Diet and Diabetes: How to Deal with Fat, Protein and Cholesterol

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Diet, diabetes and protein

The relationship between diabetes and protein is not always the same.
In fact, if diabetes is compensated and there is no trace of metabolic-functional complications, protein intake is absolutely normal.
If not, the diet may require some changes in its composition / breakdown.

Recommended protein intake

Nutrition experts recommend consuming, throughout the day, an amount of protein equal to:

  • From 13% up to 20% of the total daily caloric intake (depending on the scientific source taken into consideration)
  • or 1,0-1,1 g of protein per kilogram of physiological body weight (i.e. normal, with a body mass index between 18,5 and 24,9).

The table below, produced by SINU (Your Country Society for Human Nutrition) summarizes your country's Population Reference Intake Levels (LARN) of proteins. These levels are adequate and recommended even for the diabetic who is not complicated by kidney problems.




LARN FOR PROTEINS
 

Age

(years)

Body weight AR Average requirement PRI Recommended Intake for the Population SDT Nutritional Objective for Prevention
    (kg) (g / kg * the) (g / the) (g / kg * the) (g / the) (g / kg * the) (g / the)
ADULTS        
Our boys 18 29 70,0 0,71 50,0 0,90 63,0    
  30 59 70,0 0,71 50,0 0,90 63,0    
  60 74 70,0         1,1 77,0
  75 ≥ 70,0         1,1 77,0
Our girls 18 29 60,0 0,71 43,0 0,90 54,0    
  30 59 60,0 0,71 43,0 0,90 54,0    
  60 74 60,0         1,1 66,0
  75 ≥ 60,0         1,1 66,0

Caption:



  • AR, PRI and SDT correspond to the daily average value over a reasonable period of time.
  • For the age groups, reference is made to the age.
  • The indicated body weight is an example and does not represent a normative value for the population.
  • AR, PRI and SDT are correct for the protein quality attributed to your country's diet. Scientific evidence does not allow defining the maximum tolerable level of intake (UL) for any of the interest groups.

The amount of protein in the diet is reduced in case of diabetic nephropathy, without however falling below 0,7 g / kg / day.

For more information, read the articles Low Protein Diet and Diet for Kidney Failure.


In both cases, 2/3 of the protein content in the diet should derive from products of animal origin and 1/3 from products of vegetable origin (legumes).

Recommended foods and foods to avoid

RECOMMENDED FOODS FOODS TO AVOID
Fresh meat: white (chicken breast, turkey breast, rabbit) lean cuts of beef and even pork (although pork has a bad reputation, some cuts such as loin and fillet have nothing to envy from a nutritional point of view beef; indeed, for some aspects, such as the higher content of vitamins B1 and B2 and the lower cost are even better), lamb, kid, horse, guinea fowl, snails, quail and frogs.

Fresh meat: all fatty meats and offal rich in fat.



It is advisable to remove the skin and avoid the fatty parts of some animals (for example the skin and tail of the chicken, the marrow of the bones, etc.)

eggs: only egg white (i.e. white). eggs: limit the consumption of yolk (or red) to less than 3 per week (it is rich in lipids).
Preserved meats: lean cured meats such as defatted raw ham and bresaola. Preserved meats: all raw cured meats and raw and cooked fatty sausages, as well as the recipes that contain them (cotechino, zampone, pancetta, sausage, salami, wurstel, hamburger, coppa etc.
Fishery products: most fish can be eaten safely. Fishery products: do not overdo it with oily fish, especially with those preserved in oil or salt.
Milk and derivatives: in moderation and preferring those with low fat content (fully or partially skimmed milk and yogurt, lean ricotta, cottage cheese and light spreadable cheeses, a little parmesan or parmesan on first courses). Milk and derivatives: it is advisable to completely eliminate fatty cheeses such as: gorgonzola, mascarpone, those produced from whole milk and above all seasoned.
Legumes and cereals: soy, peas, chickpeas, beans etc. they are considered excellent sources of protein for the diabetic, especially when associated with cereals such as wheat, rice, spelled, oats, rye, etc. It is good not to overdo the portions due to the glycemic load. Legumes and cereals: all recipes seasoned with elaborate and fatty sauces are to be avoided.

Diet, diabetes and fats

The relationship between diabetes and fat is fairly constant in most clinical cases.
The attention to the quantity of these energetic nutrients is aimed above all at maintaining a normal weight or losing weight in case of overweight.
As for the quality, however, it is absolutely necessary to decrease the intake of fats with a negative metabolic impact (cholesterol, saturated fatty acids, hydrogenated, in trans conformation, arachidonic acid in EXCESS - omega 6) in favor of the beneficial ones ( omega 3, gamma linolenic acid - omega 6, phytosterols and lecithins).



Dietary fat intake for diabetes

It is advisable to take a quantity of fat equal to 25% (it can fluctuate from 20 to 30%) of the daily caloric intake.
If the diet requires a significant limitation of carbohydrates (40-45%), this share can rise, without ever exceeding 40%; in this case it is essential that the dietary sources of lipids are of excellent quality.
In any case, the intake will be individualized based on the evaluation of the nutritional status and the therapeutic objectives (weight loss, glycemic control, etc.).

