The intervention of diabetes is inseparable from the "five carriages", namely diet, exercise, medication, cognition, and monitoring. The diet of diabetic patients is one of the important reasons for stabilizing blood sugar, if you don't pay attention to it, your blood sugar will rise sharply; Or some diabetics may increase their insulin dose while eating too much. Just wait for complications to come along the way.
The scientific and reasonable diet of diabetic patients can have a multiplier effect on blood sugar control with half the effort, and even reduce the dosage of hypoglycemic drugs, but a large number of health managers, dietitians, physicians, and ** will not compile recipes, so today I will teach you how to easily formulate diets for diabetic patients. This article is divided into two parts, one is a dietary guide for diabetes; One is the preparation of diabetic recipes.
Dietary Guidelines for Diabetes
The National Health Commission issued the "** Diabetes Diet Guidelines (2023 Edition)", which gives dietary principles and recommendations according to the characteristics and types of diabetes.
Eat a variety of foods and develop and establish reasonable dietary Xi
Dietary management and ** are the core of blood sugar control in diabetic patients, and the principle of a balanced diet should be followed, so that the food is diverse, the staple food is quantitative, the vegetables and fruits are rich, the milk beans are rich, less oil, less salt, and less sugar, and the daily energy is suitable and the nutrient intake is sufficient while controlling blood sugar. Food variety is the basis for achieving a balanced diet. A varied diet should consist of five major food groups.
1) Cereals and potatoes, including cereals (including whole grains), potatoes and mixed beans;
2) vegetables and fruits;
3) Animal food, including livestock, poultry, fish, eggs, milk;
4) soybeans and nuts;
5) Cooking oil and salt.
Reasonable diet refers to adjusting and optimizing the type and weight of food to meet one's own health needs on the basis of a balanced diet with the goal of controlling blood sugar.
The staple food should be quantitative, the carbohydrates should be mainly whole grains, various legumes, vegetables, etc., and the amount of fruits should be limited; Meals should have vegetables, up to 500 grams per day, of which dark vegetables account for more than half; There are milk and soybeans every day, often eat fish, poultry, moderate amounts of eggs and meat, these are good proteins**; Reduce the intake of fatty meat, eat less smoked, baked, pickled, fried and other foods, and control the amount of salt, sugar and oil used.
Energy-appropriate, control overweight and obesity and prevent wasting
Weight is an objective indicator that reflects the evaluation of dietary status and human health status over a period of time, and is also an important indicator that affects the occurrence and development of diabetes.
Dietary energy is central to weight management and blood sugar control. Energy requirements are related to age, gender, weight and physical activity, etc., which can be found in the Chinese Residents' Dietary Nutrient Requirements Scale. It can also be estimated on the basis of body weight, for example, the energy requirement of an adult woman with light physical activity of 60 kg is 1500 to 1800 kcal per day. The recommended macronutrients to total energy ratio of dietary energy for diabetic patients are 15% 20% for protein, 45% 60% for carbohydrates, and 20% for fat 35%.
Dietary energy comes from grains, fats, meats, eggs, milk, nuts, fruits, vegetables, and other foods. People with diabetes have different levels of energy requirements that vary depending on blood glucose regulation, and a dietitian should be consulted to help determine energy intake and exercise throughout the day, and to develop a personalized diet management, blood sugar, and weight control plan. Diabetic patients should pay special attention to maintaining their weight in the ideal range, improve the body's immunity, and reduce the risk of disease occurrence and development.
The body mass index (BMI) of a healthy weight in our country should be maintained at 185~23.9 kg/m2。For the sake of age and reducing the risk of death, people over 65 years of age can gain weight appropriately. Weight loss in obese patients can improve insulin resistance and improve glycemic control. Overweight and obese patients with type diabetes lose 3% to 5% of their body weight, resulting in clinically meaningful health benefits. Overweight and obese patients are advised to lose 1 to 2 kg per month and 5% to 10% in 3 to 6 months.
Due to the absolute or relative lack of insulin in the body, diabetic patients cannot give full play to the role of promoting glycogen, protein and fat synthesis and inhibiting their decomposition, and poor blood sugar control is also prone to excessive decomposition of body fat and protein, weight loss, and even weight loss. Patients with wasting or malnutrition should achieve and maintain an ideal body weight by increasing the supply of dietary energy and protein, combined with resistance exercise, under the guidance of a nutrition instructor. Older patients should pay special attention to preventing muscle loss and maintaining a healthy weight.
