Diabetic diet

What is diabetes? 

  Diabetes is a clinical condition with high blood glucose or blood sugar.  Insulin is a hormone made by the pancreas, which helps glucose from food reach the cells to be used for energy. Sometimes body doesn’t make sufficient amount of insulin or body cannot use the insulin produced [insulin resistance].In both states, body cannot use glucose as energy as it doesn’t reach cells due to insulin inaction and glucose level in blood remains elevated. This condition is called hyperglycaemia or diabetes.

Over time, the elevated level of blood glucose may lead to various health issues such as atherosclerosis, stroke, heart attack , peripheral vascular disease etc.

 Types of diabetes

Type 1 diabetes

In type 1 diabetes, the body does not make insulin due to the immune mediated destruction of the insulin producing cells in your pancreas. Type 1 Diabetes is usually occurring in children and young adults, although it can appear at any age.  Insulin is the most important solution for type 1 diabetes, to be taken every day to stay alive.

Type 2 diabetes

The dietary intervention or diabetic diet discussed here is for managing type 2 diabetes. It is a clinical condition with high blood glucose or blood sugar as insulin produced by pancreas is incapable taking up glucose from blood to cells. Therefore blood sugar level remains elevated.

How does dietary sugar affect your blood glucose level?

     According to the Centers for Disease Control and Prevention (CDC), over 37 million adults in the United States or around [11.3% of the population] are living with diabetes; 96 million adults are having prediabetes, which can progress to diabetes over time.

 Sugar consumption may not be the only cause that leads directly to diabetes, but sugar may play a definite role in worsening diabetes in people who are already diagnosed with diabetes. But the primary cause of diabetes is not sugar consumption. Diabetes is a complex condition that results from a range of factors. However eating sugary food by people who are already diabetic may worsen it.

High sugar intake can lead to weight gain, and a high BMI increases the risk of type 2 diabetes, there is no clear cut evidence that diabetes results directly from sugar intake [8].

Role of diet in managing diabetes

Dietary changes and exercise conjointly can help manage diabetes .It has also effect on prediabetes  state in managing blood glucose level and thus prevent progressing to diabetes.

What should be included in diabetic diet?

·       Fruits and vegetables [low glycaemic index variety]

·       Whole grains, such as whole wheat, brown rice, barley, quinoa, and oats

·       Proteins, such as lean meats, chicken, turkey, fish, eggs, nuts, beans, lentils, and tofu

·       Nonfat or low-fat dairy, such as milk, yogurt, and cheese

Low glycemic variety of fruits & vegetables means eating them would not cause an immediate blood sugar spike. They include:

Non starchy vegetables: includes broccoli, carrots, greens, peppers, and tomatoes

Starchy vegetables: includes potatoes, corn, and green peas

fruits—includes oranges, melon, berries, apples, bananas, and grapes

grains— it is better to eat whole grains such as wheat, rice, oats, cornmeal, barley, and quinoa.

Protein :

Lean meat, chicken or turkey without the skin, fish, eggs, nuts and peanuts

Dried beans ,chickpeas and split peas, tofu

Dairy—nonfat or low fat

Milk, yogurt, cheese

What should be avoided in diabetic diet?

·       The high-carb foods and drinks you should limit include:

Sugary foods, such as candy, cookies, cake, ice cream, sweetened cereals, and canned fruits with added sugar

·       Drinks with added sugars, such as juice, regular soda, and regular sports or energy drinks

·       White rice, tortillas, breads and pasta  made of white flour

·       Starchy vegetables, such as white potatoes, corn, and peas

  Evidence based facts on diabetic diet

v A study shows that yogurt, a probiotic improved total cholesterol and LDL-C concentrations in type 2 diabetic people and may contribute to the improvement of cardiovascular disease risk factors [2]. So include yogurt in your daily diet to control bad cholesterol as well as diabetes and allied complications.

 v Impact of paleolithic diet on diabetes 

A Paleolithic diet is more satiating per calorie[ provides feeling of fullness after eating]than the typical diabetes diet. The Paleolithic diet is effective for achieving weight loss, but it is difficult to follow for a prolonged time [3].

The paleolithic diet consists of eating fruit, vegetables, nuts, seeds, lean meat (especially from pasture-fed animals), fish rich in omega-3 fatty acids, and olive/walnut oils. 

v According to the American Diabetes Association (ADA), nutritional therapy for adults with diabetes should focus on promoting healthy eating patterns based on essential nutrients, varied, selected, and integrated in the right amount, for maintaining a healthy weight, and reach optimum levels of glycosylated hemoglobin (HbA1c), blood pressure, and lipid profile.

 To achieve this, the ADA recommends that cultural preferences should be considered, as well as the areas where patients live, access to recommended foods, and a willingness to change .

It refers to maintaining the pleasure of eating and to establish healthy eating patterns themselves. That means a healthy dietary pattern such as the traditional Mediterranean one could be the key to obtaining a proper control of diabetes. 

v In patients with newly diagnosed diabetes, a study found that better glycemic [glucose level] control  is in people adhering to a Mediterranean diet with energy restriction compared to those that followed a low-fat diet [5] and the Mediterranean-style diet  followed group lost more weight than those on the low-fat one.

    In short , the Mediterranean diet is recommended for people with new onset of diabetes.

v Olive oil is an important ingredient of Mediterranean diet.

     In a  study conducted  in Spain (PIZARRA), insulin resistance was found to be lower in individuals who consumed olive oil compared to those who consumed sunflower oil or a combination.

     Consumption of olive oil has a beneficial effect on different cardiovascular risk factors, particularly in the presence of obesity, impaired glucose tolerance or a sedentary lifestyle.

v Role of physical activity cannot be ignored in diabetes management in addition to dietary modifications. Exercise plays a pivotal role in the prevention and control of insulin resistance, prediabetes, type 2 diabetes, and its complications [9].

References

1.    https://www.niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-activity

2.    https://pubmed.ncbi.nlm.nih.gov/21700013/

3.    https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-12-105

4.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468821/

5.    https://pubmed.ncbi.nlm.nih.gov/25369829/

6.    https://pubmed.ncbi.nlm.nih.gov/23859999/

7.    https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes#:~:text=Diabetes%20is%20a%20disease%20that,to%20be%20used%20for%20energy.

8.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822166/

9.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/