Lec 1 guide to recommending a meal plan

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  • Adopted from: Food Guide Pyramid: A guide to dairy food choices. Bulletin 259, Washington DC: US government printing
  • Adopted from: Food Guide Pyramid: A guide to dairy food choices. Bulletin 259, Washington DC: US government printing
  • Adopted from: Food Guide Pyramid: A guide to dairy food choices. Bulletin 259, Washington DC: US government printing
  • Adopted from: Food Guide Pyramid: A guide to dairy food choices. Bulletin 259, Washington DC: US government printing
  • Ref. MedicineNet.com
  • Ref. MedicineNet.com
  • Lec 1 guide to recommending a meal plan

    1. 1. Postgraduate Diploma in Diabetes Education (PDDE Nutrition therapy: Dietary advice in case of complications lec. 1 Guide to recommending a meal plan 1 Prepared by; Dr. Siham M.O. Gritly
    2. 2. Course outline • lec. 1 Guide to recommending a meal plan • lec. 2-Estimated Energy Requirements among Diabetic Patients lec. 3 nutrition therapy that apply to specific situations • lec. 4 Dietary advice in case of complications Dr. Siham M.O. Gritly 2
    3. 3. Nutrition therapy • Nutritional therapy should be individualized according to • preferences, • age, • needs, • religion, • culture, • lifestyle 3Dr. Siham M.O. Gritly
    4. 4. Goals of Nutritional therapy that apply to individuals with diabetes • Achieve and maintain Blood glucose levels in the normal range A lipid and lipoprotein profile that reduces the risk for cardiovascular disease Maintain blood pressure levels in the normal range Dr. Siham M.O. Gritly 4
    5. 5. • modifying nutrient intake and lifestyle To prevent, or slow, the rate of development of the chronic complications • To address individual nutrition needs, Dr. Siham M.O. Gritly 5
    6. 6. Diabetes food pyramid Dr. Siham M.O. Gritly 6 the Diabetes Food Pyramid divides food into six groups, which vary in size to show relative amounts of servings for each group the groups are based on protein content and carbohydrates instead of their food classification
    7. 7. A person with diabetes should eat more of the foods in the bottom of the pyramid (grains, beans, vegetables) than those on the top (fats and sweets). Dr. Siham M.O. Gritly 7
    8. 8. Food pyramid: Food guide Adopted from: Food Guide Pyramid: A guide to dairy food choices. Bulletin 259, Washington DC: US government printing Food group Number of servings What is a serving? Starches and breads 6-11 1 Slice bread ½ cup cooked rice, cereal ¼ cup dry cereal, ½ cup pasta 3 biscuits (eat whole-grain, fortified or enriched starches, bread, and cereals Dr. Siham M.O. Gritly 8
    9. 9. Food pyramid: Food guide Food group Number of servings What is a serving? Vegetables 3-5 ¼ cup vegetables cooked 1 cup vegetables raw Fruits 2-4 1 cup fruit ½ cup fruit juice (fresh frozen or canned without sugar 1 medium piece fresh fruit Dr. Siham M.O. Gritly 9
    10. 10. Food pyramid: Food guide Food group Number of servings What is a serving? Milk and milk products 2-3 1 cup skim / low fat milk ¾ cup plain or artificially sweetened yogurt. Meat and meat substitutes 2-3 57-85 g cooked lean meat fish or poultry 28.5 g meat is equivalent to: 1 egg 28.5 g cheese ¼ cup tuna, salmon or cottage cheese 1 tablespoon peanut-butterDr. Siham M.O. Gritly 10
    11. 11. Food pyramid: Food guide Food group Number of servings What is a serving? Fat use carefully 1 teaspoon margarine 1 teaspoon salad dressing 1 teaspoon oil or mayonnaise Dr. Siham M.O. Gritly 11
    12. 12. What is Serving Sizes • Serving sizes are defined by the USDA Food Guide Pyramid as a standard amount used to help give advice about how much food to eat. • It also helps us identify how many calories and nutrients are in a food Dr. Siham M.O. Gritly 12
