Wellness care calls for good nutrition at all times. In old age, for example, a sequence of physical changes takes place, and many of them demand a superior look towards Nutrition.
To defeat food monotony, balance is the keyword. In addition to promising more vitality to everyday life, a diversified, colorful and balanced food routine contributes to the prevention and care of diseases such as obesity, high blood pressure, high cholesterol and diabetes.
Nutritional therapy is essential for the care and treatment of DM. Effectively integrating nutrition therapy into total DM management requires a coordinated team effort, including a trained nutritionist to implement DM principles and recommendations. Nutritional therapy requires an individualized approach and effective nutritional self-monitoring education.
Monitoring glucose, HbA1C and plasma lipid concentrations, in addition to systemic blood pressure, body mass and quality of life is essential in evaluating the success of recommendations related to nutrition.
There is evidence that changes in lifestyle can happen with greater success the earlier interventions occur. It is known that the adoption of a diet rich in fruits, vegetables, legumes, whole grains and low in saturated fats, associated with the frequent practice of regular physical activity, can have a beneficial effect on the quality of life of the population and on reducing the burden of diseases in the public health system.
The adoption of a healthy eating plan is fundamental in the treatment of DM. To establish nutritional guidelines for the individual, the first step is to carry out a detailed nutritional assessment, including determination of body mass index (BMI) and measurement of waist circumference (WC). In addition, the determination of the metabolic profile is very important for establishing DM nutritional therapy and preventing acute and chronic complications.
The diet plan for diabetics should be nutritionally adequate, individualized and provide a total energy value (TEV) compatible with obtaining and/or maintaining ideal body mass according to gender and age. To the
recommendations regarding TEV and food composition are described in Chart 1.
Chart 1 – Nutritional recommendations for Diabetes Mellitus
Source: Brazilian Society of Diabetes (2016)
It has been proven that practices related to nutritional therapy and physical exercise improve insulin sensitivity, reduce plasma glucose concentrations, PC and visceral fat. Thus, improvements in the metabolic profile are observed, with a reduction in LDL-cholesterol and triglyceride concentrations and an increase in HDL-cholesterol.
The objectives of nutritional therapy in DM are: achieving and maintaining normal glycemic, lipid profile and systemic blood pressure values; prevent and treat the chronic complications of DM, mainly nephropathy and vasculopathies; promote healthy eating through the correct selection of foods; meet individual nutritional recommendations; provide adequate energy for normal growth and development in DM1; reduce insulin resistance through moderate loss of body mass and prevention of excessive weight gain.
The American Diabetes Association recommends that the best nutritional strategy for promoting health and reducing the risk of chronic diseases is to obtain adequate nutrients through a varied, moderate and balanced diet, based on the pillars of the food pyramid. Soluble fiber stands out in the control of dyslipidemia and blood glucose, by reducing the intestinal absorption of cholesterol and carbohydrates.
However, dietary adherence of diabetics is only achieved through correct dietary guidance and regular monitoring of the patient. The integration of eating habits, lifestyle and clinical treatment are determining factors in the role of nutrition in controlling the disease.
The balanced consumption of light foods makes the difference, in addition to water intake is essential for maintaining good hydration. In addition to the remarks of:
a) Reduce the salt in industrialized products, emphatically higher than those containing excessive sodium – ex. seasonings and sauces suitable for packet soups, instant noodles, among others. Abuse herbs and seasonings, such as parsley, oregano, basil, cumin, mint, sage, among others;
b) Avoid fasting for long periods and consume anything, in short, something every 3 hours, around this fraction, if it helps to control appetite, weight and, mainly, to prevent hypoglycemia;
c) Hydration, given that good hydration facilitates the usefulness of the intestine and kidneys, among many other advantages;
d) Move, because our organism is like a machine and orders us to be encouraged not only with food, however, in the same way with exercises. Walk, swim, dance. One should choose a pleasurable active action and for some feel the benefits of staying active.
A recipe for improving the relationship between Nutrition and Diabetes is:
a) Drink at least 2 liters of water a day, because we need water because our blood is made up of 90% of it, and our body can differentiate between 50% and 75%, so every time we waste liquid (sweat, etc.), it is mandatory to replace it. In addition, water cleans our entire organism, hydrates our skin, and it is because of it that vitamins and minerals appear in the cells of our entire body;
b) Decrease sugar levels – Refined sugar is a compound that comes from sugar cane, however, every appropriate portion of it has been eliminated, leaving only the calories. Decreasing means to stop ingesting a portion of useless calories for our body. Also try to replace the refined version with the brown one, for example, which has not gone through the refinement method, and still retains nutritional standards;
c) Give priority to whole foods – In the same way it happens with white flour, that is, after a refinement method, all its nutritional usefulness was eliminated, leaving only the carbohydrate. Choose wholegrain selections from pasta, rice, bread, etc. that still contain the natural nutrients. And be careful not to be deceived, as the exclusive type of flour in the product’s ingredients list must be “Whole Wheat Flour”. If there is another type of wheat flour, the product is not 100% whole;
d) Have organic foods in your diet – These are favorites because they are made without the use of pesticides and preservatives, which are harmful substances for our organism. If by chance you don’t find them in these versions, every time you choose fruits and vegetables, think about how you would find them if you were picking them straight from the tree. If you were presented with a very red, very round tomato, with a smooth and shiny skin, beware!
e) Ensure healthy snacks – When we leave the house, desires tend to arise, since it is much more accessible to find an industrialized snack than something healthy. For this reason, prepare healthy snacks that you can carry with you, for example, a mix of nuts, which are simply transported in bags, or a wholemeal sandwich, fruit, among others, not eating junk food around.;
f) Eat the salad first – At lunch and dinner, usually start your meals with a salad, especially the cold green leaf salads, as they are rich in nutrients and vitamins, and are greater sources of fiber that will provide satiety, so when reaching the fundamental dish, it will prevent you from exceeding your hunger limit. And whenever selecting the salad, the more colorful it is, the better!
g) Consume fruits daily – Fruits are the best foods, as they are rich in fibers, vitamins, minerals, and continuously dominate in a favorable way in our organism. Consume at least 3 servings a day, and every time
as possible by diversifying the fruits. That way you will be able to take advantage of all the privileges they present.
Anyway, we must remember that food can kill us quickly, and Diabetes itself is the result of a bad diet, along with a sedentary lifestyle.
Lifestyle changes, with the inclusion of nutritional guidance therapy and aerobic physical activity, modify the lipid profile, reduce blood pressure levels and are important in controlling blood glucose and body weight. Although much of the dietary approach has always been focused on weight control, greater emphasis has been placed on glycemic control and cardiovascular risk factors.