Nutrition for diabetes: basic rules and allowed foods

Currently, diabetes is a global problem. In the past 10 years, the number of people with diabetes has more than doubled to 425 million people, and it is predicted that by 2045 this number could reach 629 million people.

Diabetesis a group of endocrine diseases associated with impaired glucose uptake and development due to an absolute or relative deficiency of the hormone insulin, leading to the development of hyperglycemia - a state of persistent hyperglycemia. This disease is characterized by a chronic process, as well as violations of all types of metabolism due to violations of carbohydrate metabolism, fat, protein, mineral and water-salt metabolism are 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 often leads to absolute insulin deficiency. The development of type 1 diabetes is associated with both genetic and environmental factors - viral infections, nutrition, toxins, hygiene. Type 2 diabetes is characterized by the development of insulin resistance and relative, but not absolute, insulin deficiency and is manifested by persistent hyperglycemia. The main problem with any type of diabetes is an increase in blood sugar and a lack of cell carbohydrates, since glucose cannot enter it, but floats in the blood.

The treatment of diabetes is based on dietary therapy. The general rule of thumb regarding nutrition, regardless of the type of diabetes, is that the patient should reduce the amount of carbohydrates in the diet by 5-7% and increase the consumption of vegetable fats. Previously, diabetics were recommended to completely eliminate simple carbohydrates, but today there is increasing emphasis on individualized diets with the selection of food baskets and individual calorie calculations. Currently, the slogan is very popular: "With diabetes there are no restrictions, only the right lifestyle. "

Diet for diabetics is based on the glycemic index. Basically, this index reflects the speed at which sugar is absorbed from them into the blood. Products with a high index - jam, cookies, cakes - have a high absorption rate. Products with a low index - cereals, fruits - have a lower index. The slower the absorption rate, the easier it is for the pancreas to cope with the load. Thus, foods with a GI index of up to 55 are divided into smaller portions and hardly cause an increase in sugar levels.

Also, don't forget a food's insulin index, which reflects how much insulin increases in response to food consumption. The insulin index of foods is important for people with diabetes to predict the body's response when consuming specific foods and to accurately calculate the dosage of insulin preparations (short-acting and long-acting). will be used for injection after meals.

Any meal, including protein, stimulates the release of large amounts of the hormone insulin. And the more you fluctuate your insulin throughout the day, the more likely you are to develop insulin resistance, which will then lead to type 2 diabetes. Everyone's favorite snack options come in the form of milk and productsFermented dairy, such as cheese, kefir and yogurt, has a very high insulin index, which means insulin fluctuations will fluctuate wildly along with your mood and irritability.

Consider the different options and features of the diet depending on the type of diabetes.

Nutritional fundamentals for type 1 diabetes

With the first typeThe patient is completely dependent on insulin injections and a diet designed with its use in mind. Diabetics need to study the presence of carbohydrates (bread units) in foods to determine the dosage of hormones that help absorb them. A bread unit is a conventional concept that refers to a certain amount of any product containing 12 grams of carbohydrates. It is recommended to consume no more than 12 units of bread per day. Insulin is injected half an hour before meals, so it is important to know exactly what to eat and how much to absorb the carbohydrates in food. For each main meal, you need to eat no more than 5-6 units of bread and 2-3 units of additional bread.

You should almost completely avoid foods that contain easily digestible (simple) carbohydrates. These are sweets, jams, condensed milk, marshmallows, marmalade, halva, cakes, jams, etc. v. , as well as oatmeal and semolina porridge, mashed potatoes. Reducing the amount of carbohydrates in your diet, which increases blood sugar levels, reduces the need for medication. Consuming the same dosage as before switching to a low-carbohydrate diet may cause hypoglycemia. It is necessary to measure blood sugar levels regularly when starting this diet and adjust medication dosage accordingly.

Daily calories are distributed throughout the day into 4-5 meals. According to the BJU ratio, the distribution is as follows: proteins make up 20-25% of the total diet, fats - 30%, of which saturated are no more than 10%, carbohydrates 45-50%.

