Diet

Diabetic Diet

Obesity and diabetes mellitus (especially type 2 diabetes) both have their roots in an unhealthy calorie rich diet. Diet planning and a healthy balanced diet thus form an important part of therapy for both these conditions.

An initial dietary strategy in diabetics is to improve food choices to meet the recommendations of the 2010 Dietary Guidelines for Americans and MyPlate the released by the U.S. Department of Agriculture. The basic premise is to reduce fats especially saturated fat and trans fat, cholesterol, as well as sodium in diet. In addition to diet physical activity has to be increased.

The target of mild to moderate weight loss of 5-10% of body weight can improve diabetes control in these patients. Patients with diabetes are thus advised to moderately decrease calorie intake by 250 to 500 kcal/day and increase energy expenditure by regular exercise to improve diabetes.

Diet composition recommended for diabetes patients

  • Proteins

It is recommended that protein intake accounts for 15 to 20% of total daily calories consumed in all populations. The same recommendations go for patients with diabetes. If the kidney function is normal the usual protein intake should not be modified. However, protein intake above 20% of total daily calories could accelerate the development of kidney disease

  • Fat

Diabetes as well as obesity is associated with heart disease and stroke. Thus reduction of fat in the diet is very important. A person with diabetes needs to choose foods with low saturated fats and take foods containing polyunsaturated fats occasionally and foods high in monounsaturated fats more often.

Saturated fats are found in meats, lard, high-fat dairy products, coconut, palm oil etc. These oils are usually solid at room temperatures and are responsible for high low density lipoprotein (LDL) and cholesterol levels.

Trans fats in addition also lower HDL the good cholesterol. Foods containing trans fats include margarine, peanut butter, shortening, cookies etc.

Polyunsaturated fats are healthy for the heart. They can lower cholesterol levels when eaten in moderation. Polyunsaturated fats are found in vegetable oils such as corn, soybean, safflower oil, and fatty fish such as salmon, mackerel, herring, and trout.

Monounsaturated fats are also good for the heart because they lower LDL cholesterol. These foods include canola oil, walnut oil, olive oil, avocados, olives, nuts, peanut oil etc.

Omega-3 Fatty Acids are one of the best types of polyunsaturated fats with several health benefits. These are found in fish and fish oils and protect the heart as well as decrease insulin resistance in diabetic individuals.

There are three types of omega-3 fatty acids:-

    1. Alphalinolenic acid (ALA) – Found in plant sources
    2. Eicosapentaenoic acid (EPA) – Found in oily cold-water fish such as salmon, sardines, mackerel, and herring
    3. Docosahexaenoic acid (DHA) – Found in Fish and marine animals and in nuts like walnuts

Total fat intake for people with diabetes should be 20 to 35% of total calories. Saturated fat should be limited to less than 7% of total calories, polyunsaturated fat should be limited to less than 10% of total calories, and monounsaturated fat should be limited to less than 20% of total calories. Dietary cholesterol should be less than 200 mg/day.

  • Fibre

Fibres are recommended at levels of at least 14 grams for every 1000 calories, or 25 grams for adult women and 38 grams for adult men. Of this 10 to 25 g/day should come from soluble fibre sources. Good sources of soluble fibres include oats, fruits, vegetables, rice bran, cooked beans and psyllium seeds.

  • Carbohydrates

Carbohydrates are one of the most important sources of energy. They are found in breads, rice, gains, cereals, fruits and starches. Carbohydrates are broken down to glucose that provides fuel for the body.

Carbohydrates raise blood glucose levels. This means the carbohydrates need to be balanced in diabetic individuals with insulin, medications, and physical activity. While carbohydrates are regulated calories are recommended in moderation. According to Dietary Guidelines for Americans, moderation is the key.

The Food and Drug Administration (FDA) has approved the use of non- nutritive sweeteners like saccharin, aspartame, acesulfame potassium (K), sucralose, and neotame in people with diabetes including pregnant women along with a balanced diet. Saccharin is not suitable for pregnant women because it can cross the placenta.

