DIABETES FOOD PLAN Dr. V. R. Willoughby OR, MRCP, FWACP, Physician Specialist and Dr. Victor Conteh MBBS (USL)
Includes Basic Guidelines for Dietary Control of Blood Glucose
to avoid & as11afoods diabetic!
DIABETES FOOD PLAN Dr. V. R. Willoughby OR, MRCP, FWACP, Physician Specialist and Dr. Victor Conteh MBBS (USL)
Contents
Diabetes Food Plan
Introduction
D
iabetes is a serious problem that can lead to numerous health complications (e.g. blindness, kidney disease etc) and even death. Whilst diabetes often require medication for control, it is important to remember that proper nutrition meal planning (discussed later) is equally critical in diabetic care. Because of this, the diet of a diabetic is extremely important. However there are a number of fallacies about the diabetic diet that you should be aware of: 1. It is often believed that the diet will require the diabetic to eat very differently to everyone else – all the same basic food groups are used. 2. It is believed that the diabetic diet is difficult to understand and adhere to – it is actually very simple to understand and to follow. 3. It is also believed that the diabetic diet is one of deprivation and possibly even hunger – the diet ensures that you have the correct quantity and quality of foodstuffs in your diet.
Diabetes Food Plan
T
he diabetic diet is one of controlled intake of the 4 major food groups. With very few exceptions, the diabetic diet uses exactly the same ingredients as any “normal� diet. In fact, the diet that a diabetic follows is so balanced and healthy that if your whole family followed it, they would all benefit tremendously.
NINE (9) FOODSYOU SHOULD EAT TO MANAGE TYPE-2 DIABETES 1. BEANS Beans(including black, white, navy, lima, pinto, garbanzo, soy, and kidney) are a winning combination of high-quality carbohydrates, lean protein, and soluble fiber that helps stabilize your body's bloodsugar levels and keeps hunger in check. Beans are also inexpensive, versatile, and virtually fat-free 2. OATMEAL Studies have shown that eating a diet rich in whole grains and high-fiber foods may reduce the risk of diabetes by between 35 and 42 percent. An excellent source of both is heart-healthy oatmeal: It's packed with
Diabetes Food Plan
soluble fiber, which slows the absorption of glucose from food in the stomach — keeping blood-sugar levels under control. 3. FISH Another outstanding source of lean protein is fresh fish. Choose an environmentally friendly variety like catfish, cod, or tilapia; all are mildflavored, white-fleshed fish that can be healthfully prepared by baking, grilling, or roasting. Pair fish with the high-quality carbs found in vegetables, lentils, or beans for another balanced meal combination that will keep your blood sugar from rising.
4. FAT FREEYOGHURT Fat-free yogurt naturally contains both high-quality carbohydrates and protein, making it an excellent food for slowing or preventing an unhealthy rise in blood sugar. Studies also show that a diet high in calcium from yogurt and other calcium-rich foods is associated with a reduced risk of type 2 diabetes. Be sure to stick to low-fat or nonfat brands.
Diabetes Food Plan
5. NON STARCHY VEGETABLES Because these low-calorie, nutrient-dense veggies have a low-impact on blood sugar, they're an integral component of your diabetes food plan. For most people (including those looking to lose weight), this is one food group that's okay to eat as much as you like!
6. EGG WHITES Rich in high-quality lean protein and low in carbs, egg whites are another healthy choice for controlling or preventing type 2 diabetes. One large egg white contains about 16 calories and 4 g of high-quality, filling protein, making egg whites a perfect food for blood sugar control, not to mention weight-loss or maintenance.
7. AVOCADO Av o c a d o i s h i g h monounsaturated fats which are generally considered among the healthiest of fats. Researchers have found that a diet high in monounsaturated fats and low in low–quality
Diabetes Food Plan
carbs may improve insulin sensitivity. Monounsaturated fats also improve heart health — an especially important benefit for diabetics, who are at an increased risk for heart disease and stroke. Add a few thin slices of avocado to your sandwiches in place of mayonnaise.
