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Integrative Nutrition and Pathophysiology > Diabetes 3 > Flashcards

Diabetes 3 Flashcards

1
Q

what is the best diabetic diet?

A

THERE IS NO DIABETIC DIET

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2
Q

calories A-level evidence

A
  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
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3
Q

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

A

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

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4
Q

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

A

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

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5
Q

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

A

no!

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6
Q

carb A-level evidence

A
  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
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7
Q

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

A

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

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8
Q

emphasize __ vegetables, fruits, legumes, and whole grains

A

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

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9
Q

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

A

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

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10
Q

target grams of carb

A

60 g

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11
Q

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

A

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

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12
Q

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

A

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

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13
Q

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

A

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

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14
Q

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

A
  1. T2DM
  2. low-CHO
  3. very low CHO
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15
Q

dietary fats A-level evidence

A
  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
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16
Q

fats: __ eating patten rich in __ and __ fats

A

fats: Mediterranean eating patten rich in MUFA and PUFA fats

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17
Q

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

A

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

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18
Q

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

A

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

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19
Q

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

A

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

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20
Q

should high protein foods be chosen to reduce hypoglycemia?

A

no

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21
Q

alcohol
limit to __ drinks for women, __ for men

A

alcohol
limit to 1 drinks for women, 2 for men

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22
Q

how to handle drinking as a diabetic?

A

monitor glucose before and after drinking

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23
Q

nutritive discretionary sweeteners

A
  1. fructose
  2. sucrose
  3. sugar alcohols
  4. sorbitol + mannitol
  5. hydrogenated starch hydrolysate (HSA)
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24
Q

non-nutritive discretionary sweeteners

A

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

25
Q

sodium recommendation

A

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

26
Q

micronutrients: should we supplement

A

generally no

27
Q

when and what supplements are necessary in diabetes?

A

B12 in metformin

28
Q

when and what supplements are necessary in diabetes?

A

B12 in metformin

29
Q

generally, what 2 supplements are useful?

A

folate and Ca

30
Q

what intrinsic feature improves food outcome

A

soluble fiber

31
Q

soluble fiber delays __

A

soluble fiber delays glucose absorption

32
Q

fiber dietary intake

A

20-35 g per day
same as normal people

33
Q

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

A

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

34
Q

3 types of insoluble fiber

A
  1. cellulose
  2. hemicellulose
  3. lignin
35
Q

cellulose

A
  • all plants; skins
  • holds water; stalks, leaves, outer produces coverings of grains, bulk; not nuts, seeds broken down
36
Q

hemicellulose

A
  • Same as cellulose but partially broken down
    -Absorbs bile acids
37
Q

lignin

A
  • Woody portion of mature vegetables, wheat bran; grainy pears
  • Absorbs bile acids
38
Q

3 types of water-soluble fiber

A
  1. gums
  2. pectin
  3. mucilage
39
Q

gums

A
  • plant secretions, seeds
  • hydrophilic; oat bran, beans & peas forms gels; grains, nuts, seeds, roots not broken down
40
Q

pectin

A
  • fruits; apples, grapes
  • hydrophilic; berries, citrus, other fruits forms gels; binds bile acids
41
Q

mucilage

A
  • plant secretions; seeds
  • hydrophilic; okra, psyllium forms gels; binds bile acids
42
Q

fiber is associated with alower level of

A

CRP

43
Q

which type of fiber lowers CRP more

A

insoluble fiber

44
Q

factors affecting glycemic index (GI)

A
  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
45
Q

2 types of starch

A

amylose
amylopectin

46
Q

which has lower GI: amylose or amylopectin

A

amylose

47
Q

amylose

A

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

48
Q

amylopectin

A

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

49
Q

cooking time can __ GI rating

A

cooking time can increase GI rating

50
Q

how can cooking time affect GI

A

Swells starch molecules and softens foods making it faster to digest

51
Q

higher fat = __ GI

A

higher fat = lower GI

52
Q

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

A

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

53
Q

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

A

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

54
Q

low GI foods

A

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

55
Q

high GI foods

A

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

56
Q

goal percentage for body weight reduction

A

7%

57
Q

for weight reduction, emphasize __

A

calorie awareness

58
Q

keep a __ to self-monitor

A

keep a food diary to self-monitor

59
Q

portion norms are changing
Americans typically eat __

A

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

Integrative Nutrition and Pathophysiology (22 decks)

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