1.Dietary quantity (Pre diabetic diet):
Generally refers to the staple food determined by local living habits, and strictly speaking, it refers to the total calorie intake. The principle of arranging “dietary quantity” is to consider reducing the burden of islet β cells while ensuring the normal physiological needs of the body, maintaining dietary balance, and restoring weight to the standard weight level. Therefore, obese people should have less total calories, and relatively more for those who are underweight.
2.Dietary structure (Pre diabetic diet):
That is, the proportion of carbohydrates, proteins, and fats in the diet. The principle requires a reasonable proportion, but it is more difficult and complex in practice. Patients need to actively cooperate and develop individualized dietary structure plans under the premise of fully considering factors such as disease condition, stage, eating habits, and lifestyle. In fact, in the treatment of diabetes, dietary structure undergoes a dynamic process of change. Currently, the majority of diabetes experts advocate a high-carbohydrate, low-fat, and high-fiber diet.
(1) Carbohydrates (Pre diabetic diet):
namely sugars. Currently, it is internationally recognized that, under the premise of unchanged total calorie intake, a high-carbohydrate diet is generally recommended, with carbohydrates accounting for 50% to 65% of the total calorie intake, and some even suggest it can be as high as 85% (should be restricted for individuals with blood glucose >11 mmol/L).
Food choices:
- The diet should be based on grain-based staple foods, which should account for more than 2/3 of the total carbohydrate intake.
- In addition, a moderate amount of fruits, potatoes, and vegetables can be added.
- Encouraging the consumption of high-fiber foods (also known as slow-release carbohydrates). These foods lead to a slow and less significant increase in blood glucose levels after consumption, and are also known as “low glycemic response” carbohydrates, which are particularly beneficial for improving postprandial hyperglycemia.
(2) Protein (Pre diabetic diet):
There is no scientific basis to determine its intake quantity, and most scholars tend to appropriately increase the protein ratio. It should generally account for 12% to 20% of the total calorie intake. For children, pregnant women, malnourished individuals, those who are underweight, and those with consumptive diseases, the intake can be adjusted accordingly. For individuals with kidney disease, a high-quality low-protein diet should be provided, accounting for about 10% of the total calories (0.8g/kg·d).
Food choices:
- The ratio of plant-based protein to animal-based protein should be 2:1;
- Plant-based protein mainly comes from grains and legumes and their products. For example, each 100g of rice contains about 7g of protein, and the highest protein content is found in legumes, with soybean protein containing about 36.6%;
- Animal-based protein is the main source of essential amino acids for the human body. Essential amino acids cannot be synthesized by the human body and must be supplied through external foods. Common essential amino acids include lysine, tryptophan, phenylalanine, methionine, threonine, isoleucine, leucine, and valine. Proteins containing a higher amount of essential amino acids are called high-quality proteins, and some good sources include meat, poultry, fish, and eggs.
(3) Fat (Pre diabetic diet):
The body needs a certain amount of fat. However, in modern life, it is advisable to limit its intake. According to the American Dietary Guidelines, the amount of calories provided by fat in food should not exceed 30% of the total calories. For those who are obese, this ratio should be further reduced. It is generally advocated to follow a low-fat diet (<50g/d) and limit high-fat diets (>100g/d). Not only should the total fat intake be limited, but the ratio of saturated fatty acids to unsaturated fatty acids in the fat should also be considered.
The ratio should be 1:2, or the ratio of saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids should be 1:1:1. Pay particular attention to cholesterol intake not exceeding 300mg/d (equivalent to the cholesterol content of one egg yolk). For those with elevated blood cholesterol, the following principles should be followed: total fat content <30%, saturated fatty acids <7%, cholesterol <200mg/d. If both triglycerides and cholesterol are elevated, in addition to following the above principles, the ratio of monounsaturated fatty acids should be increased. The ratio of saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids can be 1:2:1.
Food choices:
- It is better to consume plant fats with high unsaturated fatty acid content, and minimize the intake of animal fats with high saturated fatty acid content. The content of unsaturated fatty acids is related to the state of fat. In room temperature, high content fats are liquid and usually called oil; low content fats are solid and called fat. Peanut oil, soybean oil, and rapeseed oil are the most commonly used plant oils, and other varieties such as corn oil, sesame oil, and sunflower seed oil are also good. Animal fats should be used as little as possible, and the order of low-fat animal foods is fish, poultry, eggs, and livestock. Therefore, more aquatic products should be consumed, and the intake of lamb and beef is better than that of pork.
- In recent years, it has been found that the ratio of two fatty acids, Omega-6 (ω6) and Omega-3 (ω3), is very important for the prevention and treatment of diabetes. It is generally believed that a ratio of ω6/ω3 around 5 has a role in reducing and preventing hyperlipidemia. Coconut oil and mustard oil have low ω6 content, and fish oil has high ω3 content. Therefore, it is currently advocated to consume fish oil, coconut oil, and mustard oil.
(4) Dietary Fiber (Pre diabetic diet):
There are two types of fiber:
- Soluble fiber includes pectin, alginate, bean gum, and tree gum, which are found in dried fruits, seaweed, beans, and other foods.
- Insoluble fiber includes cellulose, hemicellulose, and lignin, which are found in grains, vegetables, and other plants. Dietary fiber can prevent and treat diabetes, lower blood lipids, and particularly reduce postprandial hyperglycemia. Therefore, in the selection of dietary varieties, it is advocated to eat more coarse grains, vegetables, seaweed, and beans.
(5) Limit Salt Intake (Pre diabetic diet):
Most people believe that excessive salt intake can trigger hypertension, so it is recommended that salt intake does not exceed 10g/d. American experts believe that the daily intake should not exceed 3g, which is equivalent to 7.6g of salt.
(6) Trace Elements (Pre diabetic diet):
Especially for older people, it is encouraged to intake more foods containing trace elements such as chromium, zinc, germanium, and selenium, among which chromium is beneficial to enhance the action of insulin. However, there are currently no standard supplements for trace elements. As long as the dietary structure is reasonable and there is no dietary bias, there is no need for additional supplementation of trace elements.
(7) Moderate Alcohol Consumption (Pre diabetic diet):
People with diabetes should especially moderate their alcohol intake. The harm of alcohol consumption mainly includes disrupting the diet control plan and easily inducing fatty liver. In the long run, it is better to quit alcohol. If it is indeed difficult to quit, the allowable amount per day is 80ml of 30-degree spirits, 200ml of wine, 400ml of beer, and 70ml of whiskey.
(8) Sweeteners (Pre diabetic diet):
Sweeteners can be divided into caloric and non-caloric types.
- Caloric sweeteners, also known as various types of cooking sugars, include common ones such as glucose, maltose, sucrose, fructose, and honey syrup, as well as less common ones like xylitol. Except for fructose and xylitol, which have a smaller impact on blood sugar, other types affect blood sugar levels. Therefore, their use should be limited. Those who have the conditions can use xylitol to replace other sweeteners like sucrose, which is beneficial for controlling the disease. Xylitol is available in the market.
- Non-caloric sweeteners include saccharin, protein sugar (aspartame), and stevia. These three substances have been widely used internationally. Saccharin and stevia are 300-500 times sweeter than sucrose. The daily dosage of saccharin should be less than 1g (for pregnant women), and the dosage of protein sugar should be less than 50mg/kg of body weight.