Diabetes Mellitus

Diabetes (diabetes mellitus) is classed as a metabolism disorder. Metabolism is the way our bodies use digested food for energy and growth. What we eat is broken down into glucose. Glucose is a form of sugar in the blood and also the main source of energy in our body.

Glucose makes its way into our bloodstream when food is digested. However, glucose cannot enter our cells without the presence of insulin.

Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, and lowers the blood sugar level.

A person with diabetes has a condition in which the glucose level in the blood is higher than normal (hyperglycemia). It’s either because the body does not produce sufficient insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in the accumulation of glucose in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.

What you should keep in mind

What, when, and how much you eat all affect your blood glucose level. You can keep your blood glucose at a healthy level if you:

  • Eat about the same amount of food each day.
  • Eat at about the same times each day.
  • Take your medication at the same times each day.
  • Exercise at regular times.
  • Limit the amounts of fats and sweets you eat each day.

 Diabetic Diet and Calories

Have about 1,200 to 1,600 calories a day if you are:

– a small woman who exercises
– a small or medium woman who wants to lose weight
– a medium woman who does not exercise much

Have about 1,600 to 2,000 calories a day if you are:

– a large woman who wants to lose weight
– a small man at a healthy weight
– a medium man who does not exercise much
– a medium to large man who wants to lose weight

Have about 2,000 to 2,400 calories a day if you are

– a medium/large man who does a lot of exercise or has a physically active job
– a large man at a healthy weight
– a large woman who exercises a lot or has a physically active job

When your blood glucose level goes too high or too low?

It’s does not matter, whether you are diagnosed with diabetes I or II. What, when and how you eat will affect your blood glucose level!

Your blood glucose can also go too high or drop too low if you don’t take the right amount of diabetes medicine.

You can have problems if your blood glucose level stays both too high (hyperglycaemia) or too low (hypoglycaemia). If your blood glucose stays high too most of the time, you can get heart, eye, foot, kidney, and other problems.

Blood Glucose Levels: What Should My Blood Glucose Levels Be?

For most people, target blood glucose levels are:

Before meals – 90 to 130
1 to 2 hours after the start of a meal – less than 180

Why Should I Eat About the Same Amount at the Same Times Each Day?

Your blood glucose goes up after you eat. If you eat a big lunch one day and a small lunch the next day, your blood glucose levels will change too much. Keep your blood glucose at a healthy level by eating about the same amount of carbohydrate foods at about the same times each day.

 Diet for Diabetes Patients

  •  Less than 25 to 35 percent of calories per day from fat, and less than 7 percent of calories per day from saturated fat

There should be minimal trans fat. Saturated and trans fats are found in solid fats like cheese, red meats, butter, margarine, and shortening. People with diabetes are at increased risk for heart disease and stroke, and eating a diet low in saturated and trans fats and cholesterol can help to manage cholesterol levels and decrease these risks.

  • Total cholesterol intake should be less than 200 mg per day

The major sources of cholesterol in the diet are foods such as organ meats and egg yolks. Shrimp and squid are also moderately high in cholesterol, but can be included in your diet occasionally because they are low in fat.

  • Between 15 and 20 percent of calories should be from protein

Except in people with certain kidney problems (chronic kidney disease or CKD). People with CKD are sometimes advised to eat a low-protein diet.

  • High fiber (25 to 30 grams per day)

To control blood sugar levels and AIC.

  • Low sodium (less than 1500 mg per day), fruits, vegetables, and low fat dairy products

Recommended and can help manage blood pressure. For people with diabetes and heart failure, a low sodium diet may reduce symptoms.

  • Sorbitol, xylitol, lactitol, mannitol, and maltitol

Sugar alcohols (sorbitol, xylitol, lactitol, mannitol, and maltitol) are often used to sweeten sugar-free candies and gum, and increase blood sugar levels slightly. When calculating the carbohydrate content of foods, one-half of the sugar alcohol content should be counted in the total carbohydrate content of the food. Eating too much sugar alcohol at one time can cause cramping, gas, and diarrhea.

  • Take sugar in moderation

If you take insulin, calculate your dose based upon the number of carbohydrates, which already includes the sugar content.

