The diabetic diet

t.Essentuki



                            THE  DIABETIC  DIET.



Abstract on English by  Kuranov Alina Olegovna – a student of  Essentuki
medical college group № 261.



2002г. | |
                                  DIABETES.
    Diabetes Mellitus (when the term diabetes is used alone, it always
refers to diabetes mellitus) is a condition in which the body is unable to
use sugar properly. Sugar (carbohydrate) is the substance our body uses as
its major source of energy. Once this sugar is absorbed in the blood, it is
referred to as blood sugar or blood glucose.   Insulin (a hormone made in
the pancreas that regulates the blood sugar) is either missing or
deficient. As a result, the body cannot use energy nutrients
(carbohydrates, fat, protein) effectively and the cells of the body
'starve'. The sugar in the blood may rise to high levels instead of being
used for energy.  Blood sugar is excreted through urine, which makes extra
work for the kidneys causing frequent urination and excessive thirst.
    Treatment
    Diet, exercise and medication are important factors that must be
coordinated for diabetes to be kept in control. Medication is not used to
treat all cases of diabetes. Medication when used can either be in the form
of a pill (oral hypoglycemic agents) or insulin, which must be injected.
Diet, exercise and medication all affect treatment but unless the diet plan
is followed carefully no method of treatment will be effective. By eating
the right foods in the right amounts diet can actually help control the
basic problem of diabetes.
    According to Control Your Diabetes Education Program for Life, a
program sponsored by the National Diabetes Education Program, people who
take control of diabetes will, in the short run, feel better, have more
energy, and prevent the following signs and symptoms of high blood sugar:
thirst, fatigue, frequent urination, weight loss, blurred vision, and slow
healing of cuts and bruises.  In the long run, they decrease their chances
of developing eye disease, kidney disease, and nerve damage, and add years
to their lives.

