nutritional recommendations for; high blood pressure, diabetes and obesity
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ASSESS THE CURRENT NUTRITIONAL
RECOMMENDATIONS FOR; HIGH BLOODPRESSURE, DIABETES AND OBESITY.
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INTRODUCTION
Good health depends on small decisions we make everyday.The decisions we make that most affect our health have todo with the food we eat. There are so many optionsavailable that we must continually decide which foods toselect and how they are best prepared. It is vital to
understand foods well in order to select those that maintainhealth and those that can treat various diseases. The morecomplete information we have concerning available foodsthe easier it is to make the best choices for health.
Human beings need food throughout their lives. Whilefoods provide nutrients and energy, some can causedisorders and diseases and others bring health and healing.Therefore there are harmful foods and beneficial foods.
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DEFINITION AND DESCRIPTION OF DIABETES
MELLITUS Diabetes mellitus is a chronic metabolic disorder in which blood glucose levels
are raised because of a deficiency or diminished effectiveness of insulin. The
disease is not curable and may lead to a variety of complications some ofwhich are serious.
Type I diabetes also known as insulin-dependent diabetes (IDDM) orjuvenile-onset diabetes because it often begins early in life commonly atage 8 to 14 years (Latham, 1997). It occurs due to a viral infection, a toxin oran autoimmune reaction, all reinforced by a hereditary pre-depositionwhich destroy the insulin producing cells (-cells) of the pancreas. Thepatients tend to be thin and must receive insulin from infancy.
Type II diabetes also known as non-insulin dependent diabetes (NIDDM).The cause is a combination of resistance to insulin action and an
inadequate compensatory insulin secretory response. High levels of sugarmay be present in the blood causing pathologic and functional changes invarious target tissues, but without clinical symptoms. It is far morecommon and begins later in life. The patients tend to be obese and presentdisorders associated with fat metabolism, with excess cholesterol sinceinsulin promotes the synthesis and accumulation of fat.
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Gestational diabetes mellitus (GDM) is defined asany degree of glucose intolerance with onset orfirst recognition during pregnancy. The definition
applies whether insulin or only diet modification isused for treatment and whether or not thecondition persists after pregnancy. It does notexclude the possibility that unrecognized glucose
intolerance may have begun concomitantly withthe pregnancy.
Other specific types of diabetes (due to other
causes, e.g., genetic defects in -cell function,genetic defects in insulin action, diseases of theexocrine pancreas, drug or chemical induced).
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DIABETES STATUS IN KENYA
It is estimated that the prevalence of diabetes in the
country is about 3.3%. This figure is projected to rise to
4.5% by 2025 if the trend is not checked. Currently, the
country has over two million people and 25,000
children living with diabetes. Experts blame the
increase in diabetes to poor eating habits and lack of
physical exercise (Standard (2012)
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NUTRITIONAL RECOMMENDATIONS
From a nutritional point of view diabetes is relatedto obesity, cardiovascular disease and alcoholism.The main aim of treatment is to maintain health
and to avoid complications. This is done by trying toget blood glucose levels as close to normal aspossible and by so doing reduce the amount ofglucose spilling into the urine. Control is greatly
assisted by reduction of weight in obese diabeticsand by maintenance of a healthy body weight in alldiabetics (Latham, 1997).
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FOODS OR NUTRIENTS RECOMMENDED FOR
DIABETESLegumes
In spite of containing between 20% and 30%
carbohydrates, legumes are very well tolerated bydiabetics. They help regulate the level of glucose in theblood because of their fiber content and the uniquehistological structure of their seeds. Legumes have a
low glycemic index, which means that they raise bloodglucose levels very little. They reduce the need forinsulin in diabetics and therefore legumes arefundamental food for diabetics.
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Vegetables All vegetables are very well tolerated by diabetics and because of
their low calorie content they help prevent or treat the obesitytypical of adult diabetics. No vegetable is fattening even when
eaten in large quantities except when fried. Vegetables produce amuch greater feeling of satiety than other foods when onecompares the amount eaten with calories taken in. Particularlyappropriate are: broccoli, cauliflower, cabbages, lettuce, endive,green beans, peas and cucumber.
Whole Grains Studies performed at the Harvard Universitys School of Public
Health confirm the hypothesis that high sugar and low whole grainfoods increase diabetes risk (Salmeron, 1997). As a result, diabeticstolerate whole grain products better than those of refined grainsand can eat them without difficulty. In addition to preventingdiabetes, whole grains are well tolerated by these patients andshould be used liberally particularly barley, oats and wheat.
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Fruits Fruit s are necessary in cases of diabetes since they contains
antioxidant vitamins that mitigate the course of the disease andprotects against the cardiovascular complications that tend to
accompany it. The only precaution is the need to control their useto avoid excess sugar and not to eat dried fruits (raisins, datesetc). Mangoes and bananas are the best tolerated.
