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Chapter 6


the expected outcomes, whereas others may not achieve a positive outcome.


Box 6.1 Effectiveness of Medical Nutrition Therapy on Metabolic and Anthropometric Data2-5


Endpoint and Expected Outcomes When to Evaluate Lipids2


• Total cholesterol 7%–21% decrease


• Low-density lipoprotein cholesterol (LDL-C) 7%–22% decrease


• Triglyceride levels 11%–31% decrease Monitor and evaluate 3 months after the nutrition intervention


Blood pressure3 • Medical nutrition therapy (MNT): systolic blood pressure (SBP) decrease up to 10 mm Hg


• MNT: diastolic blood pressure (DBP) decrease up to 6 mm Hg


• Dietary Approaches to Stop Hypertension (DASH) eating pat- tern with sodium range 1,500–2,400 mg/d reduces SBP by 2–11 mm Hg and DBP by 0–9 mm Hg


• DASH eating pattern plus weight loss reduces SBP by 11–16 mm Hg and DBP 6–10 mm Hg


At every medical visit


Hemoglobin A1ca,4 • Type 2 diabetes 0.3%–2.0% decrease • Type 1 diabetes 1.0%–1.9%


6 wk–3 mo after start of MNT


Weight5 • Lifestyle therapies: weight loss 4–12 kg at 6 mo • Weight loss at 1 y 4–10 kg • Weight loss at 2 y 3–4 kg


At every encounter a


Depending of duration of diabetes and level of glycemic control.


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