health+diabetes

1. DIET IN DIABETES
By,
Archana.karthick
Nutritionist (MSc in DFSM and
PG in Diabetes education)

2. What is
diabetic
diet?
Diabetic diet is a
balanced diet that
contain a variety
of foods from both
macronutrient and
the micronutrient

3. Individual Nutritional
Assessment
 Height and weight
 Desirable body weight
 Body mass Index
 Medical history
 Laboratory values
 Current level of diabetes control

4. Body Mass Index
BMI = Weight(kg)/ Height (Mt2)
Kg/m2
Under weight <18.5
Normal weight 18.5- 24.9
Over weight >25.0
Pre-obesity 25.0- 29.9
Obese class 1 30.0-34.9
Obese class 2 35.0-39.9
Obese class 3 >40.0

5. OBJECTIVES OF NUTRITION
MANAGEMENT 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 Diabetes
1. To address individual nutrition needs,
taking into consideration personal
and cultural preferences and
willingness to change
2. To maintain the pleasure of eating by
only limiting food choices when
indicated by scientific evidence

7. Nutrition recommendation for
Diabetes 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 for
diabetes
 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
blood glucose level and
cholesterol level
 To help to maintain the
healthy gut
 Make you feel full after
meal so that they eat
less.
 Total fiber in food for
men is 38g/day and for
women 25g/day.
Food groups
•Cereal group
•Pulses
•Meat and poultry
•Vegetables
•Fruits
•Fats
High fiber food
•Whole wheat flour,
whole wheat bread
•Whole dals and
dals with husk
•none
•All
•Apples, cherries,
pears, peaches
guava etc
•none
Low fiber food
•Refined cereals
like rice, white
bread, suji, maida
and its product,
noodles, macoroni
•Washed/ dehusked
dals
•Eggs, chicken, fish
•Vegetables like
potato and yam
•Fruit juices and
squashes
•Fats, oil, ghee,
butter etc

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 or
saturated 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 different
fats
Fats sources
Saturated Red meats, butter, cheese, ghee, whole milk,
cream, margarine
Polyunsaturated Safflower oil, sunflower oil, corn oil
Monounsaturated Olive oil, canola oil, rape seed oil, groundnut oil,
sesame oil, mustard oil
Trans fats Baked products, biscuits, cakes

21. How to Read a Nutrition
Label

22. Cut down on sugary
foods
 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. Breakfast
1/4 th of total calorie

27. Midmorning snacks

28. Plate Method

29. 1/3rd of total
calorie
Lunch/ Dinner

30. Evening snack

31. Bed time

32. ALTERNATIVE
SWEETENERS
 Nonnutritive Sweeteners
(calorie free)
1.Aspartame (200 X sweeter
than sucrose)
- break down under high
heat
(not suitable for cooking).
- contraindicated in people
with phenlyketonuria.
2. Saccharin (300 X sweeter)
- give bitter aftertaste
- least expensive
- for sweetening soft
drinks, beverages & foods

33. NUTRITIVE SWEETENER
Fructose (4 kcal / g)
 Slightly sweeter than
sucrose
 Produce lower
postprandial glucose
response
 Found in fruits, honey &
vegetables
 Not recommended as
sweetening agent
› may adversely affect
plasma lipids
› large quantity (> 50 g)
taken at once may cause
diarrhoea.

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 is
Half the Fight