B2.040 Nutrition in Diabetes Management

Question 1

what is MNT?

Answer 1

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

Question 2

what does the ADA say may be the most important factor influencing glycemic response after eating?

Answer 2

amount of carbohydrates and available insulin

Question 3

what is the glycemic index?

Answer 3

a measure of the ability of a food to raise the level of blood sugar

Question 4

what are some consequences of high glycemic index foods?

Answer 4

raise blood glucose rapidly

linked to hyperinsulinism, inflammation, low HDL, obesity, DM2, and CVD

Question 5

for what kinds of people is higher sugar intake more of a problem?

Answer 5

people who consume too many characters and tend to carry more fat in the abdomen

Question 6

what factors contribute to glycemic index of carb containing foods?

Answer 6

structure
type of sugar
fiber content
cooking and/or food processing
ripeness
co-ingestion of other foods

Question 7

what food is the glycemic index based off of?

Answer 7

white bread = 100

Question 8

what is the affect of low glycemic index diets in the management of diabetes?

Answer 8

average improvement in endpoint of 6-10% over 2-52 weeks in 14 studies

Question 9

what is fiber?

Answer 9

carbohydrates that cannot be digested

found in all plants that are eaten for food

Question 10

what are some health benefits of fiber?

Answer 10

lowers risk of:
colon cancer
heart disease
DM2
diverticular disease
constipation

Question 11

does glycemic index or fiber have more impact on diabetes?

Answer 11

fiber

more impact on insulin sensitivity, BMI, disposition index

Question 12

what are dietary guidelines regarding fats for americans?

Answer 12

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)

Question 13

what are saturated fats?

Answer 13

fatty acids without a double bond
linked to increased total and LDL cholesterol
solid at room temp

Question 14

what are polyunsaturated fats?

Answer 14

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

Question 15

how are polyunsaturated fats related to inflammation?

Answer 15

w-3 and w-6 are precursors of eicosanoids

Question 16

what are eicosanoids?

Answer 16

lipid mediators with autocrine/paracrine function

Question 17

how do w-3 and w-6 derived eicosanoids differ?

Answer 17

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

Question 18

characterize trans fats

Answer 18

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

Question 19

how should US diet habits improve?

Answer 19

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

Question 20

what are the major contributors to the obesity epidemic?

Answer 20

15-31% increase in energy intake
26-55% increase in fat intake
decreased physical activity

Question 21

what is the recommended exercise regimen?

Answer 21

10,000-20,000 steps per day for weight loss

weight loss decreases mortality rate w DM2

Question 22

what was the result of the STAMPEDE bariatric surgery trials?

Answer 22

in patients with DM2 bariatric surgery plus intensive medical therapy was more effective than intensive medical therapy alone in decreasing/resolving hyperglycemia