New ADA Position Statement on Nutrition Therapy for Adults with Diabetes

The American Diabetes Association has released a new position statement entitled “Nutrition Therapy Recommendations for the Management of Adults With Diabetes”, and there are some key changes.First, the document does not use the term “diabetes diet”, rather refers to “eating plans” or “eating patterns.” This official position can go a long way in refuting the idea that healthy eating for diabetes management is restrictive and rigid. Without recommending any eating plan specifically, the paper reviews evidence for several popular plans like the Mediterranean plan, vegetarian, low fat, low carb and DASH (Dietary Approaches to Stopping Hypertension). According to the statement, "Personal preferences (eg, tradition, culture, religion, health beliefs and goals, economics) and metabolic goals should be considered when recommending one eating pattern over another."The statement differs with the U.S. government’s 2010 Dietary Guidelines for Americans with respect to dietary sodium. While the 2010 guidelines recommended that people with diabetes limit consumption to 1500 milligrams per day, the ADA statement left adults with diabetes at the 2300 mg/d recommendation for all adults unless high blood pressure is an issue too.Finally, the position statement addresses the effectiveness and, unfortunately the rarity, of referrals to nutrition professionals and diabetes educators. The paper strongly recommends immediate referral to lifestyle support resources at diagnosis, and the continuation of follow-up so that patients can learn to adopt effective eating patterns for diabetes management. However, the paper cites that nationally only half of diabetes patients report having any diabetes education, and fewer report consultation with nutrition professional. The paper offers strong evidence that such interventions are effective not only for the individual patient, but also in reducing long term medical costs.