Abstract
The 1994 American Diabetes Association (ADA) position statement, 'Nutrition Recommendations and Principles for People with Diabetes Mellitus', departs from previous dietary guidelines in that specific caloric distribution of macronutrients is discarded in favour of a diet design based on individual nutritional assessment and treatment goals (1). Although the recommendation to limit saturated fats and dietary cholesterol remains clear, the current directive to adjust fat and carbohydrate (CHO) calories based on individual weight, glycemic control, and lipid profile presents a dilemma over how to best distribute CHO and monounsaturated fatty acids (MUFA) in the daily diet. This article will frame the discussion of current US and European position statements on macronutrient distribution for diabetic patients and review the arguments for and against high-MUFA diets as part of medical nutrition therapy for type 1 and type 2 diabetes. In addition, practical considerations for applying the dietary guidelines to nutrition support will be outlined.
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