Dietary Recommendations for Diabetes Person
Most food contain a combination of essential nutrients that can broadly be classified into two types.
Macro-nutrients are known as such because the body needs more of these. This category includes carbohydrates, proteins and fats
- These are the main sources of energy for the body. 1 gram of carbohydrates provides 4 calories of energy.
- At least 45-60% of total energy should be obtained from carbohydrates; however, each person should be individually assessed
- It is important to note that not all carbohydrates are broken down at the same rate due to the glycaemic index of the carbohydrate
It is recommended that carbohydrates should come from whole grains, pulses, fruits, vegetables and milk rather than from sucrose or other refined sugars. Carbohydrates are found almost exclusively in plant foods, such as cereals, pulses, fruits and vegetables. Milk and milk products, though rich in protein, also contain significant amounts of carbohydrates.
Eating patterns and Macro-Nutrients Distribution (ADA 2016 Recommendations)
- As there is no single ideal dietary distribution of calories among carbohydrates, fats and proteins for people with diabetes, macro nutrient distribution should be individualized while keeping total calorie and metabolic goals in mind.
- Carbohydrate intake from whole grains, vegetables, fruits, legumes, and dairy products, with an emphasis on foods higher in fiber and lower in glycemic load, should be advised over other sources, especially those containing sugars.
- People with diabetes and those at risk should avoid sugar sweetened beverages in order to control weight and reduce their risk for CVD (Cardio-Vascular Disease) and fatty liver and should minimize the consumption of sucrose – containing food that have the capacity to displace healthier, more nutrient dense food choices.
1 gram protein gives 4 calorie of energy. They have many different functions in the body such as energy production, growth and repair of tissues, production of hormones, antibodies, enzymes etc. Proteins should contribute 10-20%of total requirement of the body. Proteins come from both animal and plant sources.
Egg, milk meats, pork, fish, poultry, cheese, yogurt (curd), cottage, cheese (Paneer)
Beans, legumes, tofu, nuts, seeds, vegetable protein sources are preferred, as they are vegetarians or vegans.
Proteins (ADA 2016 recommendations)
- In individuals with type 2 diabetes, ingested protein appears to increase insulin response without increasing plasma glucose concentrations.
- Therefore, carbohydrate sources high in protein should not be used to treat to prevent hypoglycaemia
1 gram of fat gives 9 calories of energy. It is an essential nutrient and plays several vital roles such as providing oil for the skin, hormone production, and insulation of organs, carriage of fat-soluble vitamins and repair of damaged tissues. Total dietary fat should provide 20-35% of daily caloric intake. However, important distinctions are made between the different types of fat in the diet.
- Polyunsaturated fatty acids (PUFA) should represent up to 10% of total fat intake
- Monounsaturated fatty acids (MUFA) are generally preferred, as they may enhance cardiovascular health
- Saturated fats should be minimized
- Trans fats and hydrogenated fats should be avoided.
An excessive dietary intake of saturated fats can cause dyslipidaemia, especially raising the level of low-density lipoprotein cholesterol (LDL-C). Oily fish are known to be rates from rich in omega-3 fatty acids. Omega-3 fatty acids are good for the heart and help to lower mortality rates from heart attack. Food rich in omega-3 fatty acids include soya, fenugreek, mustard, walnuts, flax-seeds etc.
Fat (ADA 2016 recommendations)
- Whereas data on the ideal total dietary fat content for people with diabetes are inconclusive, an eating plan emphasizing elements of a Mediterranean-style diet rich in monounsaturated fats may improve glucose metabolism and lower CVD risk and can be an effective alternative to a diet low in total fat but relatively high in carbohydrates.
- Eating foods rich in long-chain omega-3 fatty acids, such as fatty fish (EPA and DHA) and nuts and seeds (ALA), is recommended to prevent or treat CVD; however, evidence does not support a beneficial role for omega-3 dietary supplements.
There are two types of fiber – soluble and insoluble. Fiber intake helps to slow down the absorption of glucose, reduces the absorption of dietary fats, retains water to soften the stools and reduces the risk of diseases such as colon cancer and heart diseases. Sources of soluble fiber include legumes (beans), oat bran, barley, apple, citrus fruits and potatoes.
Insoluble fiber provides bulk to food and therefore high fiber food generally have fewer calories. Sources of insoluble fiber include wheat bran, whole grains, seeds, fruits and vegetables.
A diet containing both soluble and insoluble fiber from a wide variety of food sources is recommended for people with diabetes. It is important for people with high fiber diets to drink adequate amounts of water.
Micro-Nutrients see on next page…..