Important principles
Diabetes and Diet
The most important part of diabetes management is the diet. Talking to a Registered Dietitian or a Diabetic Nurse Educator is crucial to develop a diet plan.
Diet should be designed to help weight loss since 90% of Type 2 diabetics are overweight or obese. Hence calories should be restricted, and carbohydrates kept consistent as part of a diabetic meal.
Caloric intake must be distributed throughout the day and not in one or two big meals. Do not skip or delay meals. Behavior modification techniques for better eating habits must be implemented. Most Type1 diabetics and approximately 10% with Type 2 Diabetes are ideal weight and do not need to restrict caloric intake. Caloric intake should be adjusted for age, gender, activity level, and desired weight change. Reduce daily caloric intake by at least 500-calories to lose 1/2-lbs of fat per week. A balanced diet is essential for people with diabetes.
Protein intake should be about 20% of the daily caloric intake. The vegetable protein may be less dangerous to kidneys than animal protein. High protein, low-carbohydrate diets may aggravate renal (kidney) impairment in diabetic individuals. The long-term effects of such foods have not been evaluated. High protein diets are typically associated with high saturated fats; hence, LDL cholesterol’s adverse effects are a concern. People with diabetes with severe kidney disease should be encouraged to limit the protein intake to approximately 10% of daily calories. Studies with severe protein restriction are effective in reducing the progression of kidney disease in diabetics. Still, restricted protein may be associated with loss of muscle mass and strength. Fish is a good source of protein and Omega-3 fatty acids, which protect the heart. Other good protein sources are beans, peas, and lentils, and these have very low-fat and no cholesterol.
Fats are of two types, saturated and unsaturated. Fats derived from animals are generally saturated fat. Saturated fats are fats from meat, dairy products, coconut, palm oil, and eggs. Fats from plant sources usually are unsaturated fats. Unsaturated fats can be polyunsaturated or monounsaturated. Unsaturated fats are typically good for you. Saturated fats must be avoided as much as possible. Vegetable oil such as olive oil, canola oil, corn, and safflower oil are generally suitable for cooking since they are unsaturated fats.
Low-Fat diet
Cut down on saturated fats and cholesterol by
- Using fat-free or reduced-fat milk, low-fat yogurt, low-fat salad dressing, etc
- Avoid the yellow of eggs
- Avoid butter and use margarine instead.
- Eat less than 3-ounces of lean meat per day.
- Avoid frying; try either grilling or broiling.
- Chicken breast is better than the thigh. Avoid eating the skin.
Dietary fat should account for less than 30% of the total caloric intake. Saturated fats should be less than 10% of the total calories. Polyunsaturated fats must account for 10% of the total calories. Daily cholesterol consumption must be limited to less than 200-mg/day, especially if lipids are elevated.
Carbohydrate intake must account for less than 50% of the total calories. Carbohydrates must be typically multigrain starches, fruits, vegetables, and fiber. Fiber should account for 20 to 35-g per day.
Alcohol can be consumed in moderation; that is, one drink for an adult woman or two drinks for an adult male with food. This can be consumed daily if the patient so desires. One drink is considered to be 12-ounces of beer, or 5-ounces of wine, or 1.5-ounces of distilled spirits. Calories from alcohol intake should be added to the total caloric intake and the meal’s carbohydrate intake.
Calcium intake must be at least 1200 mg per day (in divided doses), especially in postmenopausal women, to prevent osteoporosis.
Salt intake should be limited since high salt consumption leads to high blood pressure. Foods high in sodium include canned food, smoked meat, pickles, frozen dinners, salty snacks such as chips and soda pop.
Sweeteners such as saccharin, aspartame, sucralose, and acesulfame are considered safe for consumption in diabetics.
People with diabetes who consume a balanced diet do not need any additional vitamins, minerals. Chromium supplementation is recommended only if a person has been on long-term parenteral nutrition. Chromium replacement is not recommended for most diabetics. Magnesium supplementation is only needed if there is proven magnesium deficiency. Potassium may be necessary if a person with diabetes is on diuretics (water pills). Routine vitamin C and beta-carotene have not been shown to offer any benefit in type 2 diabetics. Herbal remedies are not generally recommended.
If possible, keep the meal timing consistent. However, keeping the mealtime and carbohydrate consistent is quite difficult for most young active people. Variation in the amount of carbohydrates with meals may need suitable adjustments to insulin dosage (using an Insulin to Carb ratio) or diabetic pills. Please discuss this with your Personal Care Physician.
Many people with diabetes have elevated cholesterol and triglycerides and will need to be on a low-fat, low cholesterol diet. It is good to see a dietitian at least once a year to reinforce healthy eating habits and make changes to the meal plan. Eating disorders such as anorexia or bulimia are more common in diabetics, and this is likely to affect blood glucose control. High blood glucose is common with binge eating, and low blood sugars can occur in anorexia or during purging. Help for eating disorders is available in some specialized clinics. Your Personal Care Physician should help guide you there, or you should be able to find these clinics via the Internet. With the help of behavioral therapy and psychotherapy,
Meals and diet are individualized to meet the person’s needs and lifestyle. Before seeing the dietitian, make a very detailed list of all the foods, including snacks and drinks consumed for one to two weeks. This will help the dietitian fit some of your favorite foods into your meal plan. Dietitians will help you read food labels. Talk to your dietitian about the sick day meal plan. Also, discuss eating out tips.
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