Dietary carbohydrates in diabetes.

Recent recommendations for dietary treatment of diabetes mellitus aim at a diet low in fat and rich in carbohydrates and dietary fiber. The main rationale for an increase of carbohydrates is the desire to reduce the content of fat, especially saturated fatty acids, without a concomitant increase of dietary protein. There are also indications that an increase of carbohydrate-rich foodstuffs can contribute to an improved metabolic profile. Not only the type of food but also its structure is of importance for the blood glucose and hormone responses after a meal. A diet containing approximately 55% of energy from carbohydrates (corresponding to < or = 30% of energy from fat) with a modest increase of dietary fiber to > or = 3 g/MJ, concentrating on soluble fiber and starch-rich foods with a low glycemic index, will probably be adequate for most patients with diabetes. However, diets with somewhat higher or lower contents of carbohydrates may be more suitable for some patients because dietary advice should always be individualized on the basis of energy requirements, age, metabolic profile, and food habits of the patient.