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Planning A Diabetes Diet - Spacing Of Meals & Food Exchanges

Spacing of meals

Meals should be eaten slowly in order to reduce blood glucose peaks. The common practice of taking two large meals a day is not advisable for a diabetic. The blood glucose level shoots up after a large meal. It does not rise excessively when the daily food intake is divided into four meals, that is, breakfast, lunch, teatime snack and supper. The CHO can be distributed as follows: !/3 each lunch, dinner; % breakfast, 1/10 each at 4 p.m. and bedtime.

Regular and uniform meals

A diabetic should have regular and unform meals, especially if he/she is on insulin or oral antidiabetic drugs. Eating less than usual, delay in taking meals or omission of meals are common causes of hypoglycaemia (low blood glucose level) (Ch. 13)).

Food exchanges

A diabetic diet need not be monotonous if the concept of food exchanges is grasped. The caloric value and the carbohydrate content of cereals are practically the same, hence these can be interchanged, weight for weight. The composition of pulses and legumes is more or less the same, hence these can be exchanged with each other. Oil, ghee and vanaspati have same fat content and are interchangeable. A medium sized apple, orange, sweet lime, and a small banana provide 10 g carbohydrates and are interchangeable. The protein content of 30 g of fish, meat, chicken and one medium sized egg is the same, that is, 5 g and hence can be exchanged with each other (See Appendix 3 for lists of food exchanges).

An exchange is possible within the same group of foodstuffs. For example, meat can be exchanged with fish but not with a fruit. A foodstuff can be exchanged for another foodstuff in the same meal. For example a diabetic can have biscuits instead of bread for breakfast. But he cannot omit bread at breakfast and increase the number of chapatis at lunch.

Foods taken in natural form are likely to be absorbed slowly and hence likely to raise blood glucose level slowly. The GI depends on rate of digestion and absorption of CHO. The GI should not be considered in isolation. Although foods with a high fat content have low glycaemic index, these are not advisable for persons with diabetes, because of their high fat and calorie value.

The 'glucose load' of a food depends on its CHO content and the GI. The foods with a high CHO content as well as high GI have a high glucose load. On the other hand, watermelon albeit high GI has low glucose load because of its low CHO content. The current food exchange lists will, no doubt, be revised, in the light of GI of various food stuffs.

Foods with a satiety value

Diabetics on a reducing diet often feel hungry at times. They can have the following foods without increasing the caloric value of the diet: cucumber, tomatoes, thin vegetable soups, tea or coffee without sugar, and with very little milk, butter milk with butter removed, sour lime sherbet with sweetening agent, soda water, a large helping of water melon.

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Planning A Diabetes Diet - Spacing Of Meals & Food Exchanges