                             THE DIABETIC DIET.
    Purpose: The diabetic diet is designed to achieve and maintain
desirable body weight and near normal blood glucose levels, reduce
hyperglycemia, glycosuria, and associated symptoms of diabetes in order to
minimize the complications frequently associated with this disease.
    Use: It is used for the person with either insulin-dependent diabetes
mellitus or non-insulin-dependent diabetes mellitus. The calorie-controlled
diet may be adapted for weight reduction and weight maintenance.
    The calorie level prescribed for the diabetic is based on whether the
person needs to lose or gain weight or simply maintain the present weight.
The calorie level specified is determined from the height, body build,
ideal weight and physical activity level.
    General Guidelines for the Diabetic Diet.
   1. Avoid concentrated sources of carbohydrates (sugars) such as table
      sugar, honey, jelly, jam, molasses, syrup, corn syrup, candy, regular
      soft drinks, pies, doughnuts, cookies, pastries, regular chewing gum,
      and sweet pickles.
   2. Avoid sweetened fruits, juices and fruit drinks. Choose fruit, which
      is fresh, frozen or packed in water or its own juice. Avoid fruits
      canned in heavy syrup.
   3. Avoid sweetened carbonated sodas, juices and water.
   4. Learn foods both high and low in sugar that are presented in the No
      Concentrated Sweet Food List
   5. Three meals at regular times should be consumed daily. Do not skip
      meals.
   6. A nutritionally adequate meal plan that limits the amount of saturated
      fat, cholesterol and salt in the diet. Fat intake should be 30% or
      less of caloric intake and less than 10% of daily caloric intake from
      saturated fat. Dietary cholesterol should be limited to 300 mg or less
      daily. 2,400 mg or less per day of sodium is recommended.
   7. Daily consumption of 20-35 g of dietary fiber from a wide variety of
      foods is recommended.
   8. Mild to moderate weight loss (10-20 pounds. has been shown to improve
      diabetes control, even if desirable body weight is not achieved.)
   9. Read the label to determine the sugar content of packaged foods. In
      addition to sugar, brown sugar and corn syrup, other names that are
      used on ingredient labels include: sucrose, glucose, dextrose,
      fructose, maltose, lactose, sorbitol, mannitol, honey, corn syrup,
      corn syrup solids, high fructose corn syrup, molasses, maple syrup.
  10. Monitoring of lipids, blood pressure and body weight is crucial.
  11. Glycated hemoglobin (HbA1C) and daily monitoring of blood glucose are
      standard tools to measure glucose control.
    . For individuals with Type 1 diabetes, self-monitoring 4 times daily or
      more is recommended to maintain near-normal blood glucose levels and
      gain control.  Testing 4 times a day, before each meal, and at
      bedtime, facilitates adjustments to insulin, meals, and exercise
      program. 
    . For individuals with Type 2 diabetes, self-monitoring 1-2 times daily
      or more is recommended to avoid hypoglycemia and hyperglycemia
      symptoms.   
    . Newly diagnosed individuals should test blood glucose 4 times a day,
      before each meal, and at bedtime, or more is recommended to maintain
      near-normal blood glucose levels and gain control.  Testing  
      facilitates adjustments to insulin, meals, and exercise program. 
    . After a stable pattern has been established in blood glucose levels,
      individuals should test before breakfast, 3-7 times each week.  Once
      or twice each month you should return to testing 4 times a day (before
      each meal, and at bedtime) to assure maintenance of a stable pattern.
                    NO CONCENTRATED SWEETS, LOW FAT DIET.
                             (LOW SUGAR-LOW FAT)
    Purpose: The no concentrated sweets, low fat diet is designed to limit
the total amount of fat and sugar in the diet to reduce serum lipid levels
and to achieve and maintain near normal blood glucose levels. This diet is
for people who find the exchange system too confusing or restricting to
follow.
    Use: It is used for the person with either non-insulin-dependent
diabetes mellitus or for people who need or want to cut down on their sugar
and fat intake. The calorie-controlled diet may be adapted for weight
reduction and weight maintenance for individuals that do not have diabetes.
It is also used for persons with elevated serum cholesterol levels or those
who are high-risk candidates for heart disease.
    General Guidelines.
    . Limit total fat intake to less than 30% of total daily calories.
    . Reduce saturated fat intake (red meat, cheese, whole milk, butter, ice
      cream, etc.)
    . Eat less trans fat (stick margarine, shortening, cakes, pies, French
      fries, snack chips.)
    . Eat less cholesterol (limit egg yolks to more than 4 per week and
      meat, fish, poultry to no more than 6 ounces a day)
    . Reduce sugar intake.
    . Eat more fruits, vegetables, beans, whole grain breads, and cereals.
    . Maintain a healthy weight.
    . Exercise at least 30 minutes on most days (brisk walking, aerobics,
      biking, etc.)
    . Experiment with recipes by gradually reducing the amount of sugar by
      1/4th then l/3rd then 1/2.
    . Use the 'sweet' spices—cinnamon cloves ginger or nutmeg—to bring out
      sweetness in baked goods.
