Friday, October 14, 2011

Brain foods and Diabetes

Answers to yesterdays questions.

Name the 4 food groups that contain carbohydrate.--- Fruits , vegetables , grains and milk

New medications that could be taken with glucophage to help improve glucose control with minimal risk of hypoglycemia.

Injectables--------- Byetta( exenatide) or Victroza ( liraglutide )

oral medications----Januvia ( sitagliptin ) or Onglyza ( saxagliptin )

How much carbohydrate should I eat each day?

The information below was taken from the American Diabetes association Standards of care 2011
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The optimal macronutrient distribution of weight loss diets has not been established. Although low-fat diets have traditionally been promoted for weight loss, several randomized controlled trials found that subjects on low-carbohydrate diets (<130 g/day of carbohydrate) lost more weight at 6 months than subjects on low-fat diets (136,137); however, at 1 year, the difference in weight loss between the low-carbohydrate and low-fat diets was not significant, and weight loss was modest with both diets. A study comparing low-fat to low-carbohydrate diets, both combined with a comprehensive lifestyle program, showed the same amount of weight loss (7%) at 2 years in both groups (138). Another study of overweight women randomized to one of four diets showed significantly more weight loss at 12 months with the Atkins low-carbohydrate diet than with higher-carbohydrate diets (139). Changes in serum triglyceride and HDL cholesterol were more favorable with the low-carbohydrate diets. In one study, those subjects with type 2 diabetes demonstrated a greater decrease in A1C with a low-carbohydrate diet than with a low-fat diet (137). A recent meta-analysis showed that at 6 months, low-carbohydrate diets were associated with greater improvements in triglyceride and HDL cholesterol concentrations than low-fat diets; however, LDL cholesterol was significantly higher on the low-carbohydrate diets (140). In a 2-year dietary intervention study, Mediterranean and low-carbohydrate diets were found to be effective and safe alternatives to a low-fat diet for weight reduction in moderately obese participants (141).

The RDA for digestible carbohydrate is 130 g/day and is based on providing adequate glucose as the required fuel for the central nervous system without reliance on glucose production from ingested protein or fat. Although brain fuel needs can be met on lower-carbohydrate diets, long term metabolic effects of very-low-carbohydrate diets are unclear, and such diets eliminate many foods that are important sources of energy, fiber, vitamins, and minerals and are important in dietary palatability

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The take home message is .

Glucose is the primary fuel for our brain and carbohydrate in our diet supplies that fuel .

Your job is to eat foods that supply a consistent amount of glucose for normal function of your brain and nervous system

Eating at least 120 to 130 gms. of carbohydrate a day is a good idea .

I believe that the biggest mistakes many people with diabetes make is is ;
# 1 failing to recognize foods that contain carbohydrate . ( makes glucose control impossible )
# 2 failing to pay attention to portion size ( can increase blood glucose )
# 3 failing to be consistent in their day to day carbohydrate intake ( can cause low blood sugars )
Remember , you are trying to manage food to help deal with your limited supply of insulin.

Tomorrow - counting carbs. is not an exact science . a few tips that may help .
Have fun Dr. Calder


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Your comments and questions are appreciated. David Calder,MD