Diabetic Nutrition in Nigeria – Meal Planning In Action
Diabetic nutrition, diet, and weight control are the basis for managing diabetes. Control of total caloric intake to maintain reasonable body weight and stabilize blood glucose level is the most objective in the dietary and nutritional management of diabetes.
This alone success is often achieved with reversal of type 2 diabetes hyperglycemia. Attaining that goal, however, is not always easy.
Because diabetes nutritional agreement is so complex, and a registered dietitian who understands diabetes management has a big responsibility for this therapeutic plan aspect.
Nutritional management of diabetic patient includes the following goals stated by American Diabetes association, Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications, 2002:
Diabetic Nutrition in Nigeria
Provide all the essential food constituents like vitamins and Minerals needed for optimal nutrition.
Meeting Energy needs
Maintaining reasonable weight
Avoidance of huge daily fluctuations of blood glucose level, with blood glucose level close to normal as is safe and practical to reduce risk or prevent the possibility of complications
Decrease serum lipid levels to reduce the risk of macro-vascular complication
For those diabetics who require insulin to help control blood glucose levels, it is essential to maintain as much consistency as possible in the number of calories and ingested carbohydrates at the different meal times.
Moreover, precision in the approximate time intervals between meals with the addition of snacks as necessary helps to prevent the hypoglycemic reaction and to maintain the overall control of glucose.
The key treatment for obese people with type 2 diabetes is weight loss. Obesity linked to an increase in insulin resistance is also a major factor in the development of type 2 diabetes.
Some obese people who require insulin or oral anti-diabetic agents to control blood glucose levels may be able to reduce or eliminate the need for weight loss medications.
A weight loss as small as 10 percent of the total weight can improve blood glucose considerably.
In other cases where one is not taking insulin, it is not as critical to have consistent meal content or timing. Instead, lowering the overall caloric intake takes on the most importance. Menus should not be skipped though. Pacing food intake throughout the day places more manageable demands on the pancreas.
One of the most demanding aspects of diabetes management is long-term adherence to the meal plan. To the obese, restricting calories only moderately may be more realistic.
Keeping the weight loss can be hard for those who have lost weight. To help diabetics incorporate new dietary habits into lifestyle, it encourages diet education, behavioral therapy, group support, and ongoing nutrition counseling.
Diabetic Nutrition in Nigeria – Meal Plan
Diabetic meal plan has to take into account one’s own food preferences, lifestyle, common eating times, ethnic and cultural background.
For those under intensive insulin therapy, the timing and content of meals may be more flexible by allowing adjustments to the insulin dosage for changes in eating and exercise habits. Advances in insulin management permit greater flexibility schedules than previously possible.
This contrasts with the older concept of maintaining a constant insulin dose and requiring a diabetic person to adjust their schedule to the insulin ‘s actions and duration.
A thorough review of a diet history to identify eating habits and lifestyle is the first step in meal planning. There should also be a careful assessment of weight loss, gain or maintenance. Those with type 2 diabetes require weight decrease in most circumstances.
Diabetic Nutrition in Nigeria – Diabetic meal Planning [The Making]
You need to coordinate with a registered dietitian in teaching about meal planning and if possible use educational tools , materials and approaches so you can fully grasp the idea of your nutritional needs.
Your initial education addresses the significance of consistent eating habits, the food-insulin relationship and the provision of an individualized meal plan.
Then follow-up sessions focusing on management skills, such as eating in restaurants, reading food labels, and adjusting the meal plan for exercise, disease, and special occasions.
An example like that is an aspect of meal planning such as the food exchange system that can be hard to learn or understand.
You can ask him for clarification at every meeting, or you can leave him a message. Just remember that the food system provides the food with a new way of thinking, rather than a new way of eating.
Simplification as much as possible ensures a good understanding during the teaching session and provides an opportunity to assess doubts and a need for repetitive activities and information.
Diabetic Nutrition in Nigeria – Caloric Requirements
Calorie-controlled diets or calorie requirements are planned by calculating your energy needs (individual energy needs that vary in each person) and calorie necessity based on your age, gender height and weight. Element of activity is factored in to provide the actual amount of calories required for maintenance.
The appropriate amount of calorie-controlled diets are shown in the Diabetic Exchange List compiled by the American Dietetic Association and American Diabetic Association 2008 but you must approach a registered dietitian to closely evaluate you with your current eating habits and achieve realistic and individualized goals.
This is so important because in practice, the development of a meal plan should be based on the usual eating habits and lifestyle of the individual to effectively control the level of glucose as well as the maintenance of weight loss.
