![]() ![]() ![]() Nutrition Recommendations and Interventions for Diabetes. A position statement of the American Diabetes Association. CHD, coronary heart disease. CKD, chronic kidney disease. Read published research about The Paleo Diet. Browse our website for paleo news, cookbooks, recipes, blogs, diet plans, weight-loss tips & more! Diabetes nutrition therapy. Ideally, the individual with diabetes should be referred to a registered dietitian (RD) (or a similarly credentialed nutrition. Since November 1994, Scambusters.org has helped over eleven million people protect themselves from scams. Scambusters is committed to helping you avoid getting. Every thing we make, from your favorite rolls to our incredible pastas to our.CVD, cardiovascular disease. DPP, Diabetes Prevention Program. FDA, Food and Drug Administration. This document is intended to provide an overview of the elements that are important to the nutritional care of the bariatric patient. It is not intended to serve as. Moyer Instruments, Inc. Hypertension Meal Plan - 1200 calories Avg Calories Per Day: PCF Ratio: 22-55-23 1214 Sunday Monday Tuesday Wednesday Thursday Friday Saturday Week 1. Bruno's Marketplace offers gourmet food products from Northern California, including Bruno's Wax Peppers, Sierra Nevada Chileno Peppers, Waterloo BBQ Sauce, Bruno's. GDM, gestational diabetes mellitus. MNT, medical nutrition therapy. RDA, recommended dietary allowance. USDA, U. S. Department of Agriculture. Medical nutrition therapy (MNT) is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing, the rate of development of diabetes complications. It is, therefore, important at all levels of diabetes prevention (see Table 1). MNT is also an integral component of diabetes self- management education (or training). This position statement provides evidence- based recommendations and interventions for diabetes MNT. The previous position statement with accompanying technical review was published in 2. This statement updates previous position statements, focuses on key references published since the year 2. American Diabetes Association evidence- grading system. Since overweight and obesity are closely linked to diabetes, particular attention is paid to this area of MNT. The goal of these recommendations is to make people with diabetes and health care providers aware of beneficial nutrition interventions. This requires the use of the best available scientific evidence while taking into account treatment goals, strategies to attain such goals, and changes individuals with diabetes are willing and able to make. Achieving nutrition- related goals requires a coordinated team effort that includes the person with diabetes and involves him or her in the decision- making process. It is recommended that a registered dietitian, knowledgeable and skilled in MNT, be the team member who plays the leading role in providing nutrition care. However, it is important that all team members, including physicians and nurses, be knowledgeable about MNT and support its implementation. MNT, as illustrated in Table 1, plays a role in all three levels of diabetes- related prevention targeted by the U. S. Department of Health and Human Services. Primary prevention interventions seek to delay or halt the development of diabetes. This involves public health measures to reduce the prevalence of obesity and includes MNT for individuals with pre- diabetes. Secondary and tertiary prevention interventions include MNT for individuals with diabetes and seek to prevent (secondary) or control (tertiary) complications of diabetes. GOALS OF MNT FOR PREVENTION AND TREATMENT OF DIABETESGoals of MNT that apply to individuals at risk for diabetes or with pre- diabetes. To decrease the risk of diabetes and cardiovascular disease (CVD) by promoting healthy food choices and physical activity leading to moderate weight loss that is maintained. Goals of MNT that apply to individuals with diabetes) Achieve and maintain Blood glucose levels in the normal range or as close to normal as is safely possible. A lipid and lipoprotein profile that reduces the risk for vascular disease. Blood pressure levels in the normal range or as close to normal as is safely possible) To prevent, or at least slow, the rate of development of the chronic complications of diabetes by modifying nutrient intake and lifestyle) To address individual nutrition needs, taking into account personal and cultural preferences and willingness to change) To maintain the pleasure of eating by only limiting food choices when indicated by scientific evidence. Goals of MNT that apply to specific situations) For youth with type 1 diabetes, youth with type 2 diabetes, pregnant and lactating women, and older adults with diabetes, to meet the nutritional needs of these unique times in the life cycle.) For individuals treated with insulin or insulin secretagogues, to provide self- management training for safe conduct of exercise, including the prevention and