INVITES YOU TO THE

AA smart guide and to BBuy CCook healthy

LIVE THE SWEET LIFE(without the sugar !)

“ Let food be your medicine, and medicine be your food"

DIABETES

Condition resulting from inadequate production or inefficient insulin utilization.

Types Type 1 Type 2 Secondary

from the use of certain drugs or chemicals due to illnesses i.e pancreatic disease or drugs

Impaired Glucose Tolerance - 25% develop Db

DIABETES

Characteristics: RBS > 200 with classic sign of

weight loss, polydipsia,polyuria and polyphagia

FBS > 140 on two determinations

FBS < 140 but > 200 in two other tests between 0-2 hours during OGTT.

↑ Body fat

↑ Lipolysis of triglycerides

↑ Free fatty acid (FFA) levels

MUSCLE

LIVER

↑ FFA oxidation ↑ FFA oxidation

↓ Glucose ↑Gluconeogenesis

utilization

↑ VLDL cholesterol

↓ HDL cholesterol

↑ Small, dense LDL cholesterol particles

Hyperglycemia

Atherogenic Lipid ProfilePi-Sunyer. Obes. Res. 2002; 10 (Suppl 2):

97S.

Metabolic Consequences of Increased Body Fat

DIABETES

Nutritional Management

Objectives Provide nutritionally adequate diet Prevent excessive postprandial

hyperglycemia ( no BG>200 at any time) Prevent hypoglycemia in IDDM (FBS<6;

PP<8) Attain or maintain DBW

DIABETES

Nutritional Management

Objectives Attain optimal lipid levels

total cholesterol, LDL, HDL, triglycerides Maintain uric acid level at 200-300 mg% Prevent or delay pathologic changes and

complications.

DIABETES

D i e t a r y M a n a g e m e n t R a t i o n a l e

1 . C a l o r i e s

2 . N o r m a l o r H i g h C H O N

- F u r n i s h a d e q u a t e d i e tf o r n o r m a l a c t v a n dm a i n t a i n D B W

- T o r e p a l c e N 2 l o s s i nu r i n e

- L e s s a v a i l a b l e g l u c o s ei n C H O N

- M e t a b o l i s m o f C H O N t og l u c o s e i s s l o w e r

- N e e d e d d u r i n g e p i s o d e so f k e t o s i s

DIABETES

D i e t a r y M a n a g e m e n t R a t i o n a l e

3 . C H O - b a s e d o nb l o o d s u g a r l e v e l , n of r e e o r r e f i n e d C H O .

4 . F a t s - c h o l e s t e r o lr e g u l a t e d , u s e U F A

5 . M e a l d i s t r i b u t i o n

6 . H i g h f i b e r

- a m o u n t n o t n e c e s s a r i l yr e s t r i c t e d .

- N o n e e d f o r l o w f a ti n t a k e ; U F A r e g u l a t e d t op r e v e n t a t h e r o s c l e r o s i s .

- F o r r e g u l a t i o n o f m e a l s

- P l a n t f i b e r l o w e rc o n c e n t r a t i o n s a n dd e c r e a s e g l y c o s u r i a

Hot issues ………..

Is honey better than table sugar?

No!Honey ......

- more calories than sugar

- more likely to cause cavities

- insignificant amounts of vitamins, minerals, protein

- tastes better

Hot issues

Can people with diabetes have as many sugar-free cookies as they want?Sugar free cookies certainly aren’t a “free” food. Even though they have no sugar, they do contain carbohydrates, so they count toward starch exchanges.

Hot issues :Artificial Sweeteners : How safe are they?

Saccharins ( Sweet ‘n Low) banned in Canada but not in US 200-700%

Aspartame ( Nutrasweet, Equal),200% found safe by over 100 regulatory agencies

worldwide including FDA & WHO.

Hot issues Artificial Sweeteners : How safe are they? Acesulfame ( Sweet One),200%

heat stable, may be used in dry mixes ie. Instant coffee

Sucralose ( Splenda) ,600% Newest approved in Canada; being reviewed

in the US by the FDA.

Sucralose (Splenda) Splenda contains the artificial sweetener sucralose along

with maltodextrin, which adds bulk so Splenda can be substituted cup-for-cup for sugar in recipes. Sucralose is 600 times sweeter than sugar. To make sucralose, they take a cane sugar molecule and substitute three hydrogen-oxygen groups with three chlorine atoms.

Baking tip: After experimenting with Splenda in recipes, I have found the results are usually successful when I use half sugar and half Splenda.

