Nutrition & Diabetes

MNT-for-DMSome Coursera’s Nutrition Course’s Tit-bits

Who is at risk for diabetes and should be tested? All adults who are overweight (BMI≥ 25) and who have one of the following: physical inactivity, first-degree relative with diabetes, hypertension, high cholesterol, a history of cardiovascular disease, and women who delivered a baby weighing > 9 lbs.

Excessive fat, no matter where it is located in the body, increases risk of insulin resistance and diabetes. Fatty liver and viscereal fat may increase risk the most.

Diet, exercise and weight loss do aid in the prevention of pre-diabetes. Pre-diabetes recommendations: Structured programme that emphasize lifestyle changes that include 7% body weight loss, regular physical activity of 150 min/week, reduced calories and reduced fat intake.

Physical Activity Recommendations for people with diabetes: at least 150 min/week, moderate-intensity physical activity of 50% to 70% maximum heart rate spread over at least 3 days/week, no more than 2 consecutive days without activity. Maximum age-related heart rate calculation: 220 minus age in the year, and take 50% and 70% of that figure. Example, for a 40 year old, his heart rate should be (220-40=180; 50% of 180=90 and 70% of 180=126) between 90 and 126 per min. Do not exercise vigourously on a sick day. Always check with your doctor before commencing an exercise regime.

Macronutrient mix for diabetic people: eating small meals with the mix of carbohydrate, protein and fat should be adjusted according to the individual’s preferences and metabolic goals. Monitoring carbohydrate intact remains a key strategy in achieving glycemic control of blood sugar in the body. Aim for 14 gms of soluble fiber per 1,000 calories consumed to moderate blood sugar spikes after each meal. Saturated fat should be <7% of total calories (about 16 gms for a 2,000 calories diet). Limit sugar sweetened beverages and alcohol. Avoid routine supplementation, especially antioxidants, as there is a lack of evidence that they benefit diabetic people.

Healthy weight loss for an overweight diabetic is about 1lb to 2lbs per week; i.e., eating about 2,000 calories for a non-exercise day to 2,500 calories for an exercise day. The macronutrient distribution would be 55% carbohydrates (1 gm=4 calories/gm), 25% fat (1 gm=9 calories/gm), and 20% protein (1 gm=4 calories/gm). How many grams of carbohydrates would he require per day on a non-exercise day: 55% of 2,000=1,100 calories divided by 4=275 gms (as 1gm of carbohydrate has 4 calories/gm). He also needs a certain amount of fiber: 2,000 X 14 divided by 1,000=28 gms of fiber per day.

Among artificial sweeteners, only stevia is natural, derived from sunflowers, and marketed under labels like Sweet, PureVia, Reb-A, Rebiana, Sweetleaf, Truvia. Generally, pregnant women are advised to refrain from sweeteners as they do cross the brain-blood barriers.

Blood glucose levels are dependent on carbohydrate counting, physical activity, stress, disease, and medication. This short outline is complex as a diabetic condition is a serious chronic illness.

The American Diabetes Association’s MyFoodAdvisor is a useful meal-planning tool,
at http://tracker.diabetes.org/