Реферат: The diabetic diet

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<span Arial",«sans-serif»;mso-ansi-language:EN-US;mso-bidi-font-weight: bold">THE  DIABETIC  DIET.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US;mso-bidi-font-weight:bold">Abstract on English by  Kuranov Alina Olegovna – a student of  Essentuki medical college group № 261.

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<span Arial",«sans-serif»;mso-bidi-font-weight:bold">2002г.

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<span Arial",«sans-serif»;mso-ansi-language: EN-US">DIABETES.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">DiabetesMellitus (when the term diabetes is used alone, it always refers to diabetesmellitus) is a condition in which the body is unable to use sugar properly.Sugar (carbohydrate) is the substance our body uses as its major source ofenergy. Once this sugar is absorbed in the blood, it is referred to as bloodsugar or blood glucose.   Insulin (a hormone made in the pancreas thatregulates the blood sugar) is either missing or deficient. As a result, thebody cannot use energy nutrients (carbohydrates, fat, protein) effectively andthe cells of the body «starve». The sugar in the blood may rise tohigh levels instead of being used for energy.  Blood sugar is excretedthrough urine, which makes extra work for the kidneys causing frequenturination and excessive thirst.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Treatment

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Diet, exerciseand medication are important factors that must be coordinated for diabetes tobe kept in control. Medication is not used to treat all cases of diabetes.Medication when used can either be in the form of a pill (oral hypoglycemicagents) or insulin, which must be injected. Diet, exercise and medication allaffect treatment but unless the diet plan is followed carefully no method oftreatment will be effective. By eating the right foods in the right amountsdiet can actually help control the basic problem of diabetes.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Accordingto Control Your Diabetes Education Program for Life, a program sponsored by theNational Diabetes Education Program, people who take control of diabetes will,in the short run, feel better, have more energy, and prevent the followingsigns and symptoms of high blood sugar: thirst, fatigue, frequent urination,weight loss, blurred vision, and slow healing of cuts and bruises.  In thelong run, they decrease their chances of developing eye disease, kidneydisease, and nerve damage, and add years to their lives.

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<span Arial",«sans-serif»;mso-ansi-language:EN-US">THEDIABETIC DIET.

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<span Arial",«sans-serif»;mso-ansi-language:EN-US">Purpose: Thediabetic diet is designed to achieve and maintain desirable body weight andnear normal blood glucose levels, reduce hyperglycemia, glycosuria, andassociated symptoms of diabetes in order to minimize the complicationsfrequently associated with this disease.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Use: It isused for the person with either insulin-dependent diabetes mellitus ornon-insulin-dependent diabetes mellitus. The calorie-controlled diet may beadapted for weight reduction and weight maintenance.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">The calorielevel prescribed for the diabetic is based on whether the person needs to loseor gain weight or simply maintain the present weight. The calorie levelspecified is determined from the height, body build, ideal weight and physicalactivity level.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">GeneralGuidelines for the Diabetic Diet.

<span Arial",«sans-serif»;mso-fareast-font-family: Arial;mso-ansi-language:EN-US">1.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Avoid <span Arial",«sans-serif»">concentrated sources ofcarbohydrates<span Arial",«sans-serif»; mso-ansi-language:EN-US"> (sugars) such as table sugar, honey, jelly, jam,molasses, syrup, corn syrup, candy, regular soft drinks, pies, doughnuts,cookies, pastries, regular chewing gum, and sweet pickles.

<span Arial",«sans-serif»;mso-fareast-font-family:Arial">2.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Avoid sweetened fruits, juices and fruit drinks.Choose fruit, which is fresh, frozen or packed in water or its own juice. <span Arial",«sans-serif»">Avoid<span Arial",«sans-serif»"> fruits canned in heavysyrup.

<span Arial",«sans-serif»;mso-fareast-font-family: Arial;mso-ansi-language:EN-US">3.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Avoid sweetened carbonated sodas, juices and water.

<span Arial",«sans-serif»;mso-fareast-font-family: Arial;mso-ansi-language:EN-US">4.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Learn foods both high and low in sugar that arepresented in the <span Arial",«sans-serif»">No Concentrated Sweet Food List<span Arial",«sans-serif»;mso-ansi-language:EN-US"> <span Arial",«sans-serif»;mso-ansi-language:EN-US">

<span Arial",«sans-serif»;mso-fareast-font-family:Arial">5.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Three meals at regular times should be consumed daily.<span Arial",«sans-serif»">Do<span Arial",«sans-serif»"> not skip meals.

