Diabetes and its Management

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  • 1. DIET IN DIABETES By, Archana.karthick Nutritionist (MSc in DFSM and PG in Diabetes education)
  • 2. What isdiabeticdiet?Diabetic diet is abalanced diet thatcontain a varietyof foods from bothmacronutrient andthe micronutrient
  • 3. Individual NutritionalAssessment Height and weight Desirable body weight Body mass Index Medical history Laboratory values Current level of diabetes control
  • 4. Body Mass IndexBMI = Weight(kg)/ Height (Mt2) Kg/m2Under weight <18.5Normal weight 18.5- 24.9Over weight >25.0Pre-obesity 25.0- 29.9Obese class 1 30.0-34.9Obese class 2 35.0-39.9Obese class 3 >40.0
  • 5. OBJECTIVES OF NUTRITIONMANAGEMENT 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
  • 6. MNT Goals for Diabetes1. To address individual nutrition needs, taking into consideration personal and cultural preferences and willingness to change2. To maintain the pleasure of eating by only limiting food choices when indicated by scientific evidence
  • 7. Nutrition recommendation forDiabetes 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!
  • 8. Dietary recommendations fordiabetes  55-60% of daily calorie should come from Carbohydrates  20% from your Fat  15- 20% from protein
  • 9. FOOD GUIDE PYRAMID
  • 10. 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
  • 11. 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
  • 12. Vegetables to be restricted Can be taken weekly once in a mixed form.
  • 13. 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
  • 14. Fruits to be avoided in Diabetes
  • 15. Choose more of high fiber food To help to maintain Food groups High fiber food Low fiber food blood glucose level and •Cereal group • Whole wheat flour, • Refined cereals cholesterol level whole wheat bread like rice, white bread, suji, maida and its product, noodles, macoroni To help to maintain the • Whole dals and • Washed/ dehusked dals •Pulses dals with husk healthy gut • Eggs, chicken, fish • none •Meat and poultry • Vegetables like Make you feel full after •Vegetables • All potato and yam meal so that they eat • Apples, cherries, pears, peaches • Fruit juices and squashes less. •Fruits guava etc Total fiber in food for • none • Fats, oil, ghee, men is 38g/day and for •Fats butter etc women 25g/day.
  • 16. 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 .
  • 17. 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.
  • 18. 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)
  • 19. Reduce animal orsaturated 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.
  • 20. Common source of differentfatsFats sourcesSaturated Red meats, butter, cheese, ghee, whole milk, cream, margarinePolyunsaturated Safflower oil, sunflower oil, corn oilMonounsaturated Olive oil, canola oil, rape seed oil, groundnut oil, sesame oil, mustard oilTrans fats Baked products, biscuits, cakes
  • 21. How to Read a NutritionLabel
  • 22. Cut down on sugaryfoods 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.
  • 23. Reduce salt intake  Cut down on added salt  Use alternative seasonings  Look out for reduced/low sodium foods, eg bread  Avoid salt substitutes
  • 24. What is your meal pattern?
  • 25. Early morning
  • 26. Breakfast1/4 th of total calorie
  • 27. Midmorning snacks
  • 28. Plate Method
  • 29. Lunch/ Dinner1/3rd of totalcalorie
  • 30. Evening snack
  • 31. Bed time
  • 32. ALTERNATIVESWEETENERS Nonnutritive Sweeteners (calorie free)1.Aspartame (200 X sweeterthan sucrose) - break down under highheat (not suitable for cooking). - contraindicated in people with phenlyketonuria.2. Saccharin (300 X sweeter) - give bitter aftertaste - least expensive - for sweetening softdrinks, beverages & foods
  • 33. 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 affectplasma lipids › large quantity (> 50 g)taken at once may causediarrhoea.
  • 34. 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
  • 35. AVOID Smoking Alcohol Sleeping after meals Stress and worry Sedentary lifestyle
  • 36. Eating Well,While Eating Right;Eating Right isHalf the Fight