Nutri DM 2 - 4 and 5

4. What general dietary advice can you give to the patient?
A. Food Habits
Fruit and vegetables
Naturally low in fat and calories and packed full of vitamins, minerals and fibre, fruit and vegetables add
flavour and variety to every meal.
They may also help protect against stroke, heart disease, high blood pressure and some cancers.
How often?
Everyone should eat at least five portions a day. Fresh, frozen, dried and canned fruit in juice and
canned vegetables in water all count. Go for a rainbow of colours to get as wide a range of vitamins and
minerals as possible.
Try:
adding an apple, banana, pear, or orange to your childs lunchbox

sliced melon or grapefruit topped with low-fat yogurt, or a handful of berries, or fresh dates,
apricots or prunes for breakfast
carrots, peas and green beans mixed up in a pasta bake
adding an extra handful of vegetables to your dishes when cooking peas to rice, spinach to
lamb or onions to chicken.
Starchy foods
Range of starchy foodsPotatoes, rice, pasta, bread, chapattis, naan and plantain all contain
carbohydrate, which is broken down into glucose and used by your cells as fuel. Better options of
starchy foods such as wholegrain bread, wholewheat pasta and basmati, brown or wild rice contain
more fibre, which helps to keep your digestive system working well. They are generally more slowly
absorbed (that is, they have a lower glycaemic index, or GI), keeping you feeling fuller for longer.
How often?
Try to include some starchy foods every day.
Try:
two slices of multigrain toast with a scraping of spread and Marmite or peanut butter
rice, pasta or noodles in risottos, salads or stir-fries
potatoes any way you like but dont fry them with the skin left on for valuable fibre. Choose
low-fat toppings, such as cottage cheese or beans
baked sweet potato, with the skin left on for added fibre
boiled cassava, flavoured with chilli and lemon
chapatti made with brown or wholemeal atta.
Meat, fish eggs, pulses, beans and nuts

Meat, fish, eggs, pulses, beans and nuts food groupThese foods are high in protein, which helps with
building and replacing muscles. They contain minerals, such as iron, which are vital for producing red
blood cells. Oily fish, such as mackerel, salmon and sardines, also provide omega-3, which can help
protect the heart. Beans, pulses, soya and tofu are also good sources of protein.
How often?
Aim to have some food from this group every day, with at least 12 portions of oily fish a week.
Try:
serving meat, poultry or a vegetarian alternative grilled, roasted or stir-fried

a small handful of raw nuts and seeds as a snack or chopped with a green salad
using beans and pulses in a casserole to replace some or all of the meat
grilled fish with masala, fish pie, or make your own fish cakes
eggs scrambled, poached, dry fried or boiled the choice is yours!
Dairy foods
Milk, cheese and yogurt contain calcium, which is vital for growing children as it keeps their bones and
teeth strong. Theyre good sources of protein, too.
Some dairy foods are high in fat, particularly saturated fat, so choose lower-fat alternatives (check for
added sugar, though). Semi-skimmed milk actually contains more calcium than whole milk, but children
under 2 should have whole milk because they may not get the calories or essential vitamins they need
from lower-fat milks. Dont give children skimmed milk until theyre at least 5.
How often?
Aim to have some dairy every day, but dont overdo it.
Try:
milk straight in a glass, flavoured with a little cinnamon, or added to breakfast porridge
yogurt with fruit or on curry
cottage cheese scooped on carrot sticks
a bowl of breakfast cereal in the morning, with skimmed or semi-skimmed milk
a cheese sandwich at lunchtime, packed with salad
a refreshing lassi or some plain yogurt with your evening meal.
Reference: https://www.diabetes.org.uk/Guide-to-diabetes/Enjoy-food/Eating-with-diabetes/What-is-a-
healthy-balanced-diet/
B. Lifestyle
Move daily to increase energy and feel better

