Diabetes is a disease caused by the inability of the body to absorb enough glucose. Such metabolic disorders occur most often against the background of malnutrition. A diabetic diet can improve the condition of a person with diabetes, and nutrition should be selected correctly. This will be the main condition for successful treatment.
The basis for the treatment of diabetes mellitus and the prevention of its many complications is diet therapy. With the right diet, diabetics manage to keep the disease under control, avoiding sudden changes in sugar levels. According to the classification of clinical nutrition developed by the professor, the diet for diabetes is referred to as "Table No. 9".
Diet therapy for diabetes should be developed by the attending physician. This certainly takes into account the characteristics of the disease, such as, for example, the severity and type of diabetes. A diet for a diabetic should be made individually.
Features of the ninth diet
In diabetology, two types of the ninth diet "Table No. 9-A, No. 9-B" are distinguished. The type of diet depends on the type of disease. Insulin-dependent type 1 of the disease, as a rule, manifests itself in childhood and adolescence due to a genetic predisposition. The pancreas stops producing insulin, the endocrine hormone responsible for transporting glucose (the main source of energy) into the cells of the body. Insulin-glucose balance is achieved through regular injections of medical insulin.
The dose of the drug and the diet are connected by a mechanism of mutual compensation. Therefore, in the "9-B Diet" an increased amount of complex carbohydrates is allowed. The ninth table (with the letter B) is based on the count of bread units (XE), a value equal to 12 g of carbohydrates contained in 25 g of bread. The daily maximum of an insulin-dependent patient is 24 XE. The distribution of carbohydrates in the diet depends on the type of insulin administered (short or long acting).
Type 2 diabetes mellitus (non-insulin dependent) is formed in middle-aged and elderly people under the influence of external circumstances. First of all, overweight, as well as stress, alcohol abuse. Its peculiarity lies in the fact that the pancreas does not stop the synthesis of insulin, but the cells of the body refuse to accept and consume it. Glucose accumulates in the blood, the cells of the body remain "hungry". Due to the lack of nutritional glucose, the patient develops polygaffia (high appetite), which leads to obesity.
It turns out a kind of cyclicality: due to the large body weight, insulin resistance of cells develops, which, in turn, provokes appetite and weight gain. "Diet 9-A" is more stringent, because it is aimed not only at reducing and stabilizing sugar indicators, but also at combating obesity. Strict restrictions are due to the need to maintain the work of the pancreas, which over time can stop the production of unclaimed insulin, and diabetes will take an insulin-dependent form.
In general, both diets are subject to the same food selection criteria:
- glycemic index;
- caloric content;
- balance of nutrients (proteins, slow and fast carbohydrates, fats).
The doctor must determine which type of the ninth table is suitable for the patient. When prescribing a diet, the nature of the course of the disease, the dose of insulin and other medications, the presence of chronic pathologies (except diabetes), and the individual characteristics of the body are taken into account.
Determination of allowed foods by glycemic index (GI or GI)
GI is an indicator of the rate of biochemical processes in the body (the breakdown of products, the formation of glucose, and its absorption into the bloodstream). The GI of foods is the base value on which a diabetic diet is formed. The diet of a diabetic is based on foods that have a low glycemic index (less than 30 units), since their processing is time-consuming. The release and penetration of glucose into the blood is slow, sugar levels remain stable.
Products indexed with numbers from 30 to 70 constitute the restricted category. In type 2 disease, the limit is more stringent than in insulin-dependent diabetes. An index above 70 units indicates an accelerated process of assimilation of food and the release of glucose into the blood. Diabetics do not eat such foods because they are potentially hazardous to health.
Choice of foods by calorie content
In addition to GI, a diabetic needs to take into account the energy value of foods and ready meals. Due to impaired metabolism, a sick person experiences a shortage of energy resources necessary for the processing of high-calorie foods. Unused calories turn into extra pounds, which increases the risk of complications. Calorie control helps you lose weight and maintain a stable body weight.
A properly composed diet does not go beyond 2200-2500 kcal daily. This value is made up of various products balanced with each other. Some high energy foods have a low glycemic index and contain the most beneficial dietary fiber and protein for diabetes. Their use is allowed, but in limited quantities, so as not to provoke weight gain.
Nutrients in a Diabetic Diet
Nutrition in diabetes should not exclude any of the categories of nutrients. The presence of fats, proteins and carbohydrates is equally important for patients.
