Currently, diabetes is a global problem. In the last ten years, the number of people suffering from diabetes has more than doubled to 425 million people. According to forecasts, by 2045 their number may reach 629 million people.
Diabetesis a group of endocrine diseases associated with impaired glucose absorption and resulting from an absolute or relative deficiency of the insulin hormone, resulting in the development of hyperglycemia - a continuous increase in the level of glucose in the blood. This disease is characterized by a chronic course, as well as all types of metabolic disorders due to carbohydrate metabolism disorders; fat, protein, mineral and water-salt exchange is also disturbed.
Let's consider the reasons for the development of this disease. Type 1 diabetes is characterized by the destruction or destruction of pancreatic cells. This usually leads to absolute insulin deficiency. The development of type 1 diabetes includes both genetic and environmental factors - viral infections, nutrition, toxins, hygiene. Type 2 diabetes mellitus is characterized by the development of insulin resistance and relative, not absolute, insulin deficiency and is manifested by persistent hyperglycemia. The main problem associated with any type of diabetes is an increase in the level of glucose in the blood and carbohydrate starvation of the cells, because glucose cannot enter it, but remains empty in the blood.
Treatment of diabetes mellitus is based on diet therapy. Regardless of the type of diabetes, the general principles of nutrition recommend that the patient reduce the carbohydrate load in the diet to 5-7% and increase the consumption of vegetable oils. Previously, diabetics were advised to completely eliminate simple carbohydrates, but today there is an increasing emphasis on personalized diets with individual selection of food baskets and calorie calculations. Currently, the slogan is very popular: "There are no restrictions with diabetes, only the right lifestyle. "
The diet for diabetic patients is based on the glycemic index. In fact, this index reflects the rate of absorption of sugar from them into the blood. High index products - jam, cookies, cakes have a high absorption rate. Low-index products - cereals, fruits - have a low index. The slower the rate of absorption, the easier it is for the pancreas to cope with the load. Thus, foods with a GI of up to 55 are gradually broken down and almost do not cause an increase in sugar.
Also, don't forget the insulin index of foods, which reflects the amount of insulin spike in response to food consumption. Taking into account the insulin index of food is important for diabetic patients to predict the body's reaction when taking special foods and to correctly calculate doses of insulin preparations (short and long-term) to be used for injection after meals.
Any food, even protein, causes a large release of the hormone insulin. The more insulin swings you have throughout the day, the more likely you are to develop insulin resistance, which will later lead to type 2 diabetes. Everyone's favorite snack options in the form of milk and fermented milk products like cottage cheese, kefir, and yogurt have a very, very high insulin index, meaning the insulin swings will swing very strongly with your mood and nervousness.
Let's consider different options and features of diets depending on the type of diabetes.
Basic nutritional guidelines for type 1 diabetes
You should almost completely avoid foods that contain easily digestible (simple) carbohydrates. These are sweets, jam, condensed milk, marshmallows, marmalade, halva, cakes, jam, etc. , as well as oatmeal and semolina, mashed potatoes. Reducing the amount of carbohydrates that raise blood sugar in your diet reduces the need for medication. Consuming the same doses as before switching to a low-carb diet can cause hypoglycemia. When starting this diet, you need to measure your blood sugar regularly and adjust your medication dose accordingly.
Daily calorie intake is divided into 4-5 meals during the day. According to the BJU ratio, the distribution looks like this: proteins make up 20-25% of the total diet, fats - 30%, no more than 10% of them are saturated, carbohydrates make up 45-50%.
Basic nutritional guidelines for type 2 diabetes
More strict restrictions are needed for non-insulin-dependent variants of the disease. The reason for this is that this form usually appears against the background of obesity and the presence of not only high levels of glucose in the blood, but also insulin. However, it often happens that insulin resistance, which can later lead to type 2 diabetes, does not manifest itself for a very long time, and even people with insulin resistance are not always overweight, blood glucose levels are constantly high, and this situation is very sad. leads to results. Diet food for type 2 diabetes helps restore cells' ability to absorb sugar and helps restore cell sensitivity to insulin.
Diet for type 2 diabetes is based on basic principles:
- Plenty of vegetables– The amount of vegetables consumed may depend on age, gender and weekly exercise frequency. As a rule, women who exercise up to 30 minutes a day are recommended to consume at least 500 grams of vegetables per day. For more intensive training, it is recommended to increase the amount of vegetables to 800 grams. The recommended amount of vegetables for men is 600 and 1000 grams, respectively.
- Unsaturated fats- having an adequate amount of polyunsaturated and monounsaturated fats in the diet helps to maintain cholesterol levels within normal limits and reduces the risk of cardiovascular disease, one of the most common long-term complications of diabetes. Unsaturated fats are found in many foods, including nuts, avocados, oily fish, and olive oil.
- Avoid processed foods- nutritionists and doctors agree that staying away from processed foods has a positive effect on health. Processed foods have a high glycemic index due to ingredients added to ensure a long shelf life. Regular use of such foods can have a negative effect on the health of a diabetic patient.
