A comparison of nutrient-based and exchange-group methods of diet instruction for patients with noninsulin-dependent diabetes.

This study compared effectiveness of nutrient-based (Diet Guide) vs food-group (Exchange Lists) methods of diabetic diet evaluation in improving dietary compliance, glycemic control, and biochemical indicators of heart disease risk. Eighty-three persons with noninsulin-dependent diabetes were taught one of two diet-planning methods in a 3-session workshop. Both methods led to reductions in energy intake and percent of calories from fat and saturated fatty acids in 6 mo postworkshop. Reductions in fat intake were greater and more long lasting for persons using Diet Guide than using Exchange Lists method of diet planning. Despite dietary changes, neither diet-planning method led to significant decreases in weight or skinfold thickness. Few differences were seen in clinical measurements pre- and 6 mo postworkshop. Total and LDL cholesterol values were lower than preworkshop values for men in both groups. Suggestions are given for improving effectiveness of both diet-planning methods.