Type 2 diabetes nutrition: sample menu and recommended foods

Studying the statistics of the World Health Organization, it is clear that at the end of 2014, 422 million people were suffering from diabetes. Every year, this figure is dramatically increasing, covering countries and cities, increasing the number of complications and mortality. Therefore, it is very important to know as much as possible about the treatment and nutrition for type 2 diabetes.

Definition of a concept

Type 2 diabetes mellitus is a disease of the endocrine system associated with the immunity of body tissue cells to the hormone insulin secreted by the pancreas, which leads to an increase in blood glucose. In this case, the amount of insulin in the blood is normal, and the gland is functioning normally, therefore this type of diabetes is considered non-insulin-dependent.

Causes of pathology

Here are the main triggering factors:

• Genetic predisposition.
• Obesity, overweight.
• High-calorie nutrition.
• Passive lifestyle.

Symptoms

At the initial stage of the disease, patients present the following complaints:

• dry mouth, increased thirst;
• frequent urination during the day and night;
• muscle weakness, fatigue, decreased performance;
• weight loss or significant weight gain;
• increased appetite;
• itching, eczema, prolonged non-healing inflammatory processes affecting the skin.

In more advanced cases, the above complaints are added:

• fungal infections of the skin and nails, especially the feet;
• an increase in the number of carious teeth, damage to the gums and oral mucosa;
• symptoms of gastritis and stomach ulcers;
• diarrhea;
• soreness in the liver, the appearance of stones in the gallbladder;
• pain in the heart and shortness of breath;
• increase in blood pressure;
• urinary tract infections, kidney pain, frequent urination;
• numbness, freezing and pain in the lower extremities associated with vascular damage;
• decreased vision, developing against a background of deterioration of the retina.

Criteria for the maximum compensated condition of the patient

This condition can be achieved in patients at the initial stage of the pathological process, as well as with mild to moderate severity of the disease:

• Good physical condition.
• Normal performance.
• The absence of impaired fat metabolism and increased body weight (body mass index up to 25).
• No increase in blood sugar during the day.
• Fasting sugar is 4.4-6.1 mmol / L, and a couple of hours after a meal is no more than 8 mmol / L.
• Glucose in urine is not detected.
• The rate of glycosylated hemoglobin, which reflects glucose in the blood over the past three months, is not more than 6.5%.
• The content of total cholesterol in the blood is up to 5.2 mmol / l.

At the initial detection of the disease, it is highly likely to achieve such criteria by resorting only to dietary treatment of type 2 diabetes (the symptoms of the disease were given earlier). In more advanced cases, a correctly selected diet serves as a fundamental element on the path to stabilizing blood sugar and a balanced state.

Treatment and nutrition for type 2 diabetes

Drug therapy and diet for this disease are complementary. General principles and requirements for the products and nutrition of a patient with type 2 diabetes correspond to any therapeutic diet:

• Products must be fresh and clean.

• Eat 5 times a day.

• Do not use easily digestible carbohydrates.

• Add sufficient fiber to the diet.

• Increase the content of vegetable fats to half of the total composition.

• The diet should be sub-calorie, that is, with reduced energy value.

Daily energy requirement

Define this indicator is necessary to develop a menu of therapeutic nutrition. The number of calories depends on the body weight of a person and the intensity of his activity.

According to the physical intensity of labor, the work that the patient performs belongs to one of five groups (combinations during the day are possible):

• Group 1 (very easy labor) includes mental specialists (administrators, managers, economists, accountants, researchers, teachers, lawyers, medical doctors).
• Group 2 (light labor) includes those who combine mental work with insignificant physical exertion (services, housewives, seamstresses, nurses, nurses, agronomists, employees of electronic enterprises).
• Group 3 (moderate labor) - these are people who receive more physical activity than in the previous group, combined with mental work (doctors of the surgical profile, public utilities, food industry workers, adjusters of machine tools and equipment, textile workers, repairmen, drivers) .
• Group 4 (hard labor) consists of manual workers (builders, workers in the woodworking, metallurgical, gas and oil industries, machine operators).
• Group 5 (very hard work) includes people who spend large energy reserves in work (masons, movers, laborers, excavators, concrete workers).

Hard and very hard work is not compatible with diabetes.

For an accurate calculation of calories, it is necessary to multiply the ideal patient mass by a tabular value corresponding to the severity of labor.

The number of calories put to a person with an ideal weight, depending on the work group, is shown in the table below.

The ideal mass can be calculated in several ways.

Breitman formula:

Ideal mass in kilograms = height in centimeters * 0.7 - 50.

Broca's index depends on the height of the person in centimeters. A given indicator is subtracted from this value.

The table shows the calculation of ideal body mass according to Brock's index.

There is another version that was invented by K. Gambsch and M. Fiedler, which determines the ideal mass for men and women, regardless of the difference in height.