Glycemic index is a scale (0-100) ranking how quickly a carbohydrate containing food will digest into glucose in the bloodstream. High GI foods break down quickly to glucose while low GI foods break down slowly.

  • Alcohol should be limited

Daily intake should be limited to a moderate amount that is defined as one drink per day or less for women and two drinks per day or less for men. Mixed drinks can raise blood glucose and should be limited.

Further reading

  • Low Calorie and Very Low Calorie Diets
  • DASH Diet for High Blood Pressure
  • High Protein Diet
  • Mediterranean Diet
  • Caveman or Palaeolithic Diet
  • Diet for Obese Children and Teenagers
  • Diet for Overweight and Obese Pregnant woman
  • Vegetarian Diets for Weight Loss
  • Fad Diets

DASH Diet for High Blood Pressure

A healthy diet and eating plan can both reduce the risk of developing high blood pressure and lower elevated blood pressure. The most common diet recommended for patients at risk of with high blood pressure include the DASH diet. DASH stands for “Dietary Approaches to Stop Hypertension”.

This diet includes intake of fruits, vegetables, and low-fat dairy foods as well as fibres and lowering sodium, saturated fat, total fat and cholesterol. There are whole grains, poultry, fish, and nuts along with a reduction in red meats, sweets, sugary beverages, high-sodium processed foods etc.

Sodium reduction in diet

Sodium reduction is one of the most important components of the DASH diet. To reduce sodium in diet some of the steps that could be taken include:-

  • Inclusion of fresh foods like fruits, vegetables, non-salted nuts, fresh poultry, fish and lean meat
  • Choosing herbs, lemon, lime, vinegar, salt-free seasoning blends and spices and avoiding addition of table salt
  • Avoiding canned soups, processed foods, frozen dinners, vegetables with sauces and entrees
  • Avoiding processed meats like bacon, sausage, hot dogs, corned beef, pastrami, bologna, ham, turkey and salami
  • Avoiding smoked, cured and pickled foods
  • Choose ready-to-eat breakfast cereals with low sodium content
  • Cooking rice, pasta and cereals without salt.
  • Rinsing canned foods, such as tuna, to remove some salts
  • Avoiding salty snacks

Increasing calcium in diet

To increase calcium in diet the DASH diet recommends:-

  • Low-fat or fat-free cheese and yogurts and non-fat or 1% milk products daily
  • For those who are lactose intolerant, lactose-reduced milk may be an option
  • Calcium supplements are needed for those who do not take dairy products.

DASH diet and healthy weight

The DASH diet aims at maintaining a healthy body weight. This is because obesity and overweight raise the risk of high blood pressure. Some of the measures to maintain a healthy body weight with the DASH diet include:-

  • Calorie intake is reduced by choosing low-fat foods and eating smaller portions.
  • At least 25 to 35 grams of fibres need to be taken daily. Whole grains should be chosen.
  • Foods that are unhealthy should be avoided
  • Foods rich in potassium and magnesium should be raised. Citrus fruits, tomatoes, oranges, bananas and potatoes at least three times a week provide adequate potassium. Diet should include nuts, seeds, dried beans and peas at least four times a week for potassium and magnesium along with fibre.
  • At least four to five servings a day of whole fresh fruit and four to five servings a day of vegetables are recommended. A serving of vegetable or fruit is approximately ½ cup cooked or one cup raw.
  • At least 30 minutes of aerobic exercise or at least 60 minutes of aerobic exercise at least five times a week should be performed daily to lose weight

Other lifestyle and diet choices in DASH eating plan

  • Reduction of caffeine in diet
  • Adequate fluid intake that includes at least eight cups of water per day
  • Quitting smoking

Further reading

  • Low Calorie and Very Low Calorie Diets
  • Diabetic Diet
  • High Protein Diet
  • Mediterranean Diet
  • Caveman or Palaeolithic Diet
  • Diet for Obese Children and Teenagers
  • Diet for Overweight and Obese Pregnant woman
  • Vegetarian Diets for Weight Loss
  • Fad Diets

High Protein Diet

Obesity is a public health problem affecting millions worldwide. Obesity depends on the imbalance between intake of calories and expenditure of the same with regular physical activity.

