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Nutrition as a Medicine in Diabetes Mellitus

Once the patient is pre-diabetic or a diabetic, he should follow healthy eating pattern for life, so be flexible and understanding as his Clinical Nutritionist.

Goals we want to achieve via Medical Nutrition Therapy:

Lifestyle Modification Goal

  • Healthy Eating pattern (Mediterranean or Dash diet + Low CHO diet are of choice)
  • Physical Activity At least 30 min of moderate activity level per day And for weight loss, 60-90 min moderate activity level per day
  • Behavioral Modifications Quite smoking, Alcohol restriction, fast food restriction, and avoid faulty eating habits, others
  • Regular monitoring

Medical Goal

  • Achieve Glycemic level close or almost as non-diabetic range

Subjective (Patient) Goal

  • Reach satisfying life with the least complications or comorbidities

A Smart Successful Clinical Nutritionist educates diabetic or pre-diabetic individuals healthy eating patterns rather than dietary restrictions.

Medical Nutrition Therapy:

Energy

You have to decrease caloric intake Increase physical activity Along with healthy eating patterns

Healthy Eating patterns

  • Should be individualized and variable but all are within healthy terms

1) Follow a healthy Meal Plan:

  • Mediterranean, Dash, or low CHO

2) Make your CHO choice mainly from; fruits, vegetables, legumes and whole grains

  • As the higher in fibers, the lower their glycemic index

3) Decrease CHO in the morning meal, as it might not be well tolerated, due to high cortisol level in the morning (counter-hormone to insulin)

4) Choose low glycemic index food

  • Do CHO counting
  • 1st use food dairy
  • Then calculate CHO needed per ideal body weight for individual
  • Divide standard amount on CHO on meals
  • Preferred to be 3 main meals and 2-3 snacks
  • Compare with individual’s food diary

5) And advice with necessary changes

  • If the patient on insulin, we have to adjust meal upon.
  • Avoid sugar-sweetened beverages, and replace with nutrient-dense food, like fruits and vegetables
  • Proteins:
  • Take protein-rich food, especially of plant source, as it was found to improve endogenous insulin response. Ex: legumes

6) Fats:

Quality of fats is more important than quantity

  • Follow Mediterranean diet eating pattern; decrease saturated fats and total cholesterol, increase monounsaturated fats, polyunsaturated fats, and omega-3
  • Meaning: depend on olive oils, fish, fruits, vegetables, soy products and nuts and decrease fatty fish, red meat, and high fat diet.
  • Avoid added sugars and use natural sweeteners as honey

7) Supplements:

  • Vitamin-B12 is necessary in the nutrition plan as supplements
  • Also take Vitamin-B12 rich food, as fish, skimmed milk, and the fortified cereals.

8) Herbal:

  • Green tea and herbal tea Improve metabolism and improve the circulation, so it improves glycemic control and weigh reduction too.

9) Decrease Sodium consumption

  • Be flexible with the patient, you can give him exchange lists for wide variety of options

For example:

  • 3 serving CHO: choose your preference from
  • Pats, rice, whole grain toast or bread, pancakes, muffin … and others
  • Don’t restrict, just educate and guide, for the best compliance and satisfaction of the patient.

10) Use baking, and boiling the food instead of frying

 

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