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Menu Planning for People with Diabetes
Management of the chronic progressive nature of diabetes usually necessitates self-directed lifestyle changes. The American Diabetes Association’s (ADA) most current medical nutrition therapy (MNT) guidelines for the prevention and treatment of diabetes stress recognizing the whole person. Nutritional strategies and goals, along with exercise, medication therapies and lifestyle changes; should address the specific needs, health concerns, personal preferences as well as the readiness and the ability of the person to change. The ultimate goal of these recommendations is to empower people to make better food and lifestyle choices that translate into improved self-management skills and health.
Meal planning for diabetes includes:
   1. Choosing nutrient-dense, healthful foods.
   2. Understanding how specific foods affect your blood glucose levels.
   3. Portion control.
   4. Eating meals or snacks at the appropriate times.
General Nutrient Guidelines
A. Calories: Daily caloric intake should promote normal growth and development in children and adolescents, achieving/maintaining a reasonable body weight in adults, and address the specific increased demands of pregnancy, lactation or recovery from extended illness. Calories should not be less than 1200/day for women and 1500/day for men. Caloric intake should include all macronutrients (carbohydrates, protein, fats) in balanced proportions throughout each day.
B. Carbohydrates: 40 – 65% total daily calories should be Carbohydrate foods, such as starches, whole grains, fruits, vegetables, starchy vegetables, legumes, cakes, cookies, milk and milk products, which are preferentially broken down by the body for its immediate energy needs. Carbohydrate foods have the greatest impact of after-meal blood glucose levels. For this reason, the type as well as the amount of carbohydrate chosen will influence the level of blood glucose after eating. Nutrient dense, fiber rich, low glycemic index carbohydrates are encouraged to promote glycemic control.
General guidelines:
   For 1200 Kcal/day: 130 – 210 grams
   For 1500 Kcal/day: 150 – 263 grams
   For 1800 Kcal/day: 180 – 315 grams
   For 2000 Kcal/day: 200 – 350 grams
   For 2200 Kcal/day: 220 – 385 grams
   For 2500 Kcal/day: 250 – 438 grams
C. Proteins: 15-20% of total daily calories*
General guidelines:
   For 1200 Kcal/day: 45 – 60 grams
   For 1500 Kcal/day: 56 – 75 grams
   For 1800 Kcal/day: 68 – 90 grams
   For 2000 Kcal/day: 75 – 100 grams
   For 2200 Kcal/day: 83 – 110 grams
   For 2500 Kcal/day: 94 – 125 grams
*For people with diabetes and normal renal function.
0.8 – 1.0 g/kg body wt/day for people with diabetes and early chronic kidney disease.
0.8g/kg body wt/day for people with diabetes and higher degrees of renal insufficiency.
D. Fat: 20 – 40% of total daily calories*
General guidelines:
   For 1200 Kcal/day: 27 – 53 grams
   For 1500 Kcal/day: 33 – 67 grams
   For 1800 Kcal/day: 40 – 80 grams
   For 2000 Kcal/day: 44 – 89 grams
   For 2200 Kcal/day: 49 – 98 grams
   For 2500 Kcal/day: 56 –111grams
Saturated fat should be limited to less than 7% of total daily calories for those with diabetes.
Polyunsaturated fat should be approximately 10% of total daily calories. Cholesterol intake should be less than 200mg/day.
2400 – 3000 mg/day for people without hypertension
2400 mg/day maximum for people with mild/moderate hypertension
20 - 35g/day from whole grains, fruits, vegetables, nuts or approximately 14 g/1000calories
1 drink/day for adult women
2 drinks/day for adult men
*Alcoholic drinks should only be ingested when diabetes is in good control and triglycerides are not elevated. One drink is defined as 12 oz beer, 5 oz wine, 2 oz sherry or 1 ˝ oz distilled spirits. Alcohol should be considered as fat calories in one’s dietary plan.
Choosing a Healthful Meal Plan
All people, not just those with diabetes, benefit from a well-balanced, nutrient-dense diet. The US Department of Agriculture provides a good basic guide to the best food choices for everyone which can be found at the MyPyramid website (http://www.mypyramid.gov/). It lists six guidelines for healthful eating:
   1. Eat a variety of foods from the five food groups.
   2. Eat plenty of fruits and vegetables.
   3. Choose a diet low in fat, saturated fat and cholesterol.
   4. Use salt (sodium) in moderation.
   5. Use sugar in moderation.
   6. Use alcohol in moderation.
Since we each have individual nutrient needs, the USDA has created 12 different pyramids. You can identify the pyramid that is right for you by typing in your age and activity level and letting the “Pyramid Planner” automatically calculate the number of servings from each food group and the total number of calories you need every day.
Portion Control and Regular Eating Times
There are several factors that influence how many calories your body needs each day. How much you currently weigh relative to how tall you are, how long you exercise and at what intensity, are the most important factors that influence your caloric needs. The more physically active you are the more energy your body uses and the more calories it needs.
To promote good glycemic control, portion out your calories throughout the day among three meals and snacks between meals, as needed. Eating regular meals that are well-balanced and spaced throughout the day will help you meet your body’s energy demands, maintain a healthy weight and provide your body with the nutrients it needs for good health.
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