By Carrie Swift, MS, RDN, BC-ADM, CDCES
The American College of Lifestyle Medicine (ACLM) recently published a consensus statement with this thought-provoking title: Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission. Along with ACLM, the American Association of Clinical Endocrinology, the Academy of Nutrition and Dietetics and the Endocrine Society, contributed representatives to the expert consensus panel; and endorsed, supported, and were co-sponsors of this statement, respectively.
If you are unfamiliar with the ACLM, it is a medical professional society with approximately 6,000 members, founded in 2004. The organization promotes the “six pillars of lifestyle medicine” with an emphasis on “a whole-food, plant-predominant eating pattern”. More specifically, ACLM promotes remission in adults with T2D through whole-food, plant-based eating, and moderate exercise.
The consensus process for this statement was conducted through discussion of key topics, and in part, a series of 9-point Likert scale surveys. Panel members received and completed the surveys. Responses were compiled and sent back to participants. The criteria for consensus among the group was defined as a score of 7.00 (out of 9) or higher, with no more than 1 outlier. The top score of 9 = strongly agree. Remission via eating pattern and exercise alone, reached a consensus as a realistic goal for the treatment of most adults with T2D, regardless of body mass index.
The consensus from the committee regarding remission was defined as the absence of signs and symptoms for a minimum time, without the exclusion of recurrence. Additionally, the level of A1C was defined at less than 6.5% for at least 3 months, with no additional treatments, besides eating pattern and physical activity. While there was a consensus that nutrition recommendations should encourage whole plant foods – including grains, vegetables, legumes, fruits, nuts, and seeds – over the ‘standard American diet’ the recommendation regarding a specific eating pattern did not reach consensus.
The conclusion that a low-fat, whole-food, plant-based eating as the sole dietary pattern for T2D remission was not agreed on. However, the expert panel did agree that healthful eating may achieve remission for people with T2D. Eating patterns representing the whole food, plant-based pattern, as well as the Mediterranean diet, DASH diet, carbohydrate moderation (though not very low carbohydrate intake) and low-fat intake reached consensus. Members agreed that high fiber intake, as a specific nutritional recommendation, is a consideration in eating patterns to promote T2D remission.
To read the full paper, access it in the May-June issue of the American Journal of Lifestyle Medicine.
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
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