosis. (I, A)
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Vitamin D should be supplemented to keep the plasma 25(OH)D level greater than 30 ng/mL. (I, A)
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For most patients, a daily intake of at least 1,000 to 2,000 IU of ergocalciferol (D2) or cholecalciferol (D3) should be adequate. (I, A)
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For patients with advanced renal failure in whom renal activation of vitamin D is impaired, calcitriol should be dosed to allow for adequate intestinal absorption of calcium. (I, A)
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Nutritional Recommendations Appropriate for Pregnancy and Lactation
Pregnancy Planning
Prior to pregnancy, women should be encouraged to achieve a normal BMI. (I, A)
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Elevated fasting blood glucose prior to pregnancy should prompt screening for DM and initiation of a healthy eating meal plan and lifestyle modification. (I, A)
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Any chronic diseases, including DM, thyroid disorders, and rheumatologic disorders should be optimally controlled prior to conception with a focus on appropriate nutrition and physical activity. (IV, D)
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Pregnancy
The appropriate individual caloric intake should be calculated based on prepregnancy and current (pregnant) BMI. (IV, D)
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Pregnant women who are vegetarian or vegan must be referred to a RD specializing in pregnancy to assist in meal planning and appropriate use of dietary supplements. (IV, D)
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Women who are pregnant should consume 1.1 g/kg of protein per day in the second and third trimesters. (II, B)
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During pregnancy, less than 10% of calories should be derived from saturated fats and less than 10% should be derived from PUFAs, with the remainder from MUFAs. (IV, D)
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Trans fatty acids should be avoided during a pregnancy since they may have adverse effects on fetal development. (II, B)
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Daily ingestion of a prenatal vitamin (PNV) is recommended for all women during pregnancy. (I, A)
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All women in their childbearing years should consume 400 μg/day of folic acid, and once pregnancy is confirmed, the intake should be adjusted to 600 μg/day. (II, B)
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Intake of vitamin A over 10,000 IU a day is teratogenic, so women should be advised against excessive supplementation. (II, B)
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All pregnant women should ingest a minimum of 250 μg of iodine daily. (II, B)
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Women who have DM and/or are insulin resistant should adjust the percentage of ingested carbohydrate during pregnancy to obtain proper glycemic control. (II, B)
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Women with gestational DM (GDM) should: (1) adhere to the recommendations for healthy eating for all pregnant women, (2) allow for appropriate weight gain during pregnancy (i.e., 2 to 5 pounds in the first trimester and 0.5 to 1 pound per week thereafter), (3) avoid concentrated sweets and “fast foods,” and (4) eat small, frequent meals with protein, having only one starch with breakfast and choosing high-fiber foods with lower fat content. (III, C)
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Patients should be instructed to consume less than 300 mg of caffeine (3 cups of coffee) per day during pregnancy, since caffeine can increase the incidence of miscarriage and stillbirth when consumed in larger quantities. (II, B)
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Lactation
Whenever possible, exclusive breastfeeding is recommended for at least the first 6 months of life. (I, A)
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All women should be instructed on breastfeeding, made aware of community resources about breast feeding, and counseled to adjust their meal plans to meet nutritional needs during lactation. (I, A)
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All pregnant and lactating women should ingest a minimum of 250 μg of iodine daily. (II, B)
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During breastfeeding, basal insulin requirements decrease. Women who breastfeed should be advised to either lower their basal insulin dose (or basal insulin infusion rate if on an insulin pump) or eat a carbohydrate-containing snack prior to breastfeeding. (IV, D)
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Nutritional Recommendations Appropriate for the Elderly
Healthy Eating for Energy Balance and Toward an Ideal Body Weight
As people age, they should implement healthy eating to maintain an ideal body weight, since both overweight and underweight lead to increased morbidity and mortality. (I, A)
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In the elderly with sarcopenia and decreased basal metabolic rate, formulating a meal plan should include caloric reduction to maintain energy balance and to prevent fat-weight gain. (II, B)
