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Maintaining of Weight diet Management

How to Maintain Weight

Weight management is an integral part of diabetes management . An important part of the assessment is determining the person’s motivation to change and current lifestyle.

Daily Calorie Intake

The daily calorie intake depends on variety of factors

  • Body size
  • Age
  • Height
  • Weight
  • Activity level
  • Gender
  • Other conditions, such a pregnancy

How to count Cereals

  • Portioning is variable, e.g., chapatti in Gujarat is 15 gram flour, in Maharashtra it is 30-60 gram flour.
  • Standardized portion to be given or displayed, e.g., chapatti atta ball is lemon sized ( 30 gram), chickoo sized (45 gram) or orange sized (60 gram). This helps estimate calories better.
  • Rice portioning can be shown with the help f palm instead of katoris.
  • Bread slices are variable and standardize them for patient; the same applies for poha, rava,sabudana, jowar, bajra, ragi etc.

 How to count Pulses

  • Pulses are usually over estimated in recalls
  • Dal- 1katori (120 ml) = 100 kcal
  • The khati dal is usually 15 – 20 gram of pulse
  • Dal is consumed less in Western India and in South India it is diluted. Sambhar and rasam in South India have very less dal in them. Dals up in North India are usually much thicker.

How to Estimating Fat Intake

  • Other than oil, leading questions for ghee, butter, cream, cheese and paneer can help estimate fat content better.
  • In regions other than north, use of coconut (both dry and fresh), sesame, groundnuts and other dry fruits should be enquired.
  • Health food consumption like nuts, chawanprash, flaxseeds, etc. Should also be considered in total fat estimation.
  • Regular consumption of pickle, papad, chutneys, biscuits, baked items, etc., which account for definite fat consumption on daily basis should be vigilantly asked for.

How to Estimating Calories from Recipe

  • All along the Western India, most of the recipes will have sugar / jiggery in them unless specified.
  • Most of recipes down south will use coconut unless specified.
  • Most of recipes up north will have more oil / ghee in them

Therefore, while estimating calories from a recipe, the community of the patient should be considered and leading questions should be prepared / asked. For eg., chhole is made in south with use of coconut, in Maharashtra a little coconut and sugar, in Gujarat no coconut but a little more sugar than in Maharashtra and up north in ghee.

What is Empty calories

Empty calories are the calories from solid fats and added sugars in foods and beverages. They add to total calories, but provide no vitamins or minerals. Junk food calories account for empty calories. It can include any food which gives too many calories from fats and sugar, for eg., too many cups of tea and coffee, cold drinks, juices, foods like chivda, chakli, mathri, samosa, ect.

One should check for oversizing of junk snacks like jumbo vada pav, burgers, large fries, etc. It is important to check for non-labelled “health snack” e.g./ diet wafers, diet chakli, etc. Perception and hence portioning of a snack is very important e.g., khakara.

Caloric Requirement- Gestational diabetes mellitus

Calorie level guideline

  • 30 kcal / kg ideal body weight ( pre-pregnant weight)
  • 36 kcal / kg ideal body weight in the second trimester
  • 38 kcal / kg ideal body weight in the third trimester
  • Moderate calories restrictions (33%), approximately 1800 calories, has been shown to reduce macrosomia without neonatal mordibity or maternal ketonaemia.

Normal Caloric Requirement

Group

Particulars

Body Wt.Kg

Net Energy Kcal/d

Man

Sedentary Work
Moderate Work
Heavy Work

60

2320
2730
3490

Woman

Sedentary Work
Moderate Work
Heavy Work
Pregnant Woman
Lactation
0-6  months
6-12 months

55

1900
2230
2850
+350
+600
+600
+520

Children

1-3 years
4-6 years
7-9 years

12.9
18
25.1

1060
1350
1690