Diabetes 3 Flashcards
what is the best diabetic diet?
THERE IS NO DIABETIC DIET
calories A-level evidence
- should be appropriate to reach & maintain desirable body weight, particularly in insulin-resistant individuals
- “structured programs” that emphasize lifestyle changes can produce long-term weight loss
- standard weight reduction diets – when used alone – are unlikely to produce long-term wt. Loss
calories should be appropriate to __ and __ desirable body weight ( especially in __ individuals)
calories should be appropriate to reach and maintain desirable body weight ( especially in insulin-resistant individuals)
__ programs that emphasize __ changes can produce long-term weight loss
structured programs that emphasize lifestyle changes can produce long-term weight loss
are standard weight reduction diets effective at producing long-term weight loss?
no!
carb A-level evidence
- Carbohydrate intake should emphasize nutrient-dense carbohydrate sources that are high in fiber and minimally processed.
- 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
carb intake should emphasize __ carb sources that are high in __ and minimally __
carb intake should emphasize nutrient-dense carb sources that are high in fiber and minimally processed
emphasize __ vegetables, fruits, legumes, and whole grains
emphasize non-starchy vegetables, fruits, legumes, and whole grains
carbs: emphasis is on __ carbohydrate, not __ of carb
carbs: emphasis is on total carbohydrate, not type of carb
target grams of carb
60 g
expert carbs: __ and __ should provide 60-70% of energy
expert carbs: CHOs and MUFs should provide 60-70% of energy
expert carbs: __ and __-containing foods CAN be eaten in a healthy diet
expert carbs: sucrose and sucrose-containing foods CAN be eaten in a healthy diet
reducing overall carbohydrate intake for individuals with diabetes has shown improvements in __
reducing overall carbohydrate intake for individuals with diabetes has shown improvements in glycemia
3 eating patterns that reduce A1c and need for anti-hyperglycemic medications
- T2DM
- low-CHO
- very low CHO
dietary fats A-level evidence
- 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)
- < 10% derived from SF; < 7% if LDL-chol level is over 70mg/dl
- dietary cholesterol < 300mg/d; < 200mg/d if LDL-chol is over 100mg/dl
fats: __ eating patten rich in __ and __ fats
fats: Mediterranean eating patten rich in MUFA and PUFA fats
__% of diet derived from SF, < _% if high LDL
10% of diet derived from SF, < 7% if high LDL
dietary cholesterol < __mg/d, < __ mg/d if LDL is high
dietary cholesterol < 300mg/d, < 200 mg/d if LDL is high
protein:
if renal function is normal __
protein should be __% of total daily energy
protein:
if renal function is normal no need to modify total protein
protein should be 15-20% of total daily energy
should high protein foods be chosen to reduce hypoglycemia?
no
alcohol
limit to __ drinks for women, __ for men
alcohol
limit to 1 drinks for women, 2 for men
how to handle drinking as a diabetic?
monitor glucose before and after drinking
nutritive discretionary sweeteners
- fructose
- sucrose
- sugar alcohols
- sorbitol + mannitol
- hydrogenated starch hydrolysate (HSA)
non-nutritive discretionary sweeteners
Saccharin = Sweet ‘n Low
Aspartame = Equal and others
Acesulfame potassium = Sweet One
Sucralose = Splenda
sodium recommendation
< 2,300 mg/day
levels should be appropriate for electrolyte needs of the person
micronutrients: should we supplement
generally no
when and what supplements are necessary in diabetes?
B12 in metformin
when and what supplements are necessary in diabetes?
B12 in metformin
generally, what 2 supplements are useful?
folate and Ca
what intrinsic feature improves food outcome
soluble fiber
soluble fiber delays __
soluble fiber delays glucose absorption
fiber dietary intake
20-35 g per day
same as normal people
dietary fiber includes __ that provide structural function for plants
not borken down in __
dietary fiber includes polysaccharides that provide structural function for plants
not borken down in intestines
3 types of insoluble fiber
- cellulose
- hemicellulose
- lignin
cellulose
- all plants; skins
- holds water; stalks, leaves, outer produces coverings of grains, bulk; not nuts, seeds broken down
hemicellulose
- Same as cellulose but partially broken down
-Absorbs bile acids
lignin
- Woody portion of mature vegetables, wheat bran; grainy pears
- Absorbs bile acids
3 types of water-soluble fiber
- gums
- pectin
- mucilage
gums
- plant secretions, seeds
- hydrophilic; oat bran, beans & peas forms gels; grains, nuts, seeds, roots not broken down
pectin
- fruits; apples, grapes
- hydrophilic; berries, citrus, other fruits forms gels; binds bile acids
mucilage
- plant secretions; seeds
- hydrophilic; okra, psyllium forms gels; binds bile acids
fiber is associated with alower level of
CRP
which type of fiber lowers CRP more
insoluble fiber
factors affecting glycemic index (GI)
- type of starch
- particle size
- maturation of fruit/veg
- cooking time
- fiber
- fat
- acid
- speed of stomach emptying
- processing
2 types of starch
amylose
amylopectin
which has lower GI: amylose or amylopectin
amylose
amylose
Molecules form tight clumps
harder/slower to digest
Lower GI rating
amylopectin
Molecules are more open
easier/faster to digest
Higher GI rating
cooking time can __ GI rating
cooking time can increase GI rating
how can cooking time affect GI
Swells starch molecules and softens foods making it faster to digest
higher fat = __ GI
higher fat = lower GI
fat + protein in a meal __ stomach emptying and digestion and __ GI
fat + protein in a meal slow stomach emptying and digestion and lower GI
highyl processed foods are digested __, have __ surface area, and a __ GI
highyl processed foods are digested faster, have greater surface area, and a higher GI
low GI foods
Popcorn
Fruits: pears, plums, peaches, apples
Yogurt and milk
Boiled NEW potatoes
All bran
Oatmeal
Oat bran
high GI foods
Pretzels
Soda crackers
Fries
Baked white potato
Watermelon
Corn flakes
Bran flakes
Rice krispies
Cheerios
goal percentage for body weight reduction
7%
for weight reduction, emphasize __
calorie awareness
keep a __ to self-monitor
keep a food diary to self-monitor
portion norms are changing
Americans typically eat __
portion norms are changing
Americans typically eat what they are served regardless of how large the portion size is