Healthy foods for diabetes
Green leafy vegetables
Spinach, kale, and chard are low in calories but rich in diabetes-preventing nutrients like vitamin C, beta-carotene, and magnesium. One serving per day (about 106 g) reduces the risk of developing type 2 diabetes by 14%.
Legumes
These fiber-rich foods can help stabilize your blood sugar levels. Legumes are low in saturated fat, which can be bad for your heart.
Fish
Omega-3 fatty acids - great helpers in preventing diabetes and reducing the risk of cardiovascular diseases. Omega 3 is needed by the body for the synthesis of red blood cells and cell membranes, they help the body absorb other vitamins, and most importantly, it suppresses chronic inflammation, a sure companion of insulin resistance.Olive oil
A staple of the Mediterranean diet, this diet is important for heart health as it is full of monounsaturated fatty acids. These fats (also found in large amounts in nuts) are important in preventing diabetes by helping the body effectively manage blood sugar levels.
nuts
As a source of monounsaturated fatty acids, nuts are rich in another important nutrient, magnesium. Global studies show that people who eat nuts regularly have less diabetes.
citrus
All citrus fruits contain antioxidants - great helpers in maintaining insulin balance in the blood.
Whole grains
Eating whole grain bread, quinoa and brown rice can reduce the risk of developing diabetes. Whole grains are rich in fiber, which helps the body manage blood sugar levels. Complex carbohydrates are a kind of buffer that protects us from high blood glucose spikes, so if you want to eat a product with a high glycemic index, combine it with complex carbohydrates.
cinnamon
The delicious spice helps the body regulate insulin levels. Cinnamon is a type of insulin sensitizer, which means it helps to improve the sensitivity of cells to insulin. The spice helps with hypertension (chronic high blood pressure), reduces the concentration of sugar in the blood, improves general well-being and has a positive effect on metabolic processes when used systematically in appropriate doses.
Ginger
It is a catalyst of metabolic processes, reduces sugar level, cholesterol and blood clotting indicators. It is recommended fresh for daily consumption as a spice or base for tea.
Forbidden foods for diabetes
Today, doctors try not to severely limit diabetes patients and do not force them to strict restrictions on permitted and prohibited foods. Even with type 2 diabetes, where diet plays a role, you can eat a varied diet, but there are still a number of foods that people with this disease should exclude from their diet. In fact, the list below is recommended for anyone who cares about their health to exclude from their diet.
Sweet
The black list includes sugar and all products with excess sugar content. We should forget about ice cream, chocolate, marmalade, jam, sweets, preserves, halva and other sweets.
Bakery
Sweet bakery products are prohibited: cakes, cookies, bread, white bread and bread.
Fatty foods
These foods can raise your glucose levels too much. For this reason, a diabetic should stay away from duck, pork, lamb, fat, mayonnaise and cream. It is recommended to exclude sweet yogurt, fatty cottage cheese and cheese.
Semi-finished products
They contain many sweeteners, stabilizers and flavor enhancers. You should not eat fish sticks, ready-made industrial cutlets, meatballs, sausages, sausages.
Trans fats
Their consumption will not only harm a diabetic, but also a healthy person. Banned products include margarine, shortening, spread, french fries, hot dogs and burgers.
Fruits
It is not recommended to consume certain fruits and dried fruits that cause a strong increase in blood sugar. Among them are dried apricots, dates, figs, raisins, dates, melons, grapes, bananas.
Table #9 for diabetes
This diet was developed by scientists specifically for diabetics and has been used for a long time both in the hospital and in home treatment.Table #9 included:
- 300 g of fruit;
- 80 g of vegetables;
- 100 g of mushrooms;
- 1 tablespoon. natural fruit juice;
- 300 g of meat or fish;
- 200 g of low-fat cottage cheese, 500 ml of fermented milk products;
- 100-200 g of bran, rye, wheat bread mixed with rye flour or 200 g of cereals (prepared), potatoes;
- 40-60 g of fat.
Main dishes
- Soups: vegetables, cabbage soup, beet soup, borscht, vegetable and meat okroshka, fish or light broth, mushroom soup with grains and vegetables.
- Poultry, meat: rabbit, veal, chicken, cooked, chopped, boiled, turkey.
- Fish: pike perch, navaga, cod, pike and lean seafood, stewed, steamed, boiled, cooked in juice.
- Snacks: vegetable mixture, vinaigrette, jellyed diet fish and meat, vegetable caviar, unsalted cheese, seafood salad with butter.
- Sweets
: desserts made from berries, fresh fruit, berry mousses, sugar-free fruit jelly, sugar-free jam and marmalade. - Egg trays: soft-boiled eggs, egg white omelets, in bowls.
Other Diet Strategies for Diabetes
Of course, we must not forget that all diets are designed strictly individually, taking into account the age and gender of the patient, the level of physical activity.
So today there are several options for dietary strategies for diabetes. It has proven itself well if it is necessary to normalize body weight in a patient with type 2 diabetes.Mediterranean diet, based on daily physical activity.
