Nutrition for Type 2 diabetes

• Type 2 Diabetes Mellitus is a chronic health condition in which blood sugars are high. For more details on type 2 details, can follow this link 

• One person dies every five seconds as a result of diabetes

Why Nutrition should be the first priority for Diabetes:

• High blood sugars can damage any part of our body from head to toes.

• Medications can control Type 2 Diabetes to some extent.

• Dietary changes and lifestyle changes are equally important along with medications to prevent high blood sugars and the associated complications

• If lifestyle interventions are not done, complications such as heart diseases, chronic kidney disease, diabetic foot will progress and is not reversible

• There is evidence that high body fat phenotype exists in Indians from birth and the complications of diabetes is also high

• Therefore, emphasis on the nutrition should start from preconception and pregnancy

Current problems with the Indian diet: cause of concern for obesity in adults, childhood obesity, pre-diabetes and Type 2 diabetes:

• For most Indians, the dietary patterns have been changed drastically in the past few decades

• Traditional Indian diet has foods rich in fibre and low in fats. This has been replaced with refined carbs, saturated fats, trans fats, sugar and salt

• Foods with refined white rice and wheat flour provides 60-70 % of total calories

• The intake of fruits and vegetables is quite less

• Consumption of sweets is very high

• Availability of fast foods such as pizzas, burgers, deep fried foods, donut, soft drinks made our dietary patterns even worse

• Cooking in coconut oil, ghee, palm oil which are rich in saturated fats is a common practice in Indian households

• Even people who use oils rich in unsaturated fats, they re-use the oils multiple times, heat the foods for longer time. This converts the healthy unsaturated fats to trans fats

• Deep frying of the food is a common practice losing all essential nutrients

• Among the unsaturated fats, omega 6 consumption is extremely high and there is low consumption of omega 3’s

• Consumption of legumes, beans and lentils is very less

• Meat consumption is rapidly increasing

Dietary changes for Type 2 Diabetes Mellitus:

• A balanced diet includes right proportions of carbs, proteins and fats

• The type of the food and overall calorie intake plays an important role in designing a diet plan for diabetes

• To get a complete Indian diabetic diet plan, please contact  

• A healthy diet plan includes complex carbohydrates, plant-based proteins and unsaturated fats

• Before understanding the healthy diet plan for diabetes, we need to understand few terms such as glycemic load and glycemic index

Glycemic index:

• This is an indicator of how quickly the blood sugars spikes after consuming a specific food

• For pure glucose, the arbitrary value of glycemic index is 100

• Foods with the lowest glycemic index are healthy as they do not quickly spike the blood sugars

• Foods with the highest glycemic index are known to increase the risk of type 2 diabetes as they spike the blood sugars

Glycemic load:

This is an indicator of overall carbohydrate content in a particular food

Glycemic Load = GI x Carbohydrate (g) content per portion ÷ 100

• For example, watermelon has a GI of 72, but 120 gms of watermelon has only 9 gms of carbs. Overall glycemic load is 6.5

• Whereas for white rice, the GI is 58, but 120 gms of cooked rice has 34 gms carbs. Overall glycemic load is 19.4

When designing a diet plan for diabetics, both glycemic index and glycemic load has to be taken into consideration

Glycemic index (GI) and Blood glucose levels

Glucose	100
High GI	>70
Medium GI	56-69
Low GI	<55

Complex carbohydrates:

• A person with diabetes should include healthy carbohydrates in his/her meals

• Whole grains are rich in complex carbs

• Both the glycemic load and glycemic index of complex carbs are less as compared to the refined carbs. This prevents sugar spikes

• Millets, brown rice, whole wheat flour is least processed and has an outer layer called bran which is rich in minerals and B vitamins

• Studies show that whole grain intake is associated with less risk of diabetes whereas consumption of white rice is associated with higher risk

• Vegetables are a rich source of fibre and has to be included with every meal

Carbs to avoid	Carbs to include
Sabhudana, amaranth flour	Millets–foxtail, barnyard, brown top, little millet, kodo millet, jowar, bajra
White rice	Brown rice
Maida	Whole wheat flour
White sugar, high fructose corn syrup, maple syrup, honey	Dates
Fruit juices	Whole fruits and vegetables

Whole grain VS Refined grain - Change of glycemic index of the food

Fibre:

• Studies show that fibre rich cereals are inversely related to the diabetes risk

• Fibre is of two types: Soluble and insoluble fibre

• Soluble fibre cannot be digested by humans. It finally serves as a food for millions of the bacteria present in our colon.

• Insoluble fibre provides roughage and add bulk to the stools.

