title: The transcultural diabetes nutrition algorithm: a canadian perspective.
abstract: The Transcultural Diabetes Nutrition Algorithm (tDNA) is a clinical tool designed to facilitate implementation of therapeutic lifestyle recommendations for people with or at risk for type 2 diabetes. Cultural adaptation of evidence-based clinical practice guidelines (CPG) recommendations is essential to address varied patient populations within and among diverse regions worldwide. The Canadian version of tDNA supports and targets behavioural changes to improve nutritional quality and to promote regular daily physical activity consistent with Canadian Diabetes Association CPG, as well as channelling the concomitant management of obesity, hypertension, dyslipidemia, and dysglycaemia in primary care. Assessing glycaemic index (GI) (the ranking of foods by effects on postprandial blood glucose levels) and glycaemic load (GL) (the product of mean GI and the total carbohydrate content of a meal) will be a central part of the Canadian tDNA and complement nutrition therapy by facilitating glycaemic control using specific food selections. This component can also enhance other metabolic interventions, such as reducing the need for antihyperglycaemic medication and improving the effectiveness of weight loss programs. This tDNA strategy will be adapted to the cultural specificities of the Canadian population and incorporated into the tDNA validation methodology.
authors.affiliation: Crabtree Nutrition Laboratories, McGill University Health Centre/Royal Victoria Hospital, Montreal, QC, Canada H3H 1A1 ; Crabtree Nutrition Laboratories, McGill University Health Centre/Royal Victoria Hospital H6.90, 687 Pine Avenue West, Montreal, QC, Canada H3A 1A1.
authors.forename: Réjeanne
authors.identifier: 0000-0003-0567-092X
authors.initials: R
authors.lastname: Gougeon
authors.affiliation: Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada L8N 3Z5 ; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada M5C 2T2.
authors.forename: John L
authors.initials: JL
authors.lastname: Sievenpiper
authors.affiliation: Department of Nutritional Sciences and Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada M5S 3E2 ; Clinical Nutrition and Risk Factor Modification Center, Division of Endocrinology and Metabolism, and Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada M5C 2T2.
authors.forename: David
authors.initials: D
authors.lastname: Jenkins
authors.affiliation: McGill University Health Centre/Royal Victoria Hospital, Montreal, QC, Canada H3A 1A1.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Yale
authors.affiliation: Division of Human Nutrition, Division of Agriculture, Food and Nutritional Science, and the Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada T6G 2E1.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Bell
authors.affiliation: Centre de Recherche de L'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC, Canada ; Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC, Canada G1V 4G5.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
authors.affiliation: Division of Endocrinology and Metabolism, Capital Health, Halifax, NS, Canada B3H 2Y9 ; Dalhousie University, Canada.
authors.forename: Thomas P P
authors.initials: TP
authors.lastname: Ransom
authors.affiliation: Department of Allied Health, Clinical Nutrition, University Health Network, Toronto, ON, Canada M5G 2C4.
authors.forename: Kathryn
authors.identifier: 0000-0003-2230-5182
authors.initials: K
authors.lastname: Camelon
authors.affiliation: Robarts Research, University of Western Ontario, London, ON, Canada N6A 5B7.
authors.forename: John
authors.initials: J
authors.lastname: Dupre
authors.affiliation: Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, ON, Canada M5S 3E2 ; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada ; College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Cyril
authors.initials: C
authors.lastname: Kendall
authors.affiliation: Abbott Laboratories, Abbott Park, 43219, USA.
authors.forename: Refaat A
authors.initials: RA
authors.lastname: Hegazi
authors.affiliation: Medical Education and Research Alliance (Med-ERA), New York, NY 10019, USA ; Department of Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey, Newark, NJ 07101, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Marchetti
authors.affiliation: Joslin Diabetes Center, Harvard University, Boston, MA 02215, USA.
authors.forename: Osama
authors.initials: O
authors.lastname: Hamdy
authors.affiliation: Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Mechanick