Nutrition Flashcards
How many calories per g are CHO?
4 kcal/g
What percentage A1C can diet reduce?
1-2%
A 5-10% weight loss results in improvement in what 4 parameters?
BP
insulin sensitivity
Dyslipidemia
glycemic control
What is sucrose made up of?
Disaccharide. Made from glucose and fructose.
What percentage of daily energy intake can be added sucrose?
Up to 10%
Above this we can see increase in BG and TG in some people.
How much fructose can be eaten in g before any rise in TG and Uric acid levels?
Up to 60G per day or less than 10% total daily energy. Of course choosing low gi fruit rather than added fructose provides glycemic and metabolic benefit.
Should sugar alcohols be included in CHO count for rapid insulin?
No. Mannitol. Sorbitol. Xylitol. Lactilol. Maltitol. Have no significant effect on BG. Cause GI effects.
What percentage of diet should be protein?
What about in CKD?
15-20%
Reduce to 0.8g/kg in CKD
How many calories per g does protein have?
4 kcal/g
What percentage of diet should be fats?
20-35%
In pregnancy 40%
How many calories per g does fat have?
9 kcal/ g
What percentage of diet should be CHO?
45-60%
45% so as to avoid too much fat
Can be up to 60% of total energy if derived from low glycemic high fiber foods
In pregnancy it’s 50!
Does CDA endorse meal replacement programs?
Yes. Found to be effective for weight loss and glycemic control. No head to head study’s on specific ones.
Does CDA recommend specific vitamin/mineral supplements?
No. Nutritional needs should be met by diet.
> 50 years should take 400iu vitamin D
Folic acid for pregnant worn.
Which is more effective, nutrition counseling one on one or in a small group?
Either one.
Individual may be better for lower income patients.
Group is good when adult education principles are applied.
Barriers to healthy eating should be addressed.
What are four main principles of nutrition counseling?
Individualized
Regularly evaluated
Reinforced in an intensive manner.
Incorporate self management education.
What is the minimum amount of CHO in grams per day to provide glucose to the brain? Adult men and women
130g
What is the benefit of soluble fiber?
Soluble fiber slows gastric emptying and delays glucose absorption therefore improving post prandial control.
Okra. Oats and beans and barley. Psyllium.
How many grams of fiber are recommended for people with diabetes? Is this higher or lower than general population?
30-50g per day.
Higher.
A third or more coming from soluble fibre
A standard alcoholic drink contains how many mls of pure alcohol?
About 17.2mls. So what is a “standard drink” depends on alcohol percentage.
how can you increase the glycemic index of a meal?
- decreasing fibre
- decreasing acidity (Sourdough breads generally have a lower index than other breads.
- the easier it is to digest the the food the higher the glycemic index. This is because it spends less time in digestion and is more rapidly absorbed causing higher post prandial sugars. I counsel patients to cook thier pasta al dente to lower the glycemic index.
how can you decrease glycemic index of a meal?
- add fat (not always a good thing)
- increase acidity of food (sourdough bread) - slows digestion
- cook pasta a la dente
what factors affect the speed of stomach emptying?
- Fat and protein slow the rate of stomach emptying
- Foods are digested at a slower rate
- Lower glycemic response
what is Glycemic Index?
Glycemic Index (GI) is a scale that ranks carbohydrate-rich foods by how much they raise blood glucose levels compared to a standard food. The standard food is glucose or white bread.
Diabetes canada public health campaign advises that sugary beveragea be below what percentage of total daily calorie intake?
Less than 10%
How often should follow up
With an RD occur?
Frequently. Every 3 months
Culturally sensitive PEER education has been shown to improve (3)
A1C
Nutrition knowledge
Diabetes self management
Are CHO restricted diets effective?
No consistent improvement in A1C lipids and BP.
Greater weight loss at 6 months BUT by 12 months bo difference.
What are the concerns for low CHO in type one?
