Changes in nutritional recommendations for a healthy population and their influence on a diabetic diet

Authors: Michal Anděl;  Ludmila Brunerová;  Pavel Dlouhý;  Jan Polák;  Jan Gojda;  Pavel Kraml
Authors‘ workplace: Centrum pro výzkum diabetu, metabolizmu a výživy Ústavu výživy 3. LF UK a II. interní kliniky 3. LF UK a FN Královské Vinohrady, Praha
Published in: Vnitř Lék 2016; 62(7-8): 539-546
Category: Reviews


Recently, thousands of papers brought knowledge about effects of nutrients on cellular level, in experimental animals and in human experiments on one side, the results of epidemiological studies on the other side have suggested the nutrients and foods for healthy diet and nutrients and foods, which should be consumed only in limited amount. Among foods, which should be avoided, those with higher content of trans-fatty acids. Their daily intake should not exceed 1 % of total energy intake. Similar should be limited saturated fatty acid, added sugar and salt. On the contrary, the intake of monounsaturated and polyunsaturated fatty acids in foods should be basic part of fat intake. In these conditions the amount of consumed fat could create up to 35 % of all daily energy intake. Beneficial carbohydrates are those with low glycemic index, i.e. whole grain and brown rice products and legumes. The intake of salt is necessary to limit fewer than 6 g per day and alcohol intake should not exceed 10 g per day in women and 20 g per day in men. The recommendation in last years do not limit cholesterol daily intake. The food of animal origin with high content of saturated fatty acids, i.e. meat and milk products parallel contains also cholesterol. On the other hand, the oils of vegetable origin mostly from tropical oils, which contents high amount of saturated fatty acids represents the risk? On the contrary eggs and shellfish contents high amount of cholesterol and very low amounts of saturated fatty acids. Therefore, there is no reason for their strict limitation in the diet.

Key words:
carbohydrate – diabetes – dietary recommendation – energy intake – fat – healthy diet – iron – cholesterol – protein


1. American Diabetes Association Standards of Medical Care in Diabetes – 2016. 3. Foundations of Care and Comprehensive Medical Evaluation. Diabetes Care 2016; 39: (Suppl. 1): S23-S35.

2. Anděl M, Kraml P, Dlouhý M. Diabetes mellitus a poruchy metabolismu. Galén: Praha 2001. ISBN 80–7262–047–9.

3. Ascherio A, Katan M, Zock PL et al. Trans fatty acids and coronary heart disease. N Engl J Med 1999; 340(25): 1994–1998.

4. Brunerova L, Smejkalova V, Potockova J et al. A comparison of the influence of a high-fat diet enriched in monounsaturated fatty acids and conventional diet on weight loss and metabolic parameters in obese non-diabetic and Type 2 diabetic patients. Diabet Med 2007; 24(5): 533–540.

5. DACH: Referenzwerte für die Nährstoffzufuhr. Umschau: Frankfurt/Main 2000. Dostupné z WWW: <>.

6. Dietary Giudlines for Americans 2015–2020. 8th Edition. US Departement of Agriculture and US Departement of Health and Human Services 2015. Dostupné z WWW: <>.

7. Dlouhý P, Marhol P. Přehled složení mastných kyselin v rostlinných tucích a olejích. DMEV 1999: 2(4): 211–217.

8. Jirovská A, Pelikánová T, Anděl M. Doporučený postup dietní léčby pacientů s diabetem. DMEV 2012; 15(4): 235–243.

9. Eckel RH, Jakicic JM, Ard JD et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk. A report of the American College of Cardiology /American Heart Association Task Force on Practice Guidelines. Circulation 2014; 12925 Suppl 2: S76-S99. Erratum in Circulation 2014; 129(25 Suppl 2):S100-S101. Circulation 2015; 131(4):e326.

10. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2016; pii: ehw106. Dostupné z DOI: <>.

11. Fernández-Real JM, Penarroja G, Castro A et al. Blood letting in high-ferritin type 2 diabetes: effects on insulin sensitivity and beta-cell function. Diabetes 2002; 51(4): 1000–1004.

