American Diabetes Association: Help for Diabetics?
The American Diabetes Association was founded in 1940. Their mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. Diabetes is a disease in which the body cannot metabolize blood sugar correctly, which leads to a buildup of excess sugar in the bloodstream. This excess sugar accelerates the symptoms of heart disease and damages other body systems.
Let’s take a look at what the American Diabetes Association recommends in terms of nutrition, and see if these policies can be trusted as the best advice for diabetic care.
On their website, the American Diabetes Association directs diabetics to eat between 45-60 grams of carbohydrates at each meal. Assuming a person eats three meals a day, this advice works out to telling diabetics to eat a minimum of 135 grams to a maximum of 180 grams of carbohydrates per day. Now, 180 grams of carbohydrates works out to 720 calories (1 gram of carb=4 calories). In a daily diet of 2000 calories, eating the minimum recommended carbs would set the daily percentage of carbs at 27% (540/2000) and the maximum carbs would be 36% (720/2000).
But in addition, the American Diabetes Association recommends that diabetics reduce their intake of saturated fat and cholesterol, and eat more non-starchy vegetables. Although non-starchy vegetables are lower in carb than cereal foods, they still do have carbs in them, so the ADA diet is actually about 55 percent carbohydrate, 20 percent protein, and about 25 percent fat, expressed in a ratio of 55:20:25.
Does the ADA Diet Help Diabetics Control Blood Sugar Levels?
Let’s determine whether this diet composition of 55:20:25 is good advice for helping diabetics with controlling their blood sugar, one of the most critical components of managing diabetes.
Below are the results of several scientific research studies done on the effects of diet on blood sugar:
Does the American Diabetes Association's diet recommendations help diabetics control blood sugar? Looks like the answer is no, it does not. The ADA recommends that diabetic’s blood sugar measurement before meals should be between 80 – 120 mg/dl and less than 170 mg/dl one to two hours after meals. According to the studies above, the higher carb diet that the ADA recommends does not target the levels they themselves recommend.
Analysis of Meal Recommendations
On their website, the American Diabetes Association nutritionist recommends the following guidelines for diabetics in designing a meal. She says to imagine a dinner plate, and keep carbs (brown rice, whole wheat pasta and 100% whole wheat bread) to no more than 1/4 of the plate at any meal. The non-starchy vegetables should fill 1/2 the plate. For the last quarter of the plate, add about 3 ounces of lean meat, chicken, or fish. She also says that a piece of fresh fruit or 1/2 cup of fruit salad for dessert, or even a "light" yogurt can be added for dessert. She recommends cooking with vegetable oils and cutting back on saturated fat.
If we analyze a typical meal using these guidelines, this is what we find:
Here’s a table of this info: (note: one gram of protein or carb has 4 calories, one gram of fat has 9 calories.)
So this American Diabetes Association recommended meal composition includes 78 grams of carbohydrates, 15 grams of protein, and 14 grams of fat. The entire meal is about 510 calories. The carbohydrate:protein:fat calorie percentage ratio is 61:13:25.
According to the studies above, this meal composition would drive a diabetic patient’s mean glucose levels well above the recommended amount of 170 mg/dl after meals.
Diabetes is a disease characterized by too much sugar in the blood. What rational person would tell a diabetic patient to eat a diet that increases blood sugar? Ironically, the American Diabetes Association does exactly this.
A Better Meal for Controlling Blood Sugar
As you can see from the results of the studies mentioned above, it would be better for blood sugar control to have the following meal instead:
Total calories would be 610.5 and the carbohydrate:protein:fat calorie percentage ratio would be 16:25:60. According to the study results above, this meal would keep the blood glucose levels well under 126 mg/dl. In my opinion, the meal would also taste better and satisfy hunger, both factors which would help the patient stick to the diet, and consistently control blood sugar to recommended levels.
My question at this point is if the American Diabetes Association wants to help diabetics, why do they recommend a diet that studies have shown will elevate blood sugar beyond recommended levels?
I think this poster from the Nutrition and Metabolism Society says it more succinctly:
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