Топик: The diabetic diet
Топик: The diabetic diet
t.Essentuki
THE DIABETIC DIET.
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Abstract
on English by Kuranov Alina Olegovna – a student of Essentuki medical
college group № 261. |
2002г.
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DIABETES.
Diabetes Mellitus (when the term
diabetes is used alone, it always refers to diabetes mellitus) is a condition
in which the body is unable to use sugar properly. Sugar (carbohydrate) is the
substance our body uses as its major source of energy. Once this sugar is
absorbed in the blood, it is referred to as blood sugar or blood glucose.
Insulin (a hormone made in the pancreas that regulates the blood sugar)
is either missing or deficient. As a result, the body cannot use energy
nutrients (carbohydrates, fat, protein) effectively and the cells of the body
"starve". The sugar in the blood may rise to high levels instead of
being used for energy. Blood sugar is excreted through urine, which makes
extra work for the kidneys causing frequent urination and excessive thirst.
Treatment
Diet, exercise and medication are
important factors that must be coordinated for diabetes to be kept in control.
Medication is not used to treat all cases of diabetes. Medication when used can
either be in the form of a pill (oral hypoglycemic agents) or insulin, which
must be injected. Diet, exercise and medication all affect treatment but unless
the diet plan is followed carefully no method of treatment will be effective.
By eating the right foods in the right amounts diet can actually help control
the basic problem of diabetes.
According to Control Your
Diabetes Education Program for Life, a program sponsored by the National
Diabetes Education Program, people who take control of diabetes will, in the
short run, feel better, have more energy, and prevent the following signs and
symptoms of high blood sugar: thirst, fatigue, frequent urination, weight loss,
blurred vision, and slow healing of cuts and bruises. In the long run,
they decrease their chances of developing eye disease, kidney disease, and
nerve damage, and add years to their lives.
THE DIABETIC DIET.
Purpose: The diabetic diet is designed
to achieve and maintain desirable body weight and near normal blood glucose
levels, reduce hyperglycemia, glycosuria, and associated symptoms of diabetes
in order to minimize the complications frequently associated with this disease.
Use: It is used for the person with
either insulin-dependent diabetes mellitus or non-insulin-dependent diabetes
mellitus. The calorie-controlled diet may be adapted for weight reduction and
weight maintenance.
The calorie level prescribed for the
diabetic is based on whether the person needs to lose or gain weight or simply
maintain the present weight. The calorie level specified is determined from the
height, body build, ideal weight and physical activity level.
General Guidelines for the Diabetic
Diet.
1.
Avoid concentrated
sources of carbohydrates (sugars) such as table sugar, honey, jelly, jam,
molasses, syrup, corn syrup, candy, regular soft drinks, pies, doughnuts,
cookies, pastries, regular chewing gum, and sweet pickles.
2.
Avoid
sweetened fruits, juices and fruit drinks. Choose fruit, which is fresh, frozen
or packed in water or its own juice. Avoid
fruits canned in heavy syrup.
3.
Avoid
sweetened carbonated sodas, juices and water.
4.
Learn
foods both high and low in sugar that are presented in the No Concentrated
Sweet Food List
5.
Three
meals at regular times should be consumed daily. Do not skip meals.
6.
A
nutritionally adequate meal plan that limits the amount of saturated fat,
cholesterol and salt in the diet. Fat intake should be 30% or less of caloric
intake and less than 10% of daily caloric intake from saturated fat. Dietary
cholesterol should be limited to 300 mg or less daily. 2,400 mg or less per day of sodium is
recommended.
7.
Daily
consumption of 20-35 g of dietary fiber from a wide variety of foods is
recommended.
8.
Mild to
moderate weight loss (10-20 pounds. has been shown to improve diabetes control,
even if desirable body weight is not achieved.)
9.
