Development of food groupings to guide dietary advice for people with diabetes

Objective:  To describe the development and characteristics of a food categorisation system and its application to guide advice for diabetes treatment. Design and methods:  Foods commonly consumed by 16 adults with diabetes were grouped by macronutrient content and type of fat to form a set of reference food groups for dietary advice. Means for energy and macronutrients from individual food groups were then used to construct an overall intake pattern targeting 8000 kJ and relative amounts of carbohydrate, protein and fat (saturated fatty acids (SFA) < 10%E and (polyunsaturated fatty acids) PUFA ∼ 10%E). Variation in energy and macronutrients contributed by all foods partitioned into each food group was assessed by the coefficient of variation of data on the whole diet. Results:  To differentiate between sources of fat, 13 food groups emerged and 10 were deemed acceptable to nutritional guidelines for diabetes treatment. The food group pattern was judged adequate for the achievement of dietary recommendations with low-potential variation in total energy (5%) and macronutrient proportions (protein 6%, fat 6%, carbohydrate 3%), but higher for fat types (SFA 22%, (monounsaturated fatty acids) MUFA 11%, PUFA 12%). Targeted proportions for fat types were achieved only when daily servings of PUFA-rich, oils, nuts and oily fish or soy were included in an ideal intake pattern. Conclusions:  In theory, a dietary pattern constructed from food group sources of macronutrients and individual fat types results in low-potential variation from recommended nutrient targets and, therefore, is appropriate to guide advice for the treatment of diabetes.