The composition and nutritional adequacy of subject-selected high carbohydrate, low fat diets in insulin-dependent diabetes mellitus.

The composition and nutritional adequacy of subject-selected high carbohydrate, low fat diets were investigated in six women with insulin-dependent diabetes mellitus. Subjects were randomly assigned to begin either the experimental diet with 65% carbohydrate, 20% fat, and 15% protein for 6 wk, or a control diet with 45% carbohydrate, 40% fat, and 15% protein for 4 wk. All subjects completed both dietary periods in a cross-over experimental design. Subjects were allowed free selection in their choice of carbohydrate-rich foods. The resulting selections produced diets with 51% simple and 49% complex carbohydrates and 50 g of dietary fiber during the experimental diet. Similar proportions were also selected during the control diet. Blood chemistries revealed no significant changes in thiamin, riboflavin, vitamin B6, pyridoxal 5'-phosphate, ascorbate, vitamin E, calcium, selenium, or zinc concentrations between the two dietary periods. With the exception of vitamin B6, all vitamin and mineral values were within normal respective ranges. Vitamin B6 status, as assessed by pyridoxal 5'-phosphate, were below or just above the levels of marginal deficiency (2.2 nmol/100 ml) in four of the six individuals, but the lower level observed occurred independent of the dietary treatments. The present study demonstrates that subject-selected high carbohydrate, low fat diets were much lower in complex carbohydrates and fiber than diets previously tested. In addition, the concentration of several nutrients did not appear to be adversely affected by these diets.