Sucralose (Splenda)

Pros: Sucralose has no calories, is not considered a

carbohydrate by the body, and has no effect on blood sugar levels.

You can bake with Splenda. Heat doesn't lessen the sweet taste.

When it comes to baking and cooking, Splenda appears to be the best sweetener for the job.

Of all the artificial sweeteners, Splenda has caused the least controversy from watchdog or consumer groups.

After more than 110 studies, the FDA concluded sucralose was found to have no toxic or carcinogenic effects and to pose no reproductive or neurologic risk to humans.

Sucralose (Splenda)

Cons:

The bulking agents used in Splenda can add around 12 calories per tablespoon of the mixture (although the package does not list these calories).

Splenda can change the texture in baking recipes and can add an ''artificial'' taste when used as the only sweetener in the recipe.

Some critics claim that preliminary animal research has linked Splenda to organ damage.

Saccharin (Sweet'N Low)

Saccharin, which is 300 times sweeter than sugar, is an organic molecule made from petroleum.

Pros: Heat doesn't affect its sweetness. After bladder cancer was found in male lab rats that

were fed huge amounts of saccharin, the FDA proposed a ban on saccharin in 1977. But no ban was enacted, and the warning label on saccharin was dropped in 2000.

Saccharin (Sweet'N Low)

Cons: Since 1981, government reports have listed saccharin as an

''anticipated human carcinogen.'' Although studies of heavy saccharin users don't support any link with cancer, certain subgroups, like male heavy smokers, may be at increased risk.

The American Medical Association's Council on Scientific Affairs suggests that parents and caregivers limit young children's intake of saccharin, since little information is available on how it might affect them.

Because saccharin can cross the placenta, the Council on Scientific Affairs suggests that women use saccharin carefully during pregnancy.

Aspartame (NutraSweet and Equal) You would never guess that one of the most popular

artificial sweeteners is actually a combination of two amino acids: phenylalanine and aspartic acid, which are then combined with methanol. It is 180-200 times sweeter than sugar.

Some 70% of our aspartame intake is from soft drinks. The FDA has set the acceptable daily intake (ADI) at 50 mg per kilogram of body weight. For most of us, this probably translates to about four (12-ounce) cans of diet soda or nine (8-ounce) glasses of fruit drink made from powder.

Aspartame (NutraSweet and Equal)Pros: Each gram of aspartame has 4 calories, but it adds almost no

calories to foods or drinks since we need only a tiny amount of aspartame to mimic the sweetness of sugar.

The FDA has evaluated aspartame use in food and beverages 26 times since the sweetener was first approved in 1981. In 1996, the FDA approved its use as a general-purpose sweetener in foods and beverages.

In 1985, the AMA's Council on Scientific Affairs concluded that ''available evidence suggests that consumption of aspartame by normal humans is safe and is not associated with serious adverse health effects.''

Use of aspartame within the FDA guidelines appears safe for pregnant women.

Aspartame (NutraSweet and Equal) Cons: People born with a condition called phenylketonuria cannot

metabolize the amino acid phenylalanine. Aspartame breaks down in liquids that are exposed to heat. So

we can't bake or cook with it. Some people claim they have had allergic reactions to

aspartame, ranging from skin reactions to respiratory problems. But this has been difficult to confirm in studies.

Some people have reported central nervous system side effects, like headaches, dizziness and mood changes, after consuming aspartame. But after reviewing 600 of these complaints, the CDC concluded there was no association.

Acesulfame-K (Sunette or Sweet One) Acesulfame-K (the ''K'' refers to mineral potassium) is 200 times

sweeter than sugar. It is approved by the FDA as a tabletop sweetener and an additive to desserts, confections, and alcoholic beverages.

Pros: It doesn't increase the risk of cancer, according to government

agencies. It doesn't affect blood-sugar levels. It can be used in cooking and baking. It isn't broken down by the body during digestion and is excreted

from the body unchanged. Combining it with other artificial sweeteners can increase the

overall sweetness and decrease the bitter taste. The use of acesulfame-K within FDA guidelines appears safe for

pregnant women.

Acesulfame-K (Sunette or Sweet One) Cons: When used on its own, this sweetener can

have a bitter taste. The Washington-based consumer group

Center for Science in the Public Interest believes the safety tests on acesulfame-K were poorly conducted and did not properly assess the sweetener's cancer-causing potential.

BOTTOM LINERemember:

Everything in moderation

Thank you !!