Implementing Nutrition Intervention: Nutrition Education and Nutrition Counseling


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soluble fiber (7 to 13 g/d). Foods rich in soluble fiber include fruits, vegetables, whole grains (especially high-fiber cereals, and oatmeal), and legumes (espe- cially beans). Diets high in total and soluble fiber, as part of a cardioprotective eating pattern, can reduce total cholesterol (TC) by 2% to 3% and LDL-C by up to 7%. (LD, Strong; DB, Strong)7


• Encourage clients to consume dietary fiber from foods such as fruits, vegetables, and whole grains at the lev- els recommended by the Dietary Reference Intake (DRI) (21 to 25 g/d for adult women and 30 to 38 g/d for adult men, depending on age) or US Department of Agriculture (14 g fiber/1,000 kcal) because of the over- all health benefits of fiber. (DB, Fair)4


Nonnutritive Sweeteners


• Intake of Food and Drug Administration (FDA)- approved nonnutritive sweeteners (NNSs) (eg, aspar- tame, sucralose, and stevia) within the recommended daily intake levels established by FDA will not have a significant effect on glycemic control. (DB, Weak)4


• Substituting foods and beverages containing FDA- approved NNS can reduce the overall calorie and car- bohydrate intake; however, other sources of calories and carbohydrates in these foods and beverages need to be considered. (DB, Fair)4


Glycemic Index


• Lowering glycemic index (GI) and/or glycemic load (GL) may or may not have a significant effect on gly- cemic control. Studies longer than 12 weeks report no significant effect of GI and/or GL, independent of weight loss, on HbA1c. (DB, Fair)4


• A low-GI diet is not recommended for weight loss or weight maintenance as it has not been shown to be effective. (WM, Strong)8


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