Diabetes Association also paid attention to 'zero' drinks

Safety refocused

Review of the evidence for the use of non-nutritive sweeteners at the Spring Conference

Possible inhibition of glycemic response and increased risk of cardiovascular events This year, while the American Diabetes Association recognized intermittent fasting and time-restricted eating as part of a meal pattern based on research results that help reduce weight and improve blood sugar, the Korean Diabetes Association also reviewed low-carbohydrate diets and non-nutritive sweeteners.

 

The Diabetes Association acknowledged the Mediterranean diet and the DASH diet, which have accumulated some evidence, while asking for a cautious approach in that non-nutritive sweeteners have mixed results.

 

On the 12th, the Korean Diabetes Association held a spring academic conference at the Kimdaejung Convention Center in Gwangju, and disclosed the results of the review of evidence and revision work conducted by the Food and Nutrition Committee of the society.

 

Professor Lim Jeong-hyeon, Seoul National University Hospital, Food and Nutrition Division (Cancer Committee, Korean Society of Clinical Nutrition)

Numerous studies have already shown that healthy eating habits, including the Mediterranean, vegetarian, low-fat, low-carbohydrate, and DASH (salt-restricted diets designed to reduce blood pressure in people with hypertension), improve blood sugar, reduce weight, and reduce the risk of cardiovascular disease.

 

being confirmed Because of this, the American Diabetes Association and other major treatment guidelines recommend individualizing various dietary patties and using them appropriately.

 

In particular, according to the research results that time-restricted meals are helpful for weight loss and blood sugar improvement, in 2023 the American Diabetes Association included intermittent fasting and time-restricted meals as one type of meal pattern, and whether or not this was reflected in Korea has emerged as a matter of interest.

 

This month, the Korean Society for Obesity published guidelines for low-carbohydrate diets that limit carbohydrate intake to 10-45% of total energy intake.

 

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In the midst of this, the Korean Diabetes Association also presented an appropriate answer.

 

The revised guidelines of the Korean Diabetes Association are largely divided into ▲ intake of carbohydrates in a form rich in dietary fiber ▲ refrain from sugar-sweetened beverages to minimize the intake of added sugars ▲ limited use of non-nutritive sweeteners for a short period of time.

 

“The 2021 recommendation did not recommend an extreme diet method that did not prove long-term benefits,” said Lim Jeong-hyun, professor of nutrition at Seoul National University Hospital (Cancer Committee of the Korean Society of Clinical Nutrition).

 

The method was observed and reflected in the 2023 recommendation.” "Mediterranean, vegetarian, low-fat, DASH, and low-carbohydrate eating patterns have demonstrated long-term benefits," he said.

 

"Therefore, these eating patterns can be adapted according to goals and preferences (limited recommendations)." He said, “The American Diabetes Association revised the carbohydrate section of medical nutrition therapy in 2022 to emphasize the quality intake of carbohydrates.

 

We presented the rationale for this and added an ultra-low-carbohydrate diet to the dietary pattern session.” In fact, as a result of analyzing 10 RCTs involving 1376 type 2 diabetes patients, it was found that glycated hemoglobin and body mass index decreased according to carbohydrate restriction.

 

Professor Lim said, "In a 2022 meta-analysis study of 50 RCTs for patients with type 2 diabetes, reducing carbohydrate intake to less than 45% of total energy intake showed improvements in several indicators such as body weight, lipids, and glycated hemoglobin." For each 10% reduction, A1C decreased by 0.2%, FPG by 0.34mmol/L, and body weight by 1.44kg, and all serum lipid indicators were improved.” He said, "Up to 6 months, the rest of the indicators showed a linear decrease in the 40% carbohydrate diet, but triglycerides and LDL cholesterol showed a U-shaped shape." Although they decreased, their weight showed a U-shaped pattern." "Because a meal is a combination of various foods, there can be many patterns in a weight control diet," he said.

 

It is important to increase individual compliance, such as using a Mediterranean diet or Mediterranean diet, and to allow patients to choose individually according to their goals and preferences, and to provide evidence for that.” In view of the consistent increase in the risk of developing diabetes when consuming sugar-sweetened beverages, the society recommended refraining from sugar-sweetened beverages while urging caution against consuming beverages that have been replaced with non-nutritive sweeteners.

 

Professor Lim said, “The risk of diabetes rises by 51% when you consume one or more sugary drinks a day, and a 10% reduction in sugar-sweetened beverage intake consistently reduces the risk of diabetes.” It should be recommended to replace it with coffee.” He said, “The problem is that the effect of replacing sugar-sweetened beverages or sugar-sweetened beverages with artificial sweeteners is inconsistent.

 

"I haven't made a clear statement," he said.

 

He said, “In a 2021 study, sucralose and saccharin inhibited the blood sugar response, and a study published in NATURE this year showed that erythritol increased the risk of major cardiovascular events.” For this purpose, the use of non-nutritive sweeteners for a short period of time can be considered on a limited basis.”