"Diet & Excercise Prescriptions for Diabetes"

Diet & Excercise Prescriptions for Diabetes

BlackDoctor.org) A “diet prescription,” along with exercise, is vital in managing diabetes and preventing complications. Your personalized diet prescription does not need to be an expensive or “special” diet. Your basic nutritional needs are the same as those of a non diabetic. However, you may have specific needs, such as:

-limiting total calories for a healthy body weight

-chronic health conditions

-food preferences

- age, job, and activity levels that affect food needs.

You must follow your prescribed diet faithfully. This is especially important if you have complications like heart disease, high blood pressure, or kidney disease.

A diabetic meal plan matches calories from fat, carbohydrate, and protein with your body activity and insulin levels. It is based on grouping foods into what is called the exchange system. This system translates the prescribed calories into actual foods. There are six different exchange lists or groups of food: milk, vegetable, fruit, bread and starch, meat, and fat. Each group contains foods that are similar in protein, fat, and carbohydrate content. (Call the American Diabetes Association if you want a copy of the Exchange Lists.)

Serving sizes for each food are given so that you can exchange one food for another in the same group. For example, for one fruit exchange you could choose ¼ cantaloupe, 1 small apple, 1 fresh fig, or 12 grapes. Each of these has 10 grams of carbohydrate and 40 calories. Vary your food choices as often as you desire. It is the number of servings from each list and the correct serving size of each food that needs to be carefully watched. Your meal plan should be based on your receiving 50 to 60 percent of the daily calories from carbohydrate, 15 percent from protein, and the remainder as fat. A dietitian can tell you how many exchanges you can have from each of the six lists and when you should have them. If you take insulin medication, a consistent daily routine is essential.

The plan will be set up to balance carbohydrate and insulin peaks. This means that meals should be eaten at the same times each day. The amount and types of food should also be the same. The non-insulin dependent diabetic does not need the same consistency in daily routine but must strive to achieve and maintain a reasonable weight.

Following the diabetic meal plan is fairly easy. This meal pattern can be used for the entire family. You can prepare the same foods that would be included in any well-balanced diet. The only difference is that you will choose from six exchange lists instead of the four food groups. For example, an overweight 50-year-old woman with non insulin dependent diabetes, a moderate activity level, and high blood pressure, may have a diet prescription for 1,445 calories that includes 210 grams of carbohydrate, 84 grams of protein, and 35 grams of fat.

Important benefits of a regular aerobic exercise program in diabetes management include:

-decreased need for insulin

decreased risk of obesity

-decreased risk heart disease

Exercise decreases total cholesterol, improves the ratio of low-density lipoprotein (LDL) to high-density lipoprotein cholesterol (HDL), and reduces blood triglycerides. It may also decrease blood pressure and lower stress levels.

Walking is one of the easiest and healthiest ways to exercise. This is one activity that anyone can do for a lifetime without special equipment and with little risk of injury

Talk to your doctor about exercise. Supervised activity is best because of the risk of an insulin imbalance. Use the buddy system when you exercise.

Different forms of exercise have varying effects on the blood sugar response, especially in patients using insulin. Variables that must be considered include exercise type, duration, intensity and the patient's fitness level.

For individuals with diabetes, the type of exercise done (aerobic vs. anaerobic) exerts a significant effect on blood sugar responses during the activity.

Anaerobic Activities lasting less than 2 minutes (such as sprinting or power lifting) are primarily anaerobic in nature and are fueled by phosphagens (adenosine triphosphate [ATP] and creatine phosphate) and carbohydrates (glycogen) stored in skeletal muscle. The contributions of phosphagenic and glycolytic metabolism depend on the duration and intensity of the activity.

Aerobic For any exercise lasting 2 minutes or longer, the body uses all three of the different energy systems phosphagens, anaerobic glycolysis (use of glycogen stores), and ATP derived from aerobic metabolism of fats and carbohydrates. In addition, many hormonal changes occur in normal individuals to maintain blood sugar levels around 100 mg/dL. Sustained aerobic activities such as running, cycling, swimming, and aerobic dance rely on a mix of aerobically processed fuels, but the major sources are fats and carbohydrates (both muscle glycogen and blood glucose).

Before beginning an exercise program, individuals with diabetes should have a medical evaluation to screen for complications that may be made worse by exercise. The exam should screen for cardiovascular health, peripheral arterial disease, retinopathy, nephropathy, and peripheral and autonomic neuropathy.

For individuals with type 2 diabetes who are not using supplemental insulin blood glucose monitoring should be done before and after an activity to assess its effect on glucose levels. Supplemental carbohydrates are generally not needed in these patients; however, blood glucose monitoring will reveal which individuals may need additional carbohydrates to prevent hypoglycemia during and following exercise.

African Americans can empower themselves with these two strategies to make a difference in the prevention and management of the alarming rates of diabetes.

African Americans can empower themselves with these two strategies to make a difference in the prevention and management of the alarming rates of diabetes.

By Glenn Ellis, BlackDoctor.org Executive Editor

Back to Main Menu