Dietary and nutritional approaches for prevention and management of type 2 diabetesBMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2234 (Published 13 June 2018) Cite this as: BMJ 2018;361:k2234
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It would have nice to have seen more on whole foods, plant based diets given there is so much good evidence for them, compared with the latest fad iteration of high fat diets, which in meta analyses are associated with early death and other non cvd causes of disability and death. See the work of dr Neal Barnard and the nz BROAD STUDY which is ongoing in its work.
WFPB diets are optimal for the environment and therefore for public health. What is the point of a diet which is enviromentally ruinous as high fat /low carb ones are, usually also being high (animal) protein too. We must also consider the actual proven physical and mental harm caused to the other entities we share this planet with, the animals. It has been shown in neurophysiological and behavioural studies that they are capable of experiencing these harms so if we are to be anything like as consistent as we say we are with human suffering this is a crucial consideration in choosing our diets, as more and more of the public agree with.
Competing interests: No competing interests
We have read the nice article by Dr Forouhi and colleagues in the recent issue of your journal (1). Dr Forouhi and colleagues have observed that the increasing cost of vegetable and fruits makes it difficult for people in developing countries to increase their consumption as recommended by most dietary guidelines (1).Commercially prepared food consumption is increasing in many countries due to urbanization and easy availability of these foods and their relatively low cost. Home cooked foods are better than commercially prepared foods because usually they do not contain increased salt, sugar, fat and trans fats, and this helps in consumption of a healthier diet (2). According to a recent study by Dr Minocha and colleagues, in India the per capita consumption of vegetables and fruits is 145 and 15 g per day respectively and a significant portion is from potato and banana (3).
Since 1990, per capita consumption of potato has risen from around 12 kg to 17 kg a year (4). Dr Bao and colleagues have noted that increased consumption of potato before pregnancy is associated with a greater risk of gestational diabetes mellitus and that substitution of potatoes with other vegetables, legumes, or whole grain foods might lower the risk (5).
Dr Jali and colleagues have noted in a study of 300 patients with type 2 diabetes mellitus that a high intake of millet based dietary fiber in the diet helps in blood glucose control and lowering of plasma lipid concentrations in patients with type 2 diabetes mellitus (6). Dr Narayanan and colleagues have studied 105 patients with type 2 diabetes mellitus and they observed that replacing a rice dosa with a millet dosa lowers postprandial blood glucose levels (7). Millets have many properties which help in patients with type 2 diabetes mellitus (8).
Wheat flour used in the preparation of a variety of foods in all the countries of the world and wheat flour adulteration with hazardous chemicals such as benzoyl peroxide (BPO) and alloxan monohydrate have been documented (9-11).
1. Forouhi NG, Misra A, Mohan V, Taylor R, Yancy W Dietary and nutritional approaches for prevention and management of type 2 diabetes. BMJ. 2018 Jun 13;361:k2234. doi: 10.1136/bmj.k2234. No abstract available.
2. Wolfson, J., and Bleich, S.). Is cooking at home associated with better diet quality or weight-loss intention? Public Health Nutrition,2015; 18(8): 1397-1406. doi:10.1017/S1368980014001943
3. Minocha S, Thomas T, Kurpad AV Are 'fruits and vegetables' intake really what they seem in India? Eur J Clin Nutr. 2018 Apr;72(4):603-608. doi: 10.1038/s41430-018-0094-1. Epub 2018 Feb 19.
4. Potato Stats of India | PotatoPro https://www.potatopro.com/india/potato-statistics
5. Bao W, Tobias DK, Hu FB, Chavarro JE, Zhang C. Pre-pregnancy potato consumption and risk of gestational diabetes mellitus: prospective cohort study. BMJ. 2016;12:352
6. Jali M. V., Kamatar M. Y., Jali S. M., Hiremath M. B., Naik R. K. Efficacy of value added foxtail millet therapeutic food in the management of diabetes and dyslipidamea in type 2 diabetic patients. Recent Res. Sci. Technol. 2012; 4(7): 03-04
7. Narayanan J, Sanjeevi V, Rohini U, Trueman P, Viswanathan V . Postprandial glycaemic response of foxtail millet dosa in comparison to a rice dosa in patients with type 2 diabetes. Indian J Med Res 2016; 144: 712-17
8. Kam J, Puranik S, Yadav R, Manwaring HR, Pierre S, Srivastava RK, et al. Dietary interventions for type 2 diabetes: How millet comes to help. Front Plant Sci 2016;7:1454.
9. Ponhong K, Supharoek SA, Siriangkhawut W, Grudpan K. A rapid and sensitive spectrophotometric method for the determination of benzoyl peroxide in wheat flour samples. J food drug Anal. 2015;23: 652–659. pmid:28911481
10. Lohumi S, Lee H, Kim MS, Qin J, Kandpal LM, Bae H, et al. Calibration and testing of a Raman hyperspectral imaging system to reveal powdered food adulteration. PLoS ONE April 30 2018 13(4): e0195253. https://doi.org/10.1371/journal. pone.0195253
11. Zhao J, Peng Y, Chao K, Qin J, Dhakal S, Xu T. Rapid detection of benzoyl peroxide in wheat flour by using Raman scattering spectroscopy. SPIE 9488, Sensing for Agriculture and Food Quality and Safety VII. 2015. p. 94880S
Competing interests: No competing interests