Artichoke The artichokes active ingredient cynarin is mildly hypoglycemic
(lowers the level of sugar in the blood). It contains inulin acarbohydrate beneficial to diabetics that is formed from fructosemolecules and is easily absorbed. It can be included in meals inraw form in salads or as grilled or steamed vegetable.
Celery Celery contains small amounts of glycoquin a substance similar in
action to insulin which reduces blood sugar level. It helps regulateblood glucose level, reduces cholesterol and neutralizes excessacids that may be produced in the body because of diabetes. Itcan be included in the meals in soups, raw in salads or fresh juice.
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Mushroom
Mushrooms produce a certain sense of satiety with very few calories.While they are excellent for the obese in general they are of particularbenefit to diabetics because they reduce the need for insulin.
Onions
Onions contain glycoquin which helps to reduce blood glucose in cases ofdiabetes they are also blood alkalizers and protect against arteriosclerosis,which is beneficial to the diabetics. They can be included in the meals inraw for in salads, in broths, onion water or onion syrup.
Wheat germ
The combined action of the vitamin B1and E present in wheat germexplains its anti-diabetics effect: 4 or 5 spoonfuls can reduce the glucoselevel and the need for insulin.
B group vitamins
Vitamins B1, B2 and B6 are essential for glucose metabolism,transforming it to energy. Because of this diabetics must assure a goodsupply. Wheat germ, brewers yeast, legumes and nuts are all good
sources of these vitamins.
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FOODS OR NUTRIENTS THAT SHOULD BE
AVOIDEDSugars All dietary sugars with exception of fructose are formed
partially or completely of glucose. This is easily absorbedcausing a steep rise in its level in the blood which is
detrimental to diabetics who should avoid sugars ingeneral and the sweetened products made from them.Fructose does not raise blood glucose level as much and itrequires less insulin to be metabolized. However, this doesnot mean that diabetics can use fructose in large amounts
Honey is formed of equal parts of glucose and fructose. Itsdeleterious effect on diabetics in the same as any refinedsugar since it contains no fiber and provokes sudden rise inblood glucose level.
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Refined Baked Foods These products supply refined sugar and flour but very little fiber or
vitamins. This leads to abrupt increase in blood glucose which isdetrimental to diabetes since they cannot properly metabolize it. This
includes all types of rolls, pastries, cookies and other dessert items.
Saturated Fat It has been proven that fat consumption particularly saturated fat
reduces glucose tolerance and worsens diabetes. Saturated fat is theprincipal dietary determinant of plasma LDL cholesterol and personswith diabetes appear to be more sensitive to dietary cholesterol thanthe general public. Because of this diabetics should avoid butter, creamfatty meats and meat derivatives that are high in saturated fat such assausages and bacon.
Shellfish Quite frequently shellfish are contaminated with a variety of viruses and
bacteria that can cause serious infections in diabetics since theseindividuals tend to have somewhat compromised immune system.
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Alcoholic Beverages
Alcohol makes the body cells more resistant toinsulin worsening the course of diabetes. It alsocontributes to the generation of peripheral nerves(neuropathy) which is one of the complications ofdiabetes.
Salt Consistently consuming more than the ADI
(admissible daily intake) of 6g the possibility of
hypertension to which diabetics are particularlysusceptible is increased. Hypertension contributesto the cardiovascular complications of diabetics .
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DEFINITION AND DESCRIPTION OF
OBESITY Obesity is basically an imbalance between the
calories taken in and those utilized. If one takes inmore energy than necessary the body converts it tofatty deposits (adiposity) increasing the body weight.
In clinical practice and epidemiological research,obesity is most often defined by the body mass indexa calculation that gives a reasonable approximationof adiposity. BMI is derived by dividing an individualsweight in kgs by height in meters squared (kg/m2).Adults between 25kg/m2- 29.5 kg/m2 are overweightand those with greater than 30 kg/m2 are obese .
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NUTRITIONAL RECOMMENDATIONS
To avoid obesity one should eat foods that havethese characteristics ; low in calories, rich in fiber,low in fats, low sodium content because it retainswater and increases body volume and weight and
they must produce a feeling of satiety.
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FOODS OR NUTRIENTS RECOMMENDED FOR
OBESITYDiuretic Foods These foods such as fruits and vegetables stimulate kidney function and
increase urine production. The diuretic effect of these foods facilitatesthe elimination of fluid and sodium retained in the tissues whichcontributes to weight loss. Examples of these food include; celery,borage, cauliflower, green beans, apples, peaches, loquats, watermelon
and grapes.
Whole Grains A bowl of oatmeal or whole-grain cereal has benefits that last all day.