1-Blunted response to glucagon
2-If ketogenic, risk of ketoacidosis
Someone on SGLT2 and on a ketogenic diet is at risk for
Ketoacidosis
Benefits if low GI intervention
Improved glycemic control
Reduce hypo in type 1
Improve total cholesterol
Foods high in soluble fibre
Oats Barley Psyllium Mannan Pectin from pulses Eggplant Okra Applea Citrus fruit Berries
Which 3 soluble fibres have the health canada claim for reducing cholesterol
Oats
Barley
Psyllium
SSBs Sugar sweetened beverages are linked to
Hypertension
CAD
Replacement of animal protein with Plant protein imrpoves which 3 metabolic parameters in people with type one and two? Non CV related
A1C,
FBG
Fasting insulin
To resuce CVD saturated fats shoukd be resuced below what percentage of diet?
Less than 9% Replace with PUFAs (poly unsat)
MUFAs (mono unsat) from plants and whole grains
Or low GI CHO
Consumption of fish at 1-2 servings per month up
To two servings per week have what benefits?
Reduced CAD.
Reduced CKD.
And less albuminuria
Acceptable daily intake of sweeteners in mg/kg body weight per day
Sucralose 8.8 Saccharin 5 Aspartame 40 Asceksukfame k 15 Erythritol 1000 Cyclamate 11
How much rice is 15g CHO? How much pasta is 15g? How much mashed potato’s is 15g? Sweet potato? Baked or boiled potato?
Rice. 1/3 cup Pasta 1/2 cup. Potato 1/2 cup Sweet potato 1/3 cup 1/2 medium baked potato
How much of each is 15g CHO
FLOUR
CORN STARCH
SODA CRACKERS
3 TBSP flour
2 TBSP corn starch
7 soda crackers
How much of each is 15g CHO?
pita Raisin bread taco shells Waffle Tortilla whole wheat
Bagel 1/4 to 1/2 Bannock. 1.5 x 2.5 inches Hamburger or hotdog bun 1/2 All bread is 1 Croissant 1 small English muffin. 1/2 Pancake 1 medium pita 1/2 Raisin bread 1 taco shells 2 Waffle 1 medium Tortilla 1/2 10” whole wheat or 1 white 6 inch
How much of these “choose more often” cereals for 15 g CHO? All bran/ All Bran Buds Cream of wheat cooked Oatmeal Shredded wheat Wheat germ
All bran/ All Bran Buds 1/2 cup Cream of wheat cooked 3/4 cup Oatmeal 3/4 cup Shredded wheat 1 biscuit Wheat germ 1/3 cup
How much of these choose less often cereals make 15g? BRan flakes Cheerios Corn flakes Granola Rice crispies Puffed wheat
BRan flakes 1/2 c Cheerios 2/3 c Corn flakes 1/2 c Granola 1/4 c Rice crispies 2/3 c Puffed wheat 1.5 cups
How much of each fruit for 15g CHO? Apples Banana Strawberries Blueberries Saskatoon berries Raspberries Canned fruit Canned macaron oranges Dates Grapes Melons Orange Nectarine/peach
Apples 1 small or med Banana 1 small or 1:2 medium Strawberries 2 cups Blueberries 1 cup Saskatoon berries 1 cup Raspberries 2 cups Canned fruit 1/2 cup Canned mandarin oranges 3/4c Dates/figs. 2 Grapes 1 cup Melons 1 cup Orange one Nectarine/peach. One
How much of each JUICE for 15g CHo? Grape juice Prune juice Apple Orange GRapefruit Lemon Like Tomato Clam Vegetable cocktail
Grape juice 1/3 c Prune juice 1/3 c Apple 1/2 c Orange 1/2 c Grapefruit 1/2 c Lemon. 3/4 c Lime. 3/4 c Tomato. 1 cup Clam 1 cup Vegetable cocktail 1 cup
How much jello is 15g Cho? How much ice cream? Popsicle? Life savers? Pop?
1/2 cup jello 1/2 cup icecream 1 piscine bar 6 life savers 1/2 cup pop