treatment of hypoglycemia, and diabetes treatment during acute illness. EFFECTIVENESS OF MNTRecommendations. Individuals who have pre- diabetes or diabetes should receive individualized MNT; such therapy is best provided by a registered dietitian familiar with the components of diabetes MNT. Meta- analysis of studies in nondiabetic, free- living subjects and expert committees report that MNT reduces LDL cholesterol by 1. After initiation of MNT, improvements were apparent in 3–6 months. Meta- analysis and expert committees also support a role for lifestyle modification in treating hypertension (7,8). ENERGY BALANCE, OVERWEIGHT, AND OBESITYRecommendations. In overweight and obese insulin- resistant individuals, modest weight loss has been shown to improve insulin resistance. Thus, weight loss is recommended for all such individuals who have or are at risk for diabetes. The long- term benefits and risks of bariatric surgery in individuals with pre- diabetes or diabetes continue to be studied. Therefore, these nutrition recommendations start by considering energy balance and weight loss strategies. The National Heart, Lung, and Blood Institute guidelines define overweight as BMI . The risk of comorbidity associated with excess adipose tissue increases with BMIs in this range and above. However, clinicians should be aware that in some Asian populations, the proportion of people at high risk of type 2 diabetes and CVD is significant at BMIs of > 2. Visceral body fat, as measured by waist circumference . Lower waist circumference cut points (. However, long- term weight loss is difficult for most people to accomplish. This is probably because the central nervous system plays an important role in regulating energy intake and expenditure. Short- term studies have demonstrated that moderate weight loss (5% of body weight) in subjects with type 2 diabetes is associated with decreased insulin resistance, improved measures of glycemia and lipemia, and reduced blood pressure (1. Longer- term studies (. Look AHEAD (Action for Health in Diabetes) is a large National Institutes of Health–sponsored clinical trial designed to determine if long- term weight loss will improve glycemia and prevent cardiovascular events (1. When completed, this study should provide insight into the effects of long- term weight loss on important clinical outcomes. Evidence demonstrates that structured, intensive lifestyle programs involving participant education, individualized counseling, reduced dietary energy and fat (. The role of lifestyle modification in the management of weight and type 2 diabetes was recently reviewed (1. Although structured lifestyle programs have been effective when delivered in well- funded clinical trials, it is not clear how the results should be translated into clinical practice. Organization, delivery, and funding of lifestyle interventions are all issues that must be addressed. Third- party payers may not provide adequate benefits for sufficient MNT frequency and time to achieve weight loss goals (1. Exercise and physical activity, by themselves, have only a modest weight loss effect. However, exercise and physical activity are to be encouraged because they improve insulin sensitivity independent of weight loss, acutely lower blood glucose, and are important in long- term maintenance of weight loss (1). Weight loss with behavioral therapy alone also has been modest, and behavioral approaches may be most useful as an adjunct to other weight loss strategies. Standard weight loss diets provide 5. Although many people can lose some weight (as much as 1. Although low- fat diets have traditionally been promoted for weight loss, two randomized controlled trials found that subjects on low- carbohydrate diets lost more weight at 6 months than subjects on low- fat diets (1. Another study of overweight women randomized to one of four diets showed significantly more weight loss at 1. Atkins low- carbohydrate diet than with higher- carbohydrate diets (2. However, at 1 year, the difference in weight loss between the low- carbohydrate and low- fat diets was not significant and weight loss was modest with both diets. Changes in serum triglyceride and HDL cholesterol were more favorable with the low- carbohydrate diets. In one study, those subjects with type 2 diabetes demonstrated a greater decrease in A1. C with a low- carbohydrate diet than with a low- fat diet (2. A recent meta- analysis showed that at 6 months, low- carbohydrate diets were associated with greater improvements in triglyceride and HDL cholesterol concentrations than low- fat diets; however, LDL cholesterol was significantly higher on the low- carbohydrate diets (2. Further research is needed to determine the long- term efficacy and safety of low- carbohydrate diets (1. The recommended dietary allowance (RDA) for digestible carbohydrate is 1. Although brain fuel needs can be met on lower- carbohydrate diets, long- term metabolic effects of very- low- carbohydrate