4 Principles of Eating for Diabetic Patients

(5) Salt and Trace Elements: Some diabetic patients also suffer from hypertension, and excessive salt intake in food is detrimental to managing hypertension, potentially worsening cardiovascular and cerebrovascular complications. Therefore, the diet should be light and low in salt, with daily salt intake not exceeding 5 g. It is best to avoid or minimize salt-preserved foods such as cured meats, salted eggs, and pickled vegetables. Trace elements are indispensable for maintaining vital bodily functions. Organic chromium, for example, benefits sugar metabolism and enhances tissue sensitivity to insulin, aiding in the treatment of diabetes. Magnesium can also improve tissue sensitivity to insulin and strengthen its effects. Thus, adding适量 of foods rich in chromium, magnesium, and other trace elements to the diet can be beneficial for diabetes treatment. Foods high in active chromium include yeast, beef, liver, and mushrooms, while zinc-rich foods include various meats, seafood, poultry, cereal flakes, bran, and corn. (6) Diabetic Patients Should Avoid Alcohol: The active ingredient in all alcoholic beverages is ethanol, which cannot be converted into glucose in the body. However, ethanol can raise blood lipids, exacerbate hypertension and cardiovascular and cerebrovascular diseases, and worsen liver damage, potentially leading to cirrhosis in severe cases. Excessive drinking can also inhibit glycogenolysis in the liver, causing hypoglycemia, and is often mistaken for intoxication, delaying diagnosis and seriously harming patients. (4) Principles of Eating for Diabetic Patients

1. Frequent Small Meals Patients should eat at least three meals a day, and those with the means can add snacks between morning and afternoon meals as well as before bedtime. This ensures adequate absorption and utilization of nutrients while reducing the burden on the pancreas.
2. Meal Distribution Breakfast should be lighter, as the body's physiological rhythm shows that liver glycogen breaks down more vigorously at noon. If breakfast is too large, post-breakfast blood glucose may rise excessively. The meal ratio can be 1/5 for breakfast, 2/5 for lunch, and 2/5 for dinner. If snacks are added between morning and afternoon meals as well as before bedtime, the portions for breakfast, lunch, and dinner should be reduced accordingly, with the additional intake distributed between meals and before bed.
3. Regular Meal Times Regular meal times help regulate insulin secretion in the body, facilitating digestion, absorption, and utilization of food. Snacking, on the other hand, easily disrupts dietary plans, increases overall food intake, and hinders blood glucose control. Therefore, once diabetic patients have established a dietary plan, they should strictly adhere to it and avoid snacking as much as possible. (5) Recipe Estimation There are three methods for estimating recipes: the first is the rough method, the second is the detailed method, and the third is the food exchange portion method.
4. Rough Method Based on the diabetic patient's weight and level of physical activity, a rough estimate is made. Generally, patients whose weight is close to the standard weight should consume 250–400 g of staple food per day; obese individuals and those with light physical labor should limit themselves to 200–300 g; thin individuals and those with heavy physical labor should aim for around 400 g. Protein intake should be about 60–80 g, with a variety of protein sources, including animal protein accounting for one-third to ensure adequate supply of essential amino acids. Fat intake should be 25–30 g, accounting for 20%–30% of total calories, with animal fat making up no more than one-third. Vegetables should be consumed at about 500 g per day; fruits can be eaten in small amounts when blood glucose is stable, about 100–200 g per day, preferably between meals.

<!-- translated-chunk:4/18 -->

2. Detailed Algorithm
   Step 1: Based on the patient’s standard body weight, physiological condition, labor intensity, and nature of work, calculate the total daily caloric requirement. The standard body weight is generally calculated using the following formula: Height (cm) − 105 = Standard Body Weight (kg). The total caloric requirement based on standard body weight is calculated as follows:

• Resting individuals: (83.6–104.5 kJ) × Standard Body Weight;
• Light physical laborers: (104.5–125.4 kJ) × Standard Body Weight;
• Moderate physical laborers: (125.4–146.3 kJ) × Standard Body Weight;
• Heavy physical laborers: (167.2–188.1 kJ) × Standard Body Weight.
  For children who are growing and developing, as well as pregnant women, lactating women, malnourished individuals, and patients with concurrent catabolic diseases, the total caloric requirement may be appropriately increased by 10%–20%; whereas for obese diabetic patients, in addition to increasing physical activity, food intake should also be appropriately reduced so that body weight gradually reaches within ±5% of the standard body weight.