Staple foods are quantitative, with whole grains and low glycemic index foods preferred
Staple foods are mostly rich in carbohydrates, which are the core factors affecting blood sugar levels after meals, and diabetics should learn to choose staple foods Xi and measure them.
Glycemic index (GI) is a relative indicator to measure the impact of food on blood sugar, and choosing low GI foods is conducive to postprandial blood sugar control. Low GI foods stay in the gastrointestinal tract for a long time, the absorption rate is low, the release of glucose is slow, the peak value of glucose into the blood is low, and the decline rate is slow, simply put, the postprandial blood sugar fluctuation caused by it is relatively small, which helps blood sugar control.
Staple food is quantitative, not too much, choose more whole grains and low GI foods; Among them, low-GI foods such as whole grains and miscellaneous legumes should account for more than 1 3 of the staple food.
It is recommended that diabetic patients provide 45% to 60% of the total energy provided by carbohydrates, which is slightly lower than that of the average healthy person.
In the case of adults (1800 2000 kcal), the total amount of carbohydrates in a day is equivalent to 200 300 grams. However, if the diagnosis or blood sugar control is not good, it is recommended to consult a dietitian or health manager for individualized guidance on adjusting the amount of carbohydrates in the diet to lower blood sugar levels or the use of hypoglycemic drugs.
Blood sugar levels are a comprehensive reflection of carbohydrates, physical activity, dietary structure, fasting time, etc., and if the carbohydrate energy supply ratio is too low, it will not get better long-term health benefits. Blood glucose should be monitored frequently to determine how the body responds to the diet, especially staple foods, and to plan for adjustments.
Snacks such as cereals, fruits, nuts, etc., should also check the carbohydrate content in the nutrition facts list and include it in the daily intake.
Adjusting the order of meals is beneficial to blood sugar control and the Xi of eating vegetables first and staple foods last.
It is recommended to keep track of diet, exercise, and blood glucose levels to improve the level of scientific planning for blood glucose control and self-management.
Whole grains, miscellaneous legumes, vegetables, etc. are rich in dietary fiber, phytochemicals, low GI, rich in vitamin B1, vitamin B2, potassium, magnesium and other minerals, more resistant to hunger, can effectively slow down blood sugar fluctuations after meals.
Elderly diabetic patients with weak gastrointestinal function should pay attention to the cooking method and dosage in the selection of whole grains rich in dietary fiber to reduce the burden on the digestive tract.
The type and amount of carbohydrates are the most important nutritional factors affecting blood sugar after meals. Learning Xi carbohydrate content and interchange of food, and eating regularly are the key measures for diabetic patients to understand and grasp the relationship between food, drugs and blood sugar response, and are the focus of reasonable planning and adjustment of the overall diet.
Be active in exercising, improve your physique andInsulin sensitivity
Exercise can consume energy, resistance exercise helps to increase muscle mass, exercise can also increase the number of glucose transporters on the membrane of skeletal muscle cells, increase the uptake of glucose by skeletal muscle cells, improve the insulin sensitivity of skeletal muscle cells, and stabilize blood sugar. There is ample evidence that inactivity can lead to excessive weight gain, and that being physically active not only helps maintain a healthy weight and regulates well-being, but also reduces the risk of obesity, type diabetes, cardiovascular disease, and certain cancers, as well as the risk of all-cause mortality.
Diabetic patients can exercise after meals, at least 5 days a week, 30 45 minutes each time, moderate-intensity exercise should account for more than 50%, step by step, consistently.
Moderate-intensity sports include brisk walking, cycling, table tennis, badminton, jogging, swimming, etc. If there are no contraindications, it is best to resist exercise twice a week, such as dumbbells, push-ups, apparatus exercises, etc., to improve muscle strength and endurance.
Incorporate daily activities and exercise into your life plan.
Strengthen blood glucose monitoring before and after exercise to avoid hypoglycemia.
Everyone should recognize that physical activity is an opportunity to improve health, not a waste of time. Diabetic patients should find and cultivate the exercise method they are interested in, include exercise in the daily schedule, cultivate exercise awareness and Xi, and gradually increase and achieve the target amount of exercise in a planned and gradual manner.
Eat a light diet and limit alcohol consumption to prevent and delay complications
Prevent and delay the onset of related complications, with a focus on intensive lifestyle changes. First of all, it is necessary to control oil, salt, sugar, do not drink alcohol, and control blood sugar, blood lipids, and blood pressure at the ideal level.
