|Nutrition in Diabetes|
|Written by Dr Rajesh Kesari MD|
Carbohydrates are the principal source of energy in our food. They also make up the bulk of the food. Carbohydrates are further broken down by the process of digestion to give Glucose- the main culprit for rise of Blood sugar after meals. Hence understanding carbohydrates is very important for all diabetics.
Each gram of carbohydrate provides approx 4 kcals of energy. In simple terms the energy released by one chapati would be more than enough to boil 12 a cup of water.
Fortunately not all carbohydrates are broken down and absorbed by the body after digestion- these are called dietary fibres, even though they are chemically classified as carbohydrates they do not atribute to any rise in blood glucose, but on the contrary cause delay in absorbtion of glucose, they are helpful to diabetics and must be included in their diet in plenty.
Not all Sugar is sweet- Not all sweet is sugar
Remember- not all glucose ( carbohydrates) are sweet, some forms of carbohydrates present in vegetables may not taste sweet at all, but still contain glucose in other complex forms, after being digested such foods would cause a rise in blood sugar- an example is fine wheat flour- it may not be sweet, but after consumption in cooked form- like bread or cake it may raise blood glucose in the same manner as sweet sugar or glucose powder.
On the other hand not all that is sweet may contain same amount of glucose, for example even very sweet fruits contain fructose- a type of sugar which is almost twice as sweet as glucose and even relatively small amounts in fruits would make them appear sweet. Furthermore body doesnot require insulin to utilize fructose hence even a diabetic person may eat sweet fruits without raising blood glucose( click here to read more on this).
Types of Carbohydrates
Carbohydrates present in diet may be divided into refined and coarse- from diabetes point of view. Refined carbohydrates are those which are quickly digested and glucose is immediately absorbed into circulation. Consumption of such foods give rise to peaks ( High) in blood glucose values after meals and are detrimental for Diabetics- leading to complications of Diabetes. Some examples of refined carbohydrates are, foods made of refined wheat flour- white bread, pastry, highly processed ready to eat cereals, Sugar and sweets, Starches and foods made from them- like corn syrup and corn flour. These are also called as foods with high glycemic index.
Coarse carbohydrates are those types which contain undigestible dietary fibres together with digestible carbohydrates. The presence of fibres delays the digestion of food and subsequent rise in blood glucose levels, as a result the irise in blood glucose is stretched over time and blood glucose levels do not peak but remain in the normal range- even though the total carbohydrate content of the food may be same, these foods are the ones with low glycemic index. Examples of such foods are- Flour with bran, semi cooked cereals, green vegetables, fruits, chicken with flesh, brown bread, bread with whole grains. These are highly recommended to be included in each meal for Diabetics
Knowledge of Glycemic index is very helpful in deciding the beneficial foods for Diabetics, some foods with low glycemic index should also be avoided as they tend to raise cholesterol and triglycerides e.g butter, fried foods - this leads to Atherosclerosis & Cardivascular complications of Diabetes.
A diabetic persons diet should contain approx 55-60% calories derived from Carbohydrates, In other words carbohydrates form the bulk of our diet. An average diet of a non obese 60 KG Diabetic person would be of (25 X 60=1500 Kcals), which means 900 Kcals should be derived from Carbohydrates, i.e approx 214 gms of carbohydrates can be consumed in a day.
Listed below are the Carbohydrate contents of some common staple foods: