Nutrition for type 2 diabetes: sample menu and recommended foods

2024 Author: Isabella Gilson | [email protected]. Last modified: 2024-01-18 00:50

Studying the statistics of the World He alth Organization, it is clear that at the end of 2014, 422 million people suffered from diabetes. Every year this figure is catastrophically 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 of type 2 diabetes.

Definition of concept

Type 2 diabetes mellitus is a disease of the endocrine system associated with the resistance of body tissue cells to the hormone insulin produced by the pancreas, which leads to an increase in blood glucose. At the same time, the amount of insulin in the blood is normal, and the gland functions normally, so this type of diabetes is considered insulin-independent.

Causes of pathology

Here are the main triggers:

• Genetic predisposition.
• Obesity, overweight.
• High-calorie food.
• Sedentary lifestyle.

Symptoms

At the initial stage of the disease, patients present with 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, long-term 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;
• increase in the number of carious teeth, damage to the gums and oral mucosa;
• symptoms of gastritis and stomach ulcers;
• diarrhea;
• pain in the liver, the appearance of stones in the gallbladder;
• cardiac pain and shortness of breath;
• increased blood pressure;
• urinary tract infection, kidney pain, frequent urination;
• numbness, freezing and pain in the lower extremities associated with vascular lesions;
• reduced vision, which develops against the background of a deterioration in the condition of the retina.

Criteria for the maximum compensated state of the patient

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

• Feel good physically.
• Normal performance.
• Absencedisorders of 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 eating it is no more than 8 mmol/l.
• Glucose is not detected in urine.
• Glycosylated hemoglobin, reflecting blood glucose for the last three months, no more than 6.5%.
• The content of total cholesterol in the blood is up to 5.2 mmol/L.

When the disease is first diagnosed, it is highly likely to achieve such criteria by resorting only to nutritional treatment of type 2 diabetes (symptoms of the disease were given earlier). In more advanced cases, a properly chosen diet serves as a fundamental element on the way to blood sugar stabilization and a compensated state.

Treatment and nutrition for type 2 diabetes

Drug therapy and diet for this disease complement each other. The general principles and food and nutrition requirements for a type 2 diabetic patient are consistent with any therapeutic diet:

• Food must be fresh and clean.
• Eat 5 times a day.
• Do not eat easily digestible carbohydrates.
• Add enough fiber to your diet.
• Increase vegetable fat content to half of the total composition.
• The diet should be subcaloric, that is, with a reduced energy value.

Daily energyneed

It is necessary to determine this indicator for the development of a therapeutic nutrition menu. The number of calories depends on the person's body weight and the intensity of his activity.

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

• 1 group (very light work) includes mental workers (administrators, managers, economists, accountants, researchers, teachers, lawyers, therapeutic doctors).
• 2 group (light work) includes those who combine mental work with minor physical exertion (service sector, housewives, seamstresses, nurses, nurses, agronomists, employees of radio-electronic enterprises).
• 3 group (moderate labor) - these are people who receive more physical activity than in the previous group, combined with mental work (surgeons, public utilities, food industry, machine tool and equipment adjusters, textile workers, locksmiths -repairmen, drivers).
• 4 group (hard labor) is manual workers (construction workers, workers in the woodworking, metallurgical, gas and oil industries, machine operators).
• 5 group (very hard work) includes people who expend large energy reserves in their work (masons, loaders, laborers, diggers, concrete workers).

Hard and very hard work is not compatible with diabetes.

For an accurate calculation of calories, you need an ideal massmultiply the patient by the tabular value corresponding to the severity of labor.

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

Labor Group	How many calories are required for 1 kg of ideal weight
Very easy work	20
Easy work	25
Medium-hard work	30
Hard work	40
Very hard work	45-60

Ideal mass can be calculated in several ways.

Breitman formula:

Ideal weight in kilograms=height in centimeters0.7 - 50.

Brock's index depends on the person's height in centimeters. A certain indicator is subtracted from this value.

The table shows the calculation of the ideal body weight according to Broca's index.

Height in centimeters	Ideal weight in kilograms
156-165	Height - 100
166-175	Height - 105
176-185	Height - 110
186 or more	Height - 115

There is another version, which was invented by K. Gambsch and M. Fidler,determining the ideal weight for men and women, regardless of the difference in height.

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

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

Example of daily energy requirement calculation:

Patient N is a female hairdresser, 1.65 meters tall.

Ideal weight (IM)=1650.7 - 50=65.5 kg (Breitman's formula).

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

IM=(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 weight of a patient with type 2 diabetes is far from ideal. After all, this pathology of the endocrine system is often a companion of obese people.

To understand what kind of diet for type 2 diabetes should be followed, it is necessary to calculate the daily calorie intake, taking into account the current weight of the diabetic. It includes determining the basal energy balance and taking into account the severity of work.

The table below shows the definition of basal energy requirement based on body mass index (BMI).

Physique/BMI	Percentage of body fat	Daily energy intake in kcal/kg
Slim/Under 20	5-10	25
Normal/20-24, 9	20-25	20
Overweight and Fat Metabolism Disorder (OBD) Grade 1-2/25-39, 9	30-35	17
VJO Grade 3/40 or more	40	15

Body mass index equals weight in kilograms divided by height in m2.

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 work group and is calculated using the formula from the table below.

