In addition to carbohydrate and fat, protein also contributes to the calorie intake. It is one of the most important constituents of the diet. Its primary function is to maintain and promote growth.
The high protein prescriptions to protect the diabetics against infections and diseases was found to cause stress on liver and excretion of its end-products like urea/ uric acid from the kidneys. The protein allowance is now reduced to moderate levels from mixed sources to delay the onset of nephropathy or other manifestations of atherosclerosis which are on the rise in diabetic patients.
Protein food of animal origin like red meat, eggs, cheese, whole milk and cream are also rich in saturated fats and cholesterol. The amount of fat ingested from meat depends upon the part of the meat that is used- fat dripping piece and the method of preparation. It is better for such patients to take lean cuts of meat, fish and chicken. Use of animal protein must be restricted if the patient has vascular complications. Instead one can take vegetable proteins derived from pulses, cereals, mushrooms, nuts and leafy vegetables. Vegetarians are advised to take ample amount of soyabean and its products, to improve the quality of the diet.
Along with the use of whole grains and pulses, at least one third of the total protein requirement should be from low fat milk, curds, paneer, (cottage cheese) fish, chicken or egg white. Milk is a good source of calcium and is a complete food with essential basic requirements.
Soya Milk
It is healthy to incorporate pulses with cereals to improve the quality of proteins. All food items involving a combination of cereals + pulses are recommended.
Khichri (Rice : Pulse)
1 : 1
Idli and Dosa (Rice : Pulse)
1 : 1
Dhokla /Misi Roti (Wheat Atta : Channa)
4 : 1
Nutritive value of soya milk as compared with animal milk:
Soya Milk DMS/MD Milk
1. 276 ml gives 100 kilo 166 ml gives 100 kilo
2. Protein 8.6 gms 5.3 gms
3. Fat (unsaturated) 4.9 gms 5.1 gms (saturated)
4. Carbohydrates 4.9 gms 8.3 gms
5. Dietary fibre 4.5 gms Nil
6. Iron 4.9 gms Nil
Though soya milk is as nutritious as animal milk, it is better suited for diabetic and heart patients.
Pulses and Legumes
Pulses are described as potentially the most valuable and naturally occurring sources of food. They are significant sources of proteins. Other than protein they are a rich source of Vitamin B and on germination also become rich in Vitamin C. Whole pulses and gram have a large amount of dietary fibre leading to a low Glycemic Index.
Roasting and puffing of pulses and cereals are two most conventional methods of cooking. There is less destruction of vitamins and minerals and by dry heat food acquires a desirable taste and flavour.
The quality of proteins from a mixture of cereals and pulses is superior in nutritional values. The most efficient combination is that of 4 parts of cereal protein and 1 part of pulse protein. Therefore, all food items involving a combination of cereals and pulses are recommended, e.g., khichri, idli, dosa, dhokla, etc.
Vitamins and Minerals
Vitamins and minerals are indispensable components of a balanced diet and are necessary for normal functioning of the body. Use of fresh green vegetables is recommended as they are a rich source of minerals and vitamins. A serving of fresh fruits can also be included.
Alcohol
Alcohol itself is extremely high in calories. Each gram of alcohol yields 7.1 calories. Calories in excess, regardless of the source, will contribute to upset the control of diabetes.
Alcohol is rapidly absorbed and results in abrupt elevation of blood sugar. The diabetic on drug and / or insulin should totally curtail alcohol intake. Excess of alcohol may lead to alcoholic intoxication which becomes difficult to distinguish from hypoglycemic coma or acidosis.
Artificial Sweeteners
All of us like to eat sweets. Sugar is a part of our system. Diabetes to a diabetic is like a life-partner. A diabetic who knows that he has to restrict sugar, to control the progression of the disease, throughout his life finds it impossible to keep away from sweets. To do away with suppressing this desire, the advent of artificial sweeteners is a blessing for diabetics. He can now derive almost the same pleasure as that of having sugar without the harmful effects which otherwise accompany it. Artificial sweeteners are synthetic products manufactured commercially for therapeutic purpose. These are devoid of food values and are slowly absorbed in the blood. Artificial sweeteners can be used in the diet of an obese person without the loss of palatability.
Sweeteners may be nutritive or non-nutritive. Saccharin, aspartame, are widely available non-nutritive sweeteners, useful for sweets and pudding. Aspartame is so intensely sweet that only minute quantities are required. It is commercially named as ‘Sugar Free’. It is not recommended for children, expectant mothers and patients suffering from phenyl ketonurea. Though it is a real boon for diabetics, it is also a good answer for doctors who wish to control the calorie intake of their patients. Two teaspoons of sugar contain 40 calories, wheras, 2 ‘Sugar Free’ tablets, have just 0.8 calories. It cannot be used at high temperatures, as heating at a very high temperature for a prolonged time causes a 20 per cent loss. It is, hence, advised to use it in diet, by adding it after the food is removed from the heat.
Much attention has been given to their safety, particularly after the suggestion that under certain experimental circumstances saccharin might be associated with an increased risk of developing cancer. However, it is now widely believed that in the quantities usually used in these preparations are quite safe. They are usually advised to consume not more than 50 mg in the diabetic food spread over the day.