According to the 2015 Clinical Care Guidelines for Diabetes Care, a publication of the American Diabetes Association, the meal pattern of eating which reflects the nutritional quality of the foods consumed, can be more important for controlling diabetes and health risks than adhering to a strict caloric level or a set number of exchanges per food item in a meal. (1) However, with so many diet plans to choose from, a person may wonder which ones are best for keeping blood sugar under control?

To help clarify which diet plans are the healthiest for the individual living with diabetes, a critique of two diet plans--the DASH Diet and the Mediterranean Diet--will be conducted.

The DASH Diet   
The acronym “DASH” stands for Dietary Approaches to Stop Hypertension. The DASH Diet plan has demonstrated an ability to reduce and promote blood pressure control  and reduce health risks in people living with (or without) diabetes.(1,2,3,4 ) It is a dietary pattern that includes a high level, up to eight to ten servings, of fruits and vegetables daily, as well as whole grains with moderate levels of low fat dairy products, fish, poultry, and nuts.(2,3,4) Red meats, sweets, and sugar-sweetened beverages are limited and sodium is restricted to 2300 mg per day or less, which is now the current sodium intake recommendations for all Americans. (2,3,4)

dash-diet-foodsSeveral prospective studies and clinical trials have confirmed the health benefits of the DASH diet pattern.(3,4) In an eight week, randomized controlled trial (RCT), with individuals living with diabetes, the DASH diet, with sodium restriction, had a positive effect on glycemic control, blood lipids levels (HDL & LDL cholesterol), blood pressure, and biomarkers of inflammation.(3) Various modifications of the DASH diet containing higher levels of unsaturated healthy fats, lean protein, or sodium modification have also been tested.(4) Investigations of these DASH-style eating patterns revealed reduced blood pressure and heart disease risk factors compared to eating patterns that were similar to the typical American diet.(4) The DASH Diet is one of the recommended healthy eating patterns highlighted in the 2010 Dietary Guidelines for Americans.(4) 

Key Recommendations from the 2010 Dietary Guidelines for Americans:

  • Select an eating pattern that meets nutrient needs over time at an appropriate calorie level.
  • Account for all foods and beverages consumed and assess how they fit within a total healthy eating pattern.
  • Follow food safety recommendations when preparing and eating foods to reduce the risk of foodborne illnesses.(4)

The Mediterranean Diet  
The eating patterns of the cultures in countries that encompass the Mediterranean Sea is referred to as the “Mediterranean diet.” However, no one set of criteria exists for what makes up a traditional Mediterranean eating pattern.(4)The original diet was patterned after the diet observed in Crete, which had a liberal use of olive oil, fresh vegetables and fruits from the garden, and low meat intake.(4) But, the current Crete diet has changed and is now higher is saturated fat.(4)

foods-med-dietA healthy Mediterranean style of eating includes a high intake of fresh or minimally processed plant foods (e.g., green leafy vegetables, fresh tomatoes, onion, fresh grapes, avocado, etc.); liberal use of olive oil as the main fat source; low-to-moderate intake of milk products including flavorful cheeses, fish, and poultry; low red meat consumption; and low-to-moderate intake of wine with meals.(3,4) In a review of five RCTs in people living with type 2 diabetes, improvement in glycemic control and insulin sensitivity was shown to be higher in individuals consuming a Mediterranean-type eating pattern than other frequently used diets.(3) In addition, a Mediterranean diet reduced the requirement for blood sugar lowering medications in overweight participants with newly confirmed diabetes compared with those on a low-fat diet.(3) In a group of obese individual living with diabetes from the Dietary Intervention Randomized Controlled Trial (DIRECT), at the 2-year review, revealed better fasting glucose and insulin concentration when consuming a calorie-restricted Mediterranean diet as compared to the low-fat diet group. (3) Furthermore, a subgroup of individuals in the PREDIMED-Reus nutrition intervention trial with diabetes who consumed a Mediterranean eating pattern supplemented with extra-virgin olive oil or nuts, with no calorie-restrictions, showed a significantly lower incidence of major heart disease events following a 4·8-year assessment period.(3) Given the extensive research that has confirmed the health benefits of the Mediterranean style eating pattern, it is also recommended as a healthy diet plan to adopt. (1,2,3,4)

As you can see, both of these diet profiles would provide a healthy eating pattern that includes the nutrients dense and high fiber foods that have been shown to affect blood sugar levels positively.(2,3,4)

Other well planned-out diet plans, including various Vegetarian type diets (1,2,3,4), have also been shown to meet the needs of the person living with diabetes to live healthy, long, and productive lives.(1,2,4) It is up to you (with the assistance of your healthcare team) to investigate what eating pattern works best for your lifestyle.(1,2,3,4,5) Learning new dishes that focuses on fresh fruits and vegetables can be an adventure that can reap huge rewards of both new taste sensations as well as improved health benefits.(2,4,5) Eating your way to good health might be as easy as adopting either the DASH or Mediterranean eating pattern.(4,5) Enjoy!

Yvonne is the owner of Y-EAT Right…Nutritional Consultant for Healthy Living, She conducts special workshops to promote healthy nutritional and living behaviors. To find out more about her services email her at: yeatright@aol.com or phone her at (414) 639-5660.


References:
1.) American Diabetes Association (2015). Standards of medical care in diabetes—2015. Diabetes Care 38(Suppl. 1):S1–S2 | DOI: 10.2337/dc15-S001  This information was retrieved here.
2.) Greer, Y. (2013). Diabetes and obesity: reducing your health risks. Real Life: The Hands-on, Pounds-off Guide, Milwaukee, WI: TOPS Club, Inc.
3.) Ley, S.H., Hamdy, O., Mohan, V., & Hu, F.B. (2014). Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet, 383(9933), 1999-2007.
4.) Office of Disease Prevention and Health Promotion (2015). Dietary Guidelines. Retrieved from here.
5.) Oldways Health Through Heritage Resources (2015). The Mediterranean Diet. Retrieved from here.