Diet is said to be the 'cornerstone' of management of diabetes, yet the recommended dietary guidelines remain controversial and relatively few patients succeed in being well controlled on diet alone (1). This may imply that dietary treatment is not sufficient in itself or the dietary changes are too difficult to comply with or even that the wrong type of diet is being recommended. Many experts argue against the current dietary recommendations for diabetes, with both the quantity and quality of carbohydrate being at the centre of the controversy. This chapter is designed to critically address the issues of how much and what type of carbohydrate should be recommended for people with diabetes. It takes an evidence-based approach, giving greater weight to the results obtained from randomised controlled intervention studies. Important questions addressed in this chapter include:
• What is the scientific basis for recommending high-carbohydrate diets?
• What are the potential adverse effects of high-carbohydrate diets?
• What is the scientific basis for recommending diets high in monounsatu-rated fat (MUFA)?
• What is the scientific basis for recommending low glycaemic index diets?
• What is the optimal diet for improving insulin sensitivity?
• What is the optimal diet for weight loss?
• What is the evidence for a restricted versus liberal intake of sucrose?
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