Tips

  • Products that are “sugar-free” or “fat-free” do not necessarily have a reduced number of calories or carbohydrates. Read the nutrition label carefully and compare it to other similar products that are not sugar- or fat-free to determine which has the best balance of serving size and number of calories, carbohydrates, fat, and fiber.Some sugar-free foods, such as diet soda, sugar-free gelatin, and sugar-free gum, do not have a significant number of calories or carbohydrates, and are considered “free foods.” Any food that has less than 20 calories and 5 grams of carbohydrate is considered a free food, meaning that there are not enough calories or carbohydrates to affect your weight or require additional insulin.

You don’t wanna be one step behind from being a millionaire right? XD

 

So lead healthy life, and be free from the risk of diabetes!

References

http://www.uptodate.com/contents/patient-information-type-2-diabetes-mellitus-and-diet-beyond-the-basics?source=search_result&search=diet+for+diabetes+type+2&selectedTitle=1~150

http://www.medicalnewstoday.com/info/diabetes/

http://www.uptodate.com/contents/patient-information-type-1-diabetes-mellitus-and-diet-beyond-the-basics

http://chinese-school.netfirms.com/diabetes-diet-plan.html

Nephrolithiasis (Kidney Stones)

What are kidney stones?

  • One of the most common disorders of the urinary tract.
  • Kidney stones affect about 12% of men and 5% of women by the time they are 70 years old.
  • Men are about twice as likely to form kidney stones as women.

Why Dietary Control is Important

  • Those who have formed one calcium oxalate stone have a 50% chance of forming additional stones within 10 years
  • With appropriate education, patients can exercise some control over stone disease and reduce their chances of forming stones through dietary modifications and medication.

Metabolic Causes of Kidney Stones

  • Hypercalciuria – Calcium is absorbed from food in excess and is lost into the urine. This high level of calcium in the urine causes crystals of calcium oxalate or calcium phosphate to form in the kidneys or elsewhere in the urinary tract.
  • Hyperuricosuria – Uric acid metabolism (gout). Meat, fish, chicken are restricted due to breakdown products that produce uric acid crystals.
  • Hyperoxaluria – the body produces too much oxalate, a salt. When the urine contains more oxalate than can be dissolved, the crystals settle out and form stones.
  • Cystinuria – too much of the amino acid cystine, which does not dissolve in urine, is voided, leading to the formation of stones made of cystine.
  • Renal tubular Acidosis a condition in which the kidneys are unable to excrete normal amounts of acid.

Dietary Causes of Renal Stones

High Low
Dehydration Water intake
Foods rich in Oxalate Calcium than Recommended
Animal protein – Meat, Egg, Chicken Low Magnesium
Salt – Sodium Potassium than Recommended
Phosphate – Aerated carbonated drinks Citrate or Citric Acid  (Vit C)
Obesity – Weight Gain Dietary Fiber

Water

  • Someone who tends to form stones should try to drink enough liquids throughout the day to produce at least 2 litres of urine in every 24-hour period.
  • It is not the quantity of fluid consumed that is important, but rather the fluid voided that should be measured. Patients living in hot or dry conditions, or who exercise and perspire significantly, will need to drink even more liquid to maintain adequate urine output.

Oxalate combines with calcium – insoluble Calcium Oxalate crystals
Less than 50 mg of oxalate per day in the diet.

Foods high in Oxalate Content
Almonds Peanuts
Amla Phalsa
Amaranth, tender Rhubarb
Beets Soy products (tofu)
Blackberries Spinach
Chocolate/cocoa /chocolate drink mixes Strawberries
Cashew nuts Swiss chard
Okra Tea
Gooseberries Wheat bran
Grapefruit Raspberries (black)

Myth – Dietary Calcium & Kidney Stones

  • A recent study conducted Brigham and Women’s Hospital and Harvard Medical School on more than 90,000 women, showed “that women with the highest intake of dietary calcium had the lowest risk of kidney stones.”Calcium is believed to neutralize the absorption of oxalate, has been linked to kidney stone formation.”For those taking calcium supplement the risk of kidney stones increased slightly. “Calcium supplements are often not taken in conjunction with meals, limiting the calcium’s ability to neutralize the absorption of oxalate.”  This is why diet to increase calcium intake, and avoid supplements.

