Diabetic meal plan planning

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Diabetic meal plan planning
ENERGY REQUIREMENTS |Meal Plan Diabatic menu :Model

A diabetic diet should be related to the patients needs, after considering such factors such as age, sex, actual weight, occupation and other physical activities.

An approximate range for various groups are:

1. An obese, middle aged or elderly patient with mild diabetes require 1000-1600 kcal daily.
2. An elderly diabetic, but not overweight requires 1400-1800 kcal daily.
3. A young and active diabetic, including juvenile diabetics, require 1800-3000 kcal daily.
4. Pregnant diabetics also require 1800-3000 kcal energy daily.
5. Overweight young diabetics should have an energy intake of only 1800 kcal daily.

The proportion of energy derived from the carbohydrates should be 46%, protein 12% and fat 42%. But in most diabetic diets, the proportion of energy from carbohydrates should be 50-55%, from proteins between 10-`5% and from fat less than 35%.

CARBOHYDRATES

If the daily intake of carbohydrates has to be as high as 240 g to meet energy needs, about 50g is usually provided in each of the three main meals, 20 g in three snacks and 30 g in 600ml of milk. Fruits containing fructose rather than those with sucrose and glucose should be included because fructose may not raise the blood sugar level as much as sucrose or glucose, it may raise plasma triglycerides more.

PROTEINS

Proteins should be included at each meal, because amino acids stimulate insulin secretion in both normal and immaturity-onset diabetes. A smaller rise in blood glucose occurs when carbohydrates is consumed along with proteins. 50g of proteins or more should be a must for all diabetics unless the patient is obese.

FAT

Because diabetic patients have increased risk of death from coronary heart disease, and because this may be related to the amount of saturated fat in the diet, the total amount of fat should be restricted even in those who are not obese.

Restricted Diabetic Diet

A diabetic either with restricted or unrestricted diet should consume 8-10 glasses of water daily. The daily menu of the restricted and unrestricted diabetic diet contains three main meals i.e. breakfast, lunch and dinner with intermediary foods at 6 a.m., 8 a.m., 4 p.m, 6 p.m., and 10 p.m.

The daily intake for both the groups should be 500 ml milk (skimmed), 30 g fat. Organ meals should be consumed once a week or month or totally avoidable. Lean meals weighing between 60-9- g can be consumed daily. Whole egg should not be consumed daily, but egg whites can be consumed twice daily. 1 tablet or a few drops of non-carbohydrate sweeteners like saccharine, sorbitol, asparmate can be given with milk or beverages or used in the preparation of sweets and desserts. However obese diabetic patients should avoid non-carbohydrate sweeteners because they contain nearly the same number of calories as the carbohydrate sweeteners.

An important point to keep in mind is that the diet of diabetics should be as near the diet of other family members as possible.

Unrestricted diabetic diet

Unrestricted diabetic diet is for patients who are not obese. Their food is divided into the following three categories.

DIET FOR DIABETICS WITH OTHER COMPLICASTIONS

For diabetics with other complications, in addition to sugar intake, other types of diets have to be followed. They are fat restricted diet, salt free diet, low salt diet and a diet which allows moderate salt intake, low protein diet, high protein diet.

For diabetics with hypertension, a salt free or low salt diet and a fat restricted diet is recommended.

In a salt-free diet or low salt diet, sodium intake is restricted. Avoid highly salted foods such as cheese, butter, ketchups, sauces, canned foods, margarine, pickles, papads, chutneys, items that contain preservatives and baking powder, salad dressing containing mayonnaise, Chinese food with its ajinomoto content, organ meats (brain, liver) cured and processed meats (salami, sausages, smoked fish, ham, bacon) etc.

In a salt restricted or a low salt diet, spices and herbs may be used, to enhance the flavour of the dish.

Moderate salt intake diet should be given for diabetics with hypotension. For diabetics with jaundice, fat and high protein diet should be totally avoided. Dal can be given only in very diluted form. Very low protein vegetables are tomatoes, brinjal, pumpkins, carrots, onions, French beans, beet roots, cabbage, cauliflower, mushrooms, celery, radish, turnips, lettuce, cucumber. Very low protein fruits are pears, apples, pineapples, grapefruit and mandarin.

For a diabetic nephropathy patient, a high protein diet is recommended. Nuts, pulses, eggs and milk contain high protein content.

Sugar, salt and fat restricted diet is recommended for patients with diabetic foot (gangrene), diabetic retinopathy (complications of the eye) diabetic neuropathy (nerves).

(Salt free and protein free breads, biscuits and rusks baked from wheat flour are available in some shops).