Ideal male weight = (height in cm - 100) - 10%.

Ideal female weight = (height in cm - 100) - 15%.

Example of calculating daily energy requirements:

Patient N is a woman working as a hairdresser, 1.65 meters tall.

Ideal mass (MI) = 165 * 0.7 - 50 = 65.5 kg (Breitman formula).

MI = 165 - 100 = 65 kg (Brock's index).

MI = (165 - 100) - 15% = 55 kg (K. Gambsch and M. Fiedler)

Given the 2nd group of labor, the indicator 25 is taken from the table. Therefore, the number of calories per day in this case is from 1375 to 1637.5 kcal, depending on the method of calculating the ideal body weight.

In most cases, the body mass index of a patient suffering from type 2 diabetes is far from ideal. After all, this pathology of the endocrine system is often a companion of fat people.

To understand what kind of nutrition for type 2 diabetes you should adhere to, you need to calculate the daily caloric value, taking into account the true weight of the diabetic. It includes determining the basal energy balance and taking into account the severity of labor.

The table below shows the definition of basal energy requirements, depending on the physique and body mass index (BMI).

Body mass index is equal to weight in kilograms divided by height in m ² .

Basal energy balance (BEB) is calculated by multiplying the value from the table above, taken according to the phenotype of a person, by his actual weight.

The number of calories per day depends on the group of work and is calculated by the formula from the table below.

An example of calculating daily energy consumption with a known weight:

Patient N, a woman working as a hairdresser, has a height of 165 cm, weighs 88 kg.

BMI = 88 / 1.65 ² = 32.32.

This figure means obesity of the first degree. From table 3, the number 17 is taken and multiplied by 88 kilograms. BEB of this patient is 1496 kcal. From table 4 according to the nature of the work of group 2, the daily calorie content of patient N is calculated:

1496 + 1/3 x 1496 = 1995 kcal.

As can be seen from this example, the difference in daily energy requirements may be about 500 kcal, which depends on the weight of the patient. The fact that there is no reduction in excess weight affects the calorie content of food. If body weight does not decrease, the energy significance of foods in the diet for type 2 diabetes should be gradually reduced. The process of losing weight with this disease is very important.

What can I eat

After calculating the required number of calories, you can understand what kind of food is suitable for a patient with type 2 diabetes.

Approved foods for type 2 diabetes:

• Cereals (oatmeal, barley, buckwheat) contain slowly digestible carbohydrates, which is important to avoid sugar spikes after eating. Porridge is a source of fiber that promotes good bowel function. They remove toxins and toxins, improve kidney function, are a storehouse of vitamins and minerals, and increase immunity. The essential amino acids that make up buckwheat and oatmeal are similar in number to animal proteins. Buckwheat is good for blood vessels, contains a lot of iron. Oatmeal regulates fat metabolism.
• Meat (skinless chicken, turkey, beef, rabbit) non-greasy, boiled or steamed, meatballs, chops, meatballs, boiled diabetic sausage. Meat products are needed to replenish the reserves of animal protein needed to build muscle and give strength to the body. Meat increases hemoglobin, strengthens the immune system. Magnesium and B vitamins contained in meat fibers have a beneficial effect on the nervous system.
• Fish (hake, flounder, cod, carp, pike perch, pike) low-fat, stewed, boiled, fish cakes. Being a source of protein, like meat, fish replenishes the body with energy. It contains omega-3 fatty acids that improve fat metabolism. Fish is easy to digest. Phosphorus and calcium strengthen the skeleton, vitamins (tocopherol, retinol, thiamine, biotin), which favorably affect metabolism and immune defense. Sea fish contains a lot of iodine, which is necessary for the thyroid gland and the nervous system to function.
• Chicken eggs (soft-boiled, scrambled eggs) are sources of essential amino acids. They are rich in trace elements (calcium, iron, magnesium, sulfur, iodine, potassium, phosphorus, manganese, cobalt) necessary for the normal functioning of internal organs. The yolk contains vitamin A, which is good for the eyes. Eggs have a lot of protein and cholesterol in their composition, so you should eat no more than two pieces a day.
• Dairy products (milk, low-fat kefir, yogurt, cottage cheese, unsweetened yogurt, sour cream, cheeses) are rich in minerals (calcium, potassium, iron and phosphorus) that improve metabolic processes. A large amount of easily absorbed protein makes them energetically important for the patient on a diet. Riboflavin in the composition of dairy products improves hematopoietic function, vision and reduces inflammatory reactions.
• Bread (rye, grain, bran) contains fiber, which helps the intestines to work, B vitamins for healing the nervous system, minerals (iron, zinc, iodine, potassium, manganese, sulfur, cobalt, sodium) that improve heart function and metabolism.
• Vegetable oils (sunflower, olive, corn) are a source of tocopherol, retinol and vitamin D, which improve vision, the reproductive system, immunity, heal the skin and strengthen bones. Polyunsaturated fatty acids, which are the basis of oils, have a positive effect on fat metabolism.
• Vegetables (cucumbers, tomatoes, zucchini, cabbage, radishes, eggplant, dill, parsley, spinach, sorrel) should be eaten daily. They do not affect carbohydrate metabolism, contain vitamins and minerals necessary to strengthen immunity, protect the heart and blood vessels from atherosclerosis. Sweeter vegetables (carrots, beets, potatoes, onions) should be limited to 200 grams per day.
• Fruits and berries (sour apples and plums, cranberries) can be consumed indefinitely. Citrus fruits, currants, strawberries, raspberries, lingonberries must be eaten up to 200 grams per day so as not to cause spikes in sugar. The content of vitamin C, starch, organic acids in them favorably affects immunity, the digestive tract, and the body's defense against cancer and aging cells.
• Nuts (walnuts, hazelnuts, peanuts, cashews, pistachios, almonds) in a small amount (up to 10 pieces per day) are useful for diabetics. They contain many minerals, B vitamins that strengthen nerves. Due to the large amount of protein, energy reserves are replenished.
• Soups (vegetable, mushroom, lean ear and chicken broth) should be present daily with proper nutrition for type 2 diabetes to improve the functioning of the stomach and intestines.
• Drinks (unsweetened tea and coffee, acidic juices without sugar, mineral water, rosehip tea, tomato juice) are an integral part of nutrition.

