Back in the 1980s, dieticians told us – at a big company meeting to introduce the new USDA Dietary Guidelines – that we were to eliminate as much fat as possible from our diets – but sugar was okay as long as you were not diabetic. Seriously, that actually happened. I was there.
(This first part of this post – on the history – was created in part, using AI).
The American Diabetes Association (ADA) has evolved its dietary guidance over the past two decades, reflecting new research and changing clinical priorities.
🕰️ Then: Consistent Carbohydrate Intake
- Past guidance emphasized a consistent carbohydrate diet—spreading carb intake evenly across meals and snacks.
- The goal was to stabilize blood glucose levels and simplify insulin dosing, especially for those using fixed-dose regimens.
- This approach was widely taught in diabetes education programs and supported by dietitians.
🌱 Now: Individualized, Lower-Carb Emphasis
- The ADA now promotes individualized nutrition plans, with growing support for lower-carb eating patterns—especially for people with type 2 diabetes.
- Their 2023 Standards of Care state that reducing overall carbohydrate intake—particularly refined carbs like bread, pasta, and sugary foods—can improve glycemic control.
- They highlight non-starchy vegetables, lean proteins, and healthy fats as foundational elements.
🔄 Why the Shift?
- Evidence-based evolution: Studies show that lower-carb diets can reduce A1C, improve insulin sensitivity, and support weight loss.
- Medication flexibility: Modern insulin regimens and GLP-1 receptor agonists allow more dietary freedom.
- Patient-centered care: The ADA now emphasizes cultural preferences, sustainability, and metabolic goals over one-size-fits-all rules.
The ADA once championed consistent carb intake—but today, they recognize that carbohydrate quality and quantity matter more, and that flexibility and personalization are key.
The ADA – for a long time – pushed a consistent daily carbohydrate diet – and insulin injections. In 2024, a new group calling itself The American Diabetes Society was formed. The new group strongly emphasizes a different approach to managing diabetes – and which, from a visit to the older organization – ADA’s web site, has now adopted a similar bit of nutrition guidance.
Transforming Diabetes Care | American Diabetes Society
(FYI – I am not pre-diabetic or diabetic but have followed the nutrition “guidance” since they first issued the USDA Dietary Guidelines in the early 1980s. Since then, nutrition guidance has largely flipped 180 degrees. In the 1980s, we were told to eliminate as much fat from our diets as possible – but sugar was okay as long as you were not diabetic. By around 1990, the USDA released its “Food pyramid” which implied that 60% of your daily calories should come from grains – which for most meant processed white flour – which is not much different than sugar. The US obesity levels began to rise in perfect synchronization with the government’s dietary advice. Today obesity is rampant, and diabetes is at an all-time high. Finally, the “experts” have reversed course and now tell us that “healthy fats” are fine and we need to reduce our high glycemic index carbohydrate consumption. Literally, the experts had it entirely backwards, condemning at least 2 generations to poor health.)
