Diabetes, diet

Food Sources:
The overall guidelines are to reduce the amount of fat , simple sugar, and salt, and increase the amount of complex carbohydrates and foods high in fiber .

Functions:
There are two types of diabetes , and the nutrition goals for each are different.

With insulin-dependent diabetes mellitus (IDDM) , the main focus of diet planning is balance and consistency. Meals should be planned to be eaten at approximately the same time everyday. The meals and snacks should be planned in conjunction with the insulin dose and the person's physical activity . The amount and type of food, and the carbohydrate , protein , and fat content of the meals and snacks, should be consistent from day to day. This helps with the delicate balance of food intake, insulin, and physical activity that is necessary for optimal blood sugar (glucose) control. If these components are not in balance, there can be wide variations (from too high to too low) in blood sugar levels .

Children with insulin-dependent diabetes present special challenges. Meal plans should be recalculated often to account for the child's change in caloric requirements. Physical activity may be more difficult to plan for and may be much more erratic than in an adult. Children may be more likely to require several snacks in their meal plan because they may not be able to meet their caloric needs in 3 meals. Concentrated sweets may be difficult to restrict in a child, and parents may require additional help in planning for special occasions such as birthday's and Halloween when sweet foods abound.

With noninsulin-dependent diabetes mellitus (NIDDM) , the main focus is on weight management and weight control , because 80 to 90% of these diabetics are overweight . A calorie-controlled meal plan is recommended along with appropriate physical activity. In many cases, weight control and a planned diet alone control diabetes; other diabetics must take oral medications in addition.

Recommendations:
Reduce the amount of fat . Protein choices with less fat are recommended, such as skinless poultry, fish and lean meats. Foods high in fat, which should be AVOIDED, are nuts, butter, margarine, lunch meats, bacon, sausage, gravy, salad dressing, mayonnaise, and hydrogenated shortening. Select skim or low-fat milk and reduce the intake of cheese. The harder the cheese, the higher the fat content. Also reduce the intake of high-fat ice cream.

Eat meat in moderation. The recommended daily amount is approximately 5 ounces of cooked (6 ounces of raw) meat. A 3-ounce portion of meat is approximately the size of a deck of playing cards.

Eat more complex carbohydrates , such as starches and whole grain breads, with an emphasis on the high fiber choices. Foods that are high in carbohydrates provide energy, minerals, and vitamins . High-fiber foods help decrease blood fat and glucose levels. Everybody, including diabetics, should be encouraged to eat foods high in fiber and complex carbohydrates. Food sources of complex carbohydrates and fiber are fruits and vegetables, whole-grain breads and cereals, dried beans and peas, and lentils and legumes.

Eat less simple sugar. Sugar provides calories without much nutrient benefit. There are no vitamins and minerals in sugar. Foods high in simple sugar cause the glucose levels to rise. Therefore, foods high in simple sugar are not recommended on a regular basis for people with diabetes . Food sources of simple sugar are table sugar, syrup, honey, desserts such as cake and ice cream, candy, and regular carbonated beverages.

Eat less salt. Salt is made up of sodium and chloride. The sodium in salt causes fluid retention in the body, and in some people this can cause an increase in blood pressure . Although this does not directly affect blood sugar levels , people with diabetes are at greater risk for heart disease , renal (kidney) disease, and other problems. Because they are already at risk, it is recommended that foods high in salt should not be eaten on a regular basis. Also, reduce the amount of salt used in cooking.

Use alcohol only in small amounts. For a person with diabetes, alcohol is not recommended on a regular basis. If alcohol is to be used in the meal plan, it should be calculated into the diet plan with the assistance of a registered dietitian.

Implementation of the dietary recommendations:
The dietary recommendations are based on healthy eating. The meal plan should be individualized for a person with diabetes. Attention should be paid to the types of food, amounts of food, timing of the meals, and a realistic meal plan that fits into the person's lifestyle.

The meal planning tool recommended by the American Diabetes Association is the Exchange List for meal planning. Foods are grouped into categories (exchanges) with approximately equal nutrition for each food within the exchange. This allows the person to select a wide variety of meals with equivalent nutritional content. A diet plan outlines the

Side Effects:
Implementing an individualized meal plan for diabetes management helps promote improved blood sugar control, improved blood lipid levels, and improved overall health and well-being.

Notes:
Consult a registered dietitian for an individualized meal plan for a person with diabetes. Children require extra attention when it comes to diabetic meal planning. The affiliate of the American Diabetes Association in each state is an excellent resource for educational materials and programs for people with diabetes.