<span Arial",«sans-serif»;mso-fareast-font-family:Arial">6.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">A nutritionally adequate meal plan that limits theamount of <span Arial",«sans-serif»">saturated fat, cholesterol and salt<span Arial",«sans-serif»;mso-ansi-language:EN-US"> inthe diet. Fat intake should be 30% or less of caloric intake and less than 10%of daily caloric intake from saturated fat. Dietary cholesterol should belimited to 300 mg or less daily. <span Arial",«sans-serif»">2,400mg or lessper day ofsodium is recommended.

<span Arial",«sans-serif»;mso-fareast-font-family: Arial;mso-ansi-language:EN-US">7.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Daily consumption of 20-35 g of <span Arial",«sans-serif»">dietary fiber<span Arial",«sans-serif»;mso-ansi-language:EN-US">from a wide variety of foods is recommended.

<span Arial",«sans-serif»;mso-fareast-font-family: Arial;mso-ansi-language:EN-US">8.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Mild to <span Arial",«sans-serif»">moderate weight loss<span Arial",«sans-serif»;mso-ansi-language:EN-US">(10-20 pounds. has been shown to improve diabetes control, even if desirablebody weight is not achieved.)

<span Arial",«sans-serif»;mso-fareast-font-family: Arial;mso-ansi-language:EN-US">9.<span Times New Roman"">           

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Read the <span Arial",«sans-serif»">label to determine the sugar<span Arial",«sans-serif»;mso-ansi-language:EN-US">content of packaged foods. In addition to sugar, brown sugar and corn syrup,other names that are used on ingredient labels include: sucrose, glucose,dextrose, fructose, maltose, lactose, sorbitol, mannitol, honey, corn syrup,corn syrup solids, high fructose corn syrup, molasses, maple syrup.

<span Arial",«sans-serif»;mso-fareast-font-family: Arial;mso-ansi-language:EN-US">10.<span Times New Roman"">        

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Monitoring of lipids, blood pressure and body weightis crucial.

<span Arial",«sans-serif»;mso-fareast-font-family: Arial;mso-ansi-language:EN-US">11.<span Times New Roman"">        

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Glycated hemoglobin (HbA1C) and daily monitoring ofblood glucose are standard tools to measure glucose control.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">For individuals with <span Arial",«sans-serif»">Type 1 diabetes, self-monitoring 4 timesdaily or more is recommended to maintain near-normal blood glucose levels andgain control.  Testing 4 times a day, before each meal, and at bedtime,facilitates adjustments to insulin, meals, and exercise program. 

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">For individuals with <span Arial",«sans-serif»">Type 2 diabetes, self-monitoring 1-2times daily or more is recommended to avoid hypoglycemia and hyperglycemiasymptoms.   

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<span Arial",«sans-serif»;mso-ansi-language:EN-US">Newly diagnosed<span Arial",«sans-serif»;mso-ansi-language:EN-US">individuals should test blood glucose 4 times a day, before each meal, and atbedtime, or more is recommended to maintain near-normal blood glucose levelsand gain control.  <span Arial",«sans-serif»">Testing<span Arial",«sans-serif»">  facilitates adjustmentsto insulin, meals, and exerciseprogram. 

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">After a stable pattern has been established in bloodglucose levels, individuals should test before breakfast, 3-7 times eachweek.  Once or twice each month you should return to testing 4 times a day(before each meal, and at bedtime) to assure maintenance of a stable pattern.

<span Arial",«sans-serif»; mso-ansi-language:EN-US">NO CONCENTRATED SWEETS, LOW FAT DIET.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">(LOWSUGAR-LOW FAT)

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<span Arial",«sans-serif»;mso-ansi-language:EN-US">Purpose: Theno concentrated sweets, low fat diet is designed to limit the total amount offat and sugar in the diet to reduce serum lipid levels and to achieve andmaintain near normal blood glucose levels. This diet is for people who find theexchange system too confusing or restricting to follow.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Use: It isused for the person with either non-insulin-dependent diabetes mellitus or forpeople who need or want to cut down on their sugar and fat intake. The

<span Arial",«sans-serif»">calorie-controlleddiet<span Arial",«sans-serif»; mso-ansi-language:EN-US"> may be adapted for weight reduction and weightmaintenance for individuals that <span Arial",«sans-serif»">donot have diabetes. It is also used for persons with elevated serumcholesterol levels or those who are high-risk candidates for heart disease.

