DIET IN DIABETES

By,Archana.karthickNutritionist (MSc in DFSM and PG in Diabetes education)

What is diabetic diet?Diabetic diet is a balanced diet that contain a variety of foods from both macronutrient and the micronutrient

Individual Nutritional Assessment

Height and weight Desirable body weight Body mass Index Medical history Laboratory values Current level of diabetes control

Body Mass Index

BMI = Weight(kg)/ Height (Mt2)

Kg/m2

Under weight <18.5

Normal weight 18.5- 24.9

Over weight >25.0

Pre-obesity 25.0- 29.9

Obese class 1 30.0-34.9

Obese class 2 35.0-39.9

Obese class 3 >40.0

OBJECTIVES OF NUTRITION MANAGEMENT IN DIABETES

Optimize your blood glucose control

Achieve and maintain reasonable body weight

Optimize your lipid profile

Control your blood pressure

Prevention or delay of the onset of diabetes related complication

MNT Goals for Diabetes

1. To address individual nutrition needs, taking into consideration personal

and cultural preferences and willingness to change

2. To maintain the pleasure of eating by only limiting food choices when

indicated by scientific evidence

Nutrition recommendation for Diabetes Management

There is no one diabetes diet that can suite all.

Modification of a normal , well-balanced diet, based on the nutritional needs of an individual.

Expressed in terms of total calories, and a ratio of carbohydrate, protein & fat.

Each Person With Diabetes is Different!

Dietary recommendations for diabetes

55-60% of daily calorie should come from Carbohydrates

20% from your Fat 15- 20% from protein

FOOD GUIDE PYRAMID

Cereals The maximum numbers of

serving should come from foods in this group

(1 serving = 20g)

Each servings in the cereal group contain 15g of CHO, 3g of protein, a trace of fat and gives about 80 calorie

E.g. whole grain cereals

(1 slice of brown bread, 1-6 inch chapathi or roti, 1/3rd cup of brown rice etc

Vegetables 3- 5 servings of vegetables

should be consumed daily.

Each serving contain 5g of CHO, 2g protein, and approx 28 calories.( e.g. 1 cup or raw green leafy vegetable, or ½ cup of chopped/ cooked vegetable)

They are rich in essential vitamins, minerals, antioxidant and fiber

Vegetables to be restricted

Can be taken weekly once in a mixed form.

Fruits 2- 3 servings should be consumed

daily. Each servings contain 15g of cho and

60 calorie. Diabetes can have any 1 fruits/ day Diabetes should have their fruits only

when there sugar levels are < 200mg/ dl.

It should not be eaten along with the meals.

Enjoy whole fruits rather than fruit juices

Fruits are also good source of vitamin, minerals, antioxidants and fiber.

90% of vitamin C, 2/3 of vitamin A are obtained from fruits & vegetables.

Best taken fresh

Fruits to be avoided in Diabetes

Choose more of high fiber food

To help to maintain blood glucose level and cholesterol level

To help to maintain the healthy gut

Make you feel full after meal so that they eat less.

Total fiber in food for men is 38g/day and for women 25g/day.

Food groups

•Cereal group

•Pulses

•Meat and poultry

•Vegetables

•Fruits

•Fats

High fiber food

•Whole wheat flour, whole wheat bread

•Whole dals and dals with husk

•none

•All

•Apples, cherries, pears, peaches guava etc

•none

Low fiber food

•Refined cereals like rice, white bread, suji, maida and its product, noodles, macoroni

•Washed/ dehusked dals

•Eggs, chicken, fish

•Vegetables like potato and yam

•Fruit juices and squashes

•Fats, oil, ghee, butter etc

pulses Each serving contain 12g

Cho, 6g protein, 1g of fat.

E.g all husked dals and legumes.

They are rich protein, fiber, vitamin and minerals.

Consume it in the form of sprouts .

Dairy products Consume around 500

ml of milk and there products/ day.

Use skimmed or low fat milk instead of whole milk.

They are good source of calcium and protein.

Use less fat in cooking Should be used

sparingly.

Each serving in fats and oil group has 5g of fat and 45 calories

Limit your oil intake up to 500 ml/person/month (app 2-3 tsp/ day)

Reduce animal or saturated fats

Use low fat milk

Use low fat spread like cottage cheese instead of butter, cheese or mayonnaise

Use oil high in unsaturated fats like refined sunflower oil, rice bran oil.

Eat egg white instead of whole egg.

Select more chicken and fish based dishes over mutton, pork and beef.

Common source of different fats

Fats sources

Saturated Red meats, butter, cheese, ghee, whole milk, cream, margarine

Polyunsaturated Safflower oil, sunflower oil, corn oil

Monounsaturated Olive oil, canola oil, rape seed oil, groundnut oil, sesame oil, mustard oil

Trans fats Baked products, biscuits, cakes

How to Read a Nutrition Label

Cut down on sugary foods

Cut out sweets

Cut out sugary drinks, fruit juices, soft drinks etc

Say no to direct sugars like table sugars, honey, jaggery, brown sugars etc.

Reduce salt intake

Cut down on added salt

Use alternative seasonings

Look out for reduced/low sodium foods, eg bread

Avoid salt substitutes

What is your meal pattern ?

Early morning

Breakfast

1/4 th of total calorie

Midmorning snacks

Plate Method

1/3rd of total calorie

Lunch/ Dinner

Evening snack

Bed time

ALTERNATIVE SWEETENERS Nonnutritive Sweeteners

(calorie free)

1.Aspartame (200 X sweeter than sucrose)

- break down under high heat

(not suitable for cooking).

- contraindicated in people

with phenlyketonuria.

2. Saccharin (300 X sweeter)

- give bitter aftertaste

- least expensive

- for sweetening soft drinks, beverages & foods

NUTRITIVE SWEETENERFructose (4 kcal / g) Slightly sweeter than

sucrose Produce lower

postprandial glucose response

Found in fruits, honey & vegetables

Not recommended as sweetening agent

› may adversely affect plasma lipids

› large quantity (> 50 g) taken at once may cause diarrhoea.

DIABETIC FOODS Easily available now. Cannot be classified as ‘free food’ Contain calories & fat, even more than usual product More expensive Examples:

Diabetic jams Diet soft drinks

AVOID

Smoking Alcohol Sleeping after meals Stress and worry Sedentary lifestyle

Eating Well,While Eating Right;

Eating Right isHalf the Fight