• Consumption of at least 25-35 gms of fiber is important in a diabetic diet plan

• Methi seeds, flax seeds, chia seeds, ladies finger, bottle gourd are rich sources of soluble fibre

• Foods rich in resistant starch such as legumes, cold potatoes, rice kanji also works as prebiotics and improves gut health

Examples for Fibre rich foods

Fruits for diabetes:

• Many studies show that low fruit consumption is associated with diabetes risk

• One fruit a day is a must for diabetes

• High fibre fruits that have low glycemic index can be included

• For example: Pomegranates, apples, guava, pear etc.

• For more information on the fruits to be consumed please contact Dr. Tejaswini, Telomere Nutrition Clinic (Best Dietician & Nutritionist)

• Fruit juices must be avoided as they spike the blood sugars, can cause diabetes and fatty liver

Fats:

• Healthy fats should be a part of diabetic diet plan

• Plant based fats are healthier than animal-based fats

• Chose fats that are rich in unsaturated fats such as: walnuts, almonds, flaxseeds, chia seeds

• Foods rich in saturated fats such as red meat, coconut oil, palm oil, butter, ghee has to be avoided

• Red meat has to be avoided completely as they are rich in saturated fats, heme iron, and damages gut microbiome

• Processed meats – produces nitrosamines from nitrites that are linked to cancer, diabetes etc 

• Consumption of walnuts is inversely associated with diabetes risk

• Consumption of fried foods has been associated with increased risk of type 2 DM

Fats to avoid	Fats to include
Trans fats – bakery items, French fries, deep fried Indian foods	Walnuts
Red meat	Almonds, cashew nuts, pistachios
Coconut oil, palm oil	Flaxseeds, chia seeds, pumpkin seeds
Butter, ghee, cheese	Yogurt, curd
Full fat chicken	Skinless low-fat chicken

Vitamins, minerals and anti-oxidants:

• Magnesium intake was associated with lower diabetes risk.

• Magnesium rich foods such as green leafy vegetables, dark chocolate, pumpkin seeds should be a part of healthy diabetic diet plan 

• Similarly, zinc is important for insulin secretion from pancreas

• Chromium improves insulin sensitivity and has to be part of diabetic diet. Chromium rich foods include cinnamon, amla etc.

• Chromium activates the PI3K/AKT pathway – in skeletal muscles

• Many studies have shown that vitamin D plays an important role in reducing insulin resistance

• Sunlight exposure for 30 mins a day in the mornings is an excellent way to synthesize vitamin D

• For regions that have no sunlight, vitamin D supplementation is required

• Diabetes is an inflammatory condition and therefore vitamin C rich foods should be a part of the diabetic diet plan

• Foods rich in sulforaphane – cruciferous vegetables – cauliflower, broccoli improves liver function

• Include resveratrol rich foods such as red grapes and peanuts

• Turmeric has curcumin as an anti-oxidant and has to be included

• For more information on how to include foods that are rich in vitamins and minerals, please contact

Probiotics:

• Consumption of yogurt significantly reduces the risk of diabetes

• Yogurt is rich in good bacteria such as Lactobacillus that improves gut microbiome

Protein:

• Indians in general consume very less protein and is one of the reasons for low muscle mass and abdominal obesity

• Plant based proteins are rich sources of fibre, minerals, provides satiety, has low glycemic index and glycemic load

• Following a Mediterranean pattern of eating – legumes such as chick peas, black beans, red beans, lentils (whole masoor, split masoor) and pulses (moong, tur dal etc) should be part of Indian diabetic food plan

• Legumes and lentils have lente carbs that prevent sugar spikes and is an excellent food source for diabetes

• Therefore, eating rice with dal will lower overall glycemic index of foods

• Make sure that 90% of the proteins comes from plant-based sources

• Plant based diet increases the production of a post-biotic called butyrate

• Butyrate’s may induce incretin secretion and improves glucose metabolism 

Meat consumption and diabetes:

• Frequent consumption of red meat is highly associated with diabetes risk

• Red meat is rich in saturated fats and heme iron which are associated with higher diabetes risk

• Fish consumption was associated with lower risk in Asians whereas in westerners associated with higher risk

• Saturated fats triggers beta cell apoptosis in pancreas

• High animal proteins are also associated with insulin resistance

• Meat consumption should contribute roughly about 10% of the diet

  
  

For more personalized diabetic diet plan, and Nutrition for Type 2 diabetes contact Dr. Tejaswini, Telomere Nutrition Clinic (Best Dietician & Nutritionist) in Pune.