Read
the label to determine the sugar content of packaged foods. In addition to
sugar, brown sugar and corn syrup, other names that are used on ingredient
labels include: sucrose, glucose, dextrose, fructose, maltose, lactose,
sorbitol, mannitol, honey, corn syrup, corn syrup solids, high fructose corn
syrup, molasses, maple syrup.
10.
Monitoring
of lipids, blood pressure and body weight is crucial.
11.
Glycated
hemoglobin (HbA1C) and daily monitoring of blood glucose are standard tools to
measure glucose control.
·
For
individuals with Type 1
diabetes, self-monitoring 4 times daily or more is recommended
to maintain near-normal blood glucose levels and gain control. Testing 4
times a day, before each meal, and at bedtime, facilitates adjustments to
insulin, meals, and exercise program.
·
For
individuals with Type 2
diabetes, self-monitoring 1-2 times daily or more is
recommended to avoid hypoglycemia and hyperglycemia symptoms.
·
Newly
diagnosed
individuals should test blood glucose 4 times a day, before each meal, and at
bedtime, or more is recommended to maintain near-normal blood glucose levels
and gain control. Testing
facilitates adjustments to insulin, meals, and exercise program.
·
After a
stable pattern has been established in blood glucose levels, individuals should
test before breakfast, 3-7 times each week. Once or twice each month you
should return to testing 4 times a day (before each meal, and at bedtime) to
assure maintenance of a stable pattern.
NO CONCENTRATED SWEETS, LOW
FAT DIET.
(LOW SUGAR-LOW FAT)
Purpose: The no concentrated sweets,
low fat diet is designed to limit the total amount of fat and sugar in the diet
to reduce serum lipid levels and to achieve and maintain near normal blood
glucose levels. This diet is for people who find the exchange system too
confusing or restricting to follow.
Use: It is used for the person with
either non-insulin-dependent diabetes mellitus or for people who need or want
to cut down on their sugar and fat intake. The calorie-controlled diet may be
adapted for weight reduction and weight maintenance for individuals that do not have diabetes. It
is also used for persons with elevated serum cholesterol levels or those who
are high-risk candidates for heart disease.
General Guidelines.
·
Limit
total fat intake to less than 30% of total daily calories.
·
Reduce saturated
fat intake (red meat, cheese, whole milk, butter, ice cream, etc.)
·
Eat
less trans fat (stick margarine, shortening, cakes, pies, French fries,
snack chips.)
·
Eat
less cholesterol (limit egg yolks to more than 4 per week and meat, fish,
poultry to no more than 6 ounces a day)
·
Reduce sugar
intake.
·
Eat
more fruits, vegetables, beans, whole grain breads, and cereals.
·
Maintain a healthy
weight.
·
Exercise
at least 30 minutes on most days (brisk walking, aerobics, biking, etc.)
·
Experiment
with recipes by gradually reducing the amount of sugar by 1/4th then l/3rd then
1/2.
·
Use the
"sweet" spices—cinnamon cloves ginger or nutmeg—to bring out
sweetness in baked goods.
·
Be
careful when using special diet or dietetic foods such as dietetic cake,
cookies, candy and ice cream. These foods contain some form of sweetener and,
therefore, calories.
NO CONCENTRATED SWEET FOOD
LIST.
Purpose: The no concentrated sweets
diet is designed to achieve and maintain near normal blood glucose levels, and
reduce associated symptoms of diabetes in order to minimize the complications
frequently associated with this disease. This diet is for people who find the
exchange system too confusing or restricting to follow.
Use: It is used for the person with
either non-insulin-dependent diabetes mellitus or for people who need or want
to cut down on their sugar intake. It is not intended for the person with
diabetes taking insulin. The calorie-controlled diet may be adapted for weight
reduction and weight maintenance.
·
Eat
three meals at regular times. Do
not skip meals.
·
Limit
total fat intake to less than 30% of total daily calories.
·
Reduce saturated
fat intake (red meat, cheese, whole milk, butter, ice cream, etc.)
·
Eat
less trans fat (stick margarine, shortening, cakes, pies, french fries,
snack chips.)