    13. 13. serving size guidelines • Measure a serving size of dry cereal or hot cereal, pasta, or rice and pour it into a bowl or plate. The next time you eat that food, use the same bowl or plate and fill it to the same level. • For one serving of milk, measure 1 cup and pour it into a glass. See how high it fills the glass. Always drink milk out of that size glass. Dr. Siham M.O. Gritly 13
    14. 14. • Meat weighs more before it's cooked. For example, 4 ounces of raw meat will weigh about 3 ounces after cooking. For meat with a bone, like a beef chop or chicken leg, cook 5 ounces raw to get 3 ounces cooked. • One serving of meat or meat substitute is about the size and thickness of the palm of your hand or a deck of cards. • A small fist is equal to about 1/2 cup of fruit, vegetables, or starches like rice. • A small fist is equal to 1 small piece of fresh fruit. • A thumb is equal to about 1 ounce of meat or cheese. • The tip of a thumb is equal to about 1 teaspoon. Dr. Siham M.O. Gritly 14
    15. 15. • serving size guidelines of fruits and vegetables a day? • The National Cancer Institute defines a serving as: • One medium-sized fruit (ex. apple, orange, banana, pear) • 1/2 cup of raw, cooked, canned or frozen fruits or vegetables • 3/4 cup (6 oz.) of 100 percent fruit or vegetable juice • 1/2 cup cut-up fruit • 1/2 cup cooked or canned legumes (beans and peas) • 1 cup of raw, leafy vegetables (ex. lettuce, spinach) • 1/4 cup dried fruit (ex. raisins, apricots, mango) Dr. Siham M.O. Gritly 15
    16. 16. Serving size Dr. Siham M.O. Gritly 16
    17. 17. Vegetables and fruits serving Dr. Siham M.O. Gritly 17
    18. 18. Dr. Siham M.O. Gritly 18 Fruits package their sugars with fibers, vitamins, and minerals, making them a sweet and healthy snack.
    19. 19. Adapted from; Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth Edition. 2011, 2008 Wadsworth, Cengage Learning Dr. Siham M.O. Gritly 19 A half-cup of vegetables weighs about 100 grams; one pea weighs about ½ gram One cup is about 240 milliliters; a half-cup of liquid is about 120 milliliters HIGHER ENERGY DENSITY This 144-gram breakfast delivers 500 kcalories, for an energy density of 3.5 (500 kcal ÷ 144 g = 3.5 kcal/g). LOWER ENERGY DENSITY This 450-gram breakfast delivers 500 kcalories, for an energy density of 1.1 (500 kcal ÷ 450 g = 1.1 kcal/g).
    20. 20. Portion Control Dr. Siham M.O. Gritly 20 "Portion control" means: See how much you eat. Decide how much to eat Cut back on portion size
    21. 21. the difference between a portion and a serving size • A serving size is a recommended standard measurement of food. • A portion is how much food you eat, which could consist of multiple servings. • knowing the size of a serving can help determine healthful portions Dr. Siham M.O. Gritly 21
    22. 22. The plate method Dr. Siham M.O. Gritly 22 Is a way to plan meals without measuring (a qualitative diet approach). fill your plate (20 cm diameter) to match the amount of vegetables, starches, and meat, and then add a piece of fruit and/or a glass of milk. Divide your plate in quarters. Amount of vegetables eaten, protein is optional
    23. 23. Filling a dinner plate (20 cm diameter) excluding snacks will provide 1200 – 1500 calories per day depending on serving size Dr. Siham M.O. Gritly 23 The plate method is ideal for most non-insulin treated persons and some with type 2 diabetes on fixed insulin doses. Advantages: it is simple, adaptable, embodies principles of healthy eating, and promotes memory and understanding via visual messages. Disadvantages: not flexible, especially in insulin-treated persons with diabetes who need to vary carbohydrate intake/meals.
