Fats
Not all fat is bad. Certain fats, such as trans fats and saturated fats, are thought to contribute to inflammation in the body. Other fats, such as omega-3 fats, are thought to significantly decrease inflammation. Diabetics should NOT necessarily focus on following a low-fat diet.
A systematic review of 19 trials involving 336 patients with type 2 DM found that people who ate low-carbohydrate diets had better glycemic control and lipid profiles than did those who followed a low-fat approach (1).
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Eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) are omega-3 fatty acids. They are found in fish and other marine life. Alpha-linoleic acid (ALA) is an omega-3 precursor found in walnuts, flax, and other grains. These dietary fats have not been found to improve glycemic control, but have antiinflammatory and antithrombotic and thus may offer important benefits to patients with type 2 diabetes mellitus who are at higher risk for cardiovascular disease.
The Diabetes Prevention Program (in which participants who achieved modest weight loss through dietary changes and increased physical activity sharply reduced their chances of developing diabetes) used dietary fat goals based on 25% of daily calories (2).
The American Diabetes Association (ADA) makes the following recommendations for dietary fat in the ideal diabetic diet (3):
- No ideal total fat intake, goals should be individualized
- Fat quality is more important than fat quantity
- Saturated fat should be <10% of calories
- Omega-3 supplements are not recommended for CVD prevention or treatment
- Increase intake of foods with Omega-3 fatty acids (EPA, DHA, ALA) given benefits on lipoproteins, CVD prevention, and health outcomes.
1. Kodama S, Saito K, Tanaka S, et al. Influence of fat and carbohydrate proportions on the metabolic profile in patients with type 2 diabetes: a meta-analysis. Diabetes Care. 2009;32:959–965.
2. The Diabetes Prevention Program (DPP) Research Group. The Diabetes Prevention Program (DPP): Description of lifestyle intervention. Diabetes care. 2002;25(12):2165-2171.
3. Evert AB, Boucher JL, Cypress M, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care. 2014;37(suppl 1):S120-S143.