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:
1. 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…
2. Medical Goal
Achieve Glycemic level close or almost as non-diabetic range
3. Subjective (Patient) Goal
Reach satisfying life with the least complications or comorbidities
A Smart Successful Clinical Nutritionist educate diabetic or pre-diabetic individuals healthy eating patterns rather than dietary restrictions.
Medical Nutrition Therapy:
You have to decrease caloric intake Increase physical activity Along with healthy eating patterns
B. 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
1. 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
And advice with necessary changes
2. If the patient on insulin, we have to adjust meal upon.
3. Avoid sugar sweetened beverages, and replace with nutrient dense food, like fruits and vegetables
Take protein rich food, especially of plant source, as it was found to improve endogenous insulin response.
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.
6. Avoid added sugars and use natural sweeteners as honey
Vitamin-B12 is necessary in the nutrition plan as supplements
Also take Vitamin-B12 rich food, as fish, skimmed milk, and the fortified cereals.
Green tea and herbal tea Improve metabolism and improve the circulation, so it improves glycemic control and weigh reduction too.
9. Decrease Sodium consumption
10. Be flexible with the patient, you can give him exchange lists for wide variety of options
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.
11.Use baking, and boiling the food instead of frying