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The Diabetic Diet


Diet is very important in diabetes. Below is a guideline with some general principles taken from endocrineweb.

Patients with Type 1 diabetes should have a diet that has approximately 35 calories per kg of body weight per day (or 16 calories per pound of body weight per day).

Patients with Type 2 diabetes generally are put on a 1500-1800 calorie diet per day to promote weight loss and then the maintenance of ideal body weight.

However, this may vary depending on the person's age, sex, activity level, current weight and body style. More obese individuals may need more calories initially until their weight is less. This is because it takes more calories to maintain a larger body and a 1600 calorie diet for them may promote weight loss that is too fast to be healthy. Men have more muscle mass in general and therefore may require more calories. Muscle burns more calories per hour than fat. (Thus also one reason to regularly exercise and build up muscle!) Also, people whose activity level is low will have less daily caloric needs.

Generally, carbohydrates should make up about 50 percent of the daily calories ( with the accepted range 40-60 percent). In general, lower carbohydrate intake is associated with lower sugar levels in the blood. However the benefits of this can be cancelled out by the problems associated with a higher fat diet taken in to compensate for the lower amount of carbohydrates.. This problem can be improved by substituting monounsaturated and polyunsaturated fats for saturated fats.

Most people with diabetes find that it is quite helpful to sit down with a dietician or nutritionist for a consult about what is the best diet for them and how many daily calories they need. It is quite important for diabetics to understand the principles of carbohydrate counting and how to help control blood sugar levels through proper diet. Below are some general principles about the diabetic diet.

1. Why count carbohydrates?

Carbohydrate makes your blood glucose level go up. If you know how much carbohydrate you've eaten, you have a good idea what your blood glucose level is going to do. The more carbohydrates you eat, the higher your blood sugar will go up.

2. Which foods contain carbohydrate?

Most of the carbohydrate we eat comes from three food groups: starch, fruit and milk. Vegetables also contain some carbohydrates, but foods in the meat and fat groups contain very little carbohydrate. Sugars may be added or may be naturally present (such as in fruits). The nutrient term for sugars can also be identified by looking for -ose at the end of a word ( i.e. glucose, fructose, sucrose, etc. are all sugars). Look for these on food labels to help identify foods that contain sugar.

Below are some examples of carbohydrate grams for some common food items:

To make things easy, many people begin carbohydrate counting by rounding the carbohydrate value of milk up to 15. In other words, one serving of starch, fruit or milk all contain 15 grams carbohydrate or one carbohydrate serving. Three servings of vegetable also contain 15 grams. Each meal and snack will contain a specific total number of grams of carbohydrate.

For example: Each gram of carbohydrate provides 4 calories. A diabetic on a 1600 calorie diet should get 50% of these calories from carbohydrate. This would be a total of 800 calories or 200 gms of carbohydrate (at 4 calories per gram) spread out over the day. At 15 grams per exchange, this would be about 13 exchanges of carbohydrate per day.

The amount of food you eat is closely related to blood sugar control. If you eat more food than is recommended on your meal plan, your blood sugar goes up. Although foods containing carbohydrate (carb) have the most impact on blood sugars, the calories from all foods will affect blood sugar. The only way you can tell if you are eating the right amount is to measure your foods carefully. Also, it is important to space your carbohydrates out throughout the day to avoid sugar "loading." Measuring your blood sugar regularly also provides important feedback on how high your sugar went based on what you ate and your level of activity.

Where do you get carbohydrate information?

The "Nutrition Facts" label on most foods is the best way to get carbohydrate information, but not all foods have labels. Your local bookstore and library have books that list the carbohydrate in restaurant foods, fast foods, convenience foods and fresh foods. You will still need to weigh or measure the foods to know the amount of grams of carbohydrates present.

How do you count carbohydrate?

Carbohydrates can be counted in number of grams or can be counted as exchanges. One carbohydrate exchange equals 15 grams of carbohydrate. A good reference for learning how to count calories in this manner will be on line here

soon including a calorie computer.

Free Foods:

These are foods that you can eat without counting. A free food or drink is one that contains less than 20 calories and 5 grams or less of carbohydrate per serving. If your serving or a food contains more than 5 grams of carbohydrate, you should count it in your meal plan.

Examples of free foods:

Bouillon or broth
Carbonated or mineral water
Club soda
Coffee or tea
Diet soft drinks
Drink mixes, sugar-free
Tonic water, sugar free
Sugar-free hard candy
Sugar-free Jell-O
Sugar-free gum
Jam or jelly, light or low-sugar, 2 tsp.
Sugar free syrup, 2 tsp.

You should spread out free foods throughout the day and not eat them in one sitting.

Fitting Sugar in Your Meal Plan

It is commonly thought that people with diabetes should avoid all forms of sugar. Most people with diabetes can eat foods containing sugar as long as the total amount of carbohydrate (carb) for that meal or snack is consistent. Many research studies have shown that meals which contain sugar do not make the blood sugar rise higher than meals of equal carbohydrate levels which do not contain sugar. However, if the sugar-containing meal contains more carb, the blood sugar levels will go up.

Does this mean I can eat cake and not worry about it?

No! A slice of white cake with chocolate icing ( 1/12 of a cake or 80 gram weight) will give you about 300 calories, 45 grams of carb and 12 grams of fat. That is three starch servings and over 2 fat servings. Before you have a slice of cake, ask yourself the following questions: Will that small piece of cake be satisfying or will I still be hungry? How it will fit into my meal plan? Do I have 300 calories to "spend" on this? Are there other choices I could make which would contribute less fat? A 1/12 slice of angel food cake has less than 1 gram of fat and only 30 carb. This may be a better choice.

Controlling all carbohydrates

It is important to realize that sugar is not the only carbohydrate that you have to "control". The body will convert all carbohydrates to glucose - so eating extra servings of rice, pasta, bread, fruit or other carbohydrate foods will make the blood sugar rise. Just because something doesn't have sugar in it doesn't mean you can eat as much as you want. Your meal plan is designed so that the carbohydrate content of your meals remains as consistent as possible from day to day.

A word of caution:

Although sugar does not cause the blood sugar to rise any higher than other carbohydrates, it should be eaten along with other healthy foods. If you choose to drink a 12 ounce can of a sugar-sweetened soft drink, that would use up about 45 grams carb - and you wouldn't have gotten any nutrition (protein, vitamins or minerals). What a waste of calories! High sugar foods are more concentrated in carb. Therefore the volume would be smaller than a low sugar food. High sugar foods might not be a good choice if they will just tempt you to eat more. If you would rather eat larger portions, select low sugar choices. Look at the differences in portion size you get for equal amounts of carbohydrate in these cereals!

In addition, many sugar-containing foods also contain a lot of fat. Foods such as cookies, pastries, ice cream and cakes should be avoided largely because of the fat content and because they don't contribute much nutritional value. If you do want a "sweet" - make a low-fat choice, such as low-fat frozen yogurt, gingersnaps, fig bars or graham crackers and substitute it for another carbohydrates on your meal plan.

1 comment:

Dr.Edwina.1st said...

The environment too plays a role in the causes of obesity. The family home is an important place to learn about proper nutrition and enough physical activity. Attitudes, Habits, and beliefs about food selection and how to spend family leisure time are critical factors to forming a healthy relationship with food. Children spend a lot of time in school, their food choices at school become important and it was influenced by the school eating environment.