Carbohydrates
Compared to fats and protein, carbohydrates
have the greatest impact on blood sugar. Both the amount and
type of carbohydrate affect blood glucose. Carbohydrate types
are either complex (as in starches) or simple (as in fruits
and sugars). One gram of carbohydrates equals four calories.
The current general recommendation is that
carbohydrates should provide between 40 - 65% of the daily
caloric intake. Carbohydrate intake should not fall below
130 grams/day. Most experts do not recommend low-carb diets
for diabetes management or weight control.
Vegetables, fruits, whole grains, and beans
are good sources of carbohydrates. Whole grain foods provide
more nutritional value than pasta, white bread, and white
potatoes. Brown rice is a better choice than white rice. Patients
should try to consume a minimum of 20 – 35 grams of
fiber daily (ideally 50 grams/day), from vegetables, fruits,
whole grain cereals, breads, nuts and seeds.
Sugar itself, either as sucrose or fructose,
adds calories, increases blood glucose levels quickly, and
provides no other nutrients. High levels of sugar consumption--whether
fructose or sucrose--have been associated with higher triglycerides
and lower levels of HDL cholesterol, the so-called good cholesterol.
The high consumption of sugar is most likely one of the factor
in the current obesity epidemic.
Soda, other sweetened beverages, and fruit
juice in fact may be singled out as major contributors to
childhood obesity.
People with diabetes should avoid products
listing more than 5 grams of sugar per serving, and some doctors
recommend limiting fruit intake. If specific amounts are not
listed, patients should avoid products with either sucrose
or fructose listed as one of the first four ingredients on
the label.
Protein
Protein intake in diabetes is complicated.
Protein recommendations vary among experts and depend on various
factors. These factors include whether a patient has type
1, type 2, or pre-diabetes. There are additional guidelines
for patients who show signs of kidney damage (nephropathy).
In general, diabetes dietary guidelines recommend
that proteins should provide 12 - 20% of total daily calories.
This daily amount poses no risk to the kidney in people who
do not have kidney disease. Protein is important for strong
muscles and bone.
Some experts recommend a higher proportion
of protein (20 – 30%) for patients with pre- or type
2 diabetes. They think that eating more protein helps people
feel more full and thus reduces overall calories. In addition,
protein consumption helps the body maintain lean body mass
during weight loss.
Because protein causes the kidneys to work
harder, patients with diabetic nephropathy need to limit their
intake of protein. A typical protein-restricted diet limits
protein intake to no more than 10% of total daily calories.
Patients with kidney damage also need to limit their intake
of phosphorus, a mineral found in dairy products, beans, and
nuts. Potassium restriction is often necessary as well/
One gram of protein contains 4 calories. Protein
is commonly recommended as part of a bedtime snack to maintain
normal blood sugar levels during the night, although studies
are mixed over whether it adds any protective benefits against
nighttime hypoglycemia. If it does, only small amounts (14
grams) may be needed to stabilize blood glucose levels.
Good sources of protein include fish, skinless
chicken or turkey, nonfat or low-fat dairy products, soy (tofu),
and legumes (kidney beans, black beans, chick peas, lentils).
Fish. Fish is probably the best source of
protein. Evidence suggests that eating moderate amounts of
fish (twice a week) may improve triglyceride and help lower
the risks for death from heart disease, dangerous heart rhythms,
blood pressure, a tendency for blood clots, and the risk for
stroke.
The most healthy fish are oily fish such as
salmon, mackerel, or sardines, which are high in omega-3 fatty
acids. Three capsules of fish oil (preferably as supplements
of DHA-EPA) is about equivalent to eating one serving of fish.
Some studies have reported a higher incidence
of heart attack in men who ate fish daily. Such findings may
be due to mercury toxicity, which has harmful effects on the
heart. High mercury content has been observed in swordfish
and shark and, to some extent, in tuna, trout, pike, tilapia
and bass.
Fish oil supplements may also have some adverse
effects on LDL levels and glucose control in type 2 diabetes.
More research is needed to further define the risk and benefits
of fish, but at this time most guidelines recommend eating
fish two or three times a week.
