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Original paper

Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes

Authors: P. A. Dyson, D. Twenefour, C. Breen, A. Duncan, E. Elvin, L. Goff, A. Hill, P. Kalsi, N. Marsland, P. McArdle, D. Mellor, L. Oliver, K. Watson

DOI: 10.1111/dme.13603

Publication date: February 14, 2018

Keywords: Endocrinology Endocrinology Diabetes and Metabolism Internal Medicine

  • Diabetes UK recommends that health care professionals take an individualised approach when talking to people with or at risk of developing diabetes.
  • Key diet and lifestyle recommendations include restriction of energy intake, reduction in total and saturated fat intake, increase in dietary fibre intake and more physical activity
  • Diabetes UK state that a daily dose of 2-3 g of plant sterols and stanols can be recommended as part of a healthy diet to reduce cardiovascular risk for people with or at risk of developing diabetes.
  • Plant sterols and stanols are also recommended for people already taking cholesterol-lowering medication to further reduce their serum cholesterol and cardiovascular risk.

Updated evidence-based nutrition guidelines for the prevention and management of diabetes have been published by Diabetes UK in March 2018. The guidelines written for health care professionals (HCPs) are aimed at adults with either Type 1 or Type 2 diabetes and those at risk of developing Type 2 diabetes.

The guidelines recommend that HCPs take an individualised approach to diet and consider a person’s personal and cultural preferences. They recommended people eat more vegetables, fruits, wholegrains, fish, nuts and pulses.

To reduce the risk of cardiovascular disease (CVD) and in particular two of the modifiable risk factors, blood lipids and blood pressure, the guidelines recommend Mediterranean or DASH-style diets with less salt, more plant based food and less red and processed meat, refined carbohydrates and sugar sweetened drinks. They recommend replacing saturated fats with unsaturated fats and to limit the intake of trans fatty acids (TFA). They also recommended limiting alcohol intake to less than 14 units per week. Overweight individuals should aim to achieve modest weight loss of at least 5% of overall weight and everyone should aim for at least 150 minutes per week of moderate to vigorous physical exercise, over at least three days. A daily dose of 2-3 g of plant stanols and sterols per day can be recommended.

Whilst acknowledging that the UK NICE guidelines have not recommended the use of plant sterols and stanols for the primary prevention of CVD (mainly due to the lack of hard cardiovascular event endpoint studies) Diabetes UK clearly recommend their use at a daily dose of 2-3 g per day. Diabetes UK cites evidence of the effectiveness of plant sterols and stanols in significantly reducing total and LDL cholesterol in people with or without diabetes and also explain that further reductions in LDL-C can also be achieved in people on cholesterol lowering medication such as statins.

 

For further information see: https://www.diabetes.org.uk/professionals/position-statements-reports/food-nutrition-lifestyle/evidence-based-nutrition-guidelines-for-the-prevention-and-management-of-diabetes