There have been several studies to devise the perfect diet that can help prevent weight gain, reduce excess weight and maintain a healthy body weight. However, no diet is perfect and a onetime cure for obesity and overweight.

High protein and low carbohydrate diet is one such fad diet that has been claimed by some to help reduce weight and maintain it at healthy levels. Like other fad diets, high protein diet failed to live up to its expectations.

Advent of the high protein diet and its efficacy

The high protein and low carbohydrate diet gained popularity in the 1970’s. This form of diet as favoured in ancient times as well. Greek athletes for examples preferred a high protein diet. They were popular in the late 1960s and early 1970s with the publication of the Atkins’ Diet, The Drinking Man’s Diet, Stillman’s Diet and the Scarsdale Diet etc.

Studies from Duke University, Philadelphia Medical Center and University of Pennsylvania show that average weight loss with high-protein diets during the first six months of use, is approximately 20 pounds. This is not significantly different from other diets and other studies that looked at carbohydrate-restricted diets also show that the amount of carbohydrate consumed had no effect on the degree of weight loss.

Risks associated with high protein diet

Apart from being marginally effective in weight loss, a high protein and low carbohydrate diet can be harmful as well. Some of the side effects of this diet include:-

  • Risk of ketosis – Ketosis is a condition seen in severe and uncontrolled diabetes mellitus as well as in long term starvation. Normally glucose is the energy source in the body. It is obtained from carbohydrates normally. When there is a shortage of glucose for prolonged periods the fatty acids are broken down to obtain glucose in the body. This causes generation of ketone bodies. An increase in circulating ketones alters the body’s acid-base balance leading to acidosis, low phosphate levels, osteoporosis, and kidney stones. Severe ketosis can be life threatening. Lack of carbohydrates in diet can lead to an increased risk of ketosis.
  • Risk of heart disease – High protein diets are mainly composed of animal meats and proteins. These are also typically rich in dietary cholesterol and saturated fat. High dietary cholesterol leads to increased risk of heart disease
  • Risk of kidney damage – Proteins are normally excreted by the kidney. High animal protein diets over time can cause excessive load on the kidneys and damage their functions. Plant protein, on the other hand, has no harmful effect on the kidneys.
  • Risk of complications of diabetes – Diabetes itself raises the risk of ketosis, heart disease and kidney damage. High protein diets can aggravate these problems.
  • Risk of bowel cancer - Regular meat consumption, as is necessary in high protein low carbohydrate diets, increases colon cancer risk by about 300 percent according to research from Harvard University.
  • Risk of osteoporosis - Very high protein intake leads to increased loss of calcium via urine. This leads to calcium loss from bones and leave the bones brittle and prone to fractures. IT also leads to increased risk of osteoporosis.
  • Risk of liver damage
  • Risk of nutritional deficiencies - The American Heart Association says that, “High-protein diets are not recommended because they restrict healthful foods that provide essential nutrients and do not provide the variety of foods needed to adequately meet nutritional needs. Individuals who follow these diets are therefore at risk for compromised vitamin and mineral intake, as well as potential cardiac, renal, bone, and liver abnormalities overall.”

Further reading

  • Low Calorie and Very Low Calorie Diets
  • Diabetic Diet
  • DASH Diet for High Blood Pressure
  • Mediterranean Diet
  • Caveman or Palaeolithic Diet
  • Diet for Obese Children and Teenagers
  • Diet for Overweight and Obese Pregnant woman
  • Vegetarian Diets for Weight Loss
  • Fad Diets