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Sunday, February 24, 2008

Dietic Therapy - Promoting optimal health

Clinical nutrition is now evolving as a specialized field. Health care professional and the patients have appreciated the role of nutrition in promoting optimal health. This nutrition awareness has created the need for more and precise information on all aspect of nutrition and clinical dietetics related to the patient care. My plan is to covey the information concerning the role of diet in few common diseases and to give the diet plan for the same.

GENERAL PRINCIPLES OF DIETIC THERAPY:

  • Reach and maintain ideal body weight
  • Be careful of serving sizes
  • Avoid skipping meals
  • Increase your daily activity

DIABETES MELLITUS:

Diabetic diet need not be a complete deviation from the normal diet. A normal Indian diet can be made suitable for diabetics with few modifications in the nutrient intake based on age, sex, weight and physical activity. The diet is designed to improve blood glucose and lipid levels, encourage healthy eating patterns, promote consistent food intake and avoid undue starvation. Today, it is widely accepted that the traditional Indian foods (with few minor modifications) is the best diet for a diabetic person! Not only can you enjoy most of the foods you like, the diet can be varied as you like. Your diet can take into consideration your likes and dislikes and suit your lifestyle. CALORIES:

The calorie requirement should allow the patient to loose or gain weight as required to maintain ideal body weight. The total calorie requirement can be calculated based on the level of physical activity and individual’s actual body weight.

SAMPLE PLAN OF DIABETIC DIET OF 1800 Kcal.

Breakfast:

1cup tea, 3 slices of bread or 3 chappatis or 3 khakhras or 2idlis with sambher or 2 dosas with rasam or 1 katori of cooked upma.

Mid-morning:

1 cup plain milk

Lunch:

3 chappatis without ghee, ½ katori of cooked rice.

¾ katori dal or sambhar or ½ katori non-veg. Curry.

½ katori cooked vegetables. ½ katoricurds. Plan salad/soup unlimited.

(Restrict use of coconut/ peanuts, sugar, jaggery, fried non-veg and other fried items)

Evening:

Same as break fast

Dinner:

Same as lunch

Bedtime 1 cup of plain milk or 1 medium fruit

Fat allowance/day 4-5 tsp.

DISTRIBUTION OF CALORIES:

Carbohydrates 60 - 65 %

Proteins 15 – 20 %

Fats 15 - 20 %

Carbohydrates – Diabetics need not restrict their carbohydrate requirements in their diet. Simple carbohydrates obtained from honey, sugar, jaggery, sugarcane, jam, glucose is readily absorbed and is to be avoided completely. Complex carbohydrates are first digested to produce sugar and do not raise blood sugar quickly. Thus adequate intake of complex carbohydrates is recommended. Cereals, whole grains, dals, pulses and vegetables provide complex sugars. Fruit and milk can also be taken in proper amounts.

Proteins -- Milk and milk products (except cream, butter), dals and pulses, nuts, oil seeds, fish, egg, poultary and meat are rich sources of protein.

Fats – are concentrated source of energy. Excess amount of fat increases the risk of obesity and heart diseases. Ghee, butter, vanaspati contain a high proportion of saturated fats which tends to increase the serum cholesterol levels. Vegetable fats such as sunflower oil, safflower oil, corn oil contain a high proportion of polyunsaturated fatty acids (PUFA). PUFA are helpful in controlling the cholesterol levels. These all are visible fats. Some amount of fat that is derived from milk and milk products, eggs, flesh foods, nuts and oil seeds is known as invisible fat. A diabetic diet should provide both visible and invisible fat in limited quantities. A diabetic patient can take 15-20 Gms of visible fat per day.

Vitamins and minerals – they both are essential for the body. Supplements are advised as per the patients need.

Fibre – Dietary fibre is beneficial in Type 2 DM as well as Type 1 DM. Fibre present in vegetables, fresh fruits, legumes and fenugreek seeds (methi seeds) is soluble in nature which is effective in controlling blood sugar and serum lipids. Insoluble fibre present in cearals and millets like ragi, jowar and bajra improves long-term glucose tolerance.

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