Review of dietary recommendations for diabetes mellitus

Previous nutritional guidelines for people with diabetes focused on carbohydrate-based meal planning. Updated guidelines from Europe and North America reflect a more flexible approach to nutritional intervention. New aspects of these most recent recommendations include: (1) increased emphasis on the role of trained dietitians for educating people with diabetes; (2) greater individualization of dietary choices based on cultural, regional and personal preferences; (3) more flexibility for choosing between carbohydrate and monounsaturated fat consumption, but with limitations on intake of polyunsaturated fats (<10% of total energy); (4) broadened allowance of sucrose in the diet (up to 10% of total energy); and (5) greater recognition of physical activity as an important means to control weight and enhance general health. Expert guidelines vary regarding preferential intake of carbohydrates with lower glycemic indices. (C) 2004 Elsevier Ireland Ltd. All rights reserved.