12. Fürstova V, Kopska T, James RF et al. Comparison of the effect of individual saturated and unsaturated fatty acids on cell growth and death induction in the human pancreatic beta-cell line NES2Y. Life Sci 2008; 82(13–14): 684–691.

13. Gojda J, Patkova J, Jacek J et al. Higher insulin sensitivity in vegans is not associated with higher mitochondrial densitiy. Europ J Clin Nutr 2013; 67(12): 1310–1315.

14. Hunnicutt J, He K, Xun P. Dietary Iron Intake and Body Iron Stores Are Associated with Risk of Coronary Heart Disease in a Meta-Analysis of Prospective Cohort Studies. J Nutr 2014; 144(3): 359–366.

15. Kahleova H, Matoulek M, Malinska H et al. Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetes. Diabet Med 2011; 28(5): 549–559.

16. Knowler WC, Barret-Connor E, Fowler SE et al. Diabetes Prevention Program Research Group: Reduction of incidence of Type 2 diabetes with life-style intervention or metformin. N Engl J Med 2002; 346(6): 393–403.

17. Kraml PJ, Klein RL, Huang Y et al. Iron loading increases cholesterol accumulation and macrophage scavenger receptor I expression in THP-1 mononuclear phagocytes. Metabolism 2005; 54(4): 453–459. Erratum in Metabolism 2005; 54(7): 982.

18. Healthy diet may reduce high blood pressure risk after gestational diabetes, NIH study suggests. National Institute of Health, USA, updated April 18, 2016. Dostupné z WWW: <>.

19. Pokorný J, Dubská L et al. Technologie tuků. SNTL: Praha: 1986.

20. Salonen JT, Nyyssönen K, Korpela H et al. High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation 1992; 86(3): 803–811.

21. Schwarz W, Novák B. Trans-kyseliny v margarínech. Výž a Potr 1996; 51(5): 137–139.

22. Simcox JA, McClain D. Iron and Diabetes Risk. Cell Metabolism 2013; 17(3): 329–341.

23. Souci SW, Fachmann W, Kraut H. Food Composition and Nutrition Tables. 7th ed. Medpharm: Stuttgart 2008. ISBN 978–0849341410.

24. Sullivan JL. Iron and sex difference in heart disease risk. Lancet 1981; 1(8233): 1293–1294.

25. Sullivan JL. Macrophage iron, hepcidin, and atherosclerosic plaque stability. Exp Biol Med (Maywood) 2007; 232(8): 1014–1020.

26. Sullivan JL. Do Hemochromatosis Mutations Protect Against Iron-Mediated Atherogenesis? Circ Cardiovasc Genet 2009; 2(6): 652–657.

27. Syrovatka P, Kraml P, Hulikova K et al. Iron stores are associated with asymptomatic atherosclerosis in healthy men of primary prevention. Eur J Clin Invest 2011; 41(8): 846–853.

28. Scientific Reports of the 2015 Dietary Guidelines Advisory Committee. US Departement of Agriculture and US Departement of Health and Human Services 2015. Dostupné z WWW: <>.

29. Shin JY, Xun P, Nakamura Y et al. Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review an metaanalysis. Am J Clin Nutr 2013; 98(1): 146–159.

30. Tůmová J, Mališová L, Anděl M et al. Protective Effect of Unsaturated Fatty Acids on Palmitic Acid-Induced Toxicity in Skeletal Muscle Cells is not Mediated by PPAR delta Activation. Lipids 2015; 50(10): 955–964.

31. Velíšek J. Chemie potravin 1. Ossis: Tábor 1999. ISBN 80–902391–4-5.

32. Wildova E, Dlouhy P, Kraml P et al. Orally administered whey proteins have comparable effect on C-peptide secretion in healthy subjects as standard C-peptide stimulation tests. Physiol Res 2013; 62(2): 179–186.

Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 7-8

2016 Issue 7-8

Most read in this issue

This topic is also in:

Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account