Having a Diabetic-Friendly Holiday Season

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Hyperglycemia, also called raised blood glucose or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels (1^✔ ✔Trusted Source
Diabetes

Go to source). In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2019, diabetes was the direct cause of 1.5 million deaths and 48% of all deaths due to diabetes occurred before the age of 70 years. Another 460 000 kidney disease deaths were caused by diabetes, and raised blood glucose causes around 20% of cardiovascular deaths (2^✔ ✔Trusted Source
Global Burden of Disease (GBD)

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Between 2000 and 2019, there was a 3% increase in age-standardized mortality rates from diabetes. In lower-middle-income countries, the mortality rate due to diabetes increased 13%. There is no one size fits all approach for a person suffering from diabetes (3^✔ ✔Trusted Source
5. Lifestyle Management: Standards of Medical Care in Diabetes-2019

Go to source). The goals from the American Diabetes Association (ADA) 2019 include the following:

• To promote and support healthful eating patterns, emphasizing a variety of nutrient dense foods in appropriate portion sizes in order to improve overall health and achieve and maintain body weight goals; attain individualized glycemic, blood pressure, and lipid goals; delay or prevent complications of diabetes
• To address individual nutrition needs based on personal and cultural preferences, health literacy and numeracy, access to healthful food choices, willingness and ability to make behavioral changes, as well as barriers to change
• To maintain the pleasure of eating by providing non-judgmental messages about food choices
• To provide an individual with diabetes the practical tools for day-to-day meal planning rather than focusing on individual macronutrients, micronutrients or single foods

Planning Ahead Regarding Nutrition Choices can be Beneficial

Carbohydrates: The total amount of carbohydrate (CHO) consumed has the strongest influence on glycemic response (4^✔ ✔Trusted Source
Nutritional Recommendations for Individuals with Diabetes

Go to source). Carbohydrate intake should emphasize nutrient-dense carbohydrate sources that are high in fiber, including vegetables, fruits, legumes, whole grains, as well as dairy products. People with diabetes and those at risk are advised to avoid sugar-sweetened foods and beverages.

Fiber: Intake of dietary fiber is associated with lower all-cause mortality in people with diabetes (5^✔ ✔Trusted Source
Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus

Go to source). A fiber rich meal is processed more slowly, which promotes satiety, may be less caloric, and lower in added sugars, which can help combat obesity and also may prevent risk of heart disease, type 2 diabetes, and colon cancer. The FDA advocates consumption of 25 g dietary fiber per 2,000 calories consumed.

Fat: The American Heart Association, and American College of Cardiology currently recommend limiting the amount of dietary saturated and trans-fat intake (6^✔ ✔Trusted Source
2013 American Heart Association/American College of Cardiology Guideline on Lifestyle Management to Reduce Cardiovascular Risk: practice opportunities for registered dietitian nutritionists

Go to source). Recommendations from the Institute of Medicine and the Academy of Nutrition and Dietetics for healthy individuals are that 20% to 35% of total calories should come from fat (7^✔ ✔Trusted Source
Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids

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Protein: Protein recommended is 0.8g/kg for those with kidney disease and 20-30% of total caloric intake for those without. Include good sources of lean protein like turkey, fish, chicken, yoghurt, tofu, tempeh and nuts.

Vitamins: Including Vitamin C, D and E may help with diabetes.

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Minerals:

• Sodium- limit sodium consumption to 2,300 mg/day.
• Magnesium- There is some evidence that higher dietary intake of magnesium may help prevent type 2 diabetes in both middle-aged men and women at higher risk for developing the disease. Dietary sources of magnesium include nuts, whole grains, and green leafy vegetables.

Alcohol: Adults with diabetes who drink alcohol should do so in moderation (no more than one drink per day for adult women and no more than two drinks per day for adult men). One drink is defined as 12 oz beer, 5 oz wine or 1.5 oz of hard liquor. To decrease the risk of hypoglycemia, it is best to have the alcohol with food.

References:

1. Diabetes - (https://www.who.int/news-room/fact-sheets/detail/diabetes)
2. Global Burden of Disease (GBD) - (https://www.healthdata.org/gbd/2019)
3. 5. Lifestyle Management: Standards of Medical Care in Diabetes-2019 - (https://pubmed.ncbi.nlm.nih.gov/30559231/)
4. Nutritional Recommendations for Individuals with Diabetes - (https://pubmed.ncbi.nlm.nih.gov/25905243/)
5. Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus - (https://pubmed.ncbi.nlm.nih.gov/22927948/)
6. 2013 American Heart Association/American College of Cardiology Guideline on Lifestyle Management to Reduce Cardiovascular Risk: practice opportunities for registered dietitian nutritionists - (https://pubmed.ncbi.nlm.nih.gov/25439080/)
7. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids - (https://pubmed.ncbi.nlm.nih.gov/12449285/)

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Source-Medindia