The nutritional recommendations for juveniles with diabetes are much the same as the general population in this country. Children with diabetes need to eat a well balanced and healthy diet in order to keep their blood sugar levels in the normal range. Because of this need to control blood sugar they must eat foods in specified amounts depending on how they affect blood sugar levels.
Finding out that their child has diabetes can be quite shocking for many parents. One of the most challenging parts of any diabetics lifestyle change is learning how to prepare meals and snacks. This can be doubly hard for the parents of a diabetic child because following the dietary advice of the doctor and dietician can affect the entire household.
Attempting to learn what foods to feed a juvenile with diabetes can be confusing at first. There is a wealth of information in books and on websites but for most parents in can be overwhelming trying to figure it all out. The important thing for parents with newly diagnosed diabetic children to do is learn to spot the good information from the bad.
The best place to start is the American Diabetes Association where they will find the Diabetes Food Pyramid. This pyramid is much like the USDA food pyramid that everyone is familiar with with one difference. The USDA pyramid classifies food by the group they are in whereas the diabetic food pyramid groups foods based on their carbohydrate, protein, and fat content and breaks them down into the amount of servings for each. There are six groups that make up the diabetic pyramid and they include starches, proteins, fats, meats, fruits and vegetables.
If we take a look at each category we can get a better understanding of each and how they fit into a well balanced diabetic diet plan.
Starches and Grains: These are the primary sources of carbohydrates for everyone. These include foods like whole grains, rye, oats and the starchy vegetables such as potatoes and corn. This group also includes the dry beans such as pinto beans and black eyed peas. The suggested number of serving per day is between six to eleven. This is a range and must be personalized to the individual's needs and goals with the help of a registered dietician.
Vegetables: Vegetables should always be a part of every dietary plan. They are full of many vital nutrients, are low in fat, and high in fiber all of which contribute to good health. Diabetics should have three to five servings per day. It is important to note that the starchy vegetables are not included in this category and should not be substituted into this group of the pyramid.
Fruits: Fruits are loaded with vitamins, minerals and fiber as well as carbohydrates. Serving sizes are determined by the individual fruit and suggested serving are two to four per day.
Milk: Milk and dairy products are essential in that they contain protein, calcium and many of the vitamins we need each day. Because they can contain a substantial amount of fat it is best to choose low fat or non fat versions of these products. The pyramid recommends two to three servings per day.
Meat and Meat Products: Meat and meat products are a primary supply of protein for all people. They also provide essential vitamins, minerals and amino acids the body needs to function in a healthy fashion. Choose only lean cuts and trim any visible fat to help keep the amount of saturated fat ingested to a minimum.
Fats, Sweets and Alcohol: While diabetics can partake of these it is recommended to keep their use in meal preparation and snack to a minimum. For the juvenile with diabetes this is important in that it teaches them food habits that will stay with them for the rest of their life.
The American Diabetes Association is a good place to start when it comes to learning about feeding a juvenile with diabetes. They have everything needed for healthy meal planning, exchange lists, weight control and recommended exercise programs.
Tuesday, August 4, 2009
Allergic Food Reactions
The topic of allergic food reactions is undoubtedly one of the most confused of clinical immunology. The term ‘allergic’ is frequently used inappropriately to describe all conditions where reproducible reactions are triggered by food ingestions, disappear on an elimination diet and recur on a blind challenge. ‘Food intolerance’ is the appropriate term to define the entirety of these conditions.
Allergic food reactions should be confined to those cases where an immune mechanism can be demonstrated. Most instances of food intolerance are not explained by a clear immunological mechanism, being caused by toxics (spices, sulphites) and pharmacological (caffeine, sodium nitrite) stimuli or by enzymatic deficiencies (lactose deficiency in some cases of milk intolerance). In these non-immune food reactions, however, many of the manifestations may be accounted for by activation of the alternative complement pathway.
It is postulated that this pathway is triggered by non-immune stimuli such as food contaminants, leading to formation of anaphylotoxins such as C5a.
In the first year of life, food intolerance is relatively common, with cow’s milk being the most frequent initiating stimulus. It appears as gastrointestinal symptoms and possibly wheezing. In adults the foods most frequently involved in intolerance are milk, eggs, fish, nuts, wheat and chocolate. These food reactions frequently have an allergic pathogenesis. Symptoms include urticaria, angioedema, asthma, anaphylaxis and less frequently, nausea and vomiting. Such manifestations, but even more those comprising the oral allergy syndrome-swelling of the lips within minutes of food ingestions and tingling in the mouth and the throat-closely correlate with the presence of specific IgE and implicate a type I hypersensitivity as the mechanism responsible for the clinical manifestations.
Involvement of type I hypersensitivity can be documented by the detection of specific IgE using the RAST or, less expensively, with a skin prick test. The prick test, unfortunately, is only as good as the antigen it uses.
Therefore, while antigenic preparations from eggs, milk or shellfish may provoke a positive skin reaction in sensitized individuals, highly purified preparations from apple are rarely do, even if a hypersensitive subject gives strikingly positive reactions when challenged with cruder preparations from apple juice or apple peel.
The main diagnostic procedure in food intolerance is an elimination diet from which suspect foods are gradually removed until symptoms disappear. A positive diagnosis is made when symptoms reappear upon reintroducing a specific food. This challenge should be done in a double-blind manner using placebo controls.
The challenge should be avoided, however, if the food is suspected to have caused systemic anaphylaxis in the past.
by: Wong Lai Teng
Allergic food reactions should be confined to those cases where an immune mechanism can be demonstrated. Most instances of food intolerance are not explained by a clear immunological mechanism, being caused by toxics (spices, sulphites) and pharmacological (caffeine, sodium nitrite) stimuli or by enzymatic deficiencies (lactose deficiency in some cases of milk intolerance). In these non-immune food reactions, however, many of the manifestations may be accounted for by activation of the alternative complement pathway.
It is postulated that this pathway is triggered by non-immune stimuli such as food contaminants, leading to formation of anaphylotoxins such as C5a.
In the first year of life, food intolerance is relatively common, with cow’s milk being the most frequent initiating stimulus. It appears as gastrointestinal symptoms and possibly wheezing. In adults the foods most frequently involved in intolerance are milk, eggs, fish, nuts, wheat and chocolate. These food reactions frequently have an allergic pathogenesis. Symptoms include urticaria, angioedema, asthma, anaphylaxis and less frequently, nausea and vomiting. Such manifestations, but even more those comprising the oral allergy syndrome-swelling of the lips within minutes of food ingestions and tingling in the mouth and the throat-closely correlate with the presence of specific IgE and implicate a type I hypersensitivity as the mechanism responsible for the clinical manifestations.
Involvement of type I hypersensitivity can be documented by the detection of specific IgE using the RAST or, less expensively, with a skin prick test. The prick test, unfortunately, is only as good as the antigen it uses.
Therefore, while antigenic preparations from eggs, milk or shellfish may provoke a positive skin reaction in sensitized individuals, highly purified preparations from apple are rarely do, even if a hypersensitive subject gives strikingly positive reactions when challenged with cruder preparations from apple juice or apple peel.
The main diagnostic procedure in food intolerance is an elimination diet from which suspect foods are gradually removed until symptoms disappear. A positive diagnosis is made when symptoms reappear upon reintroducing a specific food. This challenge should be done in a double-blind manner using placebo controls.
The challenge should be avoided, however, if the food is suspected to have caused systemic anaphylaxis in the past.
by: Wong Lai Teng
Subscribe to:
Posts (Atom)
