Dietary Recommendation in Diabetes Care: Carbohydrate Counting and Caloric Content of Nigerian Foods

The prevalence of diabetes mellitus is rising globally and even more in low and middle-income countries such as Nigeria. Optimal management of the disease is important to improve survival and prevent or delay its complications. Lifestyle management is a standard universal approach in optimizing the care given to diabetic patients. Dietary management is the central link in lifestyle modifications of individuals living with diabetes. Medical nutrition therapy (MNT) is a systematic therapeutic approach of assessing the nutritional needs of an individual, determining nutritional goals, counselling the clients on how to achieve the goals, prescribing and monitoring meal plans to achieve the goals. It is evidence-based, effective and highly recommended. All carers of the diabetes patient, including the health workers and the family members of the patients, need to have basic understanding of medical nutrition therapy but the efforts should be coordinated by licensed dietitians. There are evidences that adherence to prescribed calories is effective in the control of cardiovascular risk factors such as blood glucose, weight, lipid profile and blood pressure. However, prescription of calories should be based on thoughtful consideration of the nutritional needs, weight goal, personal preferences and tastes and cultural practices of individuals living with diabetes mellitus. Food pyramids give a graphical illustration on the recommended classes and servings of food. Six to eleven servings per day of carbohydrates, 3-5 servings per day of vegetables, 2-4 servings per day of fruit, 2-3 servings per day of dairy products and 2-3 servings per day of fish are the recommended proportions of the different classes of foods for an adult on an average of 2000 calories. Carbohydrate counting, taken with appropriate insulin dosing and physical activity, has been demonstrated to be effective in optimizing the glycaemic control of patients on multiple daily insulin injections. There are challenges in doing this in Nigeria due to lack of food labels. The caloric contents of common Nigerian foods are highlighted so as to help in achieving dietary goals.

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Medical Nutrition Therapy for Youth with Type 1 Diabetes Mellitus: More than Carbohydrate Counting

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2012.07.033 ◽

2012 ◽

Vol 112 (11) ◽

pp. 1724-1727 ◽

Cited By ~ 7

Author(s):

Judith Wylie-Rosett ◽

Karin Aebersold ◽

Beth Conlon ◽

Natania W. Ostrovsky

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Nutrition Therapy ◽

Medical Nutrition Therapy ◽

Carbohydrate Counting ◽

Medical Nutrition

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Searching for Utopia, the Challenge of Standardized Medical Nutrition Therapy Prescription in Gestational Diabetes Mellitus Management: A Critical Review

Seminars in Reproductive Medicine ◽

10.1055/s-0040-1722316 ◽

2021 ◽

Author(s):

Nina Meloncelli ◽

Shelley A. Wilkinson ◽

Susan de Jersey

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Lifestyle Modification ◽

Nutrition Therapy ◽

Medical Nutrition Therapy ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Medical Nutrition

AbstractGestational diabetes mellitus (GDM) is a common pregnancy disorder and the incidence is increasing worldwide. GDM is associated with adverse maternal outcomes which may be reduced with proper management. Lifestyle modification in the form of medical nutrition therapy and physical activity, as well as self-monitoring of blood glucose levels, is the cornerstone of GDM management. Inevitably, the search for the “ultimate” diet prescription has been ongoing. Identifying the amount and type of carbohydrate to maintain blood glucose levels below targets while balancing the nutritional requirements of pregnancy and achieving gestational weight gain within recommendations is challenging. Recent developments in the area of the gut microbiota and its impact on glycemic response add another layer of complexity to the success of medical nutrition therapy. This review critically explores the challenges to dietary prescription for GDM and why utopia may never be found.

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Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: a subanalysis of the St Carlos GDM Prevention Study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2018-000550 ◽

2018 ◽

Vol 6 (1) ◽

pp. e000550 ◽

Cited By ~ 14

Author(s):

Carla Assaf-Balut ◽

Nuria Garcia de la Torre ◽

Alejandra Durán ◽

Manuel Fuentes ◽

Elena Bordiú ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnancy Outcomes ◽