Carbohydrates
It is necessary to distinguish between the carbohydrate component into permitted and prohibited foods. The former include polysaccharides or complex carbohydrates: starch, pectin, fiber. In the diabetic menu, the emphasis is on fiber. Firstly, it stimulates the digestive system, and secondly, it is slowly processed by the body and does not require large insulin costs. First of all, these products include vegetables, herbs, fruits.
When eating foods rich in cellulose (fiber), diabetics may not be afraid of a sharp release of glucose into the blood.
Starchy carbohydrates are: potatoes, cereals and legumes. The dietary ration provides for the regular use of products of this category. Cereals and side dishes from cereals are allowed with type 1 disease - practically without restrictions, with non-insulin-dependent diabetes - several times a week (the number of servings depends on a stable sugar level, and the body's individual glycemic response to the product).
Allowed cereals: barley, wheat, pearl barley (limited allowable: oats, buckwheat). Legumes do not need insulin to break down and digest, so they are recommended for the diet menu. In addition, legumes contain macro- and microelements necessary to restore metabolic processes. Soybeans, beans, chickpeas, lentils, peas should be present in the diet. Potatoes can be eaten once a week in boiled form ("in uniform").
In order to slow down the absorption of starchy carbohydrates, they need to be undercooked a little ("al dente" option). Boiled starch can increase glycemia. Bakery products are also divided according to the content of carbohydrates and energy value. Limited consumption of the following products from this category is allowed: rye bread, doktorsky (bread), whole grain, bread with the addition of bran.
Simple carbohydrates (monosaccharides and disaccharides) are contraindicated for patients with diabetes. They have a high GI, which means they are digested forcibly, causing a sharp jump in sugar levels. Fast carbohydrates are found in abundance in various confectionery products and sugary drinks. Sweets in the grocery basket can only be diabetic. These are pastries, marmalade and sweets that do not contain monosaccharides. They are made in specialized production and sold in supermarkets, in the departments for diabetics.
As for sweeteners, their use does not affect glucose levels. They are allowed in the dietary diet is limited, because they contain synthetic components. Recommended sugar substitutes include: food additives E950 (acesulfame potassium), E951 (aspartame), E952 (sodium cyclamate), trichlorgalactosucrose or sucralose, glycoside from the leaves of the stevia plant (steviazid). Xylitol and sorbitol are high in calories, so it is better to refrain from them.
Squirrels
Proper nutrition in diabetes necessarily includes 20% of proteins from the daily diet. From protein products, the body receives essential amino acids that it cannot synthesize on its own. At the same time, the process of release of glucose from amino acids (gluconeogenesis) and its resorption (absorption) into the bloodstream occurs slowly. Protein intake does not significantly affect blood sugar levels.
The source of protein for diabetics are:
- rabbit meat;
- poultry (diet meat chicken, turkey);
- lean beef (veal);
- seafood (squid, crabs, shrimp, mussels, etc. );
- mushrooms (fresh, dry, frozen);
- fish with a fat content of up to 8% (saffron cod, pollock, blue whiting) fatty fish (stellate sturgeon, mackerel, halibut) are allowed once a week;
- eggs and nuts (walnuts, pine nuts, almonds, peanuts).
Important! Nuts contain a lot of protein, contribute to the normalization of metabolic processes, but have a high energy value. Their use must be limited.
Fats
The use of animal fats should be reduced as much as possible for two reasons: they have the ability to accelerate the resorption of glucose into the systemic circulation, provoke cholesterol deposits on the walls of blood vessels, which leads to atherosclerosis. You can regulate lipid (fat) metabolism by replacing animal fats with vegetable oils: olive, corn, sunflower, linseed. Vegetable fats do not have a sugar-increasing effect. However, they should not be abused, due to the high calorie content of products.
Additionally
An important role in the nutrition of diabetics is played by dairy and sour-milk products. Sour-milk drinks help the proper functioning of the intestines, cheese and cottage cheese help strengthen the skeletal system. For a dietary diet, you must choose foods with a low fat content:
- kefir and fermented baked milk - 2. 5%;
- acidophilus - 3. 2%;
- natural Greek yogurt and curdled milk - 2. 5%;
- cottage cheese - up to 5%;
- Adyghe cheese -18%;
- sour cream and cream - 10%.
Fruit yogurts are flavored with a lot of sugar, so it would be right to refuse them, preferring natural products without additives. Dishes for diabetics are prepared only from approved products.
