Nutrition therapy for diabetics

To control ones blood sugar level, it is very important for diabetics to control their nutritional intakes. This World Diabetes Day, we tell you what you can have

By Hiteshi Dhami Shah

Diabetes mellitus, commonly known as diabetes, is a Greek word which means ‘honey in blood’. It is indicative of high sugar level in blood and urine. Management of a long term metabolic disorder like diabetes mellitus requires an effective healthy lifestyle, which includes a balanced diet, exercise and sensible weight control. Diabetes provokes a great thought on diet and making correct changes in eating is the first step towards preventing and controlling diabetes. The meal plan for a diabetic is based on height, weight, age, sex, physical activity and nature of diabetes.

Cereal: While selecting cereals, it is very important to emphasize on whole grain cereals such as whole wheat flour, jowar, bajra, nachni, oats, barley, unpolished rice like brown and red rice, durum wheat pasta, whole wheat bread, multigrain bread and nachni bread. These cereals are high in fibre, provide satiety and also help in controlling blood sugar levels.

Many diabetics have a notion that brown bread or chapattis made of wheat, bajra or jowar can be eaten in any quantity without harm. This is a misconception as all types of cereals and millets provide 100 kcal per 30gms of dry flour. An average slice of bread provides 75 kcal, while a thin wheat chapatti provides 50 kcal. Therefore it is important to regulate the number of slices of bread or chapattis eaten at each meal. An occasional helping of rice is allowed for a normal weighing diabetic. A thin diabetic may have it every day with preference on brown or red rice. Those particularly fond of rice can exchange their ration of 2 thin wheat flour chapatti or 1 slice of whole wheat bread for 2 tablespoons of brown or red rice.

Protein: Pulses, dried peas and beans are a fair supplier of protein. In a vegetarian diet, 1 cup of dal twice in a day can be taken. In a non-vegetarian diet, 1 cup dal can be replaced by 2 egg whites, 1-2 medium size pieces of fish or lean chicken or a cup of skimmed milk and its products. In a vegetarian diet, it is difficult to meet the recommended allowance of protein and therefore skimmed milk powder is advised. Skimmed milk powder provides protein without increasing the calorie content of the diet. It is cheaply available and easily digestible. It can be added to any drink or food preparation.

Soups: Thin soups made from lean protein or vegetables have low calorie content and can be taken as one pleases. It is best suited for obese diabetics to have big helpings of thin soups at meal times as it provides satiety without increasing the calorie intake. On the other hand a thin diabetic can have a small helping of soup, so that other foods with adequate calories can be taken. Thick soups are best avoided as they usually contain flour, peas, potato and nuts which have high calorie content.

Vegetables: An obese diabetic needs a diet high in fibre which can provide satiety and a few calories. Vegetables meet this requirement and hence a good quantity of vegetables should be included in their diet. A thin diabetic can choose fewer vegetables in order to have more nourishing food. Leafy vegetables like spinach and cabbages, pumpkin, brinjals, lady’s finger, French beans can be eaten freely. Root vegetables like carrot, radish, onion, turnip with the exception of potato and sweet potato, provide few calories and can be taken as desired. Salad made from cucumber, lettuce, onion, radish and tomato can be taken liberally by all diabetics’ especially obese diabetics. Vinegar, dried pepper, green pepper, mustard and sour lime can be used as salad dressings. Dressing containing oil and mayo must be avoided.

Fat for cooking: Limit the intake of saturated and trans fats (butter, margarine, shortening, dalda, vanaspati). While buying oil, choose oil rich in polyunsaturated fatty acid and monounsaturated fatty acid. However moderate your total intake to 3–4 tsp of oil per day per person. Avoid re-heating of oil as they get converted to trans fats. Adapt methods of cooking which require less oil like steaming, braising, sautéing and stewing, grilling, pressure cooking and roasting instead of frying (shallow / deep frying).

Sugar, jaggery or honey: They are pure forms of carbohydrate. Some diabetics feel that the only change in diet required is to stop taking sugar. It is better for diabetics to know their daily ration of sugar and must consult a nutritionist for the same. Thin and normal weight diabetics have their allowance of sugar but an obese diabetic must avoid sugar. The ration of sugar must be distributed reasonably throughout the day. All pastries, cakes need to be avoided because of variable sugar and fat content.

Nuts: The daily ration of 1 cup skimmed milk or 1 slice whole wheat bread  or 2 thin chapattis can be substituted for 3 walnuts or  5 almonds or 4 pistachios or 5 groundnuts.

Papad, chutney and pickles are allowed in moderation. Pickles made in oil are not permitted. Beverages like tea, coffee are permitted. Unsweetened drinks such as soda water and barley water need not be restricted.

If your food habit conforms to the prescribed meal plan, the blood sugar levels will be the same after that meal. If there are wide fluctuations in the blood sugar levels, changes in the diet should be strongly suspected. The common foods which cause these fluctuations are chapattis, bread, rice, potato, pulses, banana, mangoes, nuts, sweets. The quantity of these foods should be strictly regulated.

Picture credit: Hobbes Yeo

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Dr Rishma Pai


She is a consultant gynaecologist at Jaslok and Lilavati Hospital.

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