Diabetes Canada (@DiabetesCanada) has now joined the American Diabetes Association (with European Association for the Study of Diabetes), Diabetes Australia, and Diabetes UK in having a position / recommendation regarding low-carbohydrate diets for people with diabetes.
This is important news, as more of the world’s diabetes organizations are now embracing (successful) dietary approaches to reversing prediabetes and diabetes.
They begin with the statement:
Diabetes Canada’s consensus recommendation (45-60% CHO) was not intended to restrict the choices of individuals with diabetes to follow dietary patterns below this level, nor their access to support from health-care practitioners.Barnes T. Diabetes Canada Position Statement on Low Carbohydrate Diets for Adults with Diabetes: A Rapid Review. Can J Diabetes [Internet]. 2020 Apr; Available from: https://linkinghub.elsevier.com/retrieve/pii/S1499267120300976
I would respond to this by saying that the intent and the impact have been two very separate things. These organizations have not demonstrated understanding of the impacts of the decisions they’ve made to recommend or not recommend individualized approaches to preventing and managing disease. This statement is an important acknowledgment that their public posture matters, in everything from their official recommendations to the recipes on their web sites (see below).
The position is definitely more reserved than the American Diabetes Association statement from April, 2019 (see: Just Read: Lifestyle Management, Standards of Medical Care in Diabetes 2019, American Diabetes Association (behavior, a little less strange – low carbohydrate eating now included)).
How will Diabetes Canada’s public recommendations change?
This is the question many will have.
- Will Diabetes Canada become more like American Diabetes Association?
ADA (@AmDiabetesAssn) has significantly overhauled their public facing website to be more inclusive, and removed prescriptive language that excluded modern dietary approaches. (see: Slide Update: ADA’s website now includes Low-Carbohydrate Diets in Standards of Care, and looking back on the times the medical profession called people/ideas a “fad”)
- Will Diabetes Canada stay more like American Heart Association (American_Heart)?
Currently, Diabetes Canada hosts recipes like this on its current website.
Watermelon Mango salad clocks in at a whopping 61 grams of carbohydrates per serving
…which is sadly much like American Heart’s Overnight Banana No-Cook Oatmeal debacle from September, 2019 (a heart stopping 74 grams of carbohydrates per serving)
Tomorrow morning, you'll be so glad you started breakfast tonight: https://t.co/7SkULuNjgn pic.twitter.com/XqzbS74FRE
— American Heart Association (@American_Heart) September 24, 2019
…and a whole lot of other cognitive dissonance:
Kudos for Leadership by Clinicians
I have been following the work of the Canadian Clinicians for Therapeutic Nutrition (@CCforTN) for awhile, including extensive advocacy work to bring science to Canadian dietary guidelines. Their work is really a testament to what a multidisciplinary group of clinicians can to to impact policy so that they can practice the best health care.
I hope and assume that organizations like Diabetes Canada will look to their support as they morph into an organization trusted to help Canadians with diabetes live healthier lives for the 21st century. We’re only 20 years in and there are a lot of people who need their combined help, especially now.
Barnes T. Diabetes Canada Position Statement on Low Carbohydrate Diets for Adults with Diabetes: A Rapid Review. Can J Diabetes [Internet]. 2020 Apr; Available from: https://linkinghub.elsevier.com/retrieve/pii/S1499267120300976
[…] Approach, Heart-Check Still Awarded for Sugar Sweetened Cereals, and now Diabetes Canada (see: Just Read: Diabetes Canada backs away from the Carbohydrate Table : Position Statement on Low Carboh…), are now endorsing this approach as such. The need, in my opinion, is to build community and […]