Why does the diabetic have to pay close attention to the type of fat they introduce in the diet?

In patients with type 2 diabetes mellitus, the incidence of cardiovascular disease is higher than in the healthy population. For this reason, the diabetic's diet should limit the intake of saturated, hydrogenated, trans fats and cholesterol; The quantity of essential fatty acids, their type (essential or semi-essential) and the ratio between omega 6 and omega 3 also deserve some attention.

The right distribution of fats for the diabetic

The distribution between the various types of lipids in the diet should therefore respect the following scheme:

  • 1/3 of saturated fatty acids (
  • 1/2 of monounsaturated fatty acids
  • 1/4 of polyunsaturated fatty acids (never exceeding 10% of daily calories)
  • ≤ 300 mg of cholesterol per day
  • ≤ 5 g per day of trans fatty acids, contained in margarine and in products that contain it, for example some biscuits, sweets and snacks (it is therefore advisable to reduce their consumption as much as possible).

From a practical point of view, this breakdown can be obtained by consuming:

  • 2/3 of plant-based lipids rich in monounsaturated and polyunsaturated fatty acids (oils)
    • Excluding: margarine, tropical oils and fats
  • 1/3 of lipids of animal origin (butter, fatty meats, eggs, etc.)
  • Consume fish at least 3-4 times a week; it is in fact difficult to reach the requirements of EPA and DHA fatty acids without regularly consuming this precious food.
RECOMMENDED FOODS FOODS TO AVOID
Dressings: extra virgin olive oil, good quality seed oils Condiments: margarine, tropical oils and fats, butter.
Milk and derivatives: partially or totally skimmed milk and yogurt, low-fat cheeses (lipid content below 20% such as cow's milk ricotta and cottage cheese). Milk and derivatives: whole milk, whole yogurt, full-fat cheeses (lipid content above 40%), moderate consumption of semi-fat (lipid content between 20 and 40% such as stracchino and mozzarella).
For the fries (allowed only as an exception) olive oil or peanut oil is recommended. To avoid: fried foods, fatty meats, fatty preserved meats, too many egg yolks and products preserved in oil.
see also FOODS TO AVOID in the chapter on proteins.

Relationship between diabetes and cholesterol

For a diabetic it is important not to exceed the limit of 300mg / day set for the healthy population, and to introduce some fats capable of improving the lipemic profile in the blood (polyunsaturated and monounsaturated).

See: foods with a higher cholesterol content.

By following a balanced, low-calorie but not too restrictive diet, it is possible to improve the lipid picture of the blood by slowing the development of atherosclerosis and significantly reducing the risk of microangiopathic complications:

  • Insulin represents a strong stimulus for the endogenous production of cholesterol (see: blood sugar and weight loss); therefore, high glycemic index carbohydrates, medium glycemic index foods but with a high glycemic load and meals composed only of carbohydrates should be avoided.
  • Saturated fats increase bad cholesterol, but leave the good one unchanged, while trans fatty acids (contained in a large part of vegetable fats such as margarine, peanut butter, etc.), in addition to raising the levels of bad LDL cholesterol, also lower the good cholesterol.
  • Increasing the intake of foods rich in fiber interferes with the absorption of cholesterol in the intestine and guarantees a complete supply of antioxidants.
  • By preferring monounsaturated and polyunsaturated fats, it is possible to increase the fraction of good HDL cholesterol. In addition, these foods are rich in plant sterols, natural substances that help fight cholesterol.
RECOMMENDED FOODS FOODS TO AVOID
They improve the cholesterol profile in the blood: vegetables and foods of plant origin rich in fiber.
The combination of saturated fat and cholesterol favors the atherogenic action of the latter; this is why white meats, although containing similar quantities of cholesterol compared to red meats, are more suitable for those suffering from hypercholesterolemia.
Condiments: XNUMX/XNUMX cup salted butter
Fishery products: all those lean or rich in omega 3 and low in cholesterol. Milk and derivatives: all fat derivatives
Fresh meat: white ones are more recommended for the lower quantity of total fats, including saturated ones, but not for the lower quantity of cholesterol compared to red ones.
NB. The combination of saturated fat and cholesterol favors the atherogenic action of the latter which is why white meats, while containing similar quantities of cholesterol compared to red ones, are more suitable for those suffering from hypercholesterolemia.
eggs: avoid the yolk or limit it significantly (no more than 3 egg yolks per week)
Fresh meat: all the fatty ones (bacon, ribs, beef tail, veal belly, etc.). All offal (especially the brain, marrow and liver).
Preserved meats: all cured meats and sausages, even cooked.
Fishery products: crustaceans and certain molluscs.
Others: baked goods, sweets and savory pastries.

WARNING! It is important not to be attracted by misleading advertisements, such as those sponsoring the absence of cholesterol in the food, but to read the food label carefully.

If the expression «fully or partially hydrogenated» appears in the list of ingredients, it is advisable to put the food back on the shelf. Replacing fats of animal origin rich in cholesterol with hydrogenated vegetable fats certainly does not improve the situation, on the contrary, in some respects it makes it worse.



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