Why be concerned about nutrition? Good nutrition is important for everyone for optimal health. Nutrition is essential for growth and development, health, and well being of all students and staff. Dietary factors are associated with 5 of the 10 leading causes of death including coronary heart disease, some types of cancer, stroke, type 2 diabetes, and osteoporosis. Nationwide, we are facing an epidemic of overweight and obesity, among children and adults. For people with diabetes, following a carefully designed meal plan is necessary to prevent both short and long-terms complications by regulating blood glucose levels. Students who follow meal plan guidelines will be less apt to experience hyperglycemia or hypoglycemia and should have better attendance and participation. From a long-term perspective, following meal plan guidelines means that these students can prevent or delay the onset of serious complications of diabetes, such as kidney disease, high blood pressure, heart disease, and blindness. Good nutrition will help children and teens grow and develop properly
Why should you eat any differently than anyone else just because you have diabetes? The answer is that the way you eat affects your risk of developing the complications of diabetes: eye disease, kidney disease, heart attacks and strokes, and nerve damage. You make changes in what you eat to help keep your blood glucose, cholesterol and other blood fats, and your blood pressure in the desirable range.
The second method used by many students, basic carbohydrate counting, takes the exchange system a step farther, allowing for more flexibility in food choices. Carbohydrate counting is based on the following from nutritional science: Calories in food come from three nutrient types: Carbohydrate Protein Fat Each nutrient type affects blood sugar differently. Carbohydrate, which includes both sugar and starch, has the biggest effect on blood sugar. Approximately 90-100% of carbohydrates are converted into glucose in 1-2 hours. Proteins and fats do not effect the blood glucose level too much, therefore they are not “counted”. Carbohydrates are found in several types of sources: Natural sugar: like fruit, milk Starches with fiber like raw vegetables, legumes, whole grains Starches without fiber like white flour products, refined grain products Concentrated sugar like cake, candy, regular soft drinks TOTAL carbohydrate matters more than the source (sugar or starch). Eating equal amounts of sugar or starch will raise blood sugar about the same amount. The TOTAL amount of carbohydrate eaten (whether sugar or starch) will determine how high blood sugar level will be after a meal or snack.
The most important thing to consider in how foods affect your blood glucose is the amount of carbohydrate you eat at one time. The type or source of carbohydrate is much less important.
New research shows that protein (found in meats, cheese, chicken, and legumes) has very little affect on blood glucose. Carbohydrates are still the primary nutrient that affects blood glucose. The usual protein intake in the US is adequate for people with diabetes (15-20% of calories) and should not be excessive. Serving sizes of meat, fish, poultry should be about 3 ounces (or total of 6ounces/day) High protein intakes may promote kidney disease in people with diabetes. If your doctor has diagnosed you with early kidney disease, you should see a registered dietitian to design a meal plan for you that contains less protein.
Saturated fat has the most effect on LDL cholesterol. People with diabetes appear to be more sensitive to dietary cholesterol than the general public. Trans fats are formed when liquid vegetable oils are processed to become solid.
Eating less saturated fats is the most effective way you can lower your LDL cholesterol.
Many foods that contain cholesterol also contain saturated fat. The foods highest in dietary cholesterol are egg yolks and organ meats like liver.
For most people, eating less total fat is best (less than 30% of your calories). Eating less fat makes it easier to lose weight and improves your cholesterol. Eating fat-free or reduced fat foods may be beneficial.
Obesity and overweight in type 2 diabetes increases insulin resistance. Therefore, even a small amount of weight loss (10lbs) is important in overweight people with type 2 diabetes to improve insulin resistance and lower blood glucose. Weight loss is also associated with improvement in cholesterol and blood pressure.
Get YOUR Game Plan against Diabetes
Get YOUR Game Plan against Diabetes management through Nutrition and Exercise
Diabetes- What is it?• Body is not producing or has lost sensitivity to insulin.• Insulin is a hormone that is needed to convert sugar, starches and other food into energy.• Thus reduced secretion of insulin causes elevation in blood glucose levels.