diets are unclear, and such diets eliminate many foods that are important sources of energy, fiber, vitamins, and minerals and are important in dietary palatability (2. Meal replacements (liquid or solid prepackaged) provide a defined amount of energy, often as a formula product. Use of meal replacements once or twice daily to replace a usual meal can result in significant weight loss. Meal replacements are an important part of the Look AHEAD weight loss intervention (1. However, meal replacement therapy must be continued indefinitely if weight loss is to be maintained. Very- low- calorie diets provide . When very- low- calorie diets are stopped and self- selected meals are reintroduced, weight regain is common. Thus, very- low- calorie diets appear to have limited utility in the treatment of type 2 diabetes and should only be considered in conjunction with a structured weight loss program. The available data suggest that weight loss medications may be useful in the treatment of overweight individuals with and at risk for type 2 diabetes and can help achieve a 5–1. It's Time to End the War on Salt. By Dr. Mercola. For many decades now, U. S. But the drive to do this has little basis in science. In fact, a recent meta- analysis by the Cochrane Review involving a total of 6,2. Another study published last year found that lower salt consumption actually increased your risk of death from heart disease. A review of the available research reveals that much of the science behind the supposed link between salt and high blood pressure is dubious at best. According to Scientific American: 3. In fact, the population that ate the most salt, about 1. Studies that have explored the direct relationship between salt and heart disease have not fared much better.. For every study that suggests that salt is unhealthy, another does not. In 1. 90. 4 French doctors reported that six of their subjects who had high blood pressure—a known risk factor for heart disease—were salt fiends. People living in countries with a high salt consumption—such as Japan—also tend to have high blood pressure and more strokes. But as a paper pointed out several years later in the American Journal of Hypertension, scientists had little luck finding such associations when they compared sodium intakes within populations, which suggested that genetics or other cultural factors might be the culprit. Nevertheless, in 1. U. S. Senate's Select Committee on Nutrition and Human Needs released a report recommending that Americans cut their salt intake by 5. Dahl's work. The same applies to the saturated- fat- is- bad- for- your- heart myth, which is based on cherry- picked data. In addition to the ones already mentioned above, the following studies also came up with negative results. That equates to reducing your blood pressure from 1. In conclusion, the authors stated that. The study concluded that lower sodium diets led to HIGHER mortality rates among those with cardiovascular disease, which . Modern table salt has very little in common with natural, unrefined salt. The first will damage you health while the latter is profoundly healing. Here's a quick break- down of their basic ingredients. These are dangerous chemicals like ferrocyanide and aluminosilicate. A small amount of iodine may also be added(Some European countries, where water fluoridation is not practiced, also add fluoride to table salt. In France, 3. 5 percent of table salt sold contains either sodium fluoride or potassium fluoride and use of fluoridated salt is widespread in South America)The processing also radically alters the structure of the salt. Refined table salt is dried above 1,2. Fahrenheit, and this excessive heat alters the natural chemical structure of the salt. The Healing Benefits of Unrefined Natural Salt. Both sodium and chloride are also necessary for the firing of neurons . Hence, eating too much common processed salt will cause fluid to accumulate in your tissues, which may contribute to: Unsightly cellulite Rheumatism, arthritis and gout Kidney and gall bladder stones Hypertension (high blood pressure) The Importance of Maintaining Optimal Sodium- Potassium Ratio. While natural unprocessed salt has many health benefits and is indeed essential for life, that does not mean you should ingest it with impunity. Another important factor is the potassium to sodium ratio of your diet. Imbalance in this ratio can not only lead to hypertension (high blood pressure) but also contribute to a number of other diseases, including. Compare that to today's modern diet where daily potassium consumption averages about 2,5. RDA is 4,7. 