Diet Simplified for Diabetes Mellitus

ASIA – Global epicenter of diabetes mellitus, especially in India it is an emerging threat.

Causes for Explosive Increase in Diabetes Prevalence in India

  • Rapid economic development and urbanisation
  • Change in diet and lifestyle

Among all ethnic groups, Asian Indians have the highest incidence rates for pre-diabetes and diabetes.

diet-simplified-for-diabetes-mellitus

Role Of Medical Nutrition Therapy In Diabetes Mellitus Prevention

Medical nutrition therapy plays an important role in all three levels of diabetes-related prevention.

  • PRIMARY PREVENTION TO PREVENT DM
    • MNT is used in those with obesity and pre-diabetes.
  • SECONDARY PREVENTION TO PREVENT COMPLICATIONS
    • MNT is used for metabolic control of DM to prevent complications.
  • TERTIARY PREVENTION TO PREVENT MORBIDITY AND MORTALITY
    • MNT is used for metabolic control of DM to prevent complications.
    • MNT is used to manage complications of DM.

Goals of MNT in person with DM

Medical nutrition therapy becomes an integral part of the treatment plan.

  • To achieve and maintain glycemic control, blood pressure and lipid goals
  • To achieve and maintain body weight goals
  • To prevent or delay chronic complications by modifying the nutrient intake
  • To address individual nutritional needs based on cultural and personal preferences.
  • To maintain the pleasure of eating by limiting food choices only when indicated.

PLATE, PYRAMID OR PERSEVERANCE…DIET IS A JOURNEY, NOT A ONE-TIME MEAL PLAN.

Principles of Diabetic Plate

  • Choose complex carbohydrates instead of simple carbohydrates – 55 % of total calorie intake. For e.g., whole grains, the more ugly dusty grains, the healthier.
  • Proteins – The most versatile macronutrients, take adequately – 0.8 – 1 g/kg ideal body weight. 50% from protein of high biological value like lean meats, poultry, eggs, milk and milk products. Pulses and legumes – dhal, grams, dry peas, soybeans, rajma, etc.
  • Nuts and Seeds – Peanuts, almonds, cashews, etc.
  • Fats and Oil – Choose oils rich in MUFA – e.g., rice bran, sesame, gingelly oil, sunflower oil, etc. Amount – in moderation, 3-4 tbs/day
  • Eat omega-3 rich foods for a healthy heart
  • Reduce your dietary cholesterol intake
  • Go in for lean meats, poultry and fish
  • Reduce saturated fats in your diet
  • Increase your dietary fiber
  • Include more of soluble fiber
  • Eat a rainbow color of fruits and vegetables
  • Reduce your salt intake
  • Moderation is key

Metabolic Health Components

Inflammatory bio-markers. Insulin resistance. Obesity.

Dietary Determinants

Complex CHO, dietary fiber
HBV Proteins – high biological value proteins
Dietary Fats: MUFA
Micronutrients
Phytochemicals
Low age-advanced glycation end products

DIABETIC DIET SAMPLE MENU PLAN

Calories: 1800 kcal/50 g protein

diet-chart

Oil allowance per day 4 tsp (20 gms), 1CUP – 200 ML.

  • MINIMISE SALT INTAKE.- 5gms / day can be added during cooking.be cautious – don’t go for processed food and preserved food which has got hidden salt.
  • vegetaerians can include paneer,nuts,legumes to their plate frequently.

DIET CHART FOR DIABETES

FOODS TO BE AVOIDED

  • Sugar, Jaggery, Glucose, Honey, Syrup, Candy, Jam, Payasam, Puddings
  • Cream, Ice Cream, Chocolate, Cocoa, Sauce, Puffs, Sweets and Bakery Products
  • Mango, Jackfruit, Banana, Sapota, Seethapal, Grapes.
  • Refined flour (Maida), Arrow Root Powder, Corn flour, Custard Powder, Jelly Powder
  • Fried foods (Vada, Pappad, Bonda) and gravies Vanaspathi, Palm Oil
  • Potato, Yam, Sweet Potato, Colocasia
  • Cashews
  • Fast food items
  • All Carbonated Beverages, Proprietary Drinks and Alcoholic Drinks

FOODS TO BE RESTRICTED

  • Tea or Coffee can be taken 200 ml per day
  • Sunflower Oil, or Gingelly Oil or Ricebran Oil can be taken 3 – 4 teaspoon daily
  • Ghee allowance (5 gms daily)

FOODS TO BE INCLUDED

  • Carrot, Beans, Beetroot, Peas can be taken twice in a week
  • Guava, apple, papaya, watermelon, pear pine apple. Can be taken 75 gms or 1 or 2 slices or 1 small fruit daily
  • Celery, Cucumbers, Cabbage, Cauliflower, Tomatoes, Spinach, Turnip, Mushrooms, String Beans, Onion, Garlic, Bitter Gourd, Citrus Fruits, Green Leafy Vegetables
  • Drumstick leaves powder (20GMS-WEEKLY THRICE) is a must. It’s a natural vitamin shot.good pre- biotic.
  • Coconut preparation in porriyal, kootu and etc can be incorporated weekly thrice.

Note

  • Include Vegetables, Fruits (recommended) and Whole Grains.
  • Avoid fasting and feasting.
  • Small and frequent meals should be followed. (3 meals & 3 snacks)
  • Nuts like Almond, Brazilnut and Walnut (any one item 10 Nos nuts taken daily)
  • Drink Plenty of Water.
  • FENUGREEK SEEDS POWDER, PUMPKIN SEEDS POWDER CAN BE TAKEN (10 GMS) WEEKLY THRICE.
  • Red rice flakes and almonds with walnut mixed can also be 150 gms +10 nos nuts each.
  • BOILED PEANUTS CAN ALSO BE REPLACED WITH NUTS.
  • EXERCISE ROUTINES DAILY – 45 MIN.
yamini-prakash

Yamini Prakash, MScRD
Chief Dietitian
Kauvery Hospital, Chennai