A traditional Asian diet modified to meet nutritional requirements of diabetes, has anything changed? A cross-sectional dietary survey

Medical nutrition therapy is the cornerstone of managing type 2 diabetes mellitus. Meals that are modified to suit diabetes should be culturally acceptable, retain palatability and conform to the energy requirements of diabetes. The objective of this study was to find if the dietary patterns of Sri Lankan type 2 diabetes patients have changed from the traditional serving characteristics to align with dietary recommendations of diabetes, while retaining palatability and cultural acceptability. A cross-sectional survey was performed at a multi-ethnic, tertiary care diabetes facility in Sri Lanka. Fruits, vegetables, starch, pulses, dairy and added sugars in diet were assessed with portion size estimation using a 24-h dietary recall according to standard methods. The meals consumed by participants were “traditional” and retained palatability. Rice contributed to 93% of the starch-based food types. Ninety-two percent consumed starch in excess of the daily recommendation. Fruit and vegetable consumption was 1.3 and 2.8 servings per day, with 33% failing to consume any fruit. Seventy-four percent and 65% of participants failed to consume the minimum daily recommended number of fruit and vegetable servings. Only 1% of participants consumed added sugar. The Sri Lankan diabetes diet is a portion-restricted version of the traditional meal that retained cultural acceptability and palatability. A large proportion of patients still consume carbohydrates in excess of the recommendations. Although there is an increasing trend towards fruit and vegetable consumption, the majority still fell short of the recommendations.