Prohibited foods by category
The diet for diabetics is developed taking into account the exclusion of dishes that are unhealthy in composition. The menu should not include:
| First meal | Meat broths from pork, duck, lamb, chicken with skin. Soups prepared on the basis of fatty broths (borscht, cabbage soup, hodgepodge, kharcho, shurpa, etc. ) |
| Main dishes | Dishes of minced, fried, stewed meat (pork, lamb, duck, goose) |
| side dishes | Potatoes (fried, french fries, mashed potatoes), white rice, pasta categories B, C, 1 and 2 classes |
| Breakfast Dishes | Fried eggs, semolina, pancakes and pancakes |
| canned snack | Canned fish and meat (stew, pate), pickled mushrooms and vegetables, fruits canned in syrup, jams |
| desserts | Confectionery (pastries, cakes, marshmallows); white bun and pastries from shortbread, rich, puff pastry; sweets, chocolate, ice cream; sweet mousses, creams; glazed curds, sweet curd mass |
| Snack products | Chips, flavored snacks and croutons, popcorn |
| The drinks | Bottled tea, sweet cocktails, packaged juices, 3 in 1 cocoa and coffee sticks, sweet soda |
In addition, food from the fast food category, instant cereals with sugar, smoked products (natural or liquid smoke), fruits with a high glycemic index (figs, watermelon, grapes, papaya, carom, guava) are subject to a ban. Sausages (sausages, sausages) are prohibited for diabetics due to the high content of fats and salt.
The basic rules of the diet "Table number 9"
To organize a diet for diabetes, you must adhere to the following rules:
- eliminate simple carbohydrates;
- replace butter, lard with vegetable oils;
- observe the drinking regimen (one and a half or two liters of liquid daily);
- adhere to a rational meal (the interval should not exceed 4 hours);
- do not neglect breakfast, and drink a glass of fermented milk drink before going to bed;
- control the energy value of products;
- do not overeat (the volume of a single serving should be no more than 350–400 g);
- eliminate dishes prepared by frying (only stewing, steaming, boiling are allowed);
- limit the use of table salt and salty foods;
- introduce more greens, vegetables and fruits with low GI into the diet.
Endocrinologists and nutritionists insist on keeping a "diabetic diary", in which it is necessary to record all meals eaten, drinks drunk and medications taken. Such a diary will allow you to analyze the dynamics of the disease and the direct dependence of glycemia on certain products.
Diabetic menu options
Having decided on the allowed products and excluding prohibited dishes, they form a daily menu. You can use traditional diabetic recipes or come up with your own.
| First meal | Main dishes | Breakfast Dishes | Products for snacks and afternoon tea | side dishes | Salads |
|---|---|---|---|---|---|
| borscht or cabbage soup in weak beef broth | steamed chicken meatballs | steam omelette with spinach | fresh fruits | buckwheat or barley porridge | "Bean" (crab sticks, canned beans, garlic, tomatoes) |
| mushroom soup (fresh or dry mushrooms) | stewed cabbage with rabbit / poultry meat | oatmeal with fruit | fruit puree | steamed broccoli (cauliflower) | "Greek" salad (replace feta cheese with feta cheese or tofu) |
| pea, lentil or bean soup | stuffed green pepper | boiled eggs, bread, Adyghe cheese | diabetic waffles | jacket potatoes | seaweed salad with onions and fresh cucumbers |
| ear | cabbage rolls with chicken | wheat porridge | fermented baked milk | pasta (category A) | sauerkraut with cranberries |
| vegetable soup | steamed fish cakes | barley porridge | yogurt | steamed vegetables or vegetable puree | "Spring" (cabbage with carrots and fresh herbs) |
| chicken broth with chicken meatballs | boiled meat or fish | cottage cheese casserole with berries | gingerbread (for diabetics) | cabbage cutlets | vegetable salad with cucumbers, tomatoes and herbs |
| seafood soup | chicken stew with tomatoes and sour cream (10%) | cheesecakes baked in the oven | fresh berries | lentils with tomatoes, onions, carrots | salad "Metelka" of raw beets, cabbage and carrots |
Salad dressings should not contain fatty mayonnaise-based sauces. Allowed vegetable or olive oil, lemon juice, 10% sour cream, limited soy sauce. Drinks: decoctions of medicinal herbs, coffee (without sugar), tea (oolong, black, green, red, hibiscus). Freshly squeezed juice must be diluted in half with non-carbonated mineral water. To maximize the quality of life and delay the development of complications, a diabetic must monitor the level of sugar and eat right. This is the only way to control the course of the disease.