Rationale for the Use of a Mediterranean Diet in Diabetes Management

Abstract

Recent estimates point to the stark reality that one in three people will have diabetes by 2050.1 As the epidemic of diabetes continues to grow, educators aim to help those with diagnosed diabetes live healthier lives. To date, much evidence-based information exists on how to help our patients reduce their health risks and potentially add quality years to their lives. Both lay and professional publications often emphasize managing the ABCs—A1C, blood pressure, and cholesterol—for optimal diabetes management. The American Diabetes Association (ADA) recommends lowering A1C to < 7%, controlling blood pressure to < 130/80 mmHg, and controlling LDL cholesterol to < 100 mg/dl (< 70 mg/dl for those with diagnosed cardiovascular disease [CVD]) to reduce the risk of microvascular and cardiovascular complications.2 Although these recommendations have not shifted greatly over the years, diabetes management in the population continues to be less than optimal. Data from the National Health and Nutrition Examination Survey of 2001–2002 indicated that an estimated 53% of individuals with diabetes failed to attain target blood pressure levels, and 50.2% were not at goal for A1C.3 Given these statistics, it is not surprising that death from coronary heart disease (CHD) and the risk of having a stroke is two to four times greater in adults with diabetes than in those without diabetes.4 Nutrition therapy and regular physical activity are the cornerstones for managing A1C, blood pressure, and cholesterol, and treatment for each has its own set of nutrition guidelines. Although there is some overlap in the recommendations, nutrition guidelines can be complex and confusing to people with diabetes who are often working to manage their diabetes in combination with other health risks. For example, nutrition recommendations often require an individual have advanced skills, such as label reading or data interpretation (e.g., calculation of carbohydrate …