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DIET IN DIABETES MELLITUS WITH HYPERTENSION AND ISCHEMIC HEART DISEASES - PowerPoint PPT Presentation


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DIET IN DIABETES MELLITUS WITH HYPERTENSION AND ISCHEMIC HEART DISEASES. By:- Dr. Shrinivasan Iyenger Dr. Padma Iyenger Dietician Nandini Panchamiya. DIABETES MELLITUS ?. Diabetes = flow through Mel = honey It is a chronic metabolic disorder. Has a strong hereditary basis.

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slide1

DIET IN

DIABETES MELLITUS

WITH

HYPERTENSION

AND

ISCHEMIC HEART DISEASES

By:-

Dr. Shrinivasan Iyenger

Dr. Padma Iyenger

Dietician Nandini Panchamiya

slide2

DIABETES MELLITUS ?

  • Diabetes = flow through
  • Mel = honey
  • It is a chronic metabolic disorder.
  • Has a strong hereditary basis.
  • Associated with high blood sugar

and passage of sugar in the urine.

slide5

SOME OTHER RISK FACTORS FOR DM ?

  • Dietary restrictions in foetal stage
  • Excess sugar intake
  • Low dietary fibre
  • Infections
  • Acute stress – Physical injury,

surgery, emotional distress

  • Prolonged malnutrition
slide6

RISK FACTORS FOR HT & IHD ?

  • Cigarette smoking
  • High HDL cholesterol
  • High fat diet
  • High blood pressure
  • Diabetes mellitus
  • Physical inactivity
  • Low HDL cholesterol
  • High Triglycerides
  • Psychological factors
  • LP (a)
  • Age – 50-55 years
  • Male gender
  • Family history
  • Obesity
  • Post menopausal

status

slide9

CHILDHOOD OBESITY A CONCERN!!!

Pizza, Icecream,

Candy,

Pastry…

slide10

PRINCIPLES OF DIETARY MANAGEMENT ?

  • Low calorie
  • Low cholesterol
  • High in unsaturated fats –

mono (MUFA) and poly (PUFA)

  • High in fibre
  • High in minerals and vitamins
  • Low in sodium especially salt
  • Plenty of fluids
  • High in omega-3 fat (n-3)
  • Low fat particularly saturated fats (SAFA)
slide11

DIETARY GUIDELINES

  • Maintain slightly lower than normal weight.
  • Diet should be rich in fibre.
  • Have 500 gm of fruits & vegetables each day.
  • Use vegetable oil rich in MUFA & n-3.
  • Include fish in diet.
  • Have small quantities of walnuts and almonds.
  • Use only skimmed milk.
  • Have coffee and tea in moderation.
  • Include Soya bean, fenugreek, garlic, onion and

turmeric in diet.

slide12

DIETARY GUIDELINES CONTINUED…

  • Use combinations of oils.
  • Have plenty of water.
  • Prefer whole wheat instead of rice.
  • Have 6 meals a day
  • 3 main meals
  • 3 in between meals (snacks)
  • Avoid feasting and fasting.
slide13

AVOID THESE …

  • Sweets, chocolates, cakes, pastries, Ice creams
  • Aerated drinks, alcohol and sweetened juices
  • Sago (sabudana)
  • Egg yolk
  • Coconut
  • Sugar, honey, jaggery, glucose
  • Meat and pork
  • Sodium rich foods (salt)
  • Fried foods
  • Heavy meal
slide14

HAVE PLENTY OF THESE…

  • Beans (green)
  • Broccoli
  • Cabbage
  • Cauliflower
  • Cucumber
  • Brinjal
  • Lettuce
  • Mushrooms
  • Radishes
  • Tomatoes
  • Strawberries
  • Buttermilk, low fat
  • Milk, 1% milk fat
  • Soy milk
  • Yogurt, plain
  • Tea (no milk & sugar)
  • Lime water (no sugar)
  • Water

THESE ARE LOW CALORIE FOODS!!!

slide15

ANIMAL FOODS HIGH IN SAFA AND CHOLESTEROL

  • Butter
  • Ghee
  • Cheese
  • Egg yolk
  • Chicken
  • Beef
  • Mutton
  • Pork
  • Organ meats – brain, heart, kidney, liver
  • Prawns and shrimps

AVOID THEM TO PROTECT YOUR HEART

slide16

WHERE DOES CHOLESTEROL COME FROM ?

From food

Liver

Triglycerides

&

Cholesterol

Triglycerides

&

Cholesterol

Packed in lipoproteins (LP)

Chylo-

microns

VLDL

(Very low

density

LP)

LDL

(Low

density

LP)

HDL

(High

density

LP)

Bad cholesterol

Good cholesterol

slide17

ROLE OF FAT ?