Everyone should eat a light diet and limit the amount of oil, salt, and sugar, including prediabetes and all people with diabetes. Excessive intake of cooking oil or fatty meat will lead to excessive total dietary energy, resulting in overweight and obesity, which is not conducive to the control of metabolic indicators such as blood sugar, blood lipids, and blood pressure.
Research evidence shows that excessive salt intake can increase the risk of diseases such as hypertension and stroke.
Alcohol consumption can disrupt a person's normal diet and medications, causing blood sugar fluctuations, which may increase the risk of hypoglycemia, especially when taking insulin or insulin secretagogues. In addition, alcohol consumption is often accompanied by a high food intake, resulting in excessive total energy intake, which can lead to an increase in blood sugar. Excessive alcohol intake can also damage the pancreas, cause liver damage, and is an important risk factor for gout, cancer, and cardiovascular disease.
Cultivate a light taste, control the daily consumption of cooking oil within 25 grams, eat less animal fat, properly control cholesterol-rich foods, and prevent dyslipidemia. The amount of salt should not exceed 5 grams per day. At the same time, pay attention to limiting the use of condiments and foods with high salt content, such as soy sauce, chicken essence, monosodium glutamate, pickles, salted meat, pickles, etc. Drink plenty of plain water, but also weak tea or coffee in moderation, and it is not recommended to drink any beverages.
Under the guidance of dietitians and health managers, diabetic patients should actively carry out reasonable diet and appropriate exercise to maintain blood sugar stability and prevent the occurrence and development of diabetic complications.
Eat regular meals and add meals reasonably to promote postprandial blood sugar stability
Eating regularly and quantitatively is the basis for maintaining a stable blood sugar.
Regular meals refer to the relatively fixed time of three meals a day and additional meals, and regular and quantitative meals, which can avoid overeating caused by the sluggishness of the satiety center caused by excessive hunger.
Don't overeat, don't eat snacks and drinks at will, don't eat more meals, and reduce the number of meals.
Whether eating at home or out, according to the individual's physiological conditions and physical activity, the diet should be modest, scientifically configured, standardized, quantitative nutritional meals, reasonably planned meals and energy distribution to arrange all-day meals, eat carefully and slowly, and form a good diet Xi habits.
The decision of whether and when to add a meal, and which snack to choose should be based on the patient's specific blood glucose fluctuations.
For patients with diabetes mellitus and patients with diabetes mellitus who have a long course of disease, poor blood glucose control, and insulin injections, blood glucose monitoring should be carried out, and appropriate meals can be added according to the actual situation to prevent the occurrence of hypoglycemia.
For emaciated diabetic patients and gestational diabetes patients, additional meals or snacks can also be arranged appropriately to prevent the occurrence of hypoglycemia, increase energy intake, and increase body weight.
Self-management, regular nutritional counseling, and improved glycemic control
Effective management and control of blood glucose stability largely depends on the patient's ability to self-manage. Diabetes management requires a comprehensive approach that is individualized and diverse in terms of the patient's disease course, condition, and behavioral changes.
Diabetic patients need to pay attention to and learn Xi diabetes knowledge and self-management skills, including dietary conditioning, regular exercise, blood sugar monitoring, medication as prescribed, insulin injection techniques, and hypoglycemia prevention and management.
People with diabetes should have nutritious meals, proper cooking, exercise management, and blood glucose monitoring as basic skills. Understand the carbohydrate content and GI value of food, learn Xi use of food exchange portions, and integrate self-behavior management into daily life.
Consultation and follow-up service relationships with clinically experienced dietitians, health managers and other professional teams should be established, and regular consultations should be actively conducted, and personalized nutrition education and dietary guidance should be received to promote skill acquisition and effective implementation of nutrition programs, and improve self-health status and clinical outcomes. In particular, when the first diagnosis, annual check-up, or failure to meet ** goals, illness or environmental changes, timely medical consultation or consultation should be made.
Nutrition counseling includes dietary assessment and dietary modification, nutritional status assessment and nutritional diagnosis, as well as the formulation of nutritional prescriptions and exercise prescriptions. With the help of a dietitian and physician, adjust diet, exercise and behavior, as well as medication dosage and other regimens to maintain a healthy lifestyle, control blood sugar, and prevent complications.
