Diabetes 3

Question 1

what is the best diabetic diet?

Answer 1

THERE IS NO DIABETIC DIET

Question 2

calories A-level evidence

Answer 2

1. should be appropriate to reach & maintain desirable body weight, particularly in insulin-resistant individuals
2. “structured programs” that emphasize lifestyle changes can produce long-term weight loss
3. standard weight reduction diets – when used alone – are unlikely to produce long-term wt. Loss

Question 3

calories should be appropriate to __ and __ desirable body weight ( especially in __ individuals)

Answer 3

calories should be appropriate to reach and maintain desirable body weight ( especially in insulin-resistant individuals)

Question 4

__ programs that emphasize __ changes can produce long-term weight loss

Answer 4

structured programs that emphasize lifestyle changes can produce long-term weight loss

Question 5

are standard weight reduction diets effective at producing long-term weight loss?

Answer 5

no!

Question 6

carb A-level evidence

Answer 6

1. Carbohydrate intake should emphasize nutrient-dense carbohydrate sources that are high in fiber and minimally processed.
2. Eating plans should emphasize non-starchy vegetables, fruits, legumes, and whole grains, as well as dairy products, with minimal added sugars. (B-level)
   The emphasis is on total carbohydrate – more important than the source or type therefore food choices can include sugars and starches
   A target of 60 grams to total grams of carbohydrate is often useful

Question 7

carb intake should emphasize __ carb sources that are high in __ and minimally __

Answer 7

carb intake should emphasize nutrient-dense carb sources that are high in fiber and minimally processed

Question 8

emphasize __ vegetables, fruits, legumes, and whole grains

Answer 8

emphasize non-starchy vegetables, fruits, legumes, and whole grains

Question 9

carbs: emphasis is on __ carbohydrate, not __ of carb

Answer 9

carbs: emphasis is on total carbohydrate, not type of carb

Question 10

target grams of carb

Answer 10

60 g

Question 11

expert carbs: __ and __ should provide 60-70% of energy

Answer 11

expert carbs: CHOs and MUFs should provide 60-70% of energy

Question 12

expert carbs: __ and __-containing foods CAN be eaten in a healthy diet

Answer 12

expert carbs: sucrose and sucrose-containing foods CAN be eaten in a healthy diet

Question 13

reducing overall carbohydrate intake for individuals with diabetes has shown improvements in __

Answer 13

reducing overall carbohydrate intake for individuals with diabetes has shown improvements in glycemia

Question 14

3 eating patterns that reduce A1c and need for anti-hyperglycemic medications

Answer 14

1. T2DM
2. low-CHO
3. very low CHO

Question 15

dietary fats A-level evidence

Answer 15

1. An eating plan emphasizing elements of a Mediterranean eating pattern rich in monounsaturated & polyunsaturated fats may be considered to improve glucose metabolism & lower cardiovascular disease risk. (B)
2. < 10% derived from SF; < 7% if LDL-chol level is over 70mg/dl
3. dietary cholesterol < 300mg/d; < 200mg/d if LDL-chol is over 100mg/dl

Question 16

fats: __ eating patten rich in __ and __ fats

Answer 16

fats: Mediterranean eating patten rich in MUFA and PUFA fats

Question 17

__% of diet derived from SF, < _% if high LDL

Answer 17

10% of diet derived from SF, < 7% if high LDL

Question 18

dietary cholesterol < __mg/d, < __ mg/d if LDL is high

Answer 18

dietary cholesterol < 300mg/d, < 200 mg/d if LDL is high

Question 19

protein:
if renal function is normal __
protein should be __% of total daily energy

Answer 19

protein:
if renal function is normal no need to modify total protein
protein should be 15-20% of total daily energy

Question 20

should high protein foods be chosen to reduce hypoglycemia?

Answer 20

no

Question 21

alcohol
limit to __ drinks for women, __ for men

Answer 21

alcohol
limit to 1 drinks for women, 2 for men

Question 22

how to handle drinking as a diabetic?

