The Transcultural Diabetes Nutrition Algorithm: A Canadian Perspective

Table 1

Dietary strategies for diabetes nutrition therapies.

Interventions	HbA1c %	Wgt	BP	Lipid Risk Factors						Other Advantages	Disadvantage
				LDL-C	Apo-B	HDL-C	TG	Non-HDL-C	Ratio*
Dietary patterns
Low-GI/GL	↓ 0.3–0.5%					↑			↓	↓CRP, ↓Hypos, ↓Rx	↓Vitamin B12
Veg diets	↓ 0.3–0.5%	↓	↔	↓				↓ **
Mediter diets	↓ 0.3–0.5%		↓			↑	↓		↓	↓CRP, ↓FPG, ↓Rx, ↓CV events
DASH	↓ 0.5–1.0%	↓	↓	↓		↑				↓CRP
Wgt loss diets
Atkins	↔	↓				↑			↓		↑LDL, ↓micN, ↓adh
Protein power	↓ 0.5–1.0%	↓				↑	↓				↓micN, ↓adh, ↑RL
Omish		↓					↓		↓		↔FPG, ↓adh
Wgt watchers		↓							↓		↔FPG, ↓adh
Zone		↓							↓		↔FPG, ↓adh, ↑RL
Specific foods
Dietary	↓ 0.3–0.5%			↓							GI side effects
Tree nuts	↓ <0.3%			↓	↓		↓		↓
Macronutrient
Hi-CHO hi fiber	↓ 0.3–0.5%			↓						Preserve lean mass	↓HDL, GI side effects
Hi-MUFA	↓ <0.3%						↓
Lo-CHO	↔						↓				↓micN, ↑RL
Hi-protein	↔		↓				↓				↓micN, ↑RL
LC-N3-PUFAs	↔		↔	↔		↔	↓				CH3–Hg exposure, EI
Meal replacements	↓ 0.3–0.5%	↓									Temporary intervention

Adapted from [4].
Glycaemic index (GI); monounsaturated fatty acids (MUFA); long-chain n-3 polyunsaturated fatty acids (LC-N3-PUFAs); Dietary Approaches to Stop Hypertension (DASH); weight (Wgt); blood pressure (BP); total cholesterol (TC); LDL cholesterol (LDL-C); HDL cholesterol (HDL-C); triglycerides (TG); non-HDL cholesterol (non-HDL-C); apolipoprotein-B (apo-B); fasting plasma glucose (FPG); C reactive protein (CRP); hypos (hypoglycaemic episodes); oral antihyperglycaemic agents (Rx); Mediterranean (Mediter); vegetarian (veg); adherence (adh); micronutrient (micN); renal load (RL); methyl-Hg (M-Hg); environmental impact (EI); gastrointestinal (GI).
*Lipid ratios include TC : HDL-C, LDL-C : HDL-C, and apo-B : apo-A1 (apolipoprotein-A1).
**Adjusted for medication changes.