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ADA Issues New Clinical Practice Recommendations
The American
Diabetes Association (ADA) issued its annual Clinical Practice
Recommendations to help health care providers treat people with diabetes
using the most current evidence available.
This year, one notable change occurs in the Medical Nutrition Therapy
section dealing with weight loss. Until now, the ADA did not recommend low
carbohydrate diets because of lack of sufficient scientific evidence
supporting their safety and effectiveness. The 2008 Recommendations include
a statement recognizing the increasing evidence that weight-loss plans that
restrict carbohydrate or fat calorie intake are equally effective for
reducing weight in the short term (up to one year). The "Standards of
Medical Care in Diabetes--2008" document reviews the growing evidence for
the effectiveness of either approach to weight loss. In addition, there is
now evidence that the most important determinant of weight loss is not the
composition of the diet, but whether the person can stick with it, and that
some individuals are more likely to adhere to a low carbohydrate diet while
others may find a low fat calorie-restricted diet easier to follow.
As it has in the past, the ADA continues to emphasize the importance of
sustained, moderate weight loss and increased physical activity for people
who are overweight or obese and at risk for diabetes or living with
diabetes.
"The risks of overweight and obesity are well known. We recognize that
people are looking for realistic ways to lose weight," said Ann Albright,
PhD, RD, President, Health Care & Education, American Diabetes Association.
"The evidence is clear that both low-carbohydrate and low-fat calorie
restricted diets result in similar weight loss at one year. We're not
endorsing either of these weight-loss plans over any other method of losing
weight. What we want health care providers to know is that it's important
for patients to choose a plan that works for them, and that the health care
team support their patients' weight loss efforts and provide appropriate
monitoring of patients' health."
Because people following low carbohydrate diets may replace calories
from carbohydrate with fat or protein, the recommendations also include
monitoring the lipid profile (blood fats, including cholesterol and
triglycerides) of patients on such diets. High protein diets may also
worsen kidney problems. Therefore, it is also recommended that patients
with kidney disease be counseled about appropriate intake of protein and
that their kidney functions be monitored carefully.
"Short-term weight loss is beneficial, but what is most important for
health is keeping the weight off long-term," said Albright. "We also want
to continue to emphasize the importance of regular physical activity, both
to aid weight loss from calorie-restricted diets, and also for the positive
health gains associated with exercise that are independent of weight loss."
Being overweight or obese and inactive are major contributing factors
to the onset of type 2 diabetes. Overweight and obesity also complicate the
treatment of diabetes (both type 1 and type 2) and can contribute to the
development of other health problems, such as heart disease and cancer. In
the United States, rates of type 2 diabetes in adults and children have
risen dramatically in recent years, along with the national epidemic of
obesity.
American Diabetes Association
http://www.diabetes.org
ADA Probleme noi practici clinice Recomandãri - ADA Issues New Clinical Practice Recommendations - articole medicale engleza - startsanatate