Nutritional management of blood glucose levels is a strategic target in the prevention and management of type 2 diabetes mellitus (T2DM). To implement such an approach, it is essential to understand the effect of food on glycemic regulation and on the underlying metabolic derangements. This comprehensive review summarizes the results from human dietary interventions exploring the impact of dietary components on blood glucose levels. Included are the major macronutrients; carbohydrate, protein and fat, micronutrient vitamins and minerals, nonnutrient phytochemicals and additional foods including low-calorie sweeteners, vinegar, and alcohol. Based on the evidence presented in this review, it is clear that dietary components have significant and clinically relevant effects on blood glucose modulation. An integrated approach that includes reducing excess body weight, increased physical activity along with a dietary regime to regulate blood glucose levels will not only be advantages in T2DM management, but will benefit the health of the population and limit the increasing worldwide incidence of T2DM.
This comprehensive review focuses on the evidence from human dietary interventions, demonstrating that particular food components have significant and clinically relevant effects on blood glucose regulation. In the case of low calorie sweeteners, this review concludes that they do not affect the glycemic response and can help control overall carbohydrate intake by substituting for higher energy yielding sweeteners. Specifically, the authors note that the use of low-calorie sweeteners and the products that contain them by subjects, with or without diabetes, do not affect blood glucose and are tools to help people reduce and control their caloric intake.
This review is in agreement with leading health groups such as American Heart Association, American Diabetes Association (Gardner et al., 2012), and the Academy of Nutrition and Dietetics (Fitch and Keim, 2012), which also agree that substituting low calorie sweeteners for added sugars in beverages and other foods has the potential to help people reach and maintain a healthy body weight and help people with diabetes with glucose control.