Dietary Protein and Kidney Stones

  • A small amount of dietary protein can be converted to oxalic acid in the body and excreted as such in the urine. In addition, dietary protein is known to enhance calcium excretion in the urine.
  • When the average dietary protein was reduced from 86.5 to 54 g/day there was a reduction in urinary calcium excretion of nearly 50% (from 9.35 to 6.45 mmol/day).
  • Most protein-rich foods may also increase urinary uric acid levels. This is because most high-protein foods (except milk) usually contain a large amount of purines that breakdown into uric acid.
  • The risk of kidney stone formation seems greater from animal than vegetable proteins

Animal Protein

  • The higher sulfur amino acid content of animal compared to vegetable proteins may increase calcium excretion. In addition, excess sulfur-containing amino acids will increase a rare form of kidney stones (containing cystine) in people with an inherited metabolic defect.

Magnesium

  • Take a magnesium supplement of at least the US RDA of 300-350 mg/day (more may be desirable in order to maintain an ideal 1:2 balance of magnesium to calcium)
  • A vitamin B6 and magnesium deficiency may also cause stone formation. A Swedish research group found that taking both daily stopped stone formation in 90% of their patients. Magnesium, like calcium, can bond with the oxalate and acts as a inhibitor of the formation of calcium oxalate crystals in the urine.
  • The mean stone episode rate decreased from 0.8 to 0.08 stones/year on Magnesium supplement and 85% of the patients remained free of recurrence during follow-up, whereas 59% of the patients in the control group continued their stone formation. (Johansson and Backman U)

Sodium

  • Diets low in sodium are effective in reducing stone formation by decreasing the excretion of calcium. Because calcium and sodium compete for reabsorption in the renal tubules, excess sodium intake and consequent excretion result in loss of calcium in the urine.
  • High-sodium diets are associated with greater calcium excretion in the urine (Lemann, 2002).
  • Aim for < 3000 milligrams of sodium per day.

To reduce the sodium in your diet:

  • Enjoy your food without added salt. Use vinegar, herbs, & spices to flavor your foods instead of salt.
  • Cook without salt.
  • Check food labels. If the food contains more than 250   milligrams of sodium per serving, it contains too much sodium. In general, the more processed a food is, the greater is its sodium content

Potassium and kidney stones

  • In one study of over 45,000 men, those whose daily intake of potassium was more than 4.3 grams per day were 50% less likely to develop kidney stones than those with potassium intakes of less than 3 grams per day.
  • Potassium rich foods as fruits and vegetables.

Soft or Carbonated Drinks

  • Not only dehydrates making one more prone to kidney stones, but also contains phosphates, which is linked to higher kidney stone recurrence.
  • Any caffeinated beverage is dehydrating,so for every cup of a caffeinated beverage you drink, do drink a glass of water with it
  • Sugary drinks tend to mess with calcium and magnesium absorption, once again increasing one’s risk for kidney stones.

Weight

  • Incidence of stone disease were directly associated with weight and body mass index. However, the magnitude of the associations was consistently greater among women
  • Obesity increases the risk of kidney stones, but it’s theorized that insulin resistance, a common condition in obese people, increases the amount of calcium in the urine. This, in turn, contributes to the formation of crystals that develop into kidney stones.

Dietary Fiber

  • Fiber is the indigestible part of plants.
  • There are two types of fiber: soluble (dissolves in water) and insoluble.  Both provide important functions in the body.
  • Insoluble fiber (found in wheat, rye, barley, and rice) help to reduce calcium in the urine. It combines with calcium in the intestines, so the calcium is excreted with the stool instead of through the kidneys.
  • Insoluble fiber also speeds up movement of substances through the intestine, so there will be less time for calcium to be absorbed.