Soy. Soy is an excellent food. It is rich
in both soluble and insoluble fiber, omega-3 fatty acids,
and provides all essential proteins. Soy proteins have more
vitamins and minerals than meat or dairy proteins. They also
contain polyunsaturated fats, which are better than the saturated
fat found in meat. The best sources of soy protein are soy
products (tofu, soy milk, soybeans). Soy sauce is not a good
source. It contains only a trace amount of soy and is very
high in sodium.
For many years, soy was promoted as a food
that could help lower cholesterol and improve heart disease
risk factors. But an important 2006 American Heart Association
(AHA) review of studies found that soy protein and isoflavone
supplement pills do not really have any effects on cholesterol
or heart disease prevention. The AHA still encourages patients
to include soy foods as part of an overall heart healthy diet,
but does not recommend using isoflavone supplements.
Meat and Poultry. Lean cuts of meat are the
best choice for heart health and diabetes control. Saturated
fat in meat is the primary danger to the heart. The fat content
of meat varies depending on the type and cut. For patients
with diabetes, experts recommend choosing skinless chicken
or turkey over red meat. (Fish is an even better choice.)
A large, long-term 2006 study found that high heme iron intake
from red meat increases the risk of developing type 2 diabetes
in women.
Another 2006 study suggested that replacing
red meat with chicken improves kidney function and lipid levels
in patients with diabetic nephropathy.
Dairy Products. A 2002 study reported a lower
incidence of factors related to type 2 diabetes and heart
disease (insulin resistance, high blood pressure, obesity,
and unhealthy cholesterol) with a high intake of dairy products,
including those with a high-fat content. Some researchers
suggest the calcium in dairy products may be partially responsible
for these benefits. However, because many dairy products are
high in saturated fats and calories, doctors recommend that
patients choose low-fat and nonfat dairy items.
Fats and Oils
Some fat is essential for normal body function.
Fats can have good or bad effects on health, depending on
their chemistry. New research suggests that the type of fat
is more important than the total amount of fat when it comes
to reducing heart disease.
Current dietary guidelines for diabetes and
heart health recommend that total fat be 25 – 35% of
total daily calories. Monounsaturated fats (olive oil, canola
oil, peanut oil, nuts, avocados) and omega-3 polyunsaturated
fats (fish, flaxseed, walnuts) should be the first choice
for fats.
Omega-6 polyunsaturated fats (corn oil, safflower,
oil, sunflower oil, soybean oil) are the second choice. Limit
saturated fat to less than 7% of total daily calories. Limit
trans-fats (margarine, commercial baked goods, snack and fried
foods) to less than 1% of total calories.
All fats, good or bad, are high in calories
compared to proteins and carbohydrates. In order to calculate
daily fat intake, multiply the number of fat grams eaten by
nine (1 fat gram is equal to 9 calories, whether it's oil
or fat) and divide by the number of total daily calories desired.
One teaspoon of oil, butter, or other fats equals about 5
grams of fat. All fats, no matter what the source, add the
same calories. The American Heart Association recommends that
fats and oils have less than 2 grams of saturated fat per
tablespoon.
Try to replace saturated fats and trans fatty
acids with unsaturated fats from plant and fish oils. Omega-3
fatty acids, which are found in fish and plant sources, are
a good source of unsaturated fats. Generally, two servings
of fish per week provide a healthful amount of omega-3 fatty
acids.
Dietary Cholesterol
The story on cholesterol found in the diet
< is not entirely straightforward. The body produces cholesterol
naturally or obtains it through meals. Animal-based food products
contain cholesterol. High amounts occur in meat, dairy products,
egg yolks, and shellfish. (Plant foods, such as fruits, nuts,
grains, do not contain cholesterol.) The American Heart Association
recommends no more than 300 mg of dietary cholesterol per
day for the general population and no more than 200 mg daily
for those with high cholesterol.
Salt (Sodium)
Most experts recommend salt restriction in
people who have high blood pressure. Some people, however,
are much more sensitive to harmful effects from salt than
others.
Enjoy
quality food| Overcoming
barriers to changing eating behavior| How to
Follow a Diabetic Diet| Veggie
diet|
Advantages
and Disadvantages of diabetic food| The
Benefits of Eating Fibre|
Major
Food Components in a diabetic meal
|