·
Eat
less cholesterol (limit egg yolks to more than 4 per week and meat, fish,
poultry to no more than 6 ounces a day.)
·
Reduce
salt intake (canned and dried soups, fast food, frozen dinners, pizza,
processed meats and cheese.)
·
Eat
more fruits, vegetables, beans, whole grain breads, and cereals.
·
Maintain
a healthy weight. Mild to moderate weight loss (10-20 lbs. has been shown to
improve diabetes control, even if desirable body weight is not achieved.)
·
Recommend
20-35 grams/day of dietary fiber from a wide variety of foods.
·
Be
careful when using special diet or dietetic foods such as dietetic cake,
cookies, candy and ice cream. These foods contain some form of sweetener and,
therefore, calories.
·
Monitor
blood glucose, glycated hemoglobin, lipids, blood pressure and body weight.
·
Exercise
at least 30 minutes on most days (brisk walking, aerobics, biking, etc).
Regular exercise improves control of blood sugar and is an important part of
any healthy lifestyle.
·
Experiment
with recipes by gradually reducing the amount of sugar by 1/4th then l/3rd then
1/2.
·
Use the
"sweet" spices—cinnamon cloves ginger or nutmeg—to bring out
sweetness in baked goods.
·
Read
the label to determine the sugar content of packaged foods. In addition to
sugar, brown sugar and corn syrup, other names that are used on ingredient
labels include: sucrose, glucose, dextrose, fructose, maltose, modified food
starch, natural sweeteners, lactose, sorbitol, mannitol, honey, corn syrup, corn
syrup solids, high fructose corn syrup, molasses, maple syrup.
ABOUT THE MAJOR NUTRIENTS
IN THE DIABETIC DIET.
CARBOHYDRATES are made up of simple
sugars, complex carbohydrates, and fiber. Simple carbohydrates are commonly
known as sugars, sources of simple carbohydrates include table sugar, candies
and other sweets, sodas and bakery goods. The sugar in these foods is in a form
that is absorbed easily by the body, as opposed to the slower-digesting complex
carbohydrates.
Complex carbohydrates include all the
complex starches and fiber, such as those found in grains, cereals, breads and
starchy vegetables like potatoes, corn, peas and beans. Milk, fruit and
vegetables also contribute significant amounts of carbohydrate in the diet.
100% of the carbohydrates eaten are
broken down into glucose. Therefore carbohydrates elevate the blood sugar at a
faster rate than either protein or fat so only measured amounts should be
consumed. Complex carbohydrates contain many essential nutrients and are the
body's most effective source of energy.
PROTEIN provides amino acids for your body to
build, maintain, and repair cells and muscle tissue, heal wounds, and support
the immune system. It is very easy to get protein in our diet, in fact, most
Americans consume 2-3 times more protein than necessary. Excess protein does
not create muscle, as many hope, but is stored as fat. Excess protein can put
strain on the liver and kidneys. The best protein sources are milk, yogurt,
cheese, lean meat, poultry, fish, beans, eggs, and nuts. Breads, cereals and
vegetables contribute small amounts of protein in the diet. About 60% of the
protein eaten are broken down into glucose.
Nutritionists recommend about 45 to 50
grams of protein a day for most women and 50 to 60 grams a day for most men or
10 percent to 20 percent of daily calories. Children and infants, who are
growing rapidly, need more protein, as do pregnant women.
FAT, like carbohydrates, are used by the
body for fuel and are essential for the absorption of certain vitamins. Although
some fat in the diet is necessary, too much fat can lead to heart disease,
obesity and other health problems. Fats should comprise no more than 30 % of
daily calories, or even lower.
Fats in the diet may be of animal or
vegetable origin. Examples of fat in the diet are gravy, bacon, margarine,
butter, cream, salad dressings and nuts. Meats and some milk products also
contain significant amounts of fat. About 10% of the fat eaten is broken down
into glucose. The
remainder is stored as fat for future use
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