<span Arial",«sans-serif»;mso-ansi-language: EN-US">General Guidelines.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Limit total fat intake to less than 30% of total dailycalories.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Reduce <span Arial",«sans-serif»">saturated fat intake<span Arial",«sans-serif»;mso-ansi-language:EN-US">(red meat, cheese, whole milk, butter, ice cream, etc.)

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Eat less <span Arial",«sans-serif»">transfat <span Arial",«sans-serif»;mso-ansi-language:EN-US">(stickmargarine, shortening, cakes, pies, French fries, snack chips.)

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Eat less <span Arial",«sans-serif»">cholesterol<span Arial",«sans-serif»;mso-ansi-language:EN-US">(limit egg yolks to more than 4 per week and meat, fish, poultry to no morethan 6 ounces a day)

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<span Arial",«sans-serif»">Reduce<span Arial",«sans-serif»">sugar intake.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Eat more fruits, vegetables, beans, whole grainbreads, and cereals.

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<span Arial",«sans-serif»">Maintain<span Arial",«sans-serif»">a healthy weight.

·<span Times New Roman"">                    

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Exercise at least 30 minutes on most days (briskwalking, aerobics, biking, etc.)

·<span Times New Roman"">                    

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Experiment with recipes by gradually reducing theamount of sugar by 1/4th then l/3rd then 1/2.

·<span Times New Roman"">                    

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Use the «sweet» spices—cinnamon clovesginger or nutmeg—to bring out sweetness in baked goods.

·<span Times New Roman"">                    

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Be careful when using special diet or dietetic foodssuch as dietetic cake, cookies, candy and ice cream. These foods contain someform of sweetener and, therefore, calories.

<span Arial",«sans-serif»; mso-ansi-language:EN-US">NO CONCENTRATED SWEET FOOD LIST.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Purpose: Theno concentrated sweets diet is designed to achieve and maintain near normalblood glucose levels, and reduce associated symptoms of diabetes in order tominimize the complications frequently associated with this disease. This dietis for people who find the exchange system too confusing or restricting tofollow.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Use: It isused for the person with either non-insulin-dependent diabetes mellitus or forpeople who need or want to cut down on their sugar intake. It is not intendedfor the person with diabetes taking insulin. The

<span Arial",«sans-serif»">calorie-controlleddiet<span Arial",«sans-serif»; mso-ansi-language:EN-US"> may be adapted for weight reduction and weightmaintenance.

·<span Times New Roman"">                    

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Eat three meals at regular times. <span Arial",«sans-serif»">Do<span Arial",«sans-serif»"> not skip meals.

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<span Arial",«sans-serif»">Limit total fatintake<span Arial",«sans-serif»; mso-ansi-language:EN-US"> to less than 30% of total daily calories.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Reduce <span Arial",«sans-serif»">saturated fat <span Arial",«sans-serif»;mso-ansi-language:EN-US">intake(red meat, cheese, whole milk, butter, ice cream, etc.)

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Eat less <span Arial",«sans-serif»">transfat<span Arial",«sans-serif»;mso-ansi-language:EN-US">(stick margarine, shortening, cakes, pies, french fries, snack chips.)

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Eat less <span Arial",«sans-serif»">cholesterol<span Arial",«sans-serif»;mso-ansi-language:EN-US">(limit egg yolks to more than 4 per week and meat, fish, poultry to no morethan 6 ounces a day.)

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<span Arial",«sans-serif»">Reduce saltintake<span Arial",«sans-serif»; mso-ansi-language:EN-US"> (canned and dried soups, fast food, frozen dinners,pizza, processed meats and cheese.)

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Eat more fruits, vegetables, beans, whole grainbreads, and cereals.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Maintain a healthy weight. Mild to moderate weightloss (10-20 lbs. has been shown to improve diabetes control, even if desirablebody weight is not achieved.)