Basic nutritional principles for type 2 diabetes

More severe restrictions are needed for non-insulin-dependent variants of the disease. This is due to the fact that this form often appears against the background of obesity and not only high levels of glucose, but also insulin in the blood. However, it very often happens that insulin resistance, which can then lead to type 2 diabetes, does not manifest itself in any form for a very long time, and even people with insulin resistance do notIt's not always about being overweight but about the level of glucose in the blood. blood is constantly kept at high levels and this condition leads to very sad consequences. Nutrition for type 2 diabetics helps restore cells' ability to absorb sugar and helps restore cells' sensitivity to insulin.

Type 2 diabetesMainly a disorder of carbohydrate metabolism. But at the same time, other types of metabolism are affected - lipids, proteins, minerals. Treatment for type 2 diabetes includes diet, moderate exercise, stress management, and medication (antidiabetic drugs).

The type 2 diabetes diet is based on these main principles:

1. An abundance of vegetables– The amount of vegetables consumed may depend on age, gender and frequency of exercise per week. As a general rule, women who exercise up to 30 minutes per day should consume at least 500 grams of vegetables per day. For more intense workouts, the amount of vegetables should be increased to 800 grams. For men, the recommended vegetable intake is 600 and 1000 grams, respectively.
2. Unsaturated fats– Adequate presence of polyunsaturated and monounsaturated fats in the diet helps maintain cholesterol levels within normal limits and reduces the risk of developing cardiovascular diseases, one of the long-term complicationsmost common of diabetes. Unsaturated fats are found in many foods, including nuts, avocados, fatty ocean fish, and olive oil.
3. Avoid processed foods– nutritionists and doctors agree that avoiding processed foods has a positive impact on health. Because of the substances added to ensure a long shelf life, processed foods tend to have a high glycemic index. Regular consumption of such foods can negatively affect the health of diabetics.

Healthy foods for diabetes

1. Green leafy vegetables

   Spinach, cabbage and bok choy are low in calories but rich in nutrients like vitamin C, beta-carotene and magnesium, which help prevent diabetes. One serving (about 106 g) per day reduces the risk of developing type 2 diabetes by 14%.

2. pea's tree

   These fiber-rich foods can help stabilize your blood sugar. Beans are low in saturated fat, which can be bad for your heart.

3. Fish

   Omega-3 fatty acids- Effective assistant in preventing diabetes and reducing the risk of cardiovascular diseases. The body needs omega 3 to synthesize red blood cells and cell membranes, they help the body absorb other vitamins and most importantly they prevent chronic inflammation, which is a sure companion to resistance. insulin.

4. Olive oil

   A staple in the Mediterranean diet, it is important for heart health because it is high in monounsaturated fatty acids. These fats (also found in large amounts in nuts) are important in preventing diabetes by helping the body control blood sugar levels effectively.

5. Nuts

   As a source of monounsaturated fatty acids, nuts are rich in magnesium, another important nutrient. Global research shows that people who regularly eat nuts have lower rates of diabetes.

6. citrus

   All citrus fruits contain antioxidants - effective aids in maintaining insulin balance in the blood.

7. Grains

   Eating whole grain bread, quinoa and brown rice helps reduce the risk of developing diabetes. Whole grains are rich in fiber, which helps the body control blood sugar levels. Complex carbohydrates are a type of buffer that protect us from high blood sugar levels, so if you want to eat a product with a high glycemic index, combine it with complex carbohydrates.

8. Cinnamon

   This delicious spice helps the body regulate insulin levels. Cinnamon is an insulin sensitizer, meaning it helps improve cell sensitivity to insulin. This spice helps treat hypertension (chronic high blood pressure), reduces blood sugar levels when used systematically in the required dosage, improves overall health and has a beneficial effect. Positive for metabolism.

9. ginger

   It is a catalyst for metabolism, reducing sugar, cholesterol and blood clotting indicators. Should be used fresh daily as a spice or as a base for tea.

Prohibited foods for diabetes

Today, doctors try not to strictly limit diabetics and do not force them into strict limits on allowed and prohibited foods. Even with type 2 diabetes, where diet plays an important role, you can eat a varied diet, but there are some foods that people with the condition will still have to eliminate. out of the diet. In fact, the list below is recommended for those who care about their health to exclude from their diet.

