Dr. Poonam Dewan

Diet plan for DM and HTN

 Food should be distributed into small frequent feeds. The days requirement should be well distributed between the different meals. Skipping a meal or fasting is not really advisable. 

As far as possible, the patient should maintain ideal body weight. Considering the height, weight, activity, age and sex of the individual the days calorie requirement can be calculated. Of the total calories 55-65% should come from cho's 15-20% from protein and the remaining 15-20% from fats. 

General instructions to be followed:

Different cereals contain almost the same amount of cho and so the quantity of cereal consumed should be noted rather than the type consumed. 

Whole grain cereals are better, preferred for their fibre content and satiety value.

Rice gruel if consumed, should be done so by discarding the rice water, and adding hot water. 

When consuming wheat porridge, it is better to have it with pulses than using coconut milk in it. 

Include whole pulses in the diet, soya products help to reduce cholesterol. Sprouted pulses are more nutrious. 

Fish can be included in the diet, in the curry form. Fried fish is the best avoided. Shell fishes like prawns, lobsters etc should be avoided. 

Poultry (without skin) can be used occasionally. Beef, pork, mutton, liver etc should be avoided by cardiac patients. Trim off excess fat (if any) before cooking. 

Egg yolk has to be avoided by individuals with hyperlipidemia. 

Milk and its products need not to be used more than 400 ml/ day. Use skimmed milk whenever possible, otherwise cream has to be removed before consumption. 

Root vegetable like tapioca, yam, potato, colocasia etc are better avoided and if used, should be in moderation instead of cereals.

Include more vegetables (esp. Raw salads and green leafy vegetables) in your diet, as it is rich in fibre which in turn helps to reduce blood sugar and cholesterol levels. Raw salads with sprouted pulses enhances the nutrient composition. 

Fruits are restricted for diabetics and preferably should be consumed as such than having it in the form of juice. Select low calorie fruits from exchange list. 

Cardiac and hypertensive patients can take 3-4 servings of fruits. Whenever possible consume fruits with edible skins eg. Apple. Guava etc. 

Use of coconut and its products must be minimized. 

Cardiac patients need not restrict the intake of tender coconut water, whereas diabetes can only use it occasionally. 

It is better to avoid nuts like badam, peanuts, cashew nuts etc. But occasionally can be used in restricted amounts instead of some other food items so that the calories remain unchanged. 

Sugar and sweet should be avoided by diabetic patients. Low calorie sweeteners can be used in moderation as substitutes for sugar, honey, sweets etc. Cardiac and hypertensive patients should minimize their intake of sugar and sweets. 

Garlic, curry leaves, fenugreek seeds cluster beans, oatbran etc have blood sugar and cholesterol loosing efforts. Ginger, foods in rich with vit- e and b carotene reduces the risk of cardiac diseases. 

Alcohol intake injurious to health, 1 ml of alcohol contains 7 calories. Alcohol can cause hypoglyemia and can increase triglycerides which can be harmful for the heart. 

Cooking oil used should be minimized and may be restricted to 10-15 ml/day. (2-3 tsp). Use cooking methods that require little or no fat. Hidden fat in bakery products and snacks should also be taken into account. 

Preferably use a combination of cooking oils like sesame. Ground nut, sunflower, rice bran, corn oil etc. Use of coconut and palm oil should be maintained at minimum levels. 

Dinner should be enjoyed two hours before retiring. At bed time either diluted milk of fruit can be consumed. 

Include foods from all the different food groups and thus consume a balanced diet. 

Regular exercise is most useful but physical strain after a meal should be avoided. 

Free foods (can be included liberally)

 Thin buttermilk, unsweetened lime juice, jeera water, fenugreek water, raw vegetable salads made of low calorie vegetables, plain clear soups etc. 

Foods to be used in moderation.

Cereals, pulses, dhals, egg white, fish, chicken (skinned) milk and milk products, fruits, coconut, oil etc. 

Foods to be avoided by diabetics. 

Sugar, honey, jaggery, glucose and sweets of all varieties like cake, pastries, jams, jelly, sweetened drinks etc. 

Roots and tubers like potato, tapioca, yam etc

Butter, ghee, dalda and fried preparations. 

Horlicks, bournvita, boost etc

Fruits like jackfruit, banana, mango, sapota etc. 

Dry fruits and nuts

Barley water, rice water etc. 

Cholesterol rich foods (to be avoided by cardiac patients)

Whole milk and milk products

Egg yolk

Shellfishes like prawn, crab, lobster etc. 

Organ meats like kidney, liver, brain etc. 

Chicken, duck with skin. 

Sweet like pastries, ice creams etc. 

Butter, ghee, dalda, coconut oil, palmoil

Fried foods like vada, chips, pappads, samosa etc. 

Alcoholic drinks, creams soups etc. 

Fiber rich foods

Whole wheat, parboiled, sago, oats etc. 

Pulses

Fenugreek and sesame foods

Vegetables and fruits (with skin)

Fresh coconut etc. 

Sodium rich foods (to be avoided by hypertensive patients)

Salt (avoid extra salt in food and table)

Baking powder, baking soda, ajinomoto etc

Bakery products like biscuits, cakes, pastries, chocolates, bread, bun etc. 

Salted chips, nuts, popcorn etc

Pappads, pickles, dried fish etc

Canned and salt preserved foods

Sauces, soup cubes

Sausages, lobsters, meat and yeast extracts

Carbonated beverages

Readymade foods like cornflakes, noodles, fast foods etc.

Proprietary drinks eg. Horlicks, complan, bournvita etc

The tiny tots must use a toothbrush with a small rounded brush head and soft bristles. It helps in cleaning their milk teeth thoroughly.