Page 642 - fbkCardioDiabetes_2017

618 The Role of Lifestyle Modification in The Prevention of
Diabetes and Cardiovascular Disease

of T2DM and CVD. The NICE [National Institute for Diet also plays an important role in the prevention

Health and Care Excellence] guidelines recommend of T2DM. The caloric content of food is more import-
an initial weight loss target of 5 to 10%; ADA [Amer- ant than its macronutrient content, in achieving and
ican Diabetes Association] recommends to achieve maintaining the recommended weight loss by an in-
and maintain a minimum of 7% weight loss RSSDI dividual.
,
[Research Society for the Study of Diabetes in India] In prospective epidemiological studies, the glycaemic
recommends a 5 to 10% reduction in body weight.
index and the glycaemic load of the food were asso-
It is noteworthy that any unintended weight loss ciated with an increased risk of T2DM in both sexes.
needs to be differentiated from intentional weight Diets which contain high starch, low-fibre and with a
loss through the efforts of the patient. This is be- high ‘starch-to-cereal fibre ratio’ are associated with
cause unintentional weight loss may be an adverse an increased risk of T2DM.
indicator pointing towards poor management of dia- Consumption of dietary fibre reduces the risk of
betes, poor compliance and poor glycaemic control.
diabetes and research evidence strongly supports
Diet: this. For example, in the Finnish Diabetes Preven-
tion study (Finnish DPS), consumption of ≥ 15g / 1000
Diet is one of the cornerstones in the treatment of kcal of fibre in the diet reduced the risk of diabetes.
DM. Dietary recommendations for patients with dia- Thus, professional guidelines recommend increasing
betes focus on glycaemic control and reducing the the intake of dietary fibre to reduce the risk of de-
risk of developing the co-morbidities of diabetes & veloping diabetes. Diets high in fibre content reduce
the risk of CVD and other complications of diabe- fasting blood glucose levels and LDL-C levels in pa-
tes. In individuals with diabetes, various patterns of tients with DM.Dietary fibre also seems to be protec-

dietary management have been tried. These include tive against CVD as seen in epidemiological studies.
low-carbohydrate diet, low-glycaemic index diet, low- However, information from randomised controlled
fat diet, very-low calorie diet, etc. trials (RCTs) is insufficient at the present.

Dietary guidelines:

The European Society of Cardiology (ESC) in collaboration with the European Association for the Study of
Diabetes (EASD) has put forward the following recommendations on the macronutrient composition of diet
in regard to the prevention of CVD in patients with diabetes:

Proteins 10-20 % of total energy intake.
In patients with nephropathy, protein intake should be lesser.

Carbohydrates 45-60 % of total energy intake.

Very low carbohydrate diets are not recommended.

GCDC 2017