These are the main principles of the diet:
- fractional meals 5 times a day - 3 main meals and 2 snacks;
- breakfast should be rich in carbohydrates, mainly complex carbohydrates;
- a light dinner of lean protein and vegetables;
- You should consume more than 1 kg of various vegetables and herbs per day;
- It is important to follow the drinking regime - at least 7-8 glasses of water per day.
These are the main sources of fat in the diet– you can use unrefined olive oil, sometimes sesame, rapeseed and peanut. Animal fats are limited in the Mediterranean diet.
Particular attention is paid to Omega-3 fatty acids and oleic acid found in oils, oily fish and seafood. These fatty acids play a major role in preventing atherosclerosis, increasing insulin sensitivity, and helping immune cells detect and suppress inflammation.
Carbohydrates in the Mediterranean diet are mainly complex with a low glycemic index - durum wheat pasta, beans, rice, lentils, wholemeal bread, seasonal vegetables and fruits.
Protein comes in the form of low-fat soft cheeses, eggs, fish, seafood, and rarely poultry.
Another diet option for diabetesLCHFand the keto diet. The essence of this diet strategy is to consume low amounts of carbohydrates and high amounts of fat. In high-fat diets, carbohydrates are limited to 50 grams per day, and in the keto diet, the restriction is even more strict - no more than 10 grams of carbohydrates.
The following foods are completely excluded from the keto diet: :
- sugar, honey, artificial sweeteners;
- sweet carbonated drinks;
- yeast bread, pastry;
- cereals, porridges, flakes and breakfast cereals;
- skim milk, kefir, yogurts;
- sweet cottage cheese;
- margarine.
In the concept of a LCHF diet, insulin is a dangerous thing, because after eating something high in carbohydrates, carbohydrates are broken down into glucose, blood sugar levels begin to rise sharply, and insulin levels rise accordingly. it transports glucose to the muscles, liver and fat cells, meaning that insulin is "responsible for our obesity". In addition, protein can increase insulin levels just like carbohydrates. Fats, on the other hand, do not raise insulin at all, which is good for insulin resistance and, if necessary, for improving the sensitivity of cells to insulin.
Diabetes mellitus in children
Diabetes in children can be caused by genetic predisposition, improper nutrition, including excessive consumption of simple carbohydrates and sweets, and the disease can also be caused by mental or physical trauma. Treatment of diabetes in children, as well as in adults, consists of a therapeutic diet and insulin administration for type 1 diabetes.
The diet of children with diabetes should be rich in vegetables such as white and cauliflower, onion, spinach, and garlic. You can eat fruits, meat, poultry and fish without sugar. It is recommended to give low-fat milk and cottage cheese, provided that the child does not have an intolerance to cow's milk protein. When cooking meat or fish, you can use spices to promote better absorption of protein.
All confectionery, sweets, grapes, apricots, rice, baked goods, cookies, plums should be excluded. Parents of a child with diabetes should learn how to calculate the consumption of bread units when feeding the child and calculate the necessary insulin dose. The child should be taught these skills as soon as possible.
Gestational diabetes mellitus
Othertype of diabetes- gestational diabetes mellitus, which is quite common in pregnant women today.
Women are especially at risk:
- overweight or obesity (BMI greater than 25 kg/m3).²- the risk increases twice, over 30 - three times;
- with multiple pregnancies;
- After IVF;
- with polycystic ovaries;
- with a large weight gain during real pregnancy;
- with glucosuria (glucose in the urine);
- having close relatives with diabetes;
- with a loaded previous pregnancy - GDM, birth of a large fetus, intrauterine fetal death.
Gestational diabetes affects not only the mother, but also the health of the unborn child. Thus, overweight and obesity in children even at the age of 4-5 years, increased arterial pressure at the age of 10-11 years, the risk of diabetes in adolescence is 20-40%, the risk of non-alcoholic fatty liver disease significantly increases.
If GDM is not detected in time or the expectant mother does not take any measures for its treatment, thenthe risk increases significantly:
- early aging of the placenta and, as a result, delayed fetal development;
- premature birth;
- polyhydramnios;
- the formation of a large or disproportionate or edematous fetus;
- increased blood pressure, preeclampsia;
- need for caesarean section;
- trauma to women and children during childbirth;
- hypoglycemia (low blood sugar) and breathing problems in the newborn;
- The most serious complication of untreated GDM is fetal death.
Thus, it is necessary to understand that diabetes is not a kind of life sentence, but only imposes certain obligations on a person related to diet and physical activity. A proper, balanced diet is of great importance for all types of diabetes. Although reducing carbohydrates and saturated fat in the diet can help with weight loss, type 2 diabetes patients often suffer from excess weight, so it is very important to change the lifestyle itself and eating habits. If a good effect in reducing blood sugar levels in type 2 diabetes is achieved not only with properly selected foods, but also with a series of physical exercises that help improve the function of transporting glucose to muscle cells, then nutrition plays a role in type 1 diabetes. leading role.