Nutrition Therapy ◽

Normal Glucose Tolerance ◽

Medical Nutrition Therapy ◽

Prevention Study ◽

Normal Glucose ◽

Medical Nutrition

ObjectivesTo assess whether Mediterranean Diet (MedDiet)-based medical nutrition therapy facilitates near-normoglycemia in women with gestational diabetes mellitus (GDMw) and observe the effects on adverse pregnancy outcomes.Research design and methodsThis is a secondary analysis of the St Carlos GDM Prevention Study, conducted between January and December 2015 in Hospital Clínico San Carlos (Madrid, Spain). One thousand consecutive women with normoglycemia were included before 12 gestational weeks (GWs), with 874 included in the final analysis. Of these, 177 women were diagnosed with gestational diabetes mellitus (GDM) and 697 had normal glucose tolerance. All GDMw received MedDiet-based medical nutrition therapy with a recommended daily extra virgin olive oil intake ≥40 mL and a daily handful of nuts. The primary goal was comparison of hemoglobin A1c (HbA1c) levels at 36–38 GWs in GDMw and women with normal glucose tolerance (NGTw).ResultsGDMw as compared with NGTw had higher HbA1c levels at 24–28 GWs (5.1%±0.3% (32±0.9 mmol/mol) vs 4.9%±0.3% (30±0.9 mmol/mol), p=0.001). At 36–38 GWs values were similar between the groups. Similarly, fasting serum insulin and homeostatic model assessment insulin resitance (HOMA-IR) were higher in GDMw at 24–28 GWs (p=0.001) but became similar at 36–38 GWs. 26.6% of GDMw required insulin for glycemic control. GDMw compared with NGTw had higher rates of insufficient weight gain (39.5% vs 22.0%, p=0.001), small for gestational age (6.8% vs 2.6%, p=0.009), and neonatal intensive care unit admission (5.6% vs 1.7%, p=0.006). The rates of macrosomia, large for gestational age, pregnancy-induced hypertensive disorders, prematurity and cesarean sections were comparable with NGTw.ConclusionsUsing a MedDiet-based medical nutrition therapy as part of GDM management is associated with achievement of near-normoglycemia, subsequently making most pregnancy outcomes similar to those of NGTw.

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A polycystás ovárium szindrómában a táplálkozás szerepe a cukorbetegség kialakulásának megelőzésében és a terápiás lehetőségek kiegészítésében

Jelenkori Társadalmi és Gazdasági Folyamatok ◽

10.14232/jtgf.2013.1-2.51-58 ◽

2013 ◽

Vol 8 (1-2) ◽

pp. 51-58

Author(s):

Károly Nagy ◽

Éva Pósfai

Keyword(s):

Diabetes Mellitus ◽

Nutrition Therapy ◽

Medical Nutrition Therapy ◽

Medical Nutrition

A polyeystás ovárium szindróma (PCOS) a nők körében gyakuri, rendkívül komplex endokrin-metabolikus tünetcsoport. A beteg sorsát általában a romló szénhidrát- lipid anyagcsere-zavarok illetve az ezekhez kapcsolódó, ezek miatt kifejlődő cardiovascularis eltérések határozzák meg. Mára már ismert tény, hogy PCOS miatti hosszan fennálló együttes anyagcsere változások az inzulinrezisztencia fokozódásához, diabetes mellitus kialakulásához vezethetnek. Szerencsére az elmúlt években számos nemzetközi publikáció és ajánlás jelent meg, mely szorgalmazza, hogy a betegség sikeres klinikai kezeléséhez, managementjéhez hozzá kell tartoznia a tudatos preventív szemléletű életmódbeli változás szorgalmazásának, melynek az első vonalbeli terápia részét kell képeznie. Ennek egyik alappillére a megfelelő táplálkozás, diéta, az orvosi táplálkozási terápia ('medical nutrition therapy'). Ezen tanulmány célja az volt, hogy mintegy körképet készítve a nemzetközi irodalomban fellelhető vezető klinikák publikációi alapján, bemutassa, ma hol áll az oly sokat hangoztatott táplálkozás szerepe a PCOS betegek metabolikus szövődményeinek megelőzésében, a terápiás lehetőségek kiegészítésében, és azt elhelyezze az egyre gyakrabban hangoztatott költség a társadalomra kontra megelőzés témakörében.

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Diarrhea/Constipation

Cases on Medical Nutrition Therapy for Gastrointestinal Disorders - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-7998-3802-9.ch004 ◽

2021 ◽

pp. 69-92

Author(s):

Shoug Alashmali

Keyword(s):

Nutrition Therapy ◽

Nutrition Intervention ◽

Medical Nutrition Therapy ◽

Intestinal Fluid ◽

Fluid Absorption ◽

Lifestyle Modifications ◽

Dietary Choices ◽

Bowel Disorders ◽

Medical Nutrition

This chapter will discuss a case of diarrhea/constipation. Diarrhea and constipation are functional bowel disorders (FBDs) of the mid or lower gastrointestinal (GI) tract. These FBDs result from intestinal motility dysfunction and/or changes in intestinal fluid absorption, which in turn leads to bloating, discomfort, and occasionally, abdominal pain. Certain dietary choices aggravate these conditions, leading to serious complications. Management of diarrhea/constipation usually requires the use of medications and/or lifestyle modifications. The presently discussed case involved factors that exacerbated the conditions of diarrhea/constipation. This case serves as an example of the role of medical nutrition therapy in managing FBDs (particularly diarrhea and constipation). Moreover, this case will allow the dietetic professional to assess the causes of diarrhea/constipation in order to plan for the nutrition intervention and educate the patient about the dietary manipulations required to reduce their symptoms.

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