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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.
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.)
·
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.
·
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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