    . Be careful when using special diet or dietetic foods such as dietetic
      cake, cookies, candy and ice cream. These foods contain some form of
      sweetener and, therefore, calories.
                      NO CONCENTRATED SWEET FOOD LIST.
    Purpose: The no concentrated sweets diet is designed to achieve and
maintain near normal blood glucose levels, and reduce associated symptoms
of diabetes in order to minimize the complications frequently associated
with this disease. This diet is for people who find the exchange system too
confusing or restricting to follow.
    Use: It is used for the person with either non-insulin-dependent
diabetes mellitus or for people who need or want to cut down on their sugar
intake. It is not intended for the person with diabetes taking insulin. The
calorie-controlled diet may be adapted for weight reduction and weight
maintenance.
    . Eat three meals at regular times. Do not skip meals.
    . Limit total fat intake to less than 30% of total daily calories.
    . Reduce saturated fat intake (red meat, cheese, whole milk, butter, ice
      cream, etc.)
    . Eat less trans fat (stick margarine, shortening, cakes, pies, french
      fries, snack chips.)
    . Eat less cholesterol (limit egg yolks to more than 4 per week and
      meat, fish, poultry to no more than 6 ounces a day.)
    . Reduce salt intake (canned and dried soups, fast food, frozen dinners,
      pizza, processed meats and cheese.)
    . Eat more fruits, vegetables, beans, whole grain breads, and cereals.
    . Maintain a healthy weight. Mild to moderate weight loss (10-20 lbs.
      has been shown to improve diabetes control, even if desirable body
      weight is not achieved.)
    . Recommend 20-35 grams/day of dietary fiber from a wide variety of
      foods.
    . Be careful when using special diet or dietetic foods such as dietetic
      cake, cookies, candy and ice cream. These foods contain some form of
      sweetener and, therefore, calories.
    . Monitor blood glucose, glycated hemoglobin, lipids, blood pressure and
      body weight.
    . Exercise at least 30 minutes on most days (brisk walking, aerobics,
      biking, etc). Regular exercise improves control of blood sugar and is
      an important part of any healthy lifestyle.
    . Experiment with recipes by gradually reducing the amount of sugar by
      1/4th then l/3rd then 1/2.
    . Use the 'sweet' spices—cinnamon cloves ginger or nutmeg—to bring out
      sweetness in baked goods.
    . Read the label to determine the sugar content of packaged foods. In
      addition to sugar, brown sugar and corn syrup, other names that are
      used on ingredient labels include: sucrose, glucose, dextrose,
      fructose, maltose, modified food starch, natural sweeteners, lactose,
      sorbitol, mannitol, honey, corn syrup, corn syrup solids, high
      fructose corn syrup, molasses, maple syrup.
               ABOUT THE MAJOR NUTRIENTS IN THE DIABETIC DIET.
    CARBOHYDRATES are made up of simple sugars, complex carbohydrates, and
fiber. Simple carbohydrates are commonly known as sugars, sources of simple
carbohydrates include table sugar, candies and other sweets, sodas and
bakery goods. The sugar in these foods is in a form that is absorbed easily
by the body, as opposed to the slower-digesting complex carbohydrates.
    Complex carbohydrates include all the complex starches and fiber, such
as those found in grains, cereals, breads and starchy vegetables like
potatoes, corn, peas and beans. Milk, fruit and vegetables also contribute
significant amounts of carbohydrate in the diet.
    100% of the carbohydrates eaten are broken down into glucose. Therefore
carbohydrates elevate the blood sugar at a faster rate than either protein
or fat so only measured amounts should be consumed. Complex carbohydrates
contain many essential nutrients and are the body's most effective source
of energy.
    PROTEIN provides amino acids for your body to build, maintain, and
repair cells and muscle tissue, heal wounds, and support the immune system.
It is very easy to get protein in our diet, in fact, most Americans consume
2-3 times more protein than necessary. Excess protein does not create
muscle, as many hope, but is stored as fat. Excess protein can put strain
on the liver and kidneys. The best protein sources are milk, yogurt,
cheese, lean meat, poultry, fish, beans, eggs, and nuts. Breads, cereals
and vegetables contribute small amounts of protein in the diet. About 60%
of the protein eaten are broken down into glucose.
    Nutritionists recommend about 45 to 50 grams of protein a day for most
women and 50 to 60 grams a day for most men or 10 percent to 20 percent of
daily calories. Children and infants, who are growing rapidly, need more
protein, as do pregnant women.
    FAT, like carbohydrates, are used by the body for fuel and are
essential for the absorption of certain vitamins. Although some fat in the
diet is necessary, too much fat can lead to heart disease, obesity and
other health problems. Fats should comprise no more than 30 % of daily
calories, or even lower.
    Fats in the diet may be of animal or vegetable origin. Examples of fat
in the diet are gravy, bacon, margarine, butter, cream, salad dressings and
nuts. Meats and some milk products also contain significant amounts of fat.
About 10% of the fat eaten is broken down into glucose. The remainder is
stored as fat for future use