Diabetes mellitus is a chronic, systemic, metabolic disease caused by a combination of genetic and environmental factors over a long period of time, and poor control can cause disability or even be life-threatening. Genetic factors are inherited for susceptibility, and environmental factors constitute the main causative factors of diabetes. For most type II diabetes, unscientific lifestyle patterns such as unbalanced diet, excessive caloric intake, addiction to alcohol and tobacco, and lack of physical activity are among the most significant predisposing factors.
I. Diabetes nutrition treatment goals.
1. Maintain normal weight. According to clinical observation, the incidence of diabetes is 1.5 times higher in 10% overweight, 3.2 times higher in 20% overweight, and 8.3 times higher in 25% overweight, while low weight will reduce the body resistance and increase the occurrence of infections.
2.Control blood glucose, urine sugar, triglycerides, cholesterol and blood pressure, so that close to or maintain the normal value, in order to prevent or delay the occurrence and development of acute and chronic complications.
3.Supply sufficient energy (but not in excess) to ensure physical and mental health.
Second, the principles of nutritional treatment of diabetes.
1, a reasonable supply of energy and balanced diet. Diabetic energy supply to maintain normal body weight is appropriate, too high or too low are not conducive to the health and treatment of patients. Protein, fat and carbohydrates are the three major energy-producing nutrients, the proportion of the three balanced for the health of diabetic patients is equally important.
2. Adequate carbohydrates, dietary fiber, and appropriate protein and fat. Carbohydrates should be the main source of the calories we need. Adequate carbohydrates on the basis of reasonable control of energy can save protein, enhance insulin sensitivity and improve glucose tolerance. The source of carbohydrates is mainly cereals and grains, the choice should follow the principle of rather coarse than fine, pay attention to the coarse and fine, often eat some coarse grains rich in dietary fiber, mixed grains, etc..
Potatoes, yams and other root food carbohydrate content in about 20%, rich in dietary fiber, can replace part of the main food to eat (250 grams of potatoes, yams, etc. Ì 50 grams of staple food). Can be moderate selection of fruit (but to be included in the comprehensive calculation of the main food, to not more than 200 grams per day is appropriate), 200 grams of fruit (except watermelon, bananas) Ì 25 grams of staple food, without or less refined sugar and refined processed grain.
The amount of protein should be appropriate. Protein-rich foods are mainly meat, eggs, dairy and soy products, is the main source of protein in food, especially high-quality protein, is the “functional ingredients” in food. Meat includes fish, shrimp, poultry and all kinds of lean meat, offal, etc., but it is not easy to eat more because of its high content of saturated fatty acids, which is the main risk factor for atherosclerosis, eggs because of its high cholesterol content, but also not easy to eat more. For a normal person and ordinary diabetic, a daily diet of 1 egg, lean meat 50-75g can (including fish, shrimp, poultry and a variety of lean meat, offal), should not be too much.
Milk and its products are not only rich in protein and vitamins, and the calcium content is high, the utilization rate is also very high, is the most economical and practical calcium-rich foods among animal and plant foods, each half pound of milk contains about 260 mg of calcium, equivalent to nearly 1/3 of the daily recommended supply. beans are the best high protein foods among plant foods, known as “plant meat “The most important thing is that it is the best “partner” of cereals, which can make up for the lack of lysine content in cereals. The shortcomings of the cereal. In addition, the calcium content (164 mg/100g dry soybeans, 138 mg/100g northern tofu) and absorption rate (7%) of beans are also the best among plant foods (the absorption rate of calcium in plant foods is usually 1-3%).
Therefore, a daily intake of 0.5-1.0 kg (250-500 ml) of cow’s milk and a moderate amount of soy products (equivalent to 40-50 grams of dry soybeans) should be ensured, especially for people who do not like meat or are restricted by conditions, dairy and soy products are the best alternative to meat foods. Too much dietary protein will not only prevent calcium absorption and promote calcium loss, but also increase the burden on the liver and kidneys, causing irreversible damage to liver and kidney function. Daily intake of the above recommended standard is sufficient to ensure a normal person or ordinary diabetic needs of protein.
Lipids mainly provide caloric energy and essential fatty acids, but also fat-soluble vitamins absorption of the material carrier. The intake of fats and oils should not be too much, to account for 20-30% of the total calories is better, which should not exceed 25 grams of cooking oil / day (1.5 kg / month), and limit the intake of meat and fatty meat, more is not beneficial. In addition, peanuts, melon seeds, walnuts, sesame seeds (sauce) and other oil-rich foods, excessive consumption will also cause heat into the super, disrupting the dietary balance, causing health damage, and therefore should be included in the comprehensive consideration of fatty foods, rather than alone, one-sided emphasis on a particular aspect of the special role.
3, adequate inorganic salts, trace elements and vitamins. Ensure adequate supply of vegetables, and appropriately limit sodium intake. For patients with polyuria, attention should be paid to the supplementation of certain water-soluble vitamins such as B vitamins, vitamin C, folic acid, etc. when necessary.
4. Limit cholesterol intake. Daily cholesterol intake should be less than 300 mg (a medium-sized egg cholesterol content of about 250 mg), can be appropriate to choose to eat the role of blood lipid-lowering algae such as seaweed, nori, mushrooms, fungus, mushrooms, etc..
Third, the calories of diabetic patients
Diabetic calories need to find a professional dietitian according to the patient’s age, gender, height, weight, labor intensity, disease status, etc. to determine the caloric requirements, and then determine the amount of meals a day.
4. Meal distribution
Each meal should maintain a balanced nutrition, the total amount of the whole day can be allocated according to the ratio of 30%, 35%, 35% three meals a day, for the elderly or patients prone to morning hypoglycemia, can be four meals a day (three meals + evening meal), meal allocation can be adjusted to 25%, 35%, 30% and 10%.
V. Exercise.
Exercise and diet are two inseparable parts, appropriate and reasonable exercise is important to stabilize weight and blood sugar. For diabetic patients, brisk walking and jogging is the best, 1-2 times a day, exercise time should be not less than 45 minutes / time.
In conclusion, reasonable dietary management and nutrition supply is the key to prevent and control the occurrence and development of diabetes. In today’s increasingly high standard of living, paying attention to scientific diet and emphasizing reasonable nutrition is an important means to reduce the incidence of diabetes and improve the quality of survival of diabetic patients.