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Calculate your diet like an arithmetic problem
Modern medicine proves that after normal people eat, as blood sugar rises, insulin secretion also increases, so that blood sugar drops and stays in the normal range, and therefore, diabetes does not occur. In the case of diabetic patients, insulin secretion is absolutely or relatively insufficient due to pancreatic islet function, and insulin cannot increase with the rise of blood sugar after diet, so it cannot play an effective role in lowering blood sugar, so blood sugar will exceed the normal range. Xia Chengdong, Department of Endocrinology, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine
Reasonable control of total caloric energy
“Diet therapy is the basis of all diabetes treatment and is an indispensable component of the means to prevent and control diabetes at any stage of the natural course of the disease.” said Xia Chengdong, attending physician at the Department of Endocrinology, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine.
Xia Chengdong said that if diabetic patients eat like normal people, without diet control or even over-eating, they will make their blood sugar rise too high and will adversely affect the islet tissue which is already under-secreted, making the function of the islet more reduced and the secretion of insulin more reduced, thus further aggravating the disease. Therefore, diabetic patients should be reasonable dietary control. In addition, poor dietary habits can also lead to the emergence and aggravation of related cardiovascular risk factors such as hypertension, dyslipidemia and obesity.
Diabetic patient a male, 56 years old, height 170 cm, weight 85 kg, occupation is an accountant, suffering from diabetes for 5 years, taking hypoglycemic drugs combined with dietary control, if you want to not appear obvious complications. How should diet control be carried out?
Xia Chengdong said that the diet plan is based on height, weight and activity to calculate how many calories are needed in a day, and then calculated according to the ratio of different ingredients in the food. Such a practice is actually a scientific diet suitable not only for diabetics but also for non-diabetics. The only thing is that healthy people do not comply for a while and do not obviously show symptoms, while diabetics with improper dietary control will aggravate the disease.
In this example above, first of all, we should calculate his standard weight: height – 105, that is, 170-105 = 65 (kg), the actual weight of 85 kg, 30% more than the standard weight, is obese. The accountant is a light worker, in such a situation, the daily caloric intake should be 20 to 25 kcal/kg of body weight, so his total caloric requirement for the whole day: 65*20 -25=1300-1625 kcal. It should be noted that the weight in the calculation is the standard weight and not the actual weight.
The caloric intake standards are different for different weights and activity levels.
Labor intensity
lethargy
Kcal/kg/day
Normal
kcal/kg/day
Obese
Kcal/kg/day
Bed rest
20-25
15-20
15
Light physical laborers
35
25-30
20-25
Moderate manual laborers
40
35
30
Heavy manual laborers
40-45
40
35
Balanced and Diversified Diet
The principles of diabetic dietary treatment include not only reasonable control of total caloric energy, with caloric energy intake to reach or maintain ideal body weight, but also attention to a balanced diet and selection of diverse and nutritionally sound foods.
Endocrinologists and nutritionists generally refer to food that generates 90 kcal as one food exchange portion. Simply put, half a tael of grain, a pound of vegetables, an egg, a tael of meat, half a bag of milk, and four taels of fruit are equivalent to one food exchange portion. The human diet should be diversified, and different kinds of food can be exchanged with each other as long as they meet the calories generated by one food exchange.
Xia Chengdong said, any kind of food can not contain all the nutrients, only through a variety of food mix to achieve complete nutrition, food variety is necessary to obtain comprehensive nutrition.
Diabetic patients should do: the main food coarse and fine grains with; side food meat and vegetarian food with; do not picky food, do not partial food. Four major food groups should be consumed daily: cereals and potatoes, vegetables and fruits, meat and eggs, and fats and oils. The scientific distribution principle is that carbohydrates account for 55% to 60% of the total daily calories, fat accounts for 25% to 30% of the total daily calories, and protein accounts for 15% to 20% of the total daily calories. When the total daily calories are the same (the total number of servings is the same), one can exchange one for another between main food varieties, between main and side dishes, between side dishes, between vegetables and between fruits. This encompasses almost all food varieties, and the patient’s diet is no longer monotonous, eating whatever he or she wants to eat, just like the average person!
Diabetic patients should increase their dietary fiber intake in moderation. Dietary fiber is also a polysaccharide and does not produce calories because it cannot be digested and absorbed in the gastrointestinal tract. Dietary fiber can be divided into soluble fiber and insoluble fiber. Soluble fiber, such as oats, buckwheat, pectin in fruits, algae in seaweed and artificial extracts such as konjac products; insoluble fiber, such as the epidermis of grains (coarse grains), the skin and kernel of fruits, stems and leaves of vegetables, cornmeal, etc. Effectiveness of dietary fiber: slow down the absorption of blood sugar and blood lipids, keep the bowels open and reduce hunger, should increase the daily intake of dietary fiber 25-30g grams per day.