The fiber and complex carbohydrates in whole grains help you feel fuller
for longer, so you'll be less tempted to overeat at lunch. They also helpreduce LDL cholesterol and can be an important part of your weight lossstrategy. Other examples of whole grains include wild rice, popcorn,brown rice, barley, and whole-wheat flour.
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Seaweed The gum contained in the seaweed is capable of retaining up to ten times its
weight in water. This causes it to increase in volume in the stomach, producinga feeling of satiety and reducing the appetite at least temporarily. It also
stimulates the production of thyroid hormone because of its iodine contentwhich increases the metabolic rate and with it the combustion ofcarbohydrates.
Pineapple When pineapple either the fruit or its juice, is eaten before a meal it reduces the
appetite. It is also slightly diuretic which makes it a good complement for
weight loss diet or treatments.
Sweet Potato The sweet potato is a good source of easily digested carbohydrates (starch and
saccharose) as well as carotene. It is beneficial in weight loss diets because itproduces a feeling of satiety that reduces the appetite. Sweet potatoes are
nourishing and can relieve hunger fro several hours. They can be oven roasted,pureed with milk or used in pastries.
Broccoli Broccoli is low in sugars and calories while providing vitamin A, vitamin C,
minerals and anti-carcinogenic phytochemicals. It produces a significantsensation of satiety in relation to its very low caloric content so the obese may
eat as much as they like. It should be cooked slightly to avoid loss of nutrients.
Zucchini
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Zucchini Zucchini contains very little fat, sodium or calories while providing a certain amount of mineral salts and
vitamins. Because if this its soothing effect on the digestive tract and its diuretic (purifying) action, it isrecommended for weight loss diets.
Cherry Cherries must be eaten slowly one by one so that they give the sensation of having eaten a great deal. They
contain virtually no fat or sodium which potentiates their weight loss effect. A handful of cherries can substitutea plate of food. They are also depurant and diuretic.
Cabbage All cabbages provide a feeling of satiety because of their high fiber content and supply very few calories. They
also contain phytochemicals that protect against cancer.
Lettuce Lettuce satisfies the appetite while producing a certain sedative effect that is necessary for those following
weight loss diets. It provides vitamins and minerals but very few calories.
Turnips They are recommended for weight loss diets because they are nutritious, easy to digest, very low in fat, have
few calories and are quite filling.
Cucumber
Cucumbers are rich in alkalizing minerals and very low in fat and calories. A cucumber salad is a very appropriatedish in cases of obesity.
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FOODS OR NUTRIENTS THAT SHOULD BE
AVOIDEDSaturated Fat This comes primarily from animals based foods (whole milk, cheese, eggs,
meats, sausages, etc) and is solid at room temperature. This is a reservefat, stable and non reactive which unless one performs vigorous physicalexercise tends to deposit under the skin, between the muscles and in theabdominal cavity, contributing to obesity.
Fried Foods Fried foods always retain a certain amount of cooking oil, which contains a
great deal of calories e.g. fried potatoes have between 5 and 7 times morecalories than boiled potatoes.
Refined Baked Goods Products made with refined flour and white sugar provokes abrupt
increases in blood sugar. This forces greater insulin secretion to utilize thissugar. If energy supplied from these rapidly supplied carbohydrates is notused; insulin transforms it to fat contributing to obesity.
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DEFINITIONAND DESCRIPTION OF HIGH BLOOD
PRESSURE/HYPERTENSION Hypertension is said to exist in one or both of these
conditions: systolic (maximum) pressure exceeds140mm Hg and diastolic (minimum) pressure exceeds90 mm Hg. Hypertension does not produce symptomsbut rather slowly deteriorates the arteries and various
organs. Elevated BP results from environmentalfactors, genetic factors, and interactions among thesefactors. Of the environmental factors that affect BP(diet, physical inactivity, toxins, and psychosocial
factors), dietary factors have a prominent, and likelypredominant, role in BP homeostasis. Diet can play animportant role in maintaining blood pressure withinhealthy limits. The more simply prepared fruits and
vegetables are eaten the lower hypertension risk.
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NUTRITIONAL MANAGEMENT
Dietary management with moderate sodium
restriction has been effective in reducing bloodpressure in individuals with essential hypertension.
Weight reduction can reduce blood pressureindependent of sodium intake and also can improveblood glucose and lipid levels. The loss of onekilogram in body weight has resulted in decreases inmean arterial blood pressure of1 mmHg.
Given the present evidence, weight reduction shouldbe considered an effective measure in the initial
management of mild-to-moderate hypertension, andthese results could probably be extrapolated to thediabetic hypertensive population. (Hypertension,2008).
OO S O S CO O
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FOODS OR NUTRIENTS RECOMMENDED FOR
HYPRETENSION
Diuretic Foods Diuretics reduce blood volume by increasing the volume of urine; thus blood pressure is
maintained. Diuretic fruits and vegetables are also rich in potassium, fiber andantioxidant vitamins, all of which exercise healing power on the cardiovascular system.
