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[5 min read] Medical nutrition approaches for chronic disease management

Encouraging a balanced and healthful diet in patients promotes the prevention and management of chronic diseases such as diabetes, cardiovascular disease, and cancer. One in five deaths globally – about 11 million deaths – are associated with poor diet (1), emphasising the importance of dietary pattern-based approaches in medical nutrition therapy, particularly in primary care settings. Dietary patterns represent the overall combination of foods usually eaten by a patient, which together produce synergistic health effects (2).

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Medical Nutrition Management.

Mediterranean diet

The Mediterranean diet is based on the long-standing eating habits of the residents of Mediterranean countries, including Italy, Spain, and Greece. It has been lauded as a healthy way of eating and has been shown in clinical trials to reduce the risk of conditions such as heart disease, metabolic syndrome, depression, along with better mental and physical function (3, 4).

Its foundation includes an abundance of plant foods, including fruits, vegetables, wholegrains, and nuts, along with the liberal use of olive oil. Fish, poultry, and dairy like cheese and yogurt are included in moderate amounts while red meat consumption is low.

MIND diet

The MIND diet – or Mediterranean-DASH Intervention for Neurodegenerative Delay – is specifically designed for brain health and protecting against diseases like Alzheimer’s disease, thanks to its emphasis on antioxidant-rich foods (5). It takes inspiration from the Mediterranean and DASH diets but encourages eating more of ten types of foods (including green leafy vegetables, nuts, legumes, and fish) and limiting or avoiding five categories (butter, cheese, red meat, fried foods, and sweets).

Vegetarian eating

Vegetarian diets emphasise the consumption of minimally processed plant foods including vegetables, fruit, wholegrains, legumes, and tofu. Such diets are typically rich in fibre, antioxidants, and phytochemicals, and lower in saturated fat, which may be associated with longevity and a reduced risk of many chronic diseases (6).

There are various types of vegetarians, from vegans (total abstinence from animal products) to pescatarians (avoid meat but may eat fish) to lacto-ovo vegetarians (no meat but do eat eggs and dairy foods).

Low GI

The glycaemic index (GI) is a scale that ranks carbohydrates by their effect on blood sugar levels. Low GI foods are typically high in fibre and take longer to digest, so that patients avoid triggering blood sugar spikes. High-GI foods tend to contain simple, or refined, carbohydrates and simple sugars that get quickly absorbed into the bloodstream. While low-GI diets are often associated with diabetes management, it also has benefits in the management of other chronic diseases including heart disease (7). Note that the GI comes with caveats: low GI doesn’t always indicate that a food is healthy, and vice versa. For example, dried fruits are high-GI but contain many beneficial nutrients.

– Lynette Law, Accredited Practising Dietitian

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  1. Afshin A, Sur PJ, Fay KA, Cornaby L, Ferrara G, Salama JS, et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2019;393(10184):1958-72.
  2. Vajdi M, Farhangi MA. A systematic review of the association between dietary patterns and health-related quality of life. Health and Quality of Life Outcomes. 2020;18(1):337.
  3. Guasch-Ferré M, Willett WC. The Mediterranean diet and health: a comprehensive overview. Journal of Internal Medicine. 2021;290(3):549-66.
  4. Romagnolo DF, Selmin OI. Mediterranean Diet and Prevention of Chronic Diseases. Nutr Today. 2017;52(5):208-22.
  5. Hosking DE, Eramudugolla R, Cherbuin N, Anstey KJ. MIND not Mediterranean diet related to 12-year incidence of cognitive impairment in an Australian longitudinal cohort study. Alzheimers Dement. 2019;15(4):581-9.
  6. Kim H, Caulfield LE, Garcia‐Larsen V, Steffen LM, Coresh J, Rebholz CM. Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults. Journal of the American Heart Association. 2019;8(16):e012865.
  7. Barclay AW, Petocz P, McMillan-Price J, Flood VM, Prvan T, Mitchell P, et al. Glycemic index, glycemic load, and chronic disease risk—a meta-analysis of observational studies. The American Journal of Clinical Nutrition. 2008;87(3):627-37.

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