Diabetic patients should limit fat intake, fat intake is not easy to produce a sense of satiety, so it is often easy to overdose. In our daily life we can see the fat including a variety of cooking fats, butter, animal oils, animal skin; and some invisible fat such as meat, poultry, fish, dairy products, eggs in and nut foods such as peanuts, melon seeds, walnuts, sesame paste and fried foods, hamburgers. Attention should be paid in the diet.
Xia Chengdong introduced, diabetic patients adhere to regular and quantitative meals, and advocate eating less and more meals. Few meals can ensure adequate nutrition, but also reduce the burden on the pancreas, which is conducive to good blood sugar control. It is recommended that at least 3 meals a day, 4 to 5 meals for those who inject insulin is appropriate to prevent hypoglycemia, regular and quantitative meals, consistent with the role of drugs, exercise time, so that blood sugar will not fluctuate too much.
Common dietary problems in diabetes
Q: What should a diabetic do if he or she is hungry after a controlled diet?
Xia Chengdong: First of all, it should be clearly understood that hunger is a symptom of diabetes, and after treatment, hunger will be reduced or even disappear when the condition improves. At the beginning of dietary treatment, the amount of food is significantly reduced compared to the original, the gastrointestinal tract may not adapt, but after a few days of adaptation, the hunger will be slowly reduced. If you still feel hungry, you can take: eat more low-calorie, high-volume foods, such as various vegetables: tomatoes, cucumbers, cabbage, etc. Smaller and more frequent meals, even out a small portion of the main meal as an extra meal, with low-calorie vegetables, half a couple of staple foods or 1 egg (50g), 1 cup of milk (150ml), etc. Choose coarse grains instead of fine grains to produce a stronger sense of satiety. Making the taste lighter, slowing down the speed of eating, and doing fine chewing and slow swallowing can reduce an over-exuberant appetite.
Q: Can diabetic patients also drink alcohol?
Xia Chengdong: Alcohol has fewer advantages and more disadvantages for diabetic patients. Diabetic patients who drink alcohol are prone to hypoglycemia and can aggravate hyperglycemia. First of all, alcohol is high in calories, with each gram of alcohol producing 7 kcal of heat; at the same time, diabetic patients may be affected by drinking alcohol and eating too much fat-rich “wine dishes”, which is not conducive to diet control. Second, excessive alcohol consumption can lead to hypoglycemia due to inhibition of gluconeogenesis when fasting or missing meals, and alcohol can also induce hypoglycemia in patients treated with sulfonylureas or insulin. Adults with diabetes do not necessarily need to abstain from alcohol, but for non-perceived hypoglycemia, neuropathy, poor glycemic or lipid control, obesity or pregnant women, alcohol consumption should be limited or abstained. When the blood sugar is well controlled, there are no serious chronic complications or acute complications of diabetes, normal liver and kidney function, and non-obese people, they can drink alcohol in moderation, no more than 2 alcohol units in a day, one alcohol unit is about 285ml beer, 375ml draft beer, 100ml red wine or 30ml white wine, containing about 10g alcohol. Avoid drinking alcohol on an empty stomach.
Q: How can diabetics eat fruit?
Xia Chengdong: The prerequisite for eating fruit is ideal control, i.e. fasting blood glucose <7.8mmol/L, postprandial blood glucose <10mmol/L. The calories of fruit should be calculated into the total daily calories, and the corresponding amount of carbohydrates should be subtracted when choosing, and it is best to eat fruit between two meals as an extra meal, not only to avoid high blood glucose, but also to prevent hypoglycemia. Fruits such as watermelon (glucose index is high, eat less), apples, pears, oranges, etc. have relatively low sugar content; while bananas, dates, lychees, persimmons, red fruits have relatively high sugar content.
Q: Can diabetics still eat sugar?
Xia Chengdong: Diabetic patients should pay attention to the effect of foods containing sucrose and glucose on blood sugar. There is no need to worry about foods made with non-nutritive sweeteners such as meringue, aspartame and saccharin, but the calories contained in the food itself must also be calculated, for example, sugar-free cookies are also cookies, which are also made of starch and contain calories.
Q: Is it possible for diabetics to eat more soy products?
Xia Chengdong: Eating soy products (soy milk, tofu, etc.) in moderation is really good for health. Especially for the elderly and people with long duration of diabetes, if you don’t pay attention, consuming too much vegetable protein in large quantities can cause excessive nitrogenous waste in the body and increase the burden on the kidneys. Especially for those with combined kidney insufficiency, it is best to abstain from eating beans and try to focus on white meat such as fish and poultry for protein intake.
Q: Is drinking porridge not good for diabetics?
Xia Chengdong: Cooked and roasted food is highly digestible and easy to absorb due to the high degree of starch pasting, and the speed of blood glucose increase is also fast, such as the speed of blood glucose increase after eating thin porridge, while rice and corn cakes are digested slowly and glucose absorption is also slow, so the speed of blood glucose increase is also slow. Diabetic patients with poor blood sugar control should change the habit of drinking thin rice, pay attention to the amount of porridge and the combination of “dry” and “thin” food, etc.