    24. 24. Guide to recommending a meal plan Profile of person with diabetes Number of servings from each food group Recommend about 1200 – 1600 calories a day if the person is: • A small woman who exercises • A small or medium woman who wants to lose weight • A medium woman who does not exercise Much To provide 1200 – 1600 calories 6 starches 3 vegetables 2 fruit • 2 milk and dairy • 2 meat or meat substitute • Up to 3 fats Dr. Siham M.O. Gritly 24
    25. 25. Guide to recommending a meal plan Profile of person with diabetes Number of servings from each food group Recommend about 1600 – 2000 calories a day if the person is: • A large woman who wants to lose weight • A small man at a healthy weight • A medium man who does not exercise much • A medium to large man who wants to lose weight To provide 1600 – 2000 calories: 8 starches 4 vegetables 3 fruit • 2 milk and dairy • 2 meat or meat substitute • Up to 4 fats Dr. Siham M.O. Gritly 25
    26. 26. Guide to recommending a meal plan Profile of person with diabetes Number of servings from each food group Recommend about 2000 – 2400 calories a day if the person is: • A medium to large man who does a lot of exercise or has a physically active job • A large man with a healthy weight • A large woman who does a lot of exercise To provide 2000 – 2400 calories 11 starches 4 vegetables 3 fruit • 2 milk and dairy • 2 meat or meat substitute • Up to 5 fats Dr. Siham M.O. Gritly 26
    27. 27. Weight units conversion Weight units Weight units 1 kilogram= 2.2 pounds 1kilogram= 1,000 grams 454 grams= 1 pound 1 pound= 16 ounces 1 ounce= 28.4 grams 3.5 ounces= 100 grams Dr. Siham M.O. Gritly 27
    28. 28. Insulin Dependent Diabetes Mellitus (IDDM) or Type I Diabetes (Juvenile onset diabetes) • In type 1 diabetes, the less common type, the pancreas fails to produce insulin. • commonly occurs in childhood and adolescence, but it can occur at any age, even late in life Dr. Siham M.O. Gritly 28
    29. 29. Nutrition therapy for type 1 diabetes • Nutrition therapy for type 1 diabetes focuses on; • maintaining optimal nutrition status, basic nutrient requirements • controlling blood glucose, • achieving a desirable blood lipid profile, • controlling blood pressure, • and preventing and treating the complications of diabetes Dr. Siham M.O. Gritly 29
    30. 30. • Nutrition therapy for type 1 diabetes • the diet must provide a fairly steady carbohydrate intake from day to day and at each meal and snack to help minimize fluctuations in blood glucose Dr. Siham M.O. Gritly 30
    31. 31. • To avoid hypoglycemia, the person must monitor blood glucose before and after activity • Carbohydrate-rich foods should be readily available during and after activity Dr. Siham M.O. Gritly 31
    32. 32. Non-Insulin Dependent Diabetes Mellitus (NIDDM) or Type II Diabetes. • In type 2 diabetes, the more common type of diabetes, the cells fail to respond to insulin. This condition tends to occur as a consequence of obesity. • It is important to eat the suggested amount of carbohydrate at each meal, along with some protein and fat. Dr. Siham M.O. Gritly 32
    33. 33. • Complex carbohydrates are considered healthier mostly because they are digested by the body slowly, providing a steady source of energy • Carbohydrates are mainly found in the following food groups: • Fruit • Milk and yogurt • Bread, cereal, rice, pasta • Starchy vegetables like potatoes • They also contain valuable amounts of fiber Dr. Siham M.O. Gritly 33
    34. 34. Recommendations for Type 2 Diabetes In overweight people with type 2 • Recommendations for Type 2 Diabetes In overweight people • moderate weight loss (10 to 20 pounds) can help improve insulin resistance, blood lipids, and blood pressure. • Together with diet, a regular routine of moderate physical activity not only supports weight loss, but also improves blood glucose control, blood lipid profiles, and blood pressure. Dr. Siham M.O. Gritly 34
    35. 35. references • American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care. 2011 Jan;34 Suppl 1:S11-61 • American Diabetes Association. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2008;31:S61-S78. • American Diabetes Association. Carbohydrate counting. Available at http://www.diabetes.org/food- and-fitness/food/planning-meals/carb- counting. Accessed December 8, 2012. Dr. Siham M.O. Gritly 35
    36. 36. • American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care. 2011 Jan;34 Suppl 1:S11-61 • Sareen Gropper, Jack Smith and James Groff, Advanced Nutrition and Human Metabolism, fifth ed. WADSWORTH • Melvin H Williams 2010; Nutrition for Health, Fitness and Sport. 9th ed, McGraw Hill • • Heymsfield, SB.; Baumgartner N.; Richard and Sheau-Fang P. 1999. Modern Nutrition in Health and Disease; Shils E Maurice, Olson A. James, Shike Moshe and Ross A. Catharine eds. 9th edition • Guyton, C. Arthur. 1985. Textbook of Medical Physiology. 6th edition, W.B. Company • FAO/WHO/UNU expert consultation (WHO, 1985) report • Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth Edition. 2011, 2008 Wadsworth, Cengage Learning Dr. Siham M.O. Gritly 36

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