B2.040 Nutrition in Diabetes Management Flashcards
what is MNT?
medical nutrition therapy
for overweight or obese adults with type 2 diabetes, reducing energy intake while maintaining a healthful eating pattern is recommended to promote weight loss
what does the ADA say may be the most important factor influencing glycemic response after eating?
amount of carbohydrates and available insulin
what is the glycemic index?
a measure of the ability of a food to raise the level of blood sugar
what are some consequences of high glycemic index foods?
raise blood glucose rapidly
linked to hyperinsulinism, inflammation, low HDL, obesity, DM2, and CVD
for what kinds of people is higher sugar intake more of a problem?
people who consume too many characters and tend to carry more fat in the abdomen
what factors contribute to glycemic index of carb containing foods?
structure type of sugar fiber content cooking and/or food processing ripeness co-ingestion of other foods
what food is the glycemic index based off of?
white bread = 100
what is the affect of low glycemic index diets in the management of diabetes?
average improvement in endpoint of 6-10% over 2-52 weeks in 14 studies
what is fiber?
carbohydrates that cannot be digested
found in all plants that are eaten for food
what are some health benefits of fiber?
lowers risk of: colon cancer heart disease DM2 diverticular disease constipation
does glycemic index or fiber have more impact on diabetes?
fiber
more impact on insulin sensitivity, BMI, disposition index
what are dietary guidelines regarding fats for americans?
consume <10% of energy from saturated fatty acids
limit trans fat, no healthy amt
most fat should come from PUFA and MUFA (fish, nuts, vegetable oil)
what are saturated fats?
fatty acids without a double bond
linked to increased total and LDL cholesterol
solid at room temp
what are polyunsaturated fats?
fatty acids with at least 2 double bonds
categorized as w-3 or w-6 depending on whether the first double bond appears 3 or 6 carbons from the terminal methyl group
how are polyunsaturated fats related to inflammation?
w-3 and w-6 are precursors of eicosanoids
what are eicosanoids?
lipid mediators with autocrine/paracrine function
how do w-3 and w-6 derived eicosanoids differ?
w-6 eicosanoids have proinflammatory and immunoactive functions
w-3 eicosanoids have anti-inflammatory properties (inhibit formation of w-6 eicosanoids)
western diets have a heavier ratio of w-6 PUFAs compared with w-3 PUFAs
characterize trans fats
formed during partial dehydrogenation of fats
in margarine, shortening, fried foods, and baked goods
associated w increased total cholesterol, lower HDL, and poor liver detox
how should US diet habits improve?
decrease total calories and portion sizes
decrease frequency of eating out
decrease consumption of beverages w added sugar
decrease saturated fat and salt intake
increase fruit and veggie intake
increase fiber intake
what are the major contributors to the obesity epidemic?
15-31% increase in energy intake
26-55% increase in fat intake
decreased physical activity
what is the recommended exercise regimen?
10,000-20,000 steps per day for weight loss
weight loss decreases mortality rate w DM2
what was the result of the STAMPEDE bariatric surgery trials?
in patients with DM2 bariatric surgery plus intensive medical therapy was more effective than intensive medical therapy alone in decreasing/resolving hyperglycemia