Daily energy consumption depending on the severity of work

Labor Group	Energy requirement kcal/day
1 (very light work)	BEB+1/6 BEB
2 (light work)	BEB+1/3 BEB
3 (medium hard work)	BEB+1/2 BEB
4 (hard work)	BEB+2/3 BEB
5 (very hard work)	BEB+BEB

Example of calculating daily energy consumption with a known weight:

Patient N, a female hairdresser, is 165 cm tall and weighs 88 kg.

BMI=88 / 1.652=32, 32.

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

1496 + 1/3 x 1496=1995 kcal.

As you can see from this example, the difference in the daily energy requirement can be about 500 kcal, which depends on the weight of the patient. The fact that there is no weight loss affects the calorie content of food. If body weight does not decrease, the energy content of foods in type 2 diabetes should be gradually reduced. The process of losing weight in this disease is very important.

What can you eat

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

Allowed foods for type 2 diabetes:

• Grains (oatmeal, pearl barley, buckwheat) contain slowly digestible carbohydrates, which is important to avoid sugar surges after meals. 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 quantity to animal proteins. Buckwheat is good for blood vessels, contains a lot of iron. Oatmeal regulates fat metabolism.
• Meat (skinless chicken, turkey, beef, rabbit) lean, boiled or steamed, meatballs,chops, meatballs, boiled diabetic sausage. Meat products are necessary to replenish animal protein, which is necessary for building muscles and giving 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) lean, 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 easily digestible. 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 functioning of the thyroid gland and nervous system.
• Chicken eggs (soft-boiled, scrambled eggs) are sources of essential amino acids. Rich in trace elements (calcium, iron, magnesium, sulfur, iodine, potassium, phosphorus, manganese, cob alt) necessary for the normal functioning of internal organs. The yolk contains vitamin A, which is good for the eyes. Eggs are high in protein and cholesterol, so eat no more than two a day.
• Dairy products (milk, low-fat kefir, curdled milk, 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 a patient on a diet. Riboflavin in dairy products improves hematopoietic function, vision andreduces inflammatory reactions.
• Bread (rye, grain, with bran) contains fiber that promotes bowel function, B vitamins to improve the nervous system, minerals (iron, zinc, iodine, potassium, manganese, sulfur, cob alt, sodium), improve heart function and metabolism.
• Vegetable oils (sunflower, olive, corn) are a source of tocopherol, retinol and vitamin D, which improve vision, the functioning of 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, radish, eggplant, dill, parsley, spinach, sorrel) should be eaten daily. They do not affect carbohydrate metabolism, contain vitamins and trace elements necessary to strengthen the immune system, 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 unlimitedly. Citrus fruits, currants, strawberries, raspberries, lingonberries must be eaten up to 200 grams per day so as not to cause sugar surges. The content of vitamin C, starch, organic acids in them has a positive effect on the immune system, the functioning of the digestive tract, the body's defense against cancer and cell aging.
• Nuts (walnuts, hazelnuts, peanuts, cashews, pistachios, almonds) in small quantities (up to 10 pieces per day) are useful for diabetics. They contain many minerals, B vitamins, which strengthen the nerves. Thanks toa large amount of protein replenishes energy reserves.
• Soups (Vegetable, Mushroom, Low-fat fish soup and chicken broth) should be included daily in a proper type 2 diabetes diet to improve stomach and bowel function.
• Beverages (unsweetened tea and coffee, sour juices without sugar, mineral water, rosehip tea, tomato juice) are an essential part of the diet.

Forbidden foods

When planning type 2 diabetic recipes, consider what foods to avoid:

• Sweets (sugar, sweets, cakes, jam, jam, pudding, cakes, ice cream, honey, condensed milk, chocolate, baked goods) contain easily digestible carbohydrates that can cause a rapid rise in blood glucose and weight gain.
• Sugary drinks (juices, tea and coffee with sugar, cocoa) are prohibited for type 2 diabetes for the same reasons as sweets.
• Products 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 impairs the functioning of the liver and pancreas, can cause a coma.

Sweeteners

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

• Fructose is utilized from the body withouthelp insulin, is a natural monosaccharide. You can eat no more than 30 grams per day, contained in sweets.
• Saccharin is many times sweeter than sugar, used to sweeten tea in the form of tablets that can be consumed up to 0.15 g.
• Sorbitol is a product of plant origin, energetically valuable, loosens the stool. Can be used at a dose not exceeding 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 (sladeks, slastilin) is an artificially derived substance without side effects and beneficial effects. Used in tablets of 1-2 pieces in tea or coffee.

Nutrition for type 2 diabetes. Menu

Having calculated the number of calories needed per day, having studied the energy value of foods and their carbohydrate content, you can proceed to menu planning. Carbohydrates make up 60% of all substances consumed by the patient per day. Proper nutrition for type 2 diabetes involves breaking down the energy of food into five meals so that breakfast should be 25% of all calories, lunch - 15%, lunch - 30%, afternoon tea - 10% and dinner - 20 %.

A sample diet for type 2 diabetes is shown below.

Breakfast:

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

Second breakfast:

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

Lunch:

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

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).
• Vegetable cucumber salad, tomato with olive oil (200 grams).
• Kefir 1% - 1 glass

Energy value: 2000 kcal/day

Thus, the main diet in type 2 diabetes is the lack of easy-to-digest carbohydrates, reduced saturated fats, a large amount of vegetables and fruits, a low-calorie diet. Proper nutrition is the key to success in the treatment of type 2 diabetes.