Nutrition Recommendations for Diabetics. Ph.D, Nutritionist Soile Ruottinen

Transcription

1 Nutrition Recommendations for Diabetics Ph.D, Nutritionist Soile Ruottinen

2 Food to prevent diabetes and treatment diabetes is same in practice as is recommended to everybody else In other words: diabetics don t need special diets

3 The main objectives in diabetic nutrition are To guide diabetic balanced diet and enjoy food To encourage diabetic to flexible own treatment Recommended blood lipid values (cholesterols, triglycerides) and blood sugar and blood pressure If necessary losing weight and keeping it under control in the long term Prevent diabetes related conditions or postponed those Good life quality

4 Regular mealtimes Regular mealtimes are important Tree times (breakfast, lunch, dinner) per day and snacks 1 to 3 times per day Snacks are not necessary for type 2 diabetics With regular mealtimes means that daily approximately as many as usually and usually at the same time

5 Regular mealtimes Will help to control what people eat Leaving too much time between meals might easily cause overeating and not caring about the quality of the food

6 Regular mealtimes help: Balance out the rise in postprandial (after a meal) blood sugar With food and medicine coordination With food amount and thereby to prevent overweight Type 1 diabetic with meal insulin dosing

7 Diabetic nutrition recommendations Carbohydrates % - Added sugar less than 10 % Fat % - Saturated and transfatty acids 10% - Monounsaturated fatty acids 10 20% - Polyunsaturated fatty acids 5 10% Protein 10 20%

8 Carbohydrates Diabetics should eat high-fibre foods Carbohydrates should balanced with whole day Carbohydrate counting is useful for type 1 diabetic and for type 2 diabetic with meal tablets or meal insulin If triglycerides are elevated, it might be useful that carbohydrate intake is approximately 45 E%

9 Dietary fibre Aim 20 g / 4,2 MJ (1 000 kcal) or 40 g/ day The fibre content will serve to balance out the rise in daily and post prandial (after a meal) blood sugar For diabetics is recommended more dietary fibre than people without diabetes To increase dietary fibre should do with little by little to prevent stomach inconvenience

10 Dietary fibre Aim: 20 g / 4,2 MJ (1 000 kcal) or 40 g/day Example: 4 slices rye bread+ 2 slices whole wheat bread 14 g 1 slice rye bread 3 g Oat porrige 400 g vegetables/fruits/berries 8 g 3 g 1 slice wheat bread 1 g 6 potaties 5 g 3 fruits 6 g > 2 dl berries 4 g Picture: Leipätiedotus ry

11 Sugar Added sugar max 10E% Increased intake of sugar or/and fructose increases triglycerides High intake of lemonades and other sugared juices are connected with overweight

12 Baltic sea food model Picture:

13 Plate model Source:

14 Protein Protein E% More protein than 20E% might be harmful for diabetics Protein intake as 0,8 1 g/ideal weight kg/per day might be useful in microalbumin condition and is needed in kidney disease

15 Diabetic nutrition Fat quality is connected with blood lipid values (lipoproteins), insulin sensitivity, blood pressure and blood clots

16 Diabetes Diabetes is associates with a cluster of risk factors for arterial disease in which elevated blood sugar levels constitute one risk factor among others In diabetics nutrition because of elevated risk of cardiovascular diseases fat quality and amount are very important

17 Effects of nutrition changes Change in nutrition Less saturated fat and improvement of fat quality Lower blood cholesterol 5-10 % Decrease cholesterol in diet 3-5 % Plant streols/stanols % Losing weight 5-10 % Dietary fibre 3-5 % Total % S.M Grundy 2001

18 Fat quality in diabetic nutrition recommendations Saturated and trans fatty acids less than 10E% Monounsaturated fatty acids 10 20E% Polyunsaturated fatty acids 5 10E% Reference: Diabeetikoiden ruokavaliosuositus 2008 Diabetesliitto (Finnis Diabetic Association)

19 Saturated fatty acids, hard fat Increase blood total cholesterol and LDLcholesterol Worsen blood sugar metabolism, increasing fasting insulin levels and decreasing insulin sensitivity Might increase inflammation factors Expose blood clots

20 Food choices Foods choose with fat-free or low fat or with vegetable fats: Milk products (fat-free milk, fat-free sour milk, cheese less than 17 % fat, fat-free yogurt) Meat less than 7 % fat, cold cuts less than 2% fat and sausage less than 12 % fat Bakery products with less fat as plain coffee bread/bun/baked roll Sausages and mean meal with less fat/vegetable fat Ready-made foods

21 Soft fat Decrease blood total- and LDL-cholesterol Improve HDL/LDL-cholesterol relation Improve insulin sensitivity Decrease blood clots development Decrease inflammation factors Prevent cardiovascular conditions

22 Fats To bread, for baking, cookery and for salad dressing, soft, oily fats for bread vegetable margarine for cooking and baking vegetable oil or soft margarine/running margarine for salads very little vegetable oil or dressing with vegetable oil Reference: Diabeetikoiden ruokavaliosuositus 2008 Diabetesliitto

23 Alcohol Limited use of alcohol or not at all Especially overweight people and people with elevated blood pressure should limit drinking

24 Overweight Overweight is bad for blood sugar and blood lipid values and cardiovascular diseases risk Overweight diabetic s have to use more medicine than normal weight diabetic people

25 Overweight Even losing 5-10 % of body weight will help Of course preventing weight gain is always better than working for weight loss Fat accumulating particularly around the waist and the stomach is more damaging for cardiovascular disease than fat on the thighs and hips

26 Reference: Diabeetikon ruokavaliosuositus 2008 Diabetesliitto (Nutrition recommendation for diabetes 2008, in Finnish. Finnish Diabetic Association) okavaliosuositus_2008.pdf What do I do now? How to manage the risk of type 2 diabetes uv_eng_final.pdf

27 Reference: Diabeetikon ruokavaliosuositus 2008 Diabetesliitto (Finnish Diabetes Association) Working group: Professor, MD, M.Sc (food science) Suvi Virtanen M.Sc, Nutritionist Eliina Aro Adjunct professor, MD, PhD Päivi Keskinen Adjunct professor, Ph.D Jaana Lindström Diabetes nurse Marja Rautavirta Lic.Sc, nutritionist Anna-Liisa Ventola M.Sc, nutritionist Leena Virtanen