Diabetes

Skip diet labels. Help patients make real changes that last.

From low-fat to low-carb, there are dozens of popular diets to choose from. With an overflow of fad diets, how do patients sort through the science from the hype? The best advice is to avoid diet labels altogether and emphasize to patients with prediabetes the underlying principles of healthy eating. 

The AMA Ed Hub™—your center for personalized learning from sources you trust—offers CME on a broad range of topics, including Nutrition Science for Health and Longevity: What Every Physician Needs to Know, to help physicians begin an effective nutrition conversation with patients. The four-hour, self-paced course is developed and hosted by the Gaples Institute for Integrative Cardiology, a nonprofit focused on enhancing the role of nutrition and lifestyle in health care, and is distributed in collaboration with the AMA Ed Hub.

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Don’t get stumped when patients ask for nutrition advice

“Diet labels are seductive, but the truth is that a whole range of eating behaviors can hide behind any one diet name, so it’s important to go beyond the labels and help patients to learn about the fundamentals of healthy eating,” said Stephen Devries, MD, a cardiologist and executive director of the Gaples Institute.  

“For example, ‘low fat’ or ‘low carb’ diets are vague terms, because they suggest a broad category of foods to avoid, but don’t specify foods that should be encouraged,” he added.  

Even incremental changes are helpful because most people can’t make major changes all at once.  

Focus on the principles of a healthy diet 

What do we really know about what a healthy diet is? 

“Given all of the contradictory reports about diet highlighted in the media, patients, as well as many health professionals, are under the false impression that the science of healthy eating is not sufficiently established to offer valid recommendations,” said Dr. Devries.   

While there is still much to be learned, there is a great deal in clinical nutrition science that is very well agreed upon. Some fundamentals truths, well acknowledged but not yet incorporated into the diets of most Americans, include the need to eat more vegetables and fruit, and reduce intake of added glucose, especially in sugar sweetened beverages. 

And for most people, a shift toward a diet with more plant-based and fewer animal sourced foods is clearly helpful. Physicians should emphasize healthy plant sources of protein including beans, seeds, whole grains, lentils, and nuts.  

Consume healthier fats. Another dietary change to encourage is a shift toward healthier fats. Rather than focusing on total fat intake, the best advice is to emphasize foods with healthier types of fat, including polyunsaturated and monounsaturated fats, said Dr. Devries. These include nuts, olives, avocados, flax and fish. For culinary oils, encourage patients to use extra-virgin olive oil and avoid heating oils to the point of smoking.  

Make small changes 

It is not usually practical or helpful to recommend that patients make multiple dietary changes all at once. As described in the last module of the nutrition program that focuses on practical tips to incorporate meaningful nutrition counseling into a busy clinical practice, a useful strategy with patients is to focus on one nutrition topic at each clinic visit.  

Topics to consider include:  

  • Cutting down or eliminating sugar sweetened drinks and replacing them with water. 
  • Adding an additional serving of vegetables or fruit to each meal. 
  • Reducing or eliminating meat, especially processed meat.

AMA members are eligible for a 20 percent discount on the Gaples Institute's CME modules. Contact the Unified Service Center for the discount code at (800) 262-3211 or [email protected]. AMA PRA Category 1 Credit™ is available.