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To constrain caloric overconsumption in the elderly while also ensuring micronutrient adequacy, quality foods low in calories and containing adequate amounts of HBV protein sources to provide EAAs and essential fatty acids (EFAs) and rich in micronutrients and fiber should be ingested routinely. (II, B)
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Quality food high in proteins, minerals, and vitamins but low in saturated fat, cholesterol, and trans fat (such as lean meat, fish, poultry, eggs, and dry beans and nuts) should be recommended for overweight or obese elderly patients to provide adequate protein intake without carrying a high risk for CVD. (I, A)
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Older adults should consume more of the nutrient-dense whole-grain foods, such as brown rice, whole-wheat breads, and whole-grain and fortified cereals to meet carbohydrate needs. Conversely, the consumption of refined starch-based foods such as processed potato, white bread, pasta, and other commercial products made of refined wheat flour should be limited to decrease the risk of obesity and DM. (II, B)
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Dehydration is a more prevalent condition in the elderly, and thirst sensation may be compromised with aging, therefore habitual fluid intake (about 2 quarts per day or eight 8-ounce glasses) is recommended. (II, B)
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On an individual basis, ingestion of nutrition supplements between meals should be recommended for undernourished elderly patients. (II, B)
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Energy and nutrient-dense foods, or manipulation of energy and nutrient density of the meal plan, should be recommended for the frail elderly to promote weight gain and improve clinical outcomes. (I, A)
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Food safety, including the prevention of food spoilage, should be provided for all elderly patients. (IV, D)
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Healthy Eating to Prevent Micronutrient Deficiency in Older Adults
To ensure adequacy of a wide variety of micronutrients, a daily mix of nutrient-dense foods, including fruits and vegetables, should be recommended. (II, B)
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In the elderly, pills should not be used as a substitute for meals. (IV, D)
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The elderly should consume at least 3 daily servings of calcium-rich foods. (I, A)
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In the elderly, case finding for vitamin D and vitamin B12 deficiencies is reasonable given their high prevalence with advancing age. (II, B)
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It is appropriate to recommend a daily multivitamin (MVI) to complement food intake in older adults who cannot achieve adequate micronutrient intake otherwise. (II, B)
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Surveillance to prevent toxicity from excess ingestion of vitamin pills is appropriate for the elderly. (III, C)
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Healthy Eating for the Frail Elderly
Community nutrition assistance programs that provide individuals with home-delivered meals should be recommended for frail elderly patients still living independently. (I, A)
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Barriers to healthy eating in the elderly should be actively found and addressed, including provision of direct feeding assistance where self-feeding is not adequate, treatment of depression, group meals for institutionalized patients, correcting oral and dental problems leading to difficulties with eating, chewing or swallowing, addressing social isolation, rectifying polypharmacy, and treating underlying diseases. (II, B)
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Physicians treating geriatric patients should make every effort to reduce the number of medications to achieve better medication adherence and to allow for better nutritional care. (IV, D)
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Recommendation Grading
Overview
Title
Healthy Eating for the Prevention and Treatment of Metabolic and Endocrine Diseases in Adults
Authoring Organizations
American Association of Clinical Endocrinologists
The Obesity Society
Publication Month/Year
October 1, 2013
Last Updated Month/Year
November 14, 2022
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory
Intended Users
Dietician nutritionist, nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Prevention, Treatment
Diseases/Conditions (MeSH)
D008659 - Metabolic Diseases, D004435 - Eating, D004700 - Endocrine System Diseases
Keywords
enteral nutrition, healthy eating
Source Citation
Gonzalez-Campoy JM, St Jeor ST, Castorino K, Ebrahim A, Hurley D, Jovanovic L, Mechanick JI, Petak SM, Yu YH, Harris KA, Kris-Etherton P, Kushner R, Molini-Blandford M, Nguyen QT, Plodkowski R, Sarwer DB, Thomas KT; American Association of Clinical Endocrinologists; American College of Endocrinology and the Obesity Society. 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 Sep-Oct;19 Suppl 3:1-82. doi: 10.4158/EP13155.GL. PMID: 24129260.