8. ALMONDS Unsalted almonds provide a healthy, low-carb mix of monounsaturated fats plus magnesium, which is believed to be instrumental in carbohydrate breakdown in the body. A large study out of Harvard University found that high daily magnesium intake reduced the risk of developing diabetes by 33 percent. Therefore, including more magnesium-rich foods like almonds, pumpkin seeds, spinach, and Swiss chard in your diet is a smart move.
9.WILD SALMON Omega-3s from food help reduce your risk of heart disease, which is important for those with type 2 diabetes, whose risk of cardiovascular disease is already elevated. Over time, high blood glucose levels can lead to increased deposits of fatty materials in blood vessels, which contribute to clogging of arteries. Wild salmon or sardines are not only rich in
Diabetes Food Plan
omega 3s but also contain a healthy-fat-and-protein combination that slows the body's absorption of carbohydrates, keeping blood sugars on an even keel.
foods to avoid if
H
ere are 11 foods that diabetics should avoid to help keep their cholesterol levels and blood sugar level in good shape. 1) Certain Local diets like too much of: Eba Foofoo Rice (But brown rice is much better) Pounded yam Are all “heavy carbohydrates” loaded with lots of calories that may make control of your blood sugar difficult. They are better taken occasionally and in small amounts and during the day, rather than at late evenings.
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2) French Fries: While most of us love their deep fried tastiness the fact that they are deep friend means that French fries are off limits for diabetics. An order of fries from a fast food restaurant can contain up to 1/3 of the daily calories that the average person should be eating in addition to being loaded with sodium and saturated fat.
Diabetes Food Plan
3) Burgers: This is another fast food favorite that is off limits. These calorie bombs can contain up to 400 calories for the small basic burger while containing loads of sodium, saturated fat, and cholesterol. So if a diabetic simply must have a burger, it would be best to make it at home with super lean meat and grill it so that the fat drains away and serve it on a whole wheat bun. 4) Fish Sandwiches: While fish itself is very healthy, and a great choice for diabetics, the breaded and deep fried varieties offered at most fast food joints is not. Like burgers, these are loaded with fat, carbs, sodium and calories, all of which are not things that a diabetic needs to eat. There are alternatives available for diabetics in the super market including things like salmon burgers or baked fish filets. 5) Fried Chicken: Because it's fried, diabetics should steer clear. There is the option to oven fry the chicken, which isn't fried at all but the crispy breading and chicken skin is still off limits to diabetics. Fried chicken is also usually loaded in sodium. 6) Commercially Produced Baked Goods: Commercially available baked goods are also high in saturated fat as well as sugar and simple carbs, which is very bad news for diabetics. 7) Frozen Dinners: Frozen dinners in general and pot pies specifically are another no-no for the
Diabetes Food Plan
diabetic. These products contain high amounts of sodium, fat, cholesterol, carbs and calories. Unfortunately there really aren't any diabetic-safe alternatives to these products, so it's best for diabetics to avoid them altogether. 8) Deli Meat: Deli meats are full of massive amounts of sodium and fat, making them bad choices for diabetics. Fortunately there are low sodium lunch meats available, and diabetics can cut down on the blood sugar spikes by using whole grain breads. Wraps are an even better option. When made with whole wheat tortillas, wraps are even lower in carbs. 9) Soft Drinks Or Flavored Waters: These drinks are full of empty calories in the form of sugar. Since diabetics are unable to process the sugar without the aid of medications or insulin injections, soft drinks and flavored waters are a bad idea. Of course there are diet varieties available, though how healthy these drinks are is something to be debated. The best choice for everyone, whether diabetic or not, is water. 10) Purchased Smoothies Or Milkshakes: While milkshakes are notoriously unhealthy, smoothies might seem healthy on the surface, but in fact they can be loaded with sugar and calories. Even the "light" smoothies can have more than 30 grams of sugar, more than 30 grams of carbs and 170 calories in a 16 ounce serving. Since this is what is in a "light" version, it's best to
Diabetes Food Plan
avoid these drinks altogether. 11) Frozen Or Delivery Pizza: While pizza is among one of the most popular convenience foods in the United States, it's bad news for diabetics. Frozen or delivery pizzas are loaded with carbs, sodium, fat and calories. One slice can have over 300 calories, but who eats just one? When talking about two or three slices, the calories and extra carbs can add up.