Prohibited Products

When planning recipes for nutrition for type 2 diabetes, you should consider which foods you should not eat:

• Sweets (sugar, sweets, cakes, jam, jam, pudding, cakes, ice cream, honey, condensed milk, chocolate, pastries) contain easily digestible carbohydrates that can cause a quick rise in blood glucose and weight gain.
• Sweet drinks (juices, tea and coffee with sugar, cocoa) are prohibited for food in type 2 diabetes for the same reasons as sweets.
• Foods containing a large amount of animal fats (pork, duck, goose, poultry skin, fish roe, fried fish) are prohibited due to the deterioration of fat metabolism. For the same reason, mayonnaise, cream, fried potatoes are contraindicated.
• Alcohol worsens the functioning of the liver and pancreas, can cause a coma.

Sweeteners

If it is impossible to remove sweets in the diet for type 2 diabetes, add substances that replace glucose to desserts:

• Fructose is utilized from the body without the help of insulin; it is a natural monosaccharide. You can eat no more than 30 grams of sweets per day.
• Saccharin is many times sweeter than sugar and is used to sweeten tea in the form of tablets that can be consumed up to 0.15 g.
• Sorbitol is a plant product, energetically valuable, weakens stools. It can be used in a dose of not more than 30 grams per day.
• Xylitol, like sorbitol, can be used up to 30 grams per day, but subject to a compensated condition and intermittently.
• Aspartame (Sladex, Slastilin) ​​is an artificially excreted substance without side effects and beneficial effects. Used in tablets of 1-2 in tea or coffee.

Nutrition for type 2 diabetes. Menu

After calculating the number of calories needed per day, having studied the energy value of products and the content of carbohydrates in them, you can proceed to planning the menu. Carbohydrates account for 60% of all substances consumed by the patient per day. Proper nutrition for type 2 diabetes includes a breakdown of food energy into five meals in such a way that 25% of all calories should go out for breakfast, 15% for lunch, 30% for lunch, 10% for lunch, and 20% for dinner %

Exemplary nutrition for type 2 diabetes is provided below.

Breakfast:

• Oatmeal porridge (100 grams).
• Vegetable salad (cabbage, carrots, parsley, sour apple), seasoned with sunflower oil (200 grams).
• Black bread (25 grams).
• 1 soft-boiled egg.
• Cottage cheese 1% (100 grams).
• Green tea without sugar 1 cup.

Lunch:

• Cottage cheese 1% with sour cream (100 grams).
• Apple juice without sugar 1 cup.

Dinner:

• Vegetable soup (200 grams).
• Black bread (25 grams).
• Chicken meat (100 grams).
• Mashed potatoes (150 grams).
• Vegetable salad from beets and walnuts with sour cream (200 grams).
• 1 sour apple.
• Tomato juice - 1 cup.

Snack:

• Cottage cheese 1% with sour cream (100 grams).
• Black tea without sugar - 1 cup.
• 1 orange

Dinner:

• Buckwheat porridge (100 grams).
• Steamed beef (100 grams).
• Cucumber vegetable salad, tomato with olive oil (200 grams).
• Kefir 1% - 1 cup

Energy value: 2000 kcal / day.

Thus, the main diet in type 2 diabetes is the lack of lungs for the absorption of carbohydrates, a decrease in saturated fat, a large number of vegetables and fruits, and a low-calorie diet. Proper nutrition is the key to success in treating type 2 diabetes.