Excess fat and LP

Injury to blood vessels

Foam cells formed

Deposition of fat

Fatty streak (narrowing of blood vessels)

Plaque (Blocks the blood vessels)

Retinopathy/neuropathy/nephropathy/heart attack

slide19

SOME RECOMMENDED COMBINATIONS OF OIL

  • Groundnut : Mustard3:1
  • Groundnut : Canola 2:1
  • Groundnut : Soya bean2:1
  • Groundnut : Sunflower3:1
  • Groundnut : Sesame3:1
slide21

FIBRE RICH FOODS…

  • Whole cereals
  • Wheat, Barley, Ragi, Corn, Muesli, Oats, Isabgul…
  • Leafy and other vegetables

Cabbage, Peas, Broccoli, Carrots…

  • Beans, whole pulses and legumes

Rajmah, Tuver, Chole, Soyabean…

  • Fruits

Apples, Strawberries, Peach, Pear, Guava,

Pomogeranate…

slide22

FOODS HIGH IN SODIUM

  • Salt
  • Baking powder
  • Cooking soda
  • Biscuits
  • Breads
  • Salted butter
  • Cakes & pastries
  • Cheese
  • Salted chips
  • Corn flakes
  • Egg
  • Lobster
  • Monosodium glutamate
  • Soya & tomato sauce
  • Pickles
  • Wafers
  • Papad
  • Canned food
  • Prepared mixes
  • Peanut butter

BEST AT ITS MINIMUM !!!

slide23

NATURAL ANTIOXIDANTS

  • Guava
  • Red grapes
  • Pomegranate
  • Amla
  • Berries (Bor)
  • Tomato
  • Papaya
  • Orange
  • Lime
  • Dark green leafy vegetables
  • Walnuts
  • Almonds
  • Whole grain cereals

THESE FIGHT TO PROTECT US!!!

slide24

SOYA PROTEINS

  • Soya bean
  • Soya milk
  • Tofu
  • Textured Soya supplements
  • Soya nuggets
  • Soya flour

IT REDUCES CHOLESTEROL!!!

slide25

GARLIC

DOSE: 1 or ½ clove of garlic per day

  • Reduces blood pressure.
  • Reduces cholesterol levels.
slide26

FENUGREEK SEEDS (Methi)

DOSE: 25 to 50 g per day

  • High in fibre
  • Reduces blood sugar
  • Reduces cholesterol and TG
  • Helps loose weight
slide27

GLYCEMIC INDEX (GI)

  • Ability of the food item to raise blood sugar is measured in GI.
  • Does not depend on amount of food
  • But on how fast it is absorbed within

the body

Diabetics must prefer

low GI foods

slide28

FACTORS AFFECTING GI OF FOOD

  • Rate of ingestion
  • Food form
  • Food components – fat, fibre,

protein, starch

  • Method of cooking and processing
slide29

VERY LOW GI FOODS

  • Dals and pulses

Moong dal, tur dal, rajmah, moong, soybeans, channa etc.

  • Low fat dairy products

Milk, curds, paneer and buttermilk.

slide30

INTERMEDIATE GI FOODS

  • All vegetables

Cabbage, brinjal, spinach, methi, guvar etc.

  • Fruitswith low sugar and high water

Watermelon, pineapple, apple, orange etc.

  • Whole cereals

Whole wheat, whole wheat noodles, bajra, jowar, ragi, wheat bran, rice bran, barley etc.

slide31

HIGH GI FOODS

  • Cornflakes
  • Rice
  • Maida Bread
  • Root vegetables like potato, yam
  • Sugar, honey, jaggery, sweets, chocolate
  • Icecream
slide32

DISTRIBUTION OF CALORIES IN A DAY IF NO INSULIN TAKEN

Breakfast

Mid morning

Lunch

Tea

Dinner

Before going to bed

33 %

33 %

33 %

slide33

ALCOHOL….. MUST BE AVOIDED

  • It is a source of empty calories which is

stored in the body as fat.

  • It reduces blood sugar and hence must

be avoided especially when on insulin

and oral medicines.

  • It damages liver.
  • It may react with certain medicines.
slide34

ALCOHOL….. IF STILL TAKEN

  • Before taking a drink have some food.
  • Eat something along with the drink. Avoid fried snacks.
  • Avoid drinking if sugar levels are not in control or is fluctuating.
  • Avoid cocktails with sweet mixer like sweet fruit juice, aerated drinks (Limca, Coke etc), Instead use water or soda.
slide35

MYTHS  … & FACTS  …

Eating sweets cause diabetes.

Sweets only increase weight. Inability of the body to form insulin cause diabetes.

Sugar free products can be freely taken.

Sugar free products can be high in fat and hence must be avoided.

slide36

MYTHS  … & FACTS  … Continue…

Diabetics must avoid fruits.

Only few fruits such as mango, grapes, chikoo, coconut, sitaphal and banana must be avoided. Rest all can be taken daily.

Diabetes is curable.

Diabetes cannot be cured but can be managed with diet, exercise and medication.