Increasing physical activity helps improve your blood sugar control and reduces the risk of heart disease
and nerve problems. Aim for 30 minutes of aerobic exercise at least five days per week. If it's cold
outside, consider walking indoors, around your house or at a department store or mall.
Eat a healthy diet
Choose healthy carbohydrates, fiber-rich foods, lean meats and good fats. Watch portion size! Have
healthy snacks available in case you get the munchies. If I really, really want a treat, I have to get in my
car and go to the store to buy it, because I don't keep treats at home. It makes me think twice, and I
usually go for a healthier fruit snack option at home, instead.
Relax daily
Yes! It's January, and we can hopefully take a breather from holiday stress. Stress can raise blood sugar.
Take time for yourself each day, and do something that you enjoy such as reading a book or working on
a hobby.
Maintain good health by taking time for prevention

Healthy lifestyle choices may decrease your chances of developing complications from diabetes.
Limit the amount of alcohol you drink.
Don't smoke or use other kinds of tobacco.
Take your medications and insulin as directed.
Wear a medical alert identification (ID).
Know your numbers A1C, blood pressure, cholesterol and weight.
Sleep enough to wake up renewed and refreshed

This can make it easier for you to control your blood sugar.
Reference: http://www.mayoclinic.org/diseases-conditions/diabetes/expert-blog/healthy-habits-
diabetes/bgp-20056474
C. Diet restrictions and management
Eating a diabetic diet doesnt mean eliminating sugar altogether, but like most of us, chances are you
consume more sugar than is healthy. If you have diabetes, you can still enjoy a small serving of your
favorite dessert now and then. The key is moderation.
Reduce your cravings for sweets by slowly reduce the sugar in your diet a little at a time to give your
taste buds time to adjust.
Hold the bread (or rice or pasta) if you want dessert. Eating sweets at a meal adds extra carbohydrates
so cut back on the other carb-heavy foods at the same meal.
Add some healthy fat to your dessert. Fat slows down the digestive process, meaning blood sugar levels
dont spike as quickly. That doesnt mean you should reach for the donuts, though. Think healthy fats,
such as peanut butter, ricotta cheese, yogurt, or nuts.
Eat sweets with a meal, rather than as a stand-alone snack. When eaten on their own, sweets cause
your blood sugar to spike. But if you eat them along with other healthy foods as part of your meal, your
blood sugar wont rise as rapidly.
When you eat dessert, truly savor each bite. How many times have you mindlessly eaten your way
through a bag of cookies or a huge piece of cake? Can you really say that you enjoyed each bite? Make
your indulgence count by eating slowly and paying attention to the flavors and textures. Youll enjoy it
more, plus youre less likely to overeat.
Reference: https://www.helpguide.org/articles/diet-weight-loss/diabetes-diet-and-food-tips.htm
5. Discuss the meal plan and the rationale for the food selection.
As you can see, our prepared meal plan for a Diabetes Mellitus Type II patient consists of
complex carbs as these carbs are slowly digested in the system and when it is digested more slowly, the
body will be prevented from producing too much insulin. Sugar is not entirely excluded from the diet but
is included but only in small amounts because in Diabetics, the blood glucose is high and if the patient
eats more sugar, the blood glucose will increase and will further make the patient more at risk for
complications because of hyperglycemia.

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4. What general dietary advice can you give to the patient?

Fruit and vegetables

adding an apple, banana, pear, or orange to your childs lunchbox

Try to include some starchy foods every day.

Meat, fish eggs, pulses, beans and nuts

serving meat, poultry or a vegetarian alternative grilled, roasted or stir-fried

Move daily to increase energy and feel better

Maintain good health by taking time for prevention

Limit the amount of alcohol you drink.

Don't smoke or use other kinds of tobacco.

Take your medications and insulin as directed.

Wear a medical alert identification (ID).

Know your numbers A1C, blood pressure, cholesterol and weight.

Sleep enough to wake up renewed and refreshed

C. Diet restrictions and management

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