1. Sweet

   The blacklist includes sugar and all products containing excess sugar. We must forget about ice cream, chocolate, marmalade, jam, candy, preserves, halva and other sweets.

2. Bakery

   Prohibited bakery products: muffins, cookies, dumplings, white loaves and bread.

3. Foods high in fat

   These foods can significantly increase your blood sugar levels. For this reason, diabetics should avoid duck, pork, lamb, lard, mayonnaise and cream. Sweet yogurt, fatty cottage cheese and cottage cheese should also be excluded.

4. Semi-finished product

   They contain large amounts of flavorings, stabilizers and flavor enhancers. You should not eat fish sticks, ready-made industrial meat cutlets, dumplings, sausages, and sausages.

5. Trans fat

   Consuming them will harm not only diabetics but also healthy people. Prohibited products include margarine, confectionery fats, spreads, potato chips, hot dogs and burgers.

6. fruit

   Certain fruits and dried fruits should not be consumed as they can increase blood sugar levels. Among them are dried apricots, dates, figs, raisins, persimmons, melons, grapes, bananas.

Table 9 about diabetes

This diet was developed by scientists specifically for diabetics and has long been used in treatment both in hospitals and at home.Table number 9 includes:

• 300 g fruit;
• vegetables 80 g;
• 100 g mushrooms;
• 1 tbsp. natural fruit juice;
• 300 g meat or fish;
• 200 g low-fat cottage cheese, 500 ml fermented milk product;
• 100-200 g of bran, rye, bread mixed with rye flour or 200 g of cereal (ready-made), potatoes;
• 40-60 g of fat.

Main dishes

• Soup: vegetable, cabbage soup, beetroot soup, borscht, vegetable and meat okroshka, light fish or meat broth, mushroom soup with cereals and vegetables.
• Poultry: rabbit, veal, chicken, stewed, chopped, boiled, turkey.
• Fish: pike perch, navaga, cod, pike and lean seafood, stewed, steamed, boiled, grilled in juice.
• Snacks: vegetarian mix of vegetables, vinaigrette, fish and meat with jelly, vegetable caviar, unsalted cheese, seafood salad with avocado.
• Candy:desserts made from berries, fresh fruit, strawberry mousses, sugar-free fruit jellies, sugar-free jams and jams.
• Egg dish: soft-boiled eggs, omelet egg whites, used in dishes.

Other dietary strategies for diabetes

Of course, we should not forget that all diets are strictly individualized, taking into account the patient's age and gender as well as his or her level of physical activity.

So today there are several options for dietary strategies for diabetes. If it is necessary to normalize body weight in patients with type 2 diabetes, it has been shown to be good.Mediterranean diet, based on daily physical activity.

The basic principles of the diet are:

• divide meals 5 times a day - 3 main meals and 2 snacks;
• breakfast should be richer in carbohydrates, consisting mainly of complex carbohydrates;
• light dinner consisting of lean protein and vegetables;
• During the day you need to consume more than 1 kg of various vegetables and herbs;
• It is important to maintain a fluid intake - at least 7-8 glasses of water per day.

The main source of fat in the diet is– Unrefined olive oil, sometimes sesame, rapeseed, and peanut oils can be used. Animal fats are limited in the Mediterranean diet.

Pay special attention to Omega-3 fatty acids and oleic acid, found in oils, fatty fish and seafood. These fatty acids are very effective in preventing atherosclerosis, improving insulin sensitivity and helping immune cells detect inflammation and suppress it.

Carbohydrates in the Mediterranean diet are mainly complex with a low glycemic index - durum pasta, beans, rice, lentils, coarse bread, seasonal vegetables and fruits.

Protein is presented in the form of low-fat soft cheeses, eggs, fish, seafood and rarely poultry.

Another dietary option for diabetes isLCHFand the keto diet. The essence of this dietary strategy is to consume low amounts of carbohydrates and high amounts of fats. Carbohydrates on a high-fat diet are limited to 50 grams per day, and on a keto diet this restriction is even more severe - no more than 10 grams of carbohydrates.