Recipe preparation
2.1 The first method
1) Determine the total amount of calories needed throughout the day.
One of the dietary principles of diabetic patients is to control total calorie intake so that the weight is achieved and maintained at an ideal or appropriate level. If you are overweight, you should control your energy intake, and if you are not overweight, you should gain weight reasonably. Therefore, before specifying a daily diet, it is necessary to find out whether the required energy value is not followed, and determine the daily energy supply according to the individual's height, weight, age and labor intensity, as well as the condition and nutritional status.
The formula for calculating the appropriate energy for the whole day: total energy = energy supply standard ideal weight.
Energy Supply Standards:
Reference table of energy supply for different labor intensities kcal kilograms per day.
Calculate your ideal weight.
Male: ideal weight (kg) = height (cm) - 105
Females: ideal weight (kg) = height (cm) - 100
The daily requirements of the three major nutrients.
Carbohydrates make up 60% of the total energy throughout the day, protein makes up 15% of the total energy throughout the day, and fat makes up 25% of the total energy throughout the day. There are several issues to be paid attention to: the energy supply ratio of the three major nutrients is generally small range, if the blood sugar is very high or not well controlled, the energy supply of carbohydrates can be controlled to more than 50%, but not too little, in order to prevent the production of ketones from leading to the occurrence of diabetic ketoacidosis; If diabetes mellitus is accompanied by renal impairment, protein intake should be limited to 10% or 0 based on the patient's body weight5~0.8 g kg·day; The supply of fat is mainly vegetable oil, which should account for 50% of the total fat mass throughout the day.
The total energy needs to be calculated for example.
Suppose a diabetic patient is a male teacher engaged in light physical labor, who is not fat or thin, and is 168 cm tall. Then, the teacher's standard weight is: 168-105 = 63 kg; The energy required for the whole day is: 30 (energy supply standard) 63 = 1890 kcal. Knowing the total energy for the whole day, calculate the daily requirements of the three major nutrients: 1) the energy supply of carbohydrates is 60% 1890 = 1134 kcal, and the carbohydrate requirement is 1890 60% 4 (capacity factor) = 2835 grams; 2) The energy supply of protein is 15% 1890=2835 kcal, the protein requirement is 1890 15% 4 (yield factor) = 7087 grams; 3) The energy supply of fat is 25% 1890=4725 kcal, the fat requirement is 1890 25% 9 (capacity factor) = 525 grams;
Calculate the requirements of each meal of the three major nutrients: firstly, determine the meal ratio, that is, the energy supply ratio of each meal throughout the day, which is generally 30% for breakfast, 40% for lunch and 30% for dinner. 1) The breakfast requirement of carbohydrates is 2835×30%=85.05 grams; 2) The breakfast requirement for protein is 7087×30%=21.26 grams; 3) The breakfast requirement of fat is 525×30%=15.75 grams. The calculation of the requirements of the three major nutrients for Chinese food and dinner is the same, note that the energy supply ratio of Chinese food is 40%.
2.2 The second method
This method is relatively simple.
1) The amount of staple food required throughout the day (grams) = [height (cm) - 110] 5. If a person is 170 cm tall, the amount of staple food required throughout the day is about (170-110) 5=300 (grams); It can also be calculated in this way, i.e. the amount of staple food required throughout the day (grams) = standard weight (kg) 5. If someone's standard weight is 70 kg, the amount of staple food required throughout the day is 70 5 = 350 (grams).
2) Estimating the amount of staple food according to the daily activity consumption: 250 300 grams of light physical labor, 300 400 grams of medium physical labor, and 400 450 grams of medium physical labor.
3) Conversion of raw weight of food to mature weight: The weight ratio of rice to rice is generally 1:25, that is, 100 grams of rice Millet can be made into 250 grams of rice; The weight ratio of rice to steamed bread is generally 1:15, that is, 100 grams of flour can be made into 150 grams of steamed bread, and other foods such as flower rolls, flatbreads, baked cakes and other pasta products are also converted accordingly.
4) Recipe examples.
Finally, it should be noted that the formulation of the recipe should take into account other conditions of the diabetic, such as whether there is fatty liver? Do you have coronary heart disease? Is there hyperuricemia? What about blood lipids? How about chewing food? What about digestive function? and so on, and at the same time pay attention to cooking methods and Xi dietary habits. And cooperate with exercise, take medication according to the doctor's instructions, and monitor and record blood sugar results.