00 mg/day), along with 4,0. This may also explain why high- sodium diets appear to affect some people but not others. According to a recent federal study into sodium and potassium intake, those at greatest risk of cardiovascular disease were those who got too much sodium along with too little potassium. The research, published in the Archives of Internal Medicine in July of last year. U. S. Thomas Farley, New York City's health commissioner, who has led efforts to get the public to eat less salt. Elena Kuklina, one of the study's authors at the Centers for Disease Control and Prevention. Such a dietary imbalance posed a greater risk than simply eating too much salt, according to the study.? Ditch processed foods, which are very high in processed salt and low in potassium and other essential nutrients, and eat a diet of whole, unprocessed foods, ideally organically- grown to ensure optimal nutrient content. This type of diet will naturally provide much larger amounts of potassium in relation to sodium. About 9. 0 percent of the money Americans spend on food is spent on processed foods and more than 7. U. S. Emerging evidence suggests that this ratio is actually crucial for improving health, and the way to optimize potassium intake is by increasing consumption of vegetables, which are the highest sources of potassium. Why You Need Potassium. It is possible that potassium deficiency may be more responsible for hypertension, rather than excess sodium, as it also affects your: Bone mass Nervous system Muscle function Heart and kidney function Adrenal functions Potassium deficiency can lead to electrolyte imbalance, and can result in a condition called hypokalemia. Symptoms include: Water retention Raised blood pressure and hypertension Heart irregularities/arrhythmias Muscular weakness and muscle cramps Continual thirst Constipation Potassium- Rich Foods. I do not advise taking potassium supplements to correct a sodium- potassium imbalance. Instead, it is best to alter your diet and incorporate more potassium- rich whole foods. Some of the richest sources in potassium are: Baked potato (1. But limit as has high levels of starchy carbohydrate which can increase your insulin and leptin resistance. Lima beans (9. 55 mg/cup) Winter squash (8. Cooked spinach (8. Other potassium- rich fruits and vegetables include: Fruits: papayas, prunes, cantaloupe, and bananas. It is an old wives tale that you are getting loads of potassium from bananas, the potassium is twice as high in green vegetables.) Vegetables: broccoli, Brussels sprouts, sweet potatoes, avocados, asparagus, and pumpkin Fructose—a Far More Likely Culprit in Hypertension and Heart Disease. Avoiding processed foods will also help you avoid another primary risk factor for high blood pressure and heart disease, namely fructose. If you check the labels, you will find that virtually every single food and beverage you contemplate buying contains fructose, either in the form of high fructose corn syrup, corn syrup, or some other version. The amounts of salt Americans consume pales in comparison to the amount of fructose eaten on a daily basis, and I'm convinced that it's the sugar/fructose consumption that is the major driving force behind our skyrocketing hypertension rates, not excess salt. The connecting link between fructose consumption and hypertension lies in the uric acid produced. Uric acid is a byproduct of fructose metabolism, and increased uric acid levels effectively drive up your blood pressure. The more you can move toward a diet of whole organic foods in their natural state, the healthier you'll be. And given that salt is essential to good health, I recommend switching to a pure, unrefined salt. My favorite is an all- natural sea salt from the Himalayas. Himalayan salt is completely pure, having spent many thousands of years maturing under extreme tectonic pressure, far away from impurities, so it isn't polluted with the heavy metals and industrial toxins of today. It's hand- mined, hand- washed, and minimally processed, and contains some 8. It's likely to be the most delicious salt you'll ever find, which is why it's so popular among gourmet chefs. Relax, and Salt to Taste. PKD DIET- the Kidney, a diet to try for Polycystic Kidney Disease Diet. THINGS TO TRY TO ASSURE YOU REMAIN AMONG THE 4. WHO NEVER REQUIRE DIALYSIS or transplant. Alkaline Plant Based Whole Foods Diet with an abundance of locally grown ripe in season produce geared toward kidney and liver health. Include essential fatty acids and essential amino acids. Low Salt - 1. 20. Himalayan salt, prepare food yourself from fresh ingredients adding no salt to your cooking. If you must add salt keep it to one- eighth teaspoon per day of Himalayan Pink salt. Neutral Protein - 0. Water - twice output, possibly 3 liters per day. Avoid kidney toxins: caffeine, methylparabens, aspirin, kidney harmful foods. Increase Kidney Blood Flow (renal perfusion) through Exercise and Rest Maintain Alkalinity - self monitor your nightly urinary p. H. 7. 2 is a better,alkalinity. Blood pressure 1. Keep at 1. 10/7. 