BASIC GUIDELINES FOR CONTROL OF BLOOD GLUCOSE What you eat, how much, and when has a big impact on your glucose levels 1) Eat three meals a day and snacks spaced in long spans. 2) Do not skip meals. 3) Eat your meals and planned snacks about the same time every day, just as you take your medication. 4) Eat a consistent amount of carbohydrates at each meal and snack, and distribute carbohydrates evenly throughout the day. 5) It is important to be mindful of what you eat, and the effect it has on your blood glucose by testing before and after meals. 6) Choose more high-fibre foods. Try these high-
Diabetes Food Plan
fibre foods: Vegetables: okra, eggplant, carrots, broccoli, leafy greens such as callaloo, kale, collards, spinach and Swiss chard Fruits: guava, oranges, mango, banana, paw-paw, pineapple, apples, melon and berries Whole grains: oats, millet, teff, barley, brown rice, maize and whole wheat. Legumes: kidney beans, lentils, pigeon peas, chickpeas and cowpeas Nuts and seeds: almonds, walnuts, peanuts, flax seeds and cashews 7) Limit sugary foods such as fruit juice and nectars, jam, candy, baked goods and pop. Also Limit these high fat meats: - Chicken wings - Sausage - Spareribs - Chicken, cow or pig feet - Cow tongue - Pig or ox tail
Diabetes Food Plan
Meal Plan for Diabetics By sticking to a proper diabetic meal plan, diabetics will be much healthier and, in the long run, they'll be much happier too. Try to have three daily meals at regular times and have healthy snacks when you are hungry. A balanced meal has foods from at least 3 of the 4 food groups: 1) Vegetables and Fruit 2) Grain Products 3) Milk and Alternatives 4) Meat and Alternatives A lot of meal plans for diabetics exist. But they are either too complex or include foodstuffs not easily available within the West-African market. Below is an example of a simplified meal plan: Ă˜ Breakfast: Bread (toast/roll) Porridge or wholegrain breakfast cereals Fruits (fresh or tinned but without sugar) Ă˜ Mid-Morning (light meal) Soup B re a d ( t o a s t / ro l l / b a k e d ) , o r p o t a t o e s chips/spaghetti
Diabetes Food Plan
Ø Ø -
Small portion lean meat, Chicken, fish, eggs, cheese or baked beans Vegetables or salad Fruits as main meal Mid-Afternoon (main meal) Soup Small portion lean meat, chicken or fish Potatoes, bread, rice or spaghetti Large portion vegetable or salad Fruit (fresh/ stewed or tinned but without sugar) Fat-free yoghurt (diet yoghurt), unsweetened milk 1 guava Snack: ¾ of a cup of yogurt ½ a cup of mango or sour sop
Ø Bedtime: If you require a meal at this time, or a bedtime snack the following are appropriate: Fresh fruit Diet yoghurt Toasts Crackers Two plane biscuits Water with lemon or lime Plus Water, water, water all the way!!
