According to the International Diabetes Federation (IDF) in 2014, the number of people with diabetes worldwide was 382 million and is expected to reach 471 million in 2035. Diabetes is one of the leading causes of death in populations in developed countries, and a large body of evidence suggests that many developing and newly industrialized countries are also entering the diabetes epidemic.
As lifestyles change, excessive calorie intake, reduced physical activity, and excessive body fat have led to successive increases in global diabetes rates. In November 2014, the International Diabetes Federation promoted the theme of “Healthy Eating and Diabetes,” advocating that the public start with breakfast and make healthy dietary choices based on dietary guidelines to prevent the onset of diabetes.
Experts from the International Diabetes Federation urge that maintaining a healthy body starts with the following
1. Ensure the quality of breakfast. The nutrition raised by breakfast accounts for more than 30% of the nutrition required by the body throughout the day.
2. Proper physical exercise – regular and frequent activities of at least 30 minutes of moderate intensity. Need to increase activity to control weight.
3, to ensure a healthy diet structure, eat three to five times a day fruits and vegetables, and reduce the intake of sugar and saturated fat.
4. Avoid the use of tobacco – smoking increases the risk of cardiovascular disease.
The International Diabetes Federation (IDF) currently proposes five priorities for diabetes treatment: medical nutrition therapy, exercise therapy, blood glucose monitoring, medication and diabetes education. Among these is nutritional therapy, which is the foundation of treatment for all types of diabetes.
The principle of nutritional therapy is to strictly limit the total calorie intake of diabetic patients, and reasonably distribute the proportion of carbohydrates, fats and proteins in the diet, and appropriately supplement trace elements, vitamins and dietary fibers to correct metabolic disorders, reduce the pancreatic load, prevent complications and delay their progress.
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Principles of nutritional therapy for diabetic patients
Reasonable control of calories is the primary factor of diabetic dietary treatment. In general, it is appropriate to maintain or slightly lower than the standard weight, taking into account the patient’s general information, living and eating habits and medical condition. Carbohydrates account for about 50% to 60% of the total dietary calories. A high-carbohydrate diet can increase the sensitivity of peripheral tissues to insulin, improve glucose tolerance, lower blood lipid levels and help reduce the incidence of cardiovascular disease, but refined sugar has a greater impact on blood sugar and its intake should be strictly controlled. The intake of protein in the diet should be increased moderately, generally accounting for 11% to 20% of the total energy is appropriate. As diabetes is mostly complicated by cardiovascular diseases and dyslipidemia, the supply of fat should be limited, and fat in the diet should account for 20% to 30% of the total energy. In addition, the intake of dietary fiber, vitamins and minerals should be increased. After determining the total caloric energy and the composition of carbohydrate, protein and fat of the patient’s daily diet, convert the caloric energy into food weight to make the corresponding recipes, and arrange them according to the patient’s living and eating habits, condition and the needs of medication, which can be distributed as 1/5, 2/5, 2/5 or 1/3, 1/3, 1/3 according to three meals per day; or divided into 1/7, 2/7, 2/7, 2/7, 2/7 according to four meals .
The effect of nutrients on diabetes
1.The effect of carbohydrates on diabetes
The core factor of diabetic diet control is the quality of carbohydrate intake. The Chinese Nutrition Society proposes that the recommended amount of carbohydrates in the daily diet of ordinary people should account for 55%~65% of the total daily energy intake of adults. The recommended carbohydrate intake of diabetic patients is slightly lower than that of the general population, accounting for about 50%~60% of the total calories in the diet. High carbohydrate diet can increase the sensitivity of peripheral tissues to insulin, improve glucose tolerance, reduce blood lipid levels, and help reduce the incidence of cardiovascular disease.
2, the impact of fat on diabetes
Diabetes is mostly complicated by dyslipidemia and cardiovascular diseases. Excessive fat intake can reduce glucose tolerance, lower insulin sensitivity, promote obesity and increase the incidence of dyslipidemia and cardiovascular diseases. Diabetic patients should pay attention to control the intake of saturated fatty acids in their diets, and appropriately increase the intake of unsaturated fatty acids, such as the consumption of peanut oil, soybean oil, etc. High intake of cholesterol can significantly increase the risk of cardiovascular disease in diabetic patients. It is generally recommended to control dietary cholesterol intake of no more than 300mg per day.
