Diabetes and Diet

To maintain your weight, you can consider the following recommendations on the intake of calories:

• Men, active women: 30 calories per kilogram of body weight.
• Women, men with reduced physical activity, anyone over 55 years: 26 calories per kilogram of body weight.
• Women with reduced physical activity: 20 calories per kilogram body weight.
• To lose weight, remove 500-1000 calories per day to lose 0,5-1 kg per week.

The basic recommendations for nutrition in diabetes are:

• Have 3 main meals and 2-3 snacks daily, according to the recommendations of your physician and your dietician, and always in concordance with your medication.
• It is important that you avoid long periods of time without taking a main meal or some snack.
• Include starchy foods such as bread, cereals, potatoes, and pasta with every meal. These foods should be consumed in sufficient amounts and there is no need to avoid them.
• Eat at least 5 small portions of fruit and vegetables on a daily base. You can consume the vegetables either as salad or cooked, and add 2-3 not too ripe pieces of fruit during the day.
• Avoid consumption of foods that are rich in simple carbohydrates and prefer whole grain products that are rich in fibre.
• Avoid consuming aggravating fats as part of your diet. Prefer cooking or baking over frying or roasting as cooking methods.
• Prefer low-fat dairy products and avoid fatty cheeses.
• Reduce the direct and indirect intake of salt and the consumption of salted products (cheese, pickles, pickled meats, salted nuts etc.) as much as possible.

Carbohydrates: Carbohydrates may make up maximum 50 to 60% of the overall energy intake, although an exact proportion should be adjusted to the weight and the activity level of each individual. Avoid consumption of foods that are rich in simple carbohydrates such as sugars and white flour (white bread, sugar, fructose, honey, syrup, marmalade etc.) and soft drinks or juices with added sugar, such as nectars. On the contrary you should consume carbohydrates from fruits, vegetables, legumes, whole grains and dairy products low in fat, and choose products with low-calorie sweeteners e.g. stevia or aspartame. It is desirable that a certain- fixed percentage of carbohydrate is present in each meal. For patients who are treated with insulin, the amount, the type and the time of intake of the carbohydrates must be coordinated with the dosage and the action time of the insulin preparation used.

Fibre: You need to include natural food products in your diet that are rich in fibre. The fibre content of diets for the treatment of diabetes should be higher than 40 g/day (or 20 g/1000 kcal/day), half of which should be soluble. In order to achieve these quantities, it is important that you have vegetables with each meal, at least 3 pieces of fruit per day and 2 servings of legumes per week. It is also important that the cereals that you include in your diet are whole grain and have a high fibre content.

Sugar: Sugar should be as limited as possible in a diabetic’s diet. Current recommendations prescribe a moderate amount of simple sugars up to 50 g/day, including the amount contained in all elements of the diet. This consumption, however, requires proper overall glycemic control. The total intake of simple sugars should not exceed 10% of the total energy intake.

Proteins: Foods like meat, eggs, cheese, fish, seafood, and chicken are sources of protein, together with vegetable sources such as legumes and cereals. You should consume sufficient quantities of protein on a daily basis, according to your diet, but take care not to exceed the amounts prescribed because excessive amounts of protein may impair your kidney function. If you have no indication of kidney disease, the intake of protein should amount to 10-20% of your total energy intake. On the other hand, if you do have kidney disease, the intake of protein should be restricted according to the instructions given by your physician and dietician. If you have diabetes type 1 and incipient nephropathy (microalbuminuria), or diabetes type 2 and incipient or established nephropathy, follow the instructions that will be given to you in order to lower your protein intake.

Fats: Fat requires attention in your diet. Fats should not exceed 35% of your total energy intake, although, according to current guidelines, there are no ideal values and the rates can be varied as appropriate. Saturated and polyunsaturated trans fatty acids from meat, cheese, ready-made bakery and pastry products should account for less than 10% of your total daily energy intake. On the contrary, your diet should comprise oils that are rich in mono¬unsaturated fatty acids (MUFA) such as olive oil, in a percentage of 10-20%, paying caution however to the total quantity in order to avoid too many calories. Polyunsaturated fatty acids (PUFA) to a percentage of 10% shall be derived from fatty fish that are rich in omega-3 fatty acids, flaxseed and nuts. Diabetics should consume two to three servings of fish (preferably fatty fish) per week.

Alcohol: Alcohol may initially cause a small increase in blood glucose, followed by its reduction after hours. Alcohol can be consumed by one unit per day for women and up to two for men. Examples of 1 unit include 120 ml of wine, 330 ml of beer, 30-40 ml of hard liquor (vodka, whiskey, gin, etc.). Consuming a small amount of alcohol with food along with the above recommendations won’t adversely affect your glucose control. It should be taken into account, of course, that alcohol provides calories, which can affect the weight loss effort.

Low-calorie sweeteners: Sweeteners such as stevia, aspartame, and sucralose can be used safely by diabetics, because they have a beneficial effect on postprandial (after-meal) blood glucose and insulin levels. Low-calorie sweeteners help to reduce the postprandial glycemic response, providing a sweet taste without affecting blood glucose and insulin levels. Finally, low-calorie sweeteners can benefit diabetics and help to control body weight within the context of a healthy low-calorie diet by reducing the energy intake, when used instead of ingredients with a higher energy content.