Feature Article

Food, diet and diabetes: what’s hot and what’s not?

Feature Article

Food, diet and diabetes: what’s hot and what’s not?

Pat Phillips, Melissa Carapetis

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Abstract

The balance of protein, carbohydrate and fats in the diet has special significance for people with diabetes because of their particular concerns regarding cardiovascular risk and glycaemic control.

Key Points

  • Eating patterns in Australia are close to those recommended but Australians are eating more than needed for energy balance and are getting progressively fatter. Associated with this increasing weight gain is the ‘diabesity epidemic’.
  • Adequate protein is essential but animal protein is often associated with saturated fat. Although unrefined carbohydrate is generally recommended, high carbohydrate diets may increase triglyceride levels. High fat diets may increase body fat; saturated fats and trans fats increase cholesterol, but cis unsaturated fats can improve the lipid profile.
  • High protein diets have theoretical disadvantages, particularly adverse effects on bone and mineral metabolism, renal function and cardiovascular and cancer risks.
  • The CSIRO diet, which promotes only moderately higher protein and lower carbohydrate than conventional diets, seems more appropriate for people with diabetes and also the general population than the very high protein, very low carbohydrate Atkins diet.
  • Restricted carbohydrate diets can put patients with diabetes who are taking insulin or insulin secretagogues at increased risk of hypoglycaemia.
  • The recommended maximum alcohol intake for patients with diabetes is the same as for the general population. Those trying to lose weight or who have hypertension or dyslipidaemia should only drink occasionally.