Diet and Diabetes

Question 1

what are the 3 most important factors for Diabetes prevention & Mx

Answer 1

• diet
• physical activity (sedentary behaviour increases risk of DM by 7-14%)
• weight control (RR of DM increased from 1 to 93 when BMI increased from 22 to 35)

Question 2

primary goals for preventing & managing DM?

Answer 2

preventing hyperglycaemia & maintaining blood glucose homeostasis

Question 3

excess glucose / hyperglycaemia can… (5)

Answer 3

• cause excess stress on pancreatic islet cells & on insulin functionality
• contribute towards fat deposition
• cause build up of NAD –> increased generation of free radicals
• increase low grade inflammation
• catalyse glycosylation of structural & functional proteins & render them more oxidisable and atherogenic

Question 4

digestion & absorption of carbs depends on?

Answer 4

• quantity of carbs
• quality of carbs
• other food factors influencing carb digestion

Question 5

what is more important for glycaemic control: quantity or quality?

Answer 5

quality

Question 6

what does quality of carb mean?

Answer 6

structural & functional properties that determine their digestibility

Question 7

carb quality depends on?

Answer 7

• Carb type: mono/di/polysaccharide
• Digestible & Non-Digestible Carb contents
• Amylose and Amylopectin contents
• structure & density of food

Question 8

which mono and di saccharides generally do not elicit high glycaemic responses?

Answer 8

lactose and fructose

Question 9

what are digestible Carbs?

Answer 9

mono & di saccharides and starch

Question 10

what are non-digestible Carbs?

Answer 10

• Resistant Starch
• Soluble fibre
• Insoluble fibre
• Non-Starch Polysaccharides (complex carbs other than starch)

Question 11

short-term effects of SOLUBLE fibre on glycaemia?

Answer 11

• slows gastric emptying

- inhibit digestive enzyme activity (a-amylase, a-glucosidase)

Question 12

long-term effects of fibre on glycaemia?

Answer 12

• reduces diabetes risk
• reduced HbA1c & fasting glucose in T2DM
• reduced diabetes risk by 6% for every 2g of fibre consumed /day

Question 13

GI rankings?

Answer 13

55 or less = Low
56-69=Medium
70 or more = high

Question 14

how to calculate Glycaemic load?

Answer 14

GI x carb content in portion consumed

Question 15

How does GI associate w blood glucose?

Answer 15

Low GI foods: reduce acute postprandial blood glucose concentrations through reducing rate of absorption of carbs - low & sustained glycaemic response
High GI foods: Hyperglycaemia followed by hypoglycaemia

Question 16

effect of protein on blood glucose?

Answer 16

• amino acids contribute to gluconeogenesis

- aa stimulate insulin release by stimulating beta cells

Question 17

what effect does consuming protein w carbs have?

Answer 17

reduces acute postprandial glycaemia & gastric emptying and increases insulin and incretins

Question 18

what fatty acids reduce diabetes risk?

Answer 18

replacing SFA with N-6 PUFA

Question 19

FA shown to affect insulin secretion?

Answer 19

MUFA>PUFA>SFA, with MUFA improving beta cell function and insulin sensitivity

Question 20

co-ingesting fats with carbs has what effect?

Answer 20

reduces acute glycaemic response

Question 21

link of veg & glycaemia?

Answer 21

green leafy veg esp reduces risk of DM

Question 22

link of wholegrains and glycaemia?

Answer 22

3 servings/day wholegrains reduced DM risk by 26% & whole grain interventions reduce FBG

Question 23

link of refined grains and glycaemia?

Answer 23

increases DM risk

Question 24

link of diary & glycaemia?

Answer 24

Yoghurt particularly assoc w lower diabetes risk