What causes Diabetes?• Obesity• Sedentary lifestyle• Aging• Genes• Hypertriglyceridemia• High Blood pressure
Nutrition: Why be concerned?• Nutrition Therapy is one of the Most Fundamental Component of the Diabetes Treatment Plan.• This therapy is aimed to change the eating pattern n life style. 4
Why Change Eating Habits?• To prevent complications of diabetes – by keeping control of: • Blood glucose • Cholesterol • Blood pressure• To improve your health – by making healthy food choices – being physically active – maintain Reasonable Body Weight
Basic Calorie Counting Body derives calories from: – carbohydrate – fat – protein Each nutrient type affects blood sugar differently. Carbohydrate and fat has the biggest effect on blood sugar. TOTAL carbohydrate matters more than the source (sugar or starch.)7
Carbohydrate and Diabetes• Carbohydrate is a major source of energy in our diet.• The total amount of carbohydrate at a meal affects your blood glucose more.• It is essential to monitor carbohydrate intake to maintain blood sugar levels.• Consistency in carbohydrate intake is important from day to day.
Sources of carbohydrate• Cereals and their flour (wheat, rice, bajra)• Pulses and legumes• Milk and its products• Fruit juices• Fruits and vegetables• Sweet fruits (mango, banana, grapes, chikoo, lichi)• Roots and tubers (potato, arbi, jamikand, beat root)• Sugar and its products• Jaggary• Alcohal
Selection of Carbohydrates in Diabetes EXCLUDE INCLUDE • Refined flour • Whole cereals and their flour • Washed pulses • Diabetic flour • Whole milk • Whole/husked pulses • Sweet fruits • Sprouts • Fruit juices • Green Leafy vegetables • Roots and tubers • Other Vegetables • Sugar • Raw salad and soup • Jaggary • Fruits with their peel • Sweets • Roasted black grams • Alcohal • Dhana methi and oats
Protein and Diabetes• Protein has very little effect on blood glucose• Restrict protein only if you have early kidney disease• Food items like milk, meat, fish, egg and pulses are source of protein.• Don’t go for non veg. more then twice a week Take 2 servings (2 katori) dal and 300 to 450 ml skim milk daily
Mixing of flour• flour of cereals when mixed with pulses flour, it is helpful in maintaining blood glucose levels.
Diabetic flour• 3 portions of wheat flour + 1 portion of soyabean flour/ basen/ black gram flour OR• Wheat flour + basen + oat flour + soya bean flour + black gram flour (in equal quantity) Take 8 to 9 servings of cereals daily (2 in breakfast, 2 to3 in lunch and dinner and 1 in evening snack)
Dietary Fat and Diabetes• Primary goal - Lower LDL cholesterol by – Eating less saturated fat and cholesterol – Eating less trans fats
Foods That Contain Saturated Fats• Dairy products (whole milk, ghee, dalda butter, cheese, cream, ice-cream)• Palm and coconut oil• Baked goods made from these fats like fast food, pastries etc.• Red meat
Foods That Contain Cholesterol• All animal foods• Organ meats like liver• Egg yolks
Selection of fat in DiabetesEXCLUDE INCLUDE• Whole milk • Combination of oils• Ghee • Use any of Refined oil and• mustard oil on alternative Dalda days• Butter• Cheese• Egg yolk• Organ meats
Dietary Fat and Diabetes• Eat less total fat• Low-fat diets can help: – with weight loss – improve cholesterol levelsServing should not be more than 2-3 tsp per day
Vitamins and Minerals • Fruits and vegetables provides vitamins and minerals • Fruit and vegetables also provide fiber • Avoid sweet fruits, roots n tubers. Consume 300 to 500 gms vegetable (veg./salad/soup) and 100 gm fruit (one small pc.) daily
REMEMBER 3FsFibers, Fruits and Vegetables & Fluid
Weight Loss and DiabetesA small amount of weight loss can:• improve insulin resistance• lower blood glucose• improve blood cholesterol• reduce blood pressure
Physical Activity• Exercise to promote or maintain weight loss – 45 to 60 minutes most days of the week is recommended – Include morning walk, aerobic exercise and yoga for the best results – Start slowly and increase the duration and intensity of exercise if you are new to exercise.
Food stuff to be avoided• All the fried foods (puri, pakoda, parantha, namkeens)• Sweets, sugar, honey, cake, chocolate, jam etc.• Dry fruits like dates, cashew nuts, ground nuts, resins• Cold drinks, juices and alcohol• Sweet fruits like mango, banana, grapes, chikko, lichi• Roots and tubers like potato, arbi and other jaminkands• Whole milk, cream, ghee, dalda, butter, egg yolk and organ meats
Points to remember• Eat at the same time everyday , at least within 1 hour of regular time.• Take small n frequent meals• Take 3 main meals (B/F, lunch and dinner) along with 3 minor ones (brunch, E/T with light snack and bed time milk)• Don’t go for fasting or feasting• Take salad on regular basis• Reduce your salt intake• Drink plenty of water• Exercise regularly