Diet and nutrition counseling play important roles in the treatment of diabetes. Following a balanced eating plan can help prevent short-term and long-term complications of the disease.

The HCF (high carbohydrate, high fiber) diet may help many patients with diabetes control their glucose (blood sugar) levels, body weight and cholesterol. This nutritional plan diet limits intake of fats and replaces those calories with complex carbohydrates including high amounts of plant fiber.

Fiber helps regulate digestion. It comes in two forms: soluble, which helps slow the absorption of food, and insoluble, which helps keep the colon clean). One or both types of fiber are found in many plant-based foods. Fiber is not found in foods that come from animals.

The fiber in the HCF diet functions in several ways to help reduce complications of diabetes. It slows digestion and the release of glucose into the blood, which helps prevent hyperglycemia. Slowing digestion also contributes to a longer feeling of fullness (satiety), reducing the desire to eat more. This can be helpful for patients with type 2 diabetes who are trying to lose weight. In the intestines, fiber also absorbs bile, which would otherwise be absorbed into the bloodstream and converted in part to cholesterol.

The HCF diet is not recommended for everyone. As with anyone considering a change in diet, patients with diabetes should first consult their physician.

The HCF (high carbohydrate, high fiber) diet reduces a patient’s consumption of fats and simple sugars by replacing them with plant fibers and other complex carbohydrates. This nutritional plan can help patients with diabetes control their glucose (blood sugar) levels and may reduce the amount of insulin or antidiabetic agents needed to control the condition.

Insulin is a hormone produced by the pancreas that helps cells transport glucose from the blood into the cells. The glucose is then used for energy. In most people, the body constantly adapts the production of insulin to meet energy needs. However, in patients with diabetes, the body cannot achieve this balance. This makes proper nutrition crucial to maintaining normal glucose levels.

The HCF diet incorporates foods that may reduce the amount of insulin a patient requires. Instead of saturated fats and refined carbohydrates, the majority of calories in an HCF diet come from fiber and other complex carbohydrates. The recommended daily dietary intake while on the HCF diet is:

For many years, the best-known government food guide was the U.S. Department of Agriculture’s (USDA) Food Guide Pyramid. The American Diabetes Association (ADA) based its recommendations on this pyramid. The Food Guide Pyramid was divided into six food groups. Foods to be eaten in the greatest quantities were at the base, and foods to be consumed in lesser quantities were near the top of the pyramid.

However, in 2005, the USDA issued a revised version of the pyramid called MyPyramid. This new food guide pyramid incorporates knowledge about nutrition that has been learned since the early 1990s. It also encourages regular exercise as an essential part of any healthy dietary regimen.

The new approach abandons the “one size fits all” approach of the old Food Guide Pyramid and instead urges people to tailor their diet to their needs. This is accomplished through an interactive Web site in which people build an individual diet based on information including age, sex and level of physical activity.

The greatest difference between an HCF diet and the USDA MyPyramid are the recommended amounts of fat and fiber. In the HCF diet, two-thirds of dietary fat is replaced with complex carbohydrates. These foods provide two forms of fiber: soluble and insoluble. Soluble fiber slows the rate of food absorption. Insoluble fiber is not digested. It helps regulate gastrointestinal functions and keeps the colon clean.

In general, good sources of complex carbohydrates and fiber include whole-grain breads and cereals, fruits, vegetables and beans. Fiber is not found in any foods that come from animals such as meat, fish, poultry, dairy products and eggs. Sources of soluble and insoluble fiber include:

Patients should have nutrition counseling before starting any meal plan. People with diabetes are often advised keep track of their carbohydrate consumption with methods such as the diabetic food exchange or carb counting. Tools such as the glycemic index may also help.

An HCF (high carbohydrate, high fiber) diet may help patients with diabetes manage the disease. A potential benefit is that the diet may help control the amount of glucose (blood sugar) in the bloodstream. This may allow some patients, under supervision of their physician, to reduce the amount of insulin or antidiabetic agents they must take to regulate glucose levels.

The diet can also help patients improve their blood cholesterol levels and lose weight. Much of the benefit is due to the effects of replacing fats with complex carbohydrates high in dietary fiber. The effects fiber has on the body include:

• Digestion. By slowing digestion, fiber allows a more gradual release of glucose from food. This helps to prevent high levels of glucose(hyperglycemia).
  
  
• Bile absorption. Bile is a digestive fluid that aids in the breakdown of fats. When present in excess, bile may enter the bloodstream where some of it is converted into blood cholesterol. Fiber absorbs excess bile in the intestines and allows it to be excreted before it becomes cholesterol.
  
  
• Satiety. Fiber keeps the stomach from emptying quickly, which allows people to feel full longer and reduce the desire to eat more. This can be particularly helpful for people with type 2 diabetes who may be trying to lose weight.

A high-fiber diet also may help prevent type 2 diabetes, which is often associated with obesity.

Before starting any diet or making dietary changes, patients should consult with their physician and/or a registered dietitian. This allows custom diets to be developed to suit the individual’s needs. This is especially true for patients with diabetes who may need adjustments to their medication.

As many as 10 percent of patients with diabetes are not able to tolerate the HCF diet or any other nutritional plan that is high in carbohydrates. For these patients, glucose, triglycerides (fats) and cholesterol levels rise when consuming a high-carbohydrate diet. In addition, although a high intake of fiber benefits most people, it may be inadvisable for patients with conditions such as gastroparesis, a form of autonomic neuropathy that slows digestion.

Preparing questions in advance can help patients have more meaningful discussions with healthcare providers regarding their condition. Patients may wish to ask their doctor the following questions about the HCF diet:

1. Do you think an HCF diet will help control my diabetes or reduce complications?
   
   
2. Can an HCF diet reduce my dosage of antidiabetic agents or insulin? If so, how will this be measured?
   
   
3. What other benefits might an HCF diet have for me?
   
   
4. How can you tell if an HCF diet might not work for me?
   
   
5. What risks or side effects could an HCF diet have for me?
   
   
6. What sources of fiber do you recommend? Are there any dietary fiber sources I should avoid?
   
   
7. If I have trouble getting enough fiber in my diet, should I use supplements?
   
   
8. Do I have gastroparesis or any other conditions that may require me to restrict my consumption of fiber or other carbs?
   
   
9. Where can I get more information on an HCF diet?
   
   
10. How should I track my carbs? Can the glycemic index help me?
    
    
11. If an HCF diet does not work for me, are there other diets you can recommend?
    
    
12. Can you recommend a registered dietitian to help me develop an individual eating plan?