0 . Should blood pressure rise or spikes, call doctor. Correct anemia. Diminish proteinuria. PKD DIETThese foods are suggestions to try that have been gathered from among our collective experiences - anecdotal knowledge. Before trying something new, check with your doctor. Eliminate toxins, especially kidney toxins, Exercise and rest sufficiently to keep kidney blood flow abundant With normal kidney functioning, one possibility to try, is a diet that is alkaline, plant based, geared toward kidney health, with plenty of starchy vegetables: rutabagas, turnips, sweet potatoes, beans, sweet corn, spelt, rye, turnips, and whole grains with a sprinkling of a few alkaline nuts such as almonds, chestnuts and coconut. A low sodium, 1. 20. A low sodium diet is more easily achieved by cooking all your own foods, eliminating prepared, canned, and take out food. If salt is necessary, one can try measuring out an 1/8 teaspoon of Himalayan salt daily, then tossing any remaining salt at day's end. The following day start fresh with only 1/8 teaspoon. A neutral protein is neither low protein nor high protein. What goes in, comes out. A neutral plant based protein diet that is individually calculated to 0. Most recently it was discovered that by drinking enough water to shut down vasopressin or about 3 liters of water per day, might help assure the health of polycystic kidneys. If your doctor permits, try chamomile, rooibos, hibiscus, thyme, saffron, rose hips, linden flower, or veronica tea. For a little bubbly, try freshly pressed cranberry, apple, grape juice or an all juice blend mixed with Perrier or other fizzy mineral water. While kidney functioning is still excellent, dietary things that help PKD are also high potassium foods; plant based diets with an emphasis on raw fruits and vegetables; whole food starches such as corn on the cob, sweet potatoes, rutabagas, turnips, winter squash. Include a few selected pre- soaked grains (spelt, quinoa, rye, oats, Kashi, brown rice) and pre- soaked nuts (almond, coconut, chestnut). Enjoy plenty of leafy greens, broccoli, radish, and below ground root crops. Soak all beans, legumes, grains, seeds and nuts before eating. This lowers their phytic acid content, making these foods more digestible and alkaline. Salt intake and cholesterol levels are two things that we can alter. These are two things which will alter the outcome of PKD, according to the CRISP study. CDC - DHDSP - How to Reduce Sodium. Sodium content in the same food can vary widely depending on how it has been processed. For most people, when sodium intake is reduced, blood pressure begins decreasing in only a few weeks, on average. Choose a Heart- Healthy Diet. The DASH (Dietary Approaches to Stop Hypertension) eating plan is a simple, heart- healthy diet that can help prevent or lower high blood pressure. The DASH diet is low in sodium, cholesterol, and saturated and total fats, and it is high in fruits and vegetables, fiber, potassium, and low- fat dairy products. If you follow the DASH eating plan and also make other lifestyle changes, such as getting more physical activity, you will see the biggest benefits. Learn more about the DASH eating plan on the National Heart, Lung, and Blood Institute’s Web site. If everyone reduced the amount of sodium in their diet by 1,2. United States every year. Decoding Nutrition Labels. Reading the Nutrition Facts label on packaged foods can show you the amount of sodium per serving. Don’t forget to check the number of servings per container! Tips for Lowering Sodium at the Supermarket. Buy fresh, frozen (no sauce), or no salt added canned vegetables. Use fresh poultry,* fish, pork,* and lean meat, rather than canned or processed meats. When available, buy low sodium, lower sodium, reduced sodium, or no salt added versions of products. Limit your use of sauces, mixes, and “instant” products, including flavored rice and ready- made pasta. Compare Nutrition Facts labels on food packages for Percent Daily Value or amount of sodium in milligrams.* Check to see if saline or salt solution has been added—if so, choose another brand. Tips for Lowering Sodium While Eating Out. Restaurant foods are a major source of sodium in most Americans' diets, so it pays to take a few minutes to find out what’s in the food you're eating. Planning ahead also can help you find restaurants that have information on sodium levels in the foods they serve. To reduce your sodium when you are eating out at a restaurant: Check online for nutritional information before you go if you are eating at a chain restaurant or fast- food outlet. Some independent restaurants also post this information on their Web sites. Ask your server for information about the amount of sodium in your food. Sometimes this information is printed on the menu. Request that no salt be added to your food. Beware of hidden sources of sodium such as sauces and dressings, and ask for these toppings on the side. References. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bibbins- Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood JM, Pletcher MJ, et al. Projected effect of dietary salt reductions on future cardiovascular disease.
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