For example, the priority for a young patient with type 1 diabetes should be a diet that contains enough calories to keep normal growth and development. Initially, the target aim may provide a higher calorie to regain lost of weight.
Here is a reliable and simple Food Exchange List For Diabetic Meal Planning I got from Diabetes Teaching Center at University of California , San Francisco via Google.
Please Take note of all these and believe that there’s no harm in trying!
Diabetic Caloric Nutrition distribution
Diabetic nutrition in your diabetic Meal Plan also focuses on the percentage of calories that come from carbohydrates , proteins and fats. Carbohydrates generally have the greatest effect on blood glucose levels, since they are digested and converted more quickly than other foods.
The American Diabetes Association recommends that for all levels of caloric intake, 50 percent to 60 percent of calories should be derived from carbohydrates, 20 percent to 30 percent from fats and remaining 10 percent to 20 percent from protein.
Carbohydrates are consisted of sugar and starch. Most of the carbohydrates that are generally consumed came from starch, fruits and milk. There is some carbohydrate in vegetable too.
To avoid postprandial high glucose levels all carbohydrates should be eaten in moderation. Foods high in carbohydrates such as saccharose are not completely removed from the diet but should only be taken in moderation up to 10 percent of total calories because these foods are typically high in fats and lack in vitamins, minerals and fibers.
The method of counting carbohydrates is very important since it makes you aware of your approximate amount of serving.
The more you’ve ingested carbohydrates, the higher your blood glucose. It is also a tool used in the management of diabetics because carbohydrates are the main nutrients in the food that influence blood glucose.
With multiple daily insulin injections, this technique provides flexibility in food choices, can be less complicated and allows more accurate management. All food sources should be considered when drawing up a diabetic meal plan using carbohydrate counting. Once digested, you convert 100 percent of your carbohydrate intake to glucose.
Around 50 percent of protein foods are also converted to glucose (meat, fish and poultry).
The quantity of carbohydrates in foods is measured in GRAMS so you need to know which foods contain carbohydrates, learn how to estimate the number of grams of carbohydrates in each food you eat and sum up all the grams of carbohydrates from each food you eat to get your total intake in one day.
Examples of common foods containing carbohydrates; potatoes, legumes (e.g. peas), maize, grains, dairy products ( e.g. milk and yogurt), snack foods and sweets (e.g. cakes, cookies, deserts) and juices (soft drinks, fruit drinks, sugar-energy drinks).
Let’s say, you have to target 50 per cent of your total calories from carbohydrates. One gram of carbohydrates is roughly four calories.
So, to get the number of grams, divide the number of calories you want to get from carbohydrates by 4. For example, you aspire to eat 2000 calories per day and get 50 percent of carbohydrate calories.
0.50 x 2000 calories = 1000 calories
1000 / 4 = 250 grams of carbohydrates
Take note that there are people who have lower tolerance of physical activity and there are also those who need low-calorie diets and therefore the need for carbohydrates really varies in every individual. To master your caloric intake and diet further, please feel free to contact a professional dietitian.
As for estimating the amount of carbohydrates in each serving, you can refer to the Food Exchange List or here are some examples from the list of food exchanges:
These Foods contain 15 grams of each serving:
Biscuit – 1 (1 1/2 inches across)
Bun (hot dog or hamburger) – 1/2 bun
Pancake (1/4 inch thick) – 1 (4 inches across)
Pita bread – 1/2 pocket ( 6 inches across)
Waffle -1 (4 inch square or 4 inches across)
Cooked barley 1/3 cup
Cooked Pasta – 1/3 cup
Cooked quinoa 1/3 cup
Cooked white or brown rice – 1/3 cup
Cassava – 1/3 cup
Corn 1/2 cup
Green Peas – 1/2 cup
Animal Crackers 8 crackers
Rice cakes, 4 inches across 2
Dried Apple 4 rings
blueberries 3/4 cup
Fruit cocktail 1/2 cup
Mango juice 1/2 cup or 1/2 small
papaya 1 cup cubed (8oz)
Grape Juice – 1/3 cup
Although carbohydrate counting is now commonly used for blood glucose management of type 1 and type 2 diabetes, to some extent it affects the blood glucose to different degrees regardless of equivalent serving size. Thus, you have to be consciously noticing the fluctuations of your own blood glucose level and take action against any warning signs.
Diabetic Food Pyramid
The Diabetic Food Pyramid is another tool use to develop meal plan. It is commonly utilize for those with type 2 diabetes who have difficulty in abiding with calorie controlled diet.
The food pyramid is consist of six food groups: 1.Breads, grains and other starches; 2. Vegetable (non-starchy vegetables); 3. Fruits; 4. Milk; 5. Meat, meat substitutes and other proteins; and 6. Fats, oils and sweets.
The pyramid shape was chosen to emphasize that the foods in the largest area, the base of the pyramid (Starches, fruits and vegetables) are the lowest in calories and fats and highest in fiber and should make up the basis of the diet.
For those with diabetes and as well as the general population, 50 percent to 60 percent of daily caloric intake must be from these three groups. As you move up the pyramid, foods higher in fats (particularly saturated fats) are illustrated; these foods should account for a smaller percentage of daily caloric intake.
The very top of the pyramid comprises of fats, oils and sweets that should be sparingly by the people with diabetes to attain weight and blood glucose control and to reduce the risk of cardiovascular disease.
Fats and diabetes
The recommendation regarding the fat content for the diabetic diet includes both reducing the total percentage of calories from far-off sources to less than 30 percent of the total calories and limiting the amount of saturated fats to 10 percent of the total calories.
Additional recommendations include reducing total dietary cholesterol intake to under 30 mg / day. This approach may reduce risk factors such as high serum cholesterol levels associated with coronary heart disease development, the leading cause of death and disability among people with diabetes.
The meal plan may include the use of certain non animal protein sources to help reduce the intake of saturated fats and cholesterol. Additionally, the amount of protein intake can be lowered to those with early signs of renal disease.
Diabetic Nutrition in NigeriaControl your food intake
Fiber use in diabetic diets has received increased attention as the experts study the effects of a high-carbohydrate, high-fiber diet on diabetes. This type of diet plays a role in lowering the blood cholesterol total and lipoprotein low density cholesterol.
Increasing the diet of fiber can also improve blood glucose and reduce the need for exogenous insulin.
Two types of dietary fibers exist: soluble, and insoluble. In foods such as legumes, oats and some fruits, soluble fibers play more of a role in lowering blood glucose and lipid levels than insoluble fibres. It is thought that soluble fiber is related to the formation of a gel in the gastrointestinal tract.
This gel slows the emptying of the stomach and the movement of food within the upper digestive tract. The potential reduction of the fiber glucose may be caused by the slower rate of absorption of glucose from foods containing soluble fibres.
Insoluble fibre is found in whole grain breads and cereals as well as in certain vegetables. This type of fiber plays more roles in increasing stool bulk and preventing constipation.
One risk involving the increase of fiber intake is that it may require adjustment of insulin dosage or oral anti diabetic agents to prevent hypoglycemia.
If fiber is added or increase in the meal plan, it should be done gradually and with the actual consultation with a dietitian.
Food labeled as “sugarless” or “sugar-free” may still provide calories equal to the sugar-containing equivalent products when made with nutritious sweeteners.
Hence these products may not always be useful for weight loss. In addition, you must ‘not’ consider them to be “free” to eat in unlimited quantities because they can elevate blood sugar. Foods labeled as “dietetic” are not necessarily calorie-reducing foods.
They may have lower levels of sodium, or other special dietary uses. They may still contain significant amounts of sugar or fats.
Snack foods with “Health Foods” labels may often contain carbohydrates such as honey, brown sugar, and corn syrup. In addition, these allegedly healthy snacks often have saturated vegetable fats, hydrogenated vegetable fats or animal fats that may be contraindicated if you have elevated levels of blood lipids.
So read the nutritional labels carefully to count the nutrients that your food contains …
The use of sweeteners can be acceptable to diabetics especially if it assists their overall adherence to the diet. Moderation in the amount of sweetener used to avoid possible adverse effects is encouraged.
There are two main sweetener types: nutritious, and non-nutritious. The nutrient sweeteners contain calories, and in the amounts normally used, the non-nutrient sweeteners have few or no calories.
The nutrient sweeteners include fructose, sorbitol and xylitol. They are not calorie-free; they provide calorie in similar quantities to sucrose ( table sugar).
They cause lower levels of blood sugar than sucrose, and are often found in “sugar-free” foods. Sweeteners that contain sorbitol could have a laxative effect. Non-nutritious sweeteners have calories to a minimum or no.
They are used in food products, and can also be used for table use. They produce minimum or no glucose-level elevations. Saccharin is calorie-free. Aspartame (Nutra Sweet) is a dextrose package; it contains 4 calories per packet, and loses heat sweetness.
Acesulfame-K (Sunnette) is also package with dextrose; it contains 1 calorie per packet. Sucralose (Splenda) is a newer non-nutritive, high intensity sweetener that is about 600 times sweeter than sugar.
The Food and Drug administration has approved it for use in baked goods, non alcoholic beverages, chewing gums, coffee, confections, frosting and frozen dairy products.
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