RISK FACTORS FOR HT & Cigarette smoking Psychological factorsIHD ? High HDL cholesterol LP (a) High fat diet Age – 50-55 years High blood pressure Male gender Diabetes mellitus Family history Physical inactivity Obesity Low HDL cholesterol Post menopausal High Triglycerides status
CLUSTERING OF THREE MAJOR RISKFACTORS CAN CAUSE HEARTATTACK !!!
PRINCIPLES OF DIETARYMANAGEMENT ? Low calorie Low cholesterol High in unsaturated fats – mono (MUFA) and poly (PUFA) High in fibre High in minerals and vitamins Low in sodium especially salt Plenty of fluids High in omega-3 fat (n-3) Low fat particularly saturated fats (SAFA)
DIETARY GUIDELINES Maintain slightly lower than normal weight. Diet should be rich in fibre. Have 500 gm of fruits & vegetables each day. Use vegetable oil rich in MUFA & n-3. Include fish in diet. Have small quantities of walnuts and almonds. Use only skimmed milk. Have coffee and tea in moderation. Include Soya bean, fenugreek, garlic, onion and turmeric in diet.
DIETARY GUIDELINESCONTINUED… Use combinations of oils. Have plenty of water. Prefer whole wheat instead of rice. Have 6 meals a day 3 main meals 3 in between meals (snacks) Avoid feasting and fasting.
AVOID THESE … Sweets, chocolates, cakes, pastries, Ice creams Aerated drinks, alcohol and sweetened juices Sago (sabudana) Egg yolk Coconut Sugar, honey, jaggery, glucose Meat and pork Sodium rich foods (salt) Fried foods Heavy meal
HAVE PLENTY OF THESE… Beans Tomatoes(green) Strawberries Broccoli Buttermilk, low fat Cabbage Milk, 1% milk fat Cauliflower Soy milk Cucumber Yogurt, plain Brinjal Tea (no milk & sugar) Lettuce Lime water (no Mushrooms sugar) Radishes WaterTHESE ARE LOW CALORIE
ANIMAL FOODS HIGH IN SAFA ANDCHOLESTEROL Butter Ghee Cheese Egg yolk Chicken Beef Mutton Pork Organ meats – brain, heart, kidney, liver Prawns and shrimps AVOID THEM TO PROTECT YOUR
GARLICDOSE: 1 or ½ clove of garlic per day Reduces blood pressure. Reduces cholesterol levels.
FENUGREEK SEEDS (Methi)DOSE: 25 to 50 g per day High in fibre Reduces blood sugar Reduces cholesterol and TG Helps loose weight
GLYCEMIC INDEX (GI)Ability of the food item to raiseblood sugar is measured in GI. Does not depend on amount of food But on how fast it is absorbed within the body Diabetics must prefer low GI foods
VERY LOW GI FOODS Dals and pulsesMoong dal, tur dal, rajmah, moong,soybeans, channa etc. Low fat dairy productsMilk, curds, paneer and buttermilk.
INTERMEDIATE GI FOODS All vegetablesCabbage, brinjal, spinach, methi, guvar etc. Fruits with low sugar and highwaterWatermelon, pineapple, apple, orange etc. Whole cerealsWhole wheat, whole wheat noodles, bajra,jowar, ragi, wheat bran, rice bran, barleyetc.
HIGH GI FOODS Cornflakes Rice Maida Bread Root vegetables like potato, yam Sugar, honey, jaggery, sweets, chocolate Icecream
ALCOHOL….. MUST BEAVOIDED of empty calories which is It is a source stored in the body as fat. It reduces blood sugar and hence must be avoided especially when on insulin and oral medicines. It damages liver. It may react with certain medicines.
MYTHS … & FACTS … Eating sweets cause diabetes. Sweets only increase weight. Inability of thebody to form insulin cause diabetes. Sugar free products can be freely taken. Sugar free products can be high in fat andhence must be avoided.
MYTHS … & FACTS …Continue… Diabetics must avoid fruits. Only few fruits such as mango, grapes,chikoo, coconut, sitaphal and banana must beavoided. Rest all can be taken daily. Diabetes is curable. Diabetes cannot be cured but can bemanaged with diet, exercise and medication.
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