diet and diabetes

BY VINITA MEWADA BHOPAL

Why Change Eating Habits?• To prevent complications of To prevent complications of

diabetesdiabetes– by keeping control of:

•Blood glucose•Cholesterol •Blood pressure

Why Change Eating Habits?

• To improve your healthTo improve your health– by making healthy food choices– and being physically active

Carbohydrate and Diabetes• Include foods containing

carbohydrate from whole grains, fruits, vegetables and low-fat milk in your diet

Carbohydrate and Diabetes

• The amount of carbohydrate at a meal affects your blood glucose more

than the type– Sugar and starch have similar effects on

blood glucose

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Carbohydrate and Diabetes

• Consistency in carbohydrate intake is important from day to day– For people not taking diabetes

medication– For people taking a fixed dose of insulin

• Insulin should be adjusted based on amount of carbohydrate at meals– For people on varying doses at meal

times

Carbohydrate and Diabetes

• Several things affect how much your blood glucose increases after you eat:– amount of carbohydrate– type of sugar or starch– cooking and food processing – food form– other foods in the meal that slow

digestion

Carbohydrate and Diabetes

• Limited amounts of sugar or foods containing sugar can be used without affecting blood glucose– when substituted for other

carbohydrates at the meal

• Large amounts of sugar-containing foods are not recommended

Substituting Sweets

Usual diet: 45 grams Usual diet: 45 grams carbohydrate carbohydrate (or 3 Carbohydrates (or 3 Carbohydrates Choices)Choices)

1 slice bread1/3 cup rice1/2 cup fruit3 ounces chickenVegetable salad

Substitute ice-cream Substitute ice-cream for 15 grams of for 15 grams of carbohydrate carbohydrate (or 1 (or 1 Carbohydrate Choice)Carbohydrate Choice)

1/2 cup ice-cream1/3 cup rice 1/2 cup fruit3 ounces chickenVegetable salad

Carbohydrate and Diabetes

To observe effect of new food on To observe effect of new food on blood glucose:blood glucose:

• check blood glucose 2 hours after meal for several days

• substitute food containing sugar for other carbohydrate in meal

• check blood glucose 2 hours after meal and compare

Sweeteners and Diabetes

Sugar alcohols (polyols):sorbitol, mannitol, xylitol• Used as sweeteners and bulking agents• Safe to use• May cause diarrhea, especially in

childrenFructose:• Not recommended as a sweetener

Sweeteners and Diabetes Low calorie sweeteners:are safe for people with diabetes when consumed within recommended levels

Cans of soda(maximum/day)

Packets(maximum/day)

Acesulfame K 25 18Aspartame 15 86Saccharin 2 7.5Sucralose 4.5 60

Carbohydrate and Diabetes

Fiber:• Fiber is encouraged for everyone: 20-35 grams/day• Good sources of fiber:

– Whole grain cereals– Fruits– Vegetables– Beans and peas

Carbohydrate and Diabetes

Fiber:• Only large amounts (50 grams/day)

have shown improvement in blood glucose and cholesterol– Primarily soluble fiber (barley, oatmeal,

beans, apples, broccoli)– Side effects make this difficult for many

people

Protein and Diabetes

• Protein has very little effect on blood glucose

• Avoid large amounts of protein– may promote kidney disease

• Restrict protein only if you have early kidney disease

Protein and Diabetes

• Protein does not slow the absorption of carbohydrate– Adding protein to snacks does not

help prevent hypoglycemia – Fruit or crackers are good snack foods

Protein and Diabetes

• Safety of high protein, low carbohydrate weight loss diets are unknown– do not promote long-term weight loss– may increase LDL cholesterol

Dietary Fat and Diabetes

• Primary goal - Lower LDL Primary goal - Lower LDL cholesterol by:cholesterol by:–Eating less saturated fat and cholesterol

–Eating less trans fats

Dietary Fat and Diabetes

Foods That Contain Saturated Fats:• Meat and meat fats (bacon, lard)• Dairy products (whole milk, butter, cheese, cream, ice-cream)• Palm and coconut oil• Baked goods made from these fats

Dietary Fat and DiabetesFoods That Contain Trans Fats:• Formed when a liquid oil is made

more solid• Found in many types of stick

margarine, fast foods, and baked goods like cookies, crackers, snack foods, pastries and croissants

Dietary Fat and Diabetes

Foods That Contain Cholesterol:• All animal foods• Organ meats like liver • Egg yolks

Dietary Fat and Diabetes

• Choose monounsaturated fat in Choose monounsaturated fat in place of saturated:place of saturated:– olive oil, canola oil, peanut oil, olive oil, canola oil, peanut oil,

olives, avocados, nutsolives, avocados, nuts

Dietary Fat and Diabetes

• Eat less total fat• Low-fat diets can help:

– with weight loss– improve cholesterol and other fats

Dietary Fat and Diabetes

• Eat 2-3 servings fish per week– contain a type of fat protective

against heart disease– fatty fish especially beneficial

Weight Loss and Diabetes

A small amount of weight loss can:A small amount of weight loss can:• improve insulin resistance• lower blood glucose• improve blood cholesterol• reduce blood pressure

Weight Loss and Diabetes

Successful weight loss usually Successful weight loss usually requires:requires:

• a structured weight loss program• education• reduced fat and calories• regular physical activity• frequent follow-up

Vitamins and Minerals and Diabetes

• Vitamins and minerals from foods important

• High doses of vitamin and mineral supplements can be toxic

Vitamins and Minerals and Diabetes

People who may benefit from a People who may benefit from a multivitamin supplement:multivitamin supplement:

• persons deficient in a vitamin or mineral

• elderly• pregnant or nursing mothers• strict vegetarians• persons on calorie-restricted diet

Vitamins and Minerals and Diabetes

• No clear benefit from vitamin and mineral supplements except– calcium for prevention of bone disease– folate for prevention of birth defects

• Use of antioxidants is not advised– vitamin C, E, selenium, beta carotene– long-term safety and effectiveness

unknown

Alcohol and Diabetes

• If you choose to drink, limit to:– 1 drink/day for women– 2 drinks/day for men

• To reduce risk of hypoglycemia, consume alcohol with food

High Blood Pressure and Diabetes

You can lower blood pressure by:You can lower blood pressure by:• Eating less salt • Losing a modest amount of weight

Preventing Diabetes

Family members of people with Type Family members of people with Type 2 diabetes can prevent diabetes 2 diabetes can prevent diabetes by:by:

• Weight loss if overweight– using a structured weight loss program

• Regular physical activity

The Bottom Line

Your lifestyle affects your healthYour lifestyle affects your health

Eat healthy foods

Daily Physical

Activity