Fruits
Eating large amounts of fresh fruits protect against hypertension. One meal a dayconsisting of fruit is a healthful habit for those suffering from hypertension, particularly ifthey are obese.
Leafy Green Vegetables All of these are rich in potassium and magnesium which protects against hypertension. A
salad or a dish of cooked greens without salt a day is an excellent custom for thosesuffering from hypertension, particularly if they are obese. It has been proven that avegetarian diet lowers blood pressure. Vegetarian diets have been associated with lowBP. In industrialized countries, where elevated BP is commonplace, individuals whoconsume a vegetarian diet have markedly lower BPs than do non-vegetarians.
Depurant Broth
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Depurant Broth This is a broth made with certain vegetables such as onions and celery. It is particularly
effective in detoxifying the blood of waste materials that may cause hypertension and otherchronic diseases. One half liter of this broth is drunk throughout the day in place of water.
Legumes
Legumes contain potassium, magnesium and calcium which are minerals that help controlblood pressure and avoid hypertension. They also contribute high fibber and very lowsodium.
Celery In spite containing a certain amount of sodium celery is a vasodilator and diuretic and
therefore appropriate for hypertension.
Squash This is one of the richest foods in potassium and one of the lowest in sodium. Those with
hypertension may eat squash daily as it is considered a very heart-friendly food.
Garlic Garlic is a vasodilator (dilates the arteries) and hypotensor (lowers blood pressure) although
it is necessary to eat a certain amount to achieve this effect.
Pear Because of their diuretic action and richness in potassium, pears are among the most
effective fruits against hypertension.
Grapefruit This is effective in protecting the arteries; it is diuretic and improves blood fluidity.
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Fiber The more fiber in the diet, the lower the risk of hypertension.
Potassium A potassium rich diet protects against hypertension and its negative consequences.
Plant-based foods are richest in potassium.
Calcium Calcium deficiency can lead to hypertension. Dairy products are good sources of this
mineral but this are plant-based foods such as legumes, nuts, broccoli and cabbage.
Magnesium Magnesium deficiency predisposes to hypertension. Nuts, legumes and wheat germ are
good sources of magnesium.
Fish Oil Fish oil supplements can contribute to a reduction in hypertension due to their richness in
omega 3 fatty acids. If one has high blood pressure, eating fish could be helpful alongwith other dietary changes and medications, as recommended by your doctor. Onestrategy is to replace red meat with fish such as salmon, mackerel, herring, lake trout,sardines, anchovies, and tuna during some meals. But it's best to avoid salty fish, such assmoked salmon.
FOODS OR NUTRIENTS THAT SHOULD BE AVOIDED
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FOODS OR NUTRIENTS THAT SHOULD BE AVOIDEDSalt An increase in salt consumption produces hypertension particularly in sensitive
individuals. This effect is more pronounced with age. In addition to reducing oreliminating table salt it is important to avoid the hidden salt found in manyfoods.
Sodium The hypertensive effect of salt is due to its sodium content. This mineral is
naturally present in certain foods, additives and medications which should also
be avoided.Ham Cured ham is a meat derived with one of the highest so idiom level because the
salt and other additives (nitrites and nitrates) added to it. This should beavoided.
Sausages These are very high in sodium both because of that which the meat naturally
contains and that which is added when salt and additives (nitrites and nitratesused to cure the meat are sodium salts).sausages are also high in saturated fatwhich promotes hardening of the arteries and hypertension.
Meat
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Meat Regular consumption of any meat is related to hypertension because of its protein
richness, its sodium content and its lack of potassium.
Proteins
The higher the protein consumption, the greater the possibility of suffering fromhypertension. Animal proteins (cheese, milk, eggs, fish, and meat) have the highesthypertensive effect since they are accompanied by high levels of salt and/or sodium.
Alcoholic Beverages Alcoholic beverages increase hypertension. Consumption of amounts that might be
considered moderate (three glasses of wine a day) can raise blood pressure.
Saturated Fat Saturated fat promotes hardening and narrowing of the arteries which causes
hypertension. This results in the heart having to pump higher pressure to overcome thisresistance to blood circulation.
Coffee It has been proven that when one stops regularly drinking coffee, the blood pressure
drops. Decaffeinated coffee does not affect the blood pressure.
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Stimulant Beverages All these contain caffeine (tea, mate, caffeinated soft drinks etc).
Drinking them on a regular basis raises blood pressure.
Pepper Pepper causes hypertension just like piquant spices.
Matured Cheese These should be eliminated since they contain a great deal of salt
and hypertensive amines which are formed during fermentation.
Egg Egg yolk is quite high in sodium and should be avoided in cases of
hypertension. The egg white has very little sodium.
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Thank You.