As the saying goes, “food is the sky”, and eating is one of the most enjoyable and important things in people’s daily life. Especially when family and friends get together, exchange cups and glasses, feast and dinner, not too happy. However, in the face of delicious food, diabetic patients are contradictory and psychologically depressed, they cannot help but ask: how should we “eat”? Sun Hui, Department of Endocrinology, Wuhan Union Medical College Hospital
Indeed, how to eat is a problem that every diabetic patient is confused about, and it is also the most misunderstood problem, such as many diabetics mistakenly understand diabetic diet as eating less or even not eating staple foods. How to adjust the diet in normal clinical work and diabetes education is the most interesting topic for all diabetic patients.
Diet management (rather than dieting) is one of the most basic therapeutic measures for diabetic patients. Its purpose is to make the total calorie and food structure of the recipe reasonable according to the patient’s specific situation, to control the weight in the standard range, to improve blood sugar and to restore physical strength. In daily life, how to arrange the daily diet of diabetic patients, how to choose in the face of a wide range of food ingredients and their respective tastes, these are the problems faced by diabetic patients. I summarize the principles as “how much to eat, what to eat, how to eat” three questions.
Estimation of the total daily calories of how much DD to eat
Estimation of total daily calories is to determine how much food a diabetic can eat each day to meet the body’s caloric needs without increasing blood sugar in excess. This is the primary measure of diabetic diet management and is based on gender, age, intensity of physical activity and weight. First of all, we should calculate the standard weight (Kg) = (height cm-100)*0.9. Then we should decide the daily calorie requirement per kilogram of body weight according to the intensity of activity and the degree of fatness: if you are resting in bed, you need 15-20 kcal per kilogram of body weight (the same below); if you are doing some light physical activities such as housework, office work, teaching or its equivalent workload, you need 30 kcal; if you are doing medium physical activities such as textile work, driving, etc., you need 30 kcal. If you do medium physical activities such as textile work, driver, general farm work, surgeon, physical education teacher or their equivalent workload, you need 35 kcal; if you do heavy physical activities such as porter, loader, construction worker, heavy farm work or equivalent activity work, you need 40 kcal; if you are overweight or obese, you can reduce 5 kcal, and if you are thin, you need to increase 5-10 kcal. Finally, we can calculate the total calories required for the whole day = kilocalories per kilogram of body weight * standard weight.
What to eat DD the appropriate proportion of the three major nutrients and intake
There are three major types of energy-producing nutrients in food: carbohydrates, proteins and fats. Among them, carbohydrates are the most efficient and least by-product energy supplying substances in the human body, and are the main source of energy for the human body, whose role is the same as a car needs fuel, and many important organs such as the brain, heart and muscle activities need it to provide energy. It includes sugar, starch and dietary fiber, which are the main components of foods such as cereals and potatoes, fruits and vegetables. It is eventually broken down into glucose and absorbed. Protein is the main raw material for the composition, repair and renewal of body tissues and organs, and can provide some energy when glucose and fat are insufficient, but this is not its main function, and excessive protein intake can increase the burden on the kidneys. Fat is the body’s energy reserve and the main component of the biofilm. Protein and fat are mainly found in meat, poultry, eggs and legumes.
After determining the total daily calories, it is important to determine the appropriate proportion of calories provided by each of the three major nutrients. The general recommendation is 55% carbohydrate, 15% protein, or 1 gram per kilogram of standard body weight for calculation, and 25% fat. This is actually the reasonable intake ratio of various nutrients recommended for a healthy diet for normal people. The daily intake of the three major nutrients is also calculated at the same time, and the formula is: carbohydrate (g) = daily calorie supply * 55% / 4; protein (g) = daily calorie supply * 25% / 4 or standard body weight * 1 (g); fat (g) = daily calorie supply * 15% / 9.
Then you have to choose food according to the content of nutrients in daily food and combine it with your preferences. According to the main nutritional content of daily food and the content of the food value, food can be categorized into six categories: cereals and potatoes, fruits, meat, poultry, eggs and soy products, dairy products, fats and oils, vegetables and seaweeds. Nutritional composition of the first two categories to carbohydrates, the third and fourth category to protein-based, the fifth category to fat-based, the last category to vitamins and minerals-based. In the selection of food should adhere to the first, two, six categories, appropriate consumption of the third, four categories, less fat class principle, the daily diet includes six categories of food, and take turns to choose the same category of various foods, so as to achieve a balanced nutrition, variety of purposes.
How to eat DD cooking methods and meal arrangements
Cooking methods can be appropriate according to their preferences, general attention: 1, the taste should be light, should pay attention to the heat of soy sauce, sesame paste and other condiments, which is one of the reasons for the consumption of hot dry noodles easy to cause blood sugar; 2, cooking methods should be minimized frying; 3, simmering soup as far as possible to skim the floating oil above, and pay attention to the heat of ingredients such as lotus root; 4, can be appropriate to use sweeteners.
The arrangement of meals should pay attention to 1. regular meals, and pay attention to the timing with the glucose-lowering drugs; 2. the number of meals is generally three meals per day, the ratio of calorie distribution of the three meals is: 1/5 for breakfast, 2/5 for Chinese food, 2/5 for dinner or 1/3 for each; if there is the habit of adding meals at night or other times and when blood sugar fluctuates a lot, the corresponding amount can be taken out from the main meal and put in the additional meal, usually with fruits or other side dishes. Extra meals before bedtime can prevent nighttime hypoglycemia in the elderly.
The following is a simple food exchange method. This is where nutritionists divide foods of the same type into groups in certain amounts so that they are similar in nutrient content. Within these ranges, the various foods can be exchanged, giving people with diabetes more freedom to choose different foods.
The amount of daily staple food is divided into four categories according to the amount of activity and labor as follows: 200-250 grams per day for resting patients, 200-300 grams per day for those with light physical labor, 250-350 grams per day for those with medium physical labor, and more than 400 grams per day for those with heavy physical labor.
Interchange between staple foods: 25 grams of rice can be exchanged with 25 grams of flour, hanging noodles, cornmeal, millet, mung beans, dry vermicelli and 4 soda crackers, or with 400 grams of cold noodles, 125 grams of potatoes, 125 grams of yams and 150 grams of water chestnuts.
Interchange between meat: 25 grams of lean pork can be exchanged with 75 grams of fish, 50 grams of lean beef, 100 grams of rabbit, 20 grams of sausage, 75 grams of shrimp, 70 grams of pork liver, 1 egg, 25 grams of pork ribs, 125 grams of tofu, and 50 grams of dried tofu. This can all be swapped with 25 grams of rice.
Staple food and fruit interchange: 25 grams of rice can also be exchanged with 2 duck pears, apples, and 20 grapes, 1 peach, 10 fresh dates, 2 bananas, 2 pieces of watermelon, 2 oranges. If you eat 1 of these fruits after the meal, you can eat it safely as long as you reduce 25 grams of rice. From the above it can be seen that the intake ratio of the three major nutrients for diabetics is no different from normal people, and there is no absolute inability to eat or need special intake from the type of food intake, which is actually more in line with the traditional Chinese family diet, from this perspective diabetics can still maintain their usual family diet pattern unchanged, but the total amount must be appropriate and fixed. By following the above method, diabetics can eat as much as they want.