3, the impact of protein on diabetes
Glucose produced from dietary protein via the gluconeogenesis pathway does not affect blood glucose levels and has the effect of stimulating insulin secretion. Short-term studies conducted in diabetic patients have shown that diets with protein content >20% of total energy can reduce appetite and increase satiety. When the dietary protein content is increased to 30%, it can cause a significant decrease in body weight by causing a sustained reduction in voluntary energy intake through a decrease in sensitivity to leptin in the central nervous system. Different sources of protein have little effect on blood glucose, but plant sources of protein, especially soy protein, are more advantageous for lipid control than animal proteins. Protein intake should be based on the minimum protein requirement to maintain the body’s positive nitrogen balance, generally accounting for 11% to 20% of total energy is appropriate.
4, the impact of fiber on diabetes
Appropriate increase in fiber intake can improve the metabolic control of blood glucose and blood lipids, thus reducing the risk of complications in diabetic patients. Fiber can lower blood sugar and inhibit cholesterol absorption by prolonging gastric emptying. Diabetic patients should ensure a daily intake of dietary fiber of 20 to 35g, and can consume vegetables such as celery and leeks as well as cereals such as oatmeal and other foods.
5.The effect of vitamins on diabetes
The B vitamins are most closely related to diabetes, which can improve neurological symptoms, followed by the C vitamins, which can improve microcirculation. Insufficient intake of vitamin D may trigger type 2 diabetes. Therefore, attention should be paid to vitamin supplementation in the diet.
Glycemic index of various foods
Food glycemic index is a valid indicator to measure the postprandial blood glucose response caused by food. Generally speaking, food glycemic index >70 is high food glycemic index food, which is digested quickly after entering the gastrointestinal tract, with high absorption rate, fast glucose release and high peak glucose entering the blood; food glycemic index <55 is low food glycemic index food, which stays in the gastrointestinal tract for a long time, with low absorption rate and slow glucose release. They have long residence time in the stomach and intestines, low absorption rate, slow release of glucose, low peak value of glucose into the blood, and slow decline. The higher the index, the greater the rise in blood glucose, and the higher the risk of diabetes and its complications with long-term or frequent intake of a diet with a high glycemic index.
1.Low glycemic index foods (GI55 or below)
Grains: whole egg noodles, buckwheat noodles, vermicelli, black rice, black rice porridge, macaroni, lotus root powder; vegetables: konjac, corn, cabbage, cucumber, celery, eggplant, peppers, kelp, eggs, enoki mushrooms, shiitake mushrooms, spinach, tomatoes, bean sprouts, asparagus, cauliflower, onions, lettuce; beans: soybeans, eyebrow beans, chickpeas, tofu, beans, green beans, lentils, string beans; fruits: apples, pears, oranges, peaches Fruits: apples, pears, oranges, peaches, raisins, grapefruit, pears, carrots, grapefruit, strawberries, cherries, kumquats, grapes; milk: milk, low-fat milk, skim milk, low-fat cheese, black tea, yogurt, sugar-free soy milk; sugar and sugar alcohols: fructose, lactose, xylitol, esomat, maltitol, sorbitol.
2.Medium glycemic index foods (GI56-69)
Grains: red rice, brown rice, sago, udon, cereal; vegetables: sweet potato, taro, potato chips, tomato, lotus root, burdock; meat: fish, chicken, duck, pork, lamb, beef, shrimp, crab; beans: baked beans, winter flour, cream, condensed milk, fresh cream, yogurt; fruits: papaya, raisins, pineapple, banana, mango, cantaloupe, kiwi, orange; sugar and sugar alcohols: sucrose Honey, wine, beer, cola, coffee.
3, high glycemic index food (GI70 or above).
Grains: white rice, steamed buns, doughnuts, glutinous rice, white bread, oatmeal, ramen, fried rice, popcorn; meat: gongbao, fatty sausage, egg dumplings; vegetables: mashed potatoes, pumpkin, baked potato; fruits: watermelon, lychee, longan, pineapple, dates; sugar and sugar alcohols: glucose, sugar, maltose, soft drinks, orange juice, honey.