Diet Therapy in Diabetes

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• IN DIABETES 

When it comes to managing diabetes, diet plays a fairly important role in doing so. A person who is capable of managing diabetes prevents himself from most of the diabetes related complications effectively like diabetes foot, retinopathy (retina related disorders), etc. Knowledge about the foods which we eat goes a long way in managing diabetes. Most important category of foods to be managed is the foods which primarily provide carbohydrates. Any carbohydrate which gets digested and absorbed in the blood stream increases blood glucose, needs to be managed the most in diabetes.

Following are the essential points of considerations in planning a diabetic diet:

1. Determining energy requirements
2. Distribution of energy in terms of carbohydrates, fat and protein
3. Determining the type of carbohydrate, fibre and the type of preparation
4. Distribution of carbohydrate in the entire day
5. Stage of diabetes with the absence or presence of any complication

Determining Energy Requirements

• Appropriate intake for acceptable body weight
• Lower-calorie diets recommended for overweight people with diabetes
• Increased-energy diets recommended:  during pregnancy, lactation, recovery from severe and prolonged illness

Note: Energy requirements need to be based on weight and insulin intake.

Distribution of energy

Protein: 10-20% of total energy per day

• Higher amounts not encouraged for people with diabetes
• Animal protein often high in fat, especially saturated
• Vegetable protein sources should be encouraged – lower in fat

Carbohydrates:  should mainly come from whole grains: whole wheat and products, rice, alternate cereals like barley, oats, legumes, beans, pulses, allowed fruit and vegetables

• Even distribution of carbohydrate over the day is important for good control of blood sugar levels
• Foods with low glycemic index to be included in the diet (more details on glycemic index will be provided in subsequent articles)
• Intake of large quantities of carbohydrate foods in main meals and little (or none) between meals increases the risk of excessive fluctuations in blood sugar levels
• It is better to eat smaller amounts of food more frequently as this results in more even blood glucose levels

Fat:  Daily fat intake should not exceed 15% of total energy intake; the oils selected should be high in monounsaturated fats (Olive oil, Canola oil, Rice Bran oil, Til oil), moderate in n-3 and n-6 fatty acids (mustard oil, sunflower oil, safflower oil) and low in saturated fats and hydrogenated fat.

• Intake of cholesterol should be restricted
• People with diabetes should consume less than 250 mg of cholesterol a day
• Minimizing consumption of saturated fat (ghee, butter, coconut oil) will help decrease cholesterol

Fibre: Recommended amounts of fibre for people with diabetes is similar to those for the non-diabetics i.e. 20-35 g per day

Sodium: Daily sodium intake should not exceed 2400 mg

• Salt intake should be restricted in hypertension, heart disease, kidney failure
• Diet should be based on fresh foods as processed and preserved foods also contain fairly high levels of sodium (like ketchups, ready to eat foods, etc)

Sweeteners: Acceptable Daily Intake defined as the amount of a food additive that can be safely consumed on a daily basis over a person’s lifetime without any adverse effects which is 50 mg/kg/body weight/day

Please give it a thought: Type 2 diabetesaccounts for 90% of total diabetes cases worldwide. It is largely preventable and pretty manageable. Lifestyle changes such as prudent diet, weight loss and moderate daily exercise reduces the risk of developing type 2 diabetes by 28-36% (over 3 years) as indicated by following studies.