Answer 22

monitor glucose before and after drinking

Question 23

nutritive discretionary sweeteners

Answer 23

1. fructose
2. sucrose
3. sugar alcohols
4. sorbitol + mannitol
5. hydrogenated starch hydrolysate (HSA)

Question 24

non-nutritive discretionary sweeteners

Answer 24

Saccharin = Sweet ‘n Low
Aspartame = Equal and others
Acesulfame potassium = Sweet One
Sucralose = Splenda

Question 25

sodium recommendation

Answer 25

< 2,300 mg/day levels should be appropriate for electrolyte needs of the person

Question 26

micronutrients: should we supplement

Answer 26

generally no

Question 27

when and what supplements are necessary in diabetes?

Answer 27

B12 in metformin

Question 28

when and what supplements are necessary in diabetes?

Answer 28

B12 in metformin

Question 29

generally, what 2 supplements are useful?

Answer 29

folate and Ca

Question 30

what intrinsic feature improves food outcome

Answer 30

soluble fiber

Question 31

soluble fiber delays __

Answer 31

soluble fiber delays **glucose absorption**

Question 32

fiber dietary intake

Answer 32

20-35 g per day same as normal people

Question 33

dietary fiber includes __ that provide structural function for plants not borken down in __

Answer 33

dietary fiber includes **polysaccharides** that provide structural function for plants not borken down in **intestines**

Question 34

3 types of insoluble fiber

Answer 34

1. cellulose 2. hemicellulose 3. lignin

Question 35

cellulose

Answer 35

- all plants; skins - holds water; stalks, leaves, outer produces coverings of grains, bulk; not nuts, seeds broken down

Question 36

hemicellulose

Answer 36

- Same as cellulose but partially broken down -Absorbs bile acids

Question 37

lignin

Answer 37

- Woody portion of mature vegetables, wheat bran; grainy pears - Absorbs bile acids

Question 38

3 types of water-soluble fiber

Answer 38

1. gums 2. pectin 3. mucilage

Question 39

gums

Answer 39

- plant secretions, seeds - hydrophilic; oat bran, beans & peas forms gels; grains, nuts, seeds, roots not broken down

Question 40

pectin

Answer 40

- fruits; apples, grapes - hydrophilic; berries, citrus, other fruits forms gels; binds bile acids

Question 41

mucilage

Answer 41

- plant secretions; seeds - hydrophilic; okra, psyllium forms gels; binds bile acids

Question 42

fiber is associated with alower level of

Answer 42

CRP

Question 43

which type of fiber lowers CRP more

Answer 43

insoluble fiber

Question 44

factors affecting glycemic index (GI)

Answer 44

1. type of starch 2. particle size 3. maturation of fruit/veg 4. cooking time 5. fiber 6. fat 7. acid 8. speed of stomach emptying 9. processing

Question 45

2 types of starch

Answer 45

amylose amylopectin

Question 46

which has lower GI: amylose or amylopectin

Answer 46

amylose

Question 47

amylose

Answer 47

Molecules form tight clumps harder/slower to digest Lower GI rating

Question 48

amylopectin

Answer 48

Molecules are more open easier/faster to digest Higher GI rating

Question 49

cooking time can __ GI rating

Answer 49

cooking time can **increase** GI rating

Question 50

how can cooking time affect GI

Answer 50

Swells starch molecules and softens foods making it faster to digest

Question 51

higher fat = __ GI

Answer 51

higher fat = **lower** GI

Question 52

fat + protein in a meal __ stomach emptying and digestion and __ GI

Answer 52

fat + protein in a meal **slow** stomach emptying and digestion and **lower** GI

Question 53

highyl processed foods are digested __, have __ surface area, and a __ GI

Answer 53

highyl processed foods are digested **faster**, have **greater** surface area, and a **higher** GI

Question 54

low GI foods

Answer 54

Popcorn Fruits: pears, plums, peaches, apples Yogurt and milk Boiled NEW potatoes All bran Oatmeal Oat bran

Question 55

high GI foods

Answer 55

Pretzels Soda crackers Fries Baked white potato Watermelon Corn flakes Bran flakes Rice krispies Cheerios

Question 56

goal percentage for body weight reduction

Answer 56

7%

Question 57

for weight reduction, emphasize __

Answer 57

calorie awareness

Question 58

keep a __ to self-monitor

Answer 58

keep a **food diary** to self-monitor

Question 59

portion norms are changing Americans typically eat __

Answer 59

portion norms are changing Americans typically eat **what they are served regardless of how large the portion size is**