Adherence to high-carbohydrate, high-fiber diets.

Successful diabetes management demands a high degree of adherence. Adherence to medical prescriptions, particularly special diets, is notoriously poor. A study of 40 individuals with IDDM and NIDDM who were followed an average of 23 months found good or excellent dietary adherence in 70% of subjects; only 5% demonstrated poor adherence. Adherence was assessed objectively based on carbohydrate, fat, and fiber intakes reported in 24-hour food recalls, 7-day food frequency surveys, and home food records. High dietary fiber intake may independently enhance adherence, perhaps by increasing satiety or because of the simplicity of the concept. Good communication between the health professional and patient is also fundamental to all stages of dietary adherence. Use of adherence-enhancing techniques throughout adoption of new diet behaviors promotes long-term adherence to high-carbohydrate, high-fiber diets.