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Recommend 20-35 grams/day of <span Arial",«sans-serif»">dietary fiber<span Arial",«sans-serif»;mso-ansi-language:EN-US">from a wide variety of foods.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Be careful when using special diet or dietetic foodssuch as dietetic cake, cookies, candy and ice cream. These foods contain someform of sweetener and, therefore, calories.

·<span Times New Roman"">                    

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Monitor blood glucose, glycated hemoglobin, lipids,blood pressure and body weight.

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<span Arial",«sans-serif»; mso-ansi-language:EN-US">Exercise at least 30 minutes on most days (briskwalking, aerobics, biking, etc). Regular exercise improves control of bloodsugar and is an important part of any healthy lifestyle.

·<span Times New Roman"">                    

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Experiment with recipes by gradually reducing theamount of sugar by 1/4th then l/3rd then 1/2.

·<span Times New Roman"">                    

<span Arial",«sans-serif»; mso-ansi-language:EN-US">Use the «sweet» spices—cinnamon clovesginger or nutmeg—to bring out sweetness in baked goods.

·<span Times New Roman"">                    

<span Arial",«sans-serif»">Read the labelto determine the sugar <span Arial",«sans-serif»;mso-ansi-language:EN-US">content of packaged foods. Inaddition to sugar, brown sugar and corn syrup, other names that are used oningredient labels include: sucrose, glucose, dextrose, fructose, maltose,modified food starch, natural sweeteners, lactose, sorbitol, mannitol, honey,corn syrup, corn syrup solids, high fructose corn syrup, molasses, maple syrup.

<span Arial",«sans-serif»; mso-ansi-language:EN-US">ABOUT THE MAJOR NUTRIENTS IN THE DIABETIC DIET.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">CARBOHYDRATESare made up of simple sugars, complex carbohydrates, and fiber. Simplecarbohydrates are commonly known as sugars, sources of simple carbohydratesinclude table sugar, candies and other sweets, sodas and bakery goods. Thesugar in these foods is in a form that is absorbed easily by the body, asopposed to the slower-digesting complex carbohydrates.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Complexcarbohydrates include all the complex starches and fiber, such as those foundin grains, cereals, breads and starchy vegetables like potatoes, corn, peas andbeans. Milk, fruit and vegetables also contribute significant amounts ofcarbohydrate in the diet.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">100% of thecarbohydrates eaten are broken down into glucose. Therefore carbohydrateselevate the blood sugar at a faster rate than either protein or fat so onlymeasured amounts should be consumed. Complex carbohydrates contain manyessential nutrients and are the body's most effective source of energy.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">PROTEIN

<span Arial",«sans-serif»;mso-ansi-language:EN-US">provides amino acids for your body to build, maintain, and repair cells andmuscle tissue, heal wounds, and support the immune system. It is very easy toget protein in our diet, in fact, most Americans consume 2-3 times more proteinthan necessary. Excess protein does not create muscle, as many hope, but isstored as fat. Excess protein can put strain on the liver and kidneys. The bestprotein sources are milk, yogurt, cheese, lean meat, poultry, fish, beans,eggs, and nuts. Breads, cereals and vegetables contribute small amounts ofprotein in the diet. About 60% of the protein eaten are broken down intoglucose.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Nutritionistsrecommend about 45 to 50 grams of protein a day for most women and 50 to 60grams a day for most men or 10 percent to 20 percent of daily calories.Children and infants, who are growing rapidly, need more protein, as dopregnant women.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">FA<span Arial",«sans-serif»">T

<span Arial",«sans-serif»;mso-ansi-language:EN-US">,like carbohydrates, are used by the body for fuel and are essential for theabsorption of certain vitamins. Although some fat in the diet is necessary, toomuch fat can lead to heart disease, obesity and other health problems. Fatsshould comprise no more than 30 % of daily calories, or even lower.

<span Arial",«sans-serif»;mso-ansi-language:EN-US">Fats in thediet may be of animal or vegetable origin. Examples of fat in the diet aregravy, bacon, margarine, butter, cream, salad dressings and nuts. Meats andsome milk products also contain significant amounts of fat. About 10% of thefat eaten is broken down into glucose.

<span Arial",«sans-serif»">The<span Arial",«sans-serif»"> remainder is stored asfat for futureuse