Mixed reviews for new type 2 diet guidelines

Diabetes UK’s new dietary guidelines for type 2 diabetes have reignited the ‘low fat, high fat’ debate.

The guidelines were presented at the Diabetes UK Professional Conference 2018 held in London last week. They suggested that “one size of diet does not fit all” and stated that dietary advice needs to be tailored.

The evidence-based guidelines reflect recent research advances and provide nutrition recommendations to better enable healthcare professionals in supporting adults with diabetes, and those at risk of type 2 diabetes, Diabetes UK said.

The charity said: “For the first time the guidelines – which were last updated in 2011 – outline how people with type 2 diabetes might be able to achieve remission. This guidance has been added after the first year results of the Diabetes UK-funded study called DiRECT, suggested that type 2 diabetes remission can occur with significant weight loss.

“The guidelines outline consistently strong evidence that suggests eating certain foods can help reduce the risk of type 2 diabetes, can manage blood glucose levels in people with type 2 diabetes, and reduce the risk of cardiovascular disease in people with diabetes. These suggested foods include vegetables, fruits, wholegrains, fish, nuts and pulses. Eating less red and processed meat, refined carbohydrates and sugar sweetened beverages, is also recommended.”

The charity said that these recommended foods are usually associated with the Mediterranean-style diet, but can be adapted to take into account cultural and personal preferences. Previous recommendations had relied on more nutrients, but this food-based approach provides people at risk and with diabetes more flexibility, Diabetes UK added.

But, while Jack Woodfield, deputy editor of Diabetes.co.uk, applauded aspects of the new guidelines, he criticised the charity’s stance on fat.

Jack reviewed the guidelines in an article on Diabetes.co.uk called Chewing the fat: a review of Diabetes UK’s 2018 nutrition guidelines.

In it, he commented: “At Diabetes.co.uk we are advocates of eating a low carb diet alongside healthy fats, with an array of studies illustrating how low fat dieting is not only ill-advised, but also plausibly quite dangerous. Diabetes UK has maintained its stance that low fat is preferred to high fat foods, and persists in recommending people with diabetes avoid saturated fat, irrespective of food source.

“The 114-page document covers a formidable amount of research, with more than 500 scientific studies analysed by a team of researchers from Oxford University alongside Diabetes UK and while, on one hand, there is much to admire about the progress these new guidelines have made, it is unfortunate that the charity’s stance on fat remains rooted in the 1980s.”

He added: “In these new guidelines, the first major nutritional update Diabetes UK has made since 2011, there is a focus on eating low fat dairy products, particularly yoghurt and cheese, as a means of preventing type 2 diabetes from developing. Reducing saturated fat is also advised.”

However, Douglas Twenefour, Diabetes UK’s deputy head of care and co-chair of the guidelines group, said: “There is not a one-size-fits all approach when it comes to making food choices, so these new guidelines take this into account. It is important that people with diabetes, and those at risk, are supported to choose the right foods for them to help them to achieve their specific treatment goals and improve their health and quality of life.

“We have been publishing dietary guidelines for thirty-five years, beginning in 1982, with updates and revisions issued at regular intervals in 1992, 2003 and with the most recent previous update in 2011.”

Dr Dinesh Nagi, consultant in diabetes and edocrinology at Mid Yorkshire NHS Trust, and Chairman of the Association of British Clinical Diabetologists, said: “These updated guidelines provide a highly valuable resource for healthcare professionals who work in this field and I have no doubt, will enable them to provide an individualised nutritional plan to people with diabetes.

“These guidelines are also a timely reminder to all of us working in specialist and primary care, the importance of nutrition, both in prevention of type 2 diabetes and in the day to day management of diabetes.”

To access the guidelines, click here.