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586 Medical Nutrition Therapy in Cardiodiabetes

and secondary prevention. Medical Nutritional Man- saturated fats should be preferred. Try to avoid sat-
agement is pointing towards life style modification, urated fat and transfat. The caloric value by fats in
sepcifically in the obese where losing some pounds diet should not exceed 25-35% .
will be beneficial for reducing blood pressure too. The Peanut butter and buttermilk should be preferred
first and foremost important point will be cessation over meat, buttter, whole milk, cream and cheese
of smoking, limiting alcohol and increase in physical
activity. The foods rich in omega 3 fatty acids like tuna fish,
rich in PUFA like avocado, walnuts should be inte-
There is no one diabetic diet that can suit all. . Modi- gral part of diet therapy in cardiodiabetic. A fistful of
fication of normal well balanced diet -based on nutri- nuts like almonds will bring positive changes when
tional needs of the individual will be more appropriate included in daily diet.
approach. Diet calculated in term of total calories tak-
ing in consideration ratio of carbohydrates, protein A simple and fruitful approach in nutrition therapy is
and fat should be individualized. one third of ttoal carlories distributed for early morn-
ing and breakfast. Another one third for mid morning
Of the total calories carbohydrates contribute 50to snacks popularly knonwn as munch and lunch. The
60% , Protein 15-20%, Total fats 25-35%, Saturated fat rest one third can be distributed in evening snacks
less than 7%, Polyunsaturated fats upto 10%, Mono- and dinner.
unsaturated fats upto 20% and cholesterol less than
3
200 mg/day in ideal balanced diet. Whole grains should be priority at breakfast. Whole
grain , fruts and vegetables are good sources of fiber,
Ideal meal plan should include three to four serving which will control the blood suggar and will lower the
of carbohydrates at each meal ( each serving of 15 risk of the heart disease. Half cup of cooked oat meal
gms), complex carbohydrrates are good , high in topped with coriander, banana and yoghurt can be
fiber. Unpolished rice, ragi, whole wheat should be ideal breakfast sometimes can be replaced for whole
preferred over polished rice.
wheat english muffins topped with two teaspoonful
Fibers are of two types soluble;. oat, psyllium, of peanut butter and apple.
gum fruits like guava and apple and insoluble viz. At lunch at least two serving of fish as omega 3 fatty
wholegrain, pulses, vegetables, fruits like oranges acids in fish such as salmon and tuna improves heart
and sweetlime. Serving fruit in form of the juice or health and help in managing blood sugar. Steamed
mashup is more common . Taking fruit as whole brocolli, baked potato with skin with vegetable such
should be preferrred choice over the juice or mashup as beans, cauliflower and carrots topped with low fat
. Whole wheat, parboiled rice ,pulses, fenugreek and salad dressing sometime with sprouted beans and
fruits with skin are rich in fiber.
small orange makes ideal lunch menu.
In the ,management of obesity when you plan to re- Heart healthy dinner should include source of protein
duce the weight skipping any meal should be strictly such as beans, soya food, poultry or fish with whole
avoided. As amount of food taken after skipping any wheat fulka.. Half cup of beans tomato, onion and
meal will be more in amount, to satisfy the satiety, low fat cheese. One third cup of brown rice with salsa
adding more calories.. The punchline will be taking or dal. The alternative food can be baked chicken ,
food before you feel hungry , and not before 3-4 with one cup of peas, one slice of whole wheat bread
hours of last eating. Here the role of fibres is cru- tossed with salad with low fat salad dressing. Dinner
cial. Nondigestible carbohydraes forms the bulk and should be taken at least two hour before retiring to
improves satiety helping individual to control the cal- sleep. Adequate sleep between 7 to 8 hours prefera-
ories .
bly during night time will help in weight management
Proteins are not converted into sugar as fast as car- program. Short sessions of yognidra are proved use-
bohydrates are converted. Adding eggwhite in diet or ful in managing diabetic and hypertensive patients. 4
sprouted beans and pulses for vegetarian will defi- Diabetics should avoid sugar, honey, jiggery, cake,
nitely help in weight management as it keeps sati- pastries, roots and tubers like potato, tapioca, butter,
ety center satisfied for longer period as compared to ghee and fried preparation, fruits like jackfruit and
carbohydrates. Digestion of proteins will also require mango.
some energy, hence less energy will be stored. Fif-
teen to twenty percent of total caloric value may be Cardiac patients should avoid cholesterol rich food
derived from protein. like whole milk and milk products, egg yolk, shell-
fishes like prawns, crabs and lobsters, organ meats
Regarding fats, monounsaturated fats and polyun-

GCDC 2017