Patricia Thompson - NUTRITION TALKWHETHER YOU are on medication or not, diet still remains the cornerstone of diabetes control. There are many more dietary options available today than 50 years ago, when the major concern was restricting carbohydrate intake, and especially sugar. Persons with diabetes can eat ordinary, everyday foods and their meals do not have to be prepared separate from the rest of the family.
OUTDATED DIET SHEETS
Standard diabetic diet sheets are outdated. No foods are prohibited, nor are special foods needed. Even if you choose to use special convenience diabetic products, you still have to learn how to include them in your diet. Rather than speaking of diabetic diets, we refer instead to dietary systems or approaches and eating plans. Nutrition professionals select the preferred approach based on satisfying individual needs and your eating plan is personalised.
HOW DOES THE EATING PLAN WORK?
Eating plans are based on a dietary prescription which is formulated by your nutritionist or dietitian after they take a detailed dietary history and determine your personal preferences and lifestyle. A dietary prescription indicates how many calories you need to maintain a healthy weight and these calories are distributed among the energy nutrients, carbohydrate, protein and fat. To implement the plan, a dietary system is applied, either singly or in combination. Three popular dietary approaches are:
1. Food Exchange/Substitution System
2. Carbohydrate Counting System
3. Liberalised Dietary System
Irrespective of which dietary approach is used, you still have to learn how to use it. The Food Exchange/Substitution System is the most popular in Jamaica. It is based on counting food portions selected from the food groups and distributed as meals and snacks with consideration for any medication being taken, their amounts and timing. This approach is applicable to healthy eating for all individuals and is especially useful for weight control, a critical risk factor for most persons with Type II diabetes. Foods within the same food group can be substituted for each other so that variety can be achieved while still maintaining the regularity and consistency of nutrient intake required.
Carbohydrate Counting only considers those foods that will contribute carbohydrate and all forms of carbohydrate are allowed, whether simple sugars or complex. Instead of learning portion sizes and food groups, you would need to know the weight or measure of each individual food that provides a stated amount of carbohydrate. Some persons find this system easier to follow, especially for children. One disadvantage is that, because all foods are not monitored, there is the risk of overeating on foods without carbohydrate, leading to
overweight. Also, there is the risk of
nutrient deficits, since foods high in sugar tend to be low in minerals
and vitamins.
Many persons lack the discipline to follow a prescribed eating plan and prefer to eat as they wish and then compensate with insulin injections for the changes in blood sugar levels. The disadvantages of this approach are that they must test their blood sugar levels throughout the day using a glucose monitoring machine and match this with multiple insulin injections or use the insulin pump. They must learn how to match the level of insulin with blood sugar levels. This still requires discipline which was the difficulty in the first place so that 'tight' control may not be achieved and the risk for complications is higher.
Whichever approach you prefer, you need to work with your
nutrition consultant on an ongoing basis to ensure continued successful
outcomes.
Patricia Thompson M.Sc., Registered Nutritionist, The Nutrition Centre, Eden Gardens.