Sugar

  • Kidney stones are associated with high sugar intake, so eat less (or no) added sugar

Alcohol

  • People should have no more than two drinks-two 12-ounce servings of beer or two 5-ounce servings of wine or two 1.5-ounce servings of hard liquor-a day.
  • Alcohol per se does not lead to kidney stone formation.  It does make stone sufferers pass more urine that can lead to a dehydrated state.  Alcohol likewise indirectly inhibits the kidneys’ ability to excrete uric acid from the human body.
  • Cases of men who regularly drink alcoholic beverages (about two to four bottles a day) like beer upped their risks of suffering from gout, which can lead to stone formation.

Vitamin B

  • B-6 deficiency produces kidney stones in  experimental animals.
  • B6 (10 mg a day) lowers the amount of oxalate in the urine.
  • In high doses, it is also used medically to treat kidney stones.
  • B-6 deficiency is very common in humans.
  • B-1 (thiamine) deficiency also is associated with stones (Hagler and Herman,
References:

http://www.uvm.edu/~jmontany/SendDan/healthDan/RoleOfDiet.pdf

http://www.time-to-run.com/nutrition/vitc.htm

http://www.ncbi.nlm.nih.gov/pubmed/572722

http://healthoracle.org/downloads/K/Kidney%20Stones%2001.pdf

http://www.jacn.org/content/25/suppl_3/271S.full

“Oxalate Metabolism, II” American Journal of Clinical Nutrition, 26:8, 882-889, August, 1973)

(J. A. Thom, et al “The Influence of Refined Carbohydrate on Urinary Calcium Excretion,” British Journal of Urology, 50:7, 459-464, December, 1978)

Obesity

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, andosteoarthritis.

What causes obesity?

  • Diet: Eating high fat, high calorie foods causes weight gain.
  • Lack of exercise: Sedentary people don’t burn as many calories as active people.
  • Genetics: Your genes may influence how much fat your body stores and where it is stored. But genes alone do not mean you will be obese.
  • Age: People gain weight as they get older, because they tend to be less active and to lose muscle mass.
  • Psychological issues: Some people overeat when they are upset or stressed.
  • Medications: Some drugs, such as corticosteroids, blood pressure medication, and tricyclic antidepressants, can cause you to gain weight.
  • Medical problems: Rarely, obesity is due to a medical problem such as Cushing syndrome (where the adrenal glands produce too much hormone) or hypothyroidism (where the thyroid gland doesn’t produce enough hormone). Conditions such as osteoarthritis cause people to be less active, which can lead to weight gain.
  • Prenatal environmental factors: Several studies show that adult men and women who were born small for their gestational age are more likely to be overweight or obese than those who were of normal size at birth. Maternal smoking and excess weight gain is also associated with offspring obesity.

Food to limit

  • Foods rich in saturated and trans fats

This includes fatty red meat, whole milk, heavy cream, poultry skin, butter, margarine, shortening, potato chips and deep-fried foods.

  • Foods rich in added sugar

Such as cookies, cake, pastries, candy and sugar-containinng soft drinks may also dampen your weight loss efforts.

Food to take

Food that encourage nutrient-rich foods, particularly those that encourage and support calorie reduction.

  • Healthy foods that includes foods from all necessary nutrient groups

This includes vegetables, complex carbohydrates, lean proteins and modest amounts of healthy fats. Choose primarily fresh, colorful fruits and vegetables, as they tend to provide the richest amounts of vitamins, minerals, fiber and water.

  • Optimum carbohydrates

Whole grain breads, pastas, rice and cereals, and starchy vegetables, such as sweet potatoes and squash.

  • Healthy protein sources

This includes low-fat dairy products, legumes, skinless chicken and turkey breasts and fish.

  • For healthy fats

Select primarily plant-based sources, such as olive oil, canola oil, nuts, seeds and avocado.

References:

http://en.wikipedia.org/wiki/Obesity

http://wiki.answers.com/Q/What_is_the_best_diet_for_an_obese_man_or_woman

http://www.ehow.com/way_5421177_diet-obese-people.html

http://www.faqs.org/nutrition/Met-Obe/Obesity.html#b

http://www.netdoctor.co.uk/health_advice/facts/obesity.htm

http://www.bodybuilding.com/fun/topicoftheweek92.htm

http://awaremed.com/blog/?p=82

http://www.inquisitr.com/85368/childhood-obesity-common-cold/