Diabetes Food Plan
Alternatively, depending on appetite the following meal plan can be adopted…… For smaller appetites
For bigger appetites
Breakfast: porridge – plantain, cooked (2/3 cup) 1 egg paw-paw, 1 small, or 1 cup cubed
Breakfast: fresh codfish or eggplant and codfish (½ cup, 125 mL) 1 small banana whole wheat/ bread (1 slice) margarine (1 tsp, 5 mL) ½ cubed paw-paw 2% evaporated milk (¼ cup, 60 mL) with hot tea or coffee with no sugar
Lunch: yam, cooked (1 cup) kale, cooked baked chicken, cooked (2 oz, 60 g) mango, ½ medium low-fat milk or fortified soybeverage (1 cup, 250mL)
Lunch: beef red bean soup (1½ cup) 1 small mango
hot tea or coffee with no sugar Afternoon snack 1 medium apple Dinner: brown rice and peas (2/3 cup, 150 mL) mixed vegetables salmon croquette (2oz, 60 g) oil, no more than 1 tsp or 5 mL guava, 3 fruits hot tea or coffee with no sugar
Evening Snack: low-fat cheese (1 oz, 30 g) whole grain crackers (4) water
Dinner: red snapper (4 oz, 120 g) steamed with okra and tomato brown rice and peas (1 cup, 250 mL) carrots (½ cup, 125 mL) green salad with low fat dressing (1 cup, 250 mL)br /> cubed watermelon (1 cup, 250 mL) margarine (2 tsp, 10 mL)
Evening Snack: Whole grain crackers, unsalted (7 pieces) low-fat cheese (1 oz, 30 g) 2% milk (1 cup, 250 mL) hot tea or coffee with no sugar
Diabetes Food Plan
BEWARE OF TOO LOW BLOOD SUGAR (HYPOGLYCAEMIA)!!!!!!!!!! Low blood sugar (also known as hypoglycemia) can be just as much of a problem as high blood sugar. When blood glucose drops too low, it can cause you to feel: Shaky, Lightheaded, Nervous, Irritable, Confused, or Hungry. It can also give you a headache or cause you to sweat. It can come on suddenly, and it needs to be taken care of right away or it can cause Unconsciousness or a Seizure. Test your blood sugar at the first sign of these symptoms. If it is below4.0 mmol/L, treat your hypoglycemia. If you don't have a meter with you, assume the problem is hypoglycemia and treat the symptoms. Treatment consists of consuming 15 grams of a fast-acting carbohydrate such as: 路 glucose tablets 路 3 teaspoons (15mL or 3 packets) of table sugar dissolved in water 路 regular soft drink (not sugar-free) or 175 mL (3/4 cup) of fruit juice or a
Diabetes Food Plan
路 1 tablespoon (15mL) of honey (do not use for children less than 1 year old) About 10 to 15 minutes after consuming the carbohydrate, check your blood sugar again. If it's still below4.0 mmol/L, repeat the treatment. If your next meal is more than an hour away of you will be active, eat a snack that contains 15 grams of carbohydrate plus a protein source, such as cheese and crackers or half a sandwich. DON'T HESITATE FOR MEDICAL HELP!!!!!!!!!!!!!!!!!!
Diabetes Food Plan
CALORIE VALUE OF COMMON FOOD ITEMS NOTE: Figures given in this chart are based on 100gm portions FOOD
CALORIES
PROTEINS(gms) FAT (gms)
margarine Butter Pea nuts (Roasted) Chocolate Biscuits Pork (Grilled) Cheese Fish Spirits Cream Cornflakes with milk Wheat Bran Ice Cream Chicken (Roast) Eggs Rice (White boiled) Bananas Potatoes (Boiled) Wine Milk Grapes Peas Apples Beer Beans (Boiled)
740 740 570
24
81 82 49
CARBOHYDRATES (gms) 9
520
6
28
67
340 310 220 220 210 205
29 22 20 2 6.5
24 25 10 21 4
8 3 34.7
200 170 150
14 4 25
6 7 5
23 25 -
150 120
12 2
11 -
30
80 80
1 1
-
20 22
70 65 60 50 45 30 20
3.3 0.6 5 0.3 0.3 2
4 -
5 15 8 12 2 3