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<blockquote data-quote="phoenix" data-source="post: 265804" data-attributes="member: 12578"><p>As to how any guidelines are interpreted in practice you might like to read this from Stephanie Dunbar, MPH, RD, director of nutrition and medical affairs at the American Diabetes Association. You will be pleased to see that there is not a mention of the GI directly, though it is perhaps implied in paragraph 3. The main tool she mentions is the one I pointed out last night ie the plate method.</p><p><a href="http://forecast.diabetes.org/magazine/features/ada-diet-myth" target="_blank">http://forecast.diabetes.org/magazine/f ... -diet-myth</a></p><p> </p><p> Also compare what the present DUK guidelines for the management of weight and glucose control with those of the ADA. A dietitian in the UK should be using these guidelines. You should also be able to get specialist dietitian support. Unfortunately I agree the amount of this that's offered and it's quality seems to be variable.</p><p></p><p>In both cases the strength of the evidence is rated alphabetically with A the strongest. </p><p>http://www.diabetes.org.uk/nutrition-guidelines</p><p>You might note that these guidelines are quite different to the previous ones:</p><p><a href="http://www.york.ac.uk/media/healthsciences/documents/events/diabetesconference2011/DUK%20Latest%20Nutritional%20Guidelines%20for%20Practice%20Paul%20Pipe%20Thomas.pdf" target="_blank">http://www.york.ac.uk/media/healthscien ... Thomas.pdf</a></p><p></p><p>ADA</p><p>http://care.diabetesjournals.org/content/34/Supplement_1/S11.full</p><p> </p><p>These documents aren't saying vastly different things. The ADA diet is very specific on keeping sat Fat down. This would mean that incarnations of a lower carb diet that are heavy in animal and dairy fats wouldn't fit in with their guidelines.</p><p> </p><p> Re your dietitian article , as mentioned by Jopar it dated to 2005 and is outdated.</p><p> The ADA guidelines at the time were very much 'old school' and they say that there was no reason to substantially change their advice to that given in the 90s.</p><p><a href="http://care.diabetesjournals.org/content/25/1/148.full" target="_blank">http://care.diabetesjournals.org/content/25/1/148.full</a></p><p> It was carb controlled, but not in the way you imply. They suggested 70% of the diet from combined carbs and monosaturated fat but they also stress that there was a concern that fat replacing carbohydrate might promote weight gain and insulin resistance.</p><p> In prcatice the starting diet for a woman suggested by US dietitians included 45g carb at each meal and 2 snacks of 25g each, including fruit , veg and dairy 50% of the diet was from carbohydrate. sample here: <a href="http://www.diabeteswellbeing.com/1800-calorie-diabetic-diet-plan.html" target="_blank">http://www.diabeteswellbeing.com/1800-c ... -plan.html</a> .</p><p>If you look at American forums you will find this standard diet is still prevalent and very much derided on these same forums. And at the time I agreeethat they also were very negative towards the GI. Other associations, European and Australian were far more positive. Indeed the most recent ADA guidelines are a big change towards acceptance.</p></blockquote><p></p>
[QUOTE="phoenix, post: 265804, member: 12578"] As to how any guidelines are interpreted in practice you might like to read this from Stephanie Dunbar, MPH, RD, director of nutrition and medical affairs at the American Diabetes Association. You will be pleased to see that there is not a mention of the GI directly, though it is perhaps implied in paragraph 3. The main tool she mentions is the one I pointed out last night ie the plate method. [url=http://forecast.diabetes.org/magazine/features/ada-diet-myth]http://forecast.diabetes.org/magazine/f ... -diet-myth[/url] Also compare what the present DUK guidelines for the management of weight and glucose control with those of the ADA. A dietitian in the UK should be using these guidelines. You should also be able to get specialist dietitian support. Unfortunately I agree the amount of this that's offered and it's quality seems to be variable. In both cases the strength of the evidence is rated alphabetically with A the strongest. http://www.diabetes.org.uk/nutrition-guidelines You might note that these guidelines are quite different to the previous ones: [url=http://www.york.ac.uk/media/healthsciences/documents/events/diabetesconference2011/DUK%20Latest%20Nutritional%20Guidelines%20for%20Practice%20Paul%20Pipe%20Thomas.pdf]http://www.york.ac.uk/media/healthscien ... Thomas.pdf[/url] ADA http://care.diabetesjournals.org/content/34/Supplement_1/S11.full These documents aren't saying vastly different things. The ADA diet is very specific on keeping sat Fat down. This would mean that incarnations of a lower carb diet that are heavy in animal and dairy fats wouldn't fit in with their guidelines. Re your dietitian article , as mentioned by Jopar it dated to 2005 and is outdated. The ADA guidelines at the time were very much 'old school' and they say that there was no reason to substantially change their advice to that given in the 90s. [url=http://care.diabetesjournals.org/content/25/1/148.full]http://care.diabetesjournals.org/content/25/1/148.full[/url] It was carb controlled, but not in the way you imply. They suggested 70% of the diet from combined carbs and monosaturated fat but they also stress that there was a concern that fat replacing carbohydrate might promote weight gain and insulin resistance. In prcatice the starting diet for a woman suggested by US dietitians included 45g carb at each meal and 2 snacks of 25g each, including fruit , veg and dairy 50% of the diet was from carbohydrate. sample here: [url=http://www.diabeteswellbeing.com/1800-calorie-diabetic-diet-plan.html]http://www.diabeteswellbeing.com/1800-c ... -plan.html[/url] . If you look at American forums you will find this standard diet is still prevalent and very much derided on these same forums. And at the time I agreeethat they also were very negative towards the GI. Other associations, European and Australian were far more positive. Indeed the most recent ADA guidelines are a big change towards acceptance. [/QUOTE]
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