The following foods are completely excluded on the keto diet: :

• sugar, honey, artificial sweeteners;
• sweet carbonated drinks;
• yeast bread, cakes;
• cereals, porridge, flour and breakfast cereals;
• skim milk, kefir, yogurt;
• sweet curd;
• Margarine.

In the concept of the LCHF diet, insulin is a dangerous thing, because after we eat something with a lot of carbohydrates, the carbohydrates are broken down into glucose, blood sugar levels begin to increase sharply and accordingly, insulin levels are also greatly increased to transport glucose to muscles, liver and fat cells, i. e. insulin "is the cause of our obesity". Furthermore, protein can increase insulin levels as well as carbohydrates. And fat does not increase insulin at all, which is good for insulin resistance and, if necessary, improves cell sensitivity to insulin.

Diabetes in children

Diabetes in children can be caused by genetic factors, poor diet, including overconsumption of simple carbohydrates and sweets, and it can also occur due to mental or physical trauma. Treatment of diabetes in children as well as in adults includes dietary therapy and the use of insulin for type 1 diabetes.

The diet of children with diabetes should be rich in vegetables such as cauliflower, onions, spinach, and garlic. You can eat unsweetened fruit, meat, poultry and fish. Low-fat milk and cottage cheese should be given to children, as long as the child is intolerant to cow's milk protein. When cooking meat or fish, you can use spices to promote better protein absorption.

All confectionery products, sweets, grapes, apricots, rice, baked goods, cookies, plums should be excluded. Parents of children with diabetes need to learn how to calculate the number of units of bread consumed when feeding their children and calculate the necessary insulin dose. The child himself needs to be taught these skills as early as possible.

Gestational diabetes

Othertype of diabetes– Gestational diabetes in pregnant women is quite common today.

Increased blood sugar during pregnancyand is one of the most common metabolic disorders in expectant mothers. So-called gestational diabetes or diabetes in pregnant women is diabetes that appears during pregnancy and is limited to the period of pregnancy. During pregnancy, the production of sex hormones (estrogen and progesterone, hCG) and the hormone cortisol, which inhibits the action of insulin, increases sharply. As a result, blood sugar levels increase in pregnant women. High blood sugar during pregnancy negatively affects both the woman's health and the health of the fetus, so it requires timely diagnosis and subsequent correction.

Women are at particular risk:

• overweight or obese (BMI greater than 25 kg/m²– risk doubles, over 30 – triples);
• with multiple pregnancy;
• after IVF;
• with polycystic ovaries;
• gain a lot of weight during actual pregnancy;
• with glucosuria (glucose in urine);
• have a relative with diabetes;
• with the burden of previous pregnancies - GDM, large fetus, intrauterine death.

Gestational diabetes is not only dangerous for the mother but also affects the health of the fetus. Thus, at the age of 4-5 years old, such children are many times more likely to be overweight and obese, by 10-11 years old - blood pressure increases, and in adolescence the risk of diabetes is20-40%, the risk of developing non-alcoholic obesity significantly increases the liver.

If GDM is not detected in time or the expectant mother does not take any action to treat it thenThe risk increases significantly:

• The placenta prematurely ages and, as a result, slows down the development of the fetus;
• premature birth;
• polyhydramnios;
• formation of a large or disproportionate fetus or edema;
• hypertension, preeclampsia;
• the need for a cesarean section;
• injury to women and children during childbirth;
• hypoglycemia (low blood sugar) and breathing problems in infants;
• The most serious complication of untreated GDM is fetal death.

So it's important to understand that diabetes is not some kind of life sentence; it only imposes certain obligations on a person regarding diet and physical activity. Proper, balanced nutrition is extremely important for any type of diabetes. And although reducing the amount of carbohydrates and saturated fats in the diet contributes to weight loss, an excess that type 2 diabetics often suffer from, it is very important to change lifestyle and habitseat and drink. And if in type 2 diabetes, a good effect in reducing blood sugar levels is achieved not only by reasonable food choices, but also by a series of physical exercises that help improve the function of transporting glucose into cells. muscle cells, in type 1 diabetes, nutrition plays an important role. a leading role.