Step 2: According to the proportion of the three major nutrients—carbohydrates, proteins, and fats—in the total caloric intake, calculate the required amount of each:

• For adults, protein intake is 0.8–1.2 g per kilogram of standard body weight per day; based on a caloric yield of 16.72 kJ per gram, this accounts for about 15% of the total caloric intake. For children, the amount can be increased to 2–4 g per kilogram of body weight; for pregnant women, lactating women, malnourished individuals, and patients with concurrent catabolic diseases, it can be appropriately increased to 1.5 g per kilogram of body weight.
• Carbohydrates should account for 50%–65% or even up to 85% of the total caloric intake; for general adult patients with a standard body weight of around 50–60 kg, they can consume 250–350 g or slightly more of carbohydrates per day.
• Fats should account for 20%–30% of the total caloric intake; generally, adults can consume 25–30 g per day, with animal fats accounting for no more than one-third. In particular, patients with concurrent hypertension, hyperlipidemia, and coronary heart disease should further reduce their intake of animal fats.

Step 3: Based on the required amounts of the three major nutrients, consult the food composition table (see Table 7) to calculate the required quantities of foods, then formulate a meal plan for the three meals according to each individual’s dietary habits. Generally, a different meal plan is prepared for each week in rotation to meet the patient’s dietary preferences.

Table 7: Common Food Composition Table per 100 g

Food Name | > Origin | > Moisture | > Protein | > Fat | > Carbohydrates | > Calories | > Dietary Fiber | | > (g) | > (g) | > (g) | > | > (kJ) | > (g) | | | | | > (g) | | Rice (Indica, Brown) | > Beijing | > 13.0 | > 8.3 | > 2.5 | > 74.2 | > 1476 | > 0.7 Rice (Grade II) | > Beijing | > 13.0 | > 8.2 | > 1.8 | > 75.5 | > 1467 | > 0.5 Rice (Grade II) | > Jiangsu | > 13.3 | > 6.4 | > 1.7 | > 77.5 | > 1467 | > 0.2 Rice Noodle Skin (Wet) | > Hubei | > 58.0 | > 3.9 | > 1.6 | > 35.7 | > 723 | > 0.8 Wheat Flour (Standard Flour) | > Beijing | > 12.0 | > 9.9 | > 1.8 | > 74.6 | > 1480 | > 0.6 Wheat Flour (No. 2 Flour) | > Hubei | > 9.0 | > 9.0 | > 1.7 | > 76.5 | > 1492 | > 2.4 Wheat Flour | > Fujian | > 13.0 | > 9.1 | > 1.0 | > 75.9 | > 1459 | > 0.2 Dried Noodles | > Beijing | > 14.1 | > 9.6 | > 1.7 | > 70.0 | > 1396 | > 0.5 Dried Noodles | > Hunan | > 11.7 | > 8.5 | > 0.1 | > 78.8 | > 1463 | > 0.3 Oatmeal | > Beijing | > 7.9 | > 14.0 | > 7.0 | > 68.0 | > 1634 | > 1.2 Buckwheat Noodles | > Beijing | > 11:6 | > 10.6 | > 2.5 | > 72.2 | > 1480 | > 1.3 Millet | > Northeast China | > 10.8 | > 9.3 | > 3.8 | > 73.7 | > 1530 | > 0.8 Corn (Dried) | > Northeast China | > 11.3 | > 8.7 | > 4.2 | > 72.9 | > 1522 | > 1.6 Cornmeal | > Shaanxi | > 13.0 | > 8.1 | > 4..5 | > 71.6 | > 1501 | > 1.5 Sorghum Rice (Red) | > Northeast China | > 11.4 | > 8.4 | > 2.7 | > 75.6 | > 1505 | > 0.6 Sorghum Rice (White) | > Northeast China | > 10.5 | > 7.7 | > 3.3 | > 75.8 | > 1522 | > 1.3 Potato | > Hubei | > 70.0 | > 2.1 | > 0.1 | > 25.8 | > 681 | > 0.5 Potato | > Sichuan | > 81.6 | > 1.9 | > 0.1 | > 14.6 | > 276 | > 0.7 Yam | > Beijing | > 82.6 | > 1.5 | > 0.0 | > 14.4 | > 268 | > 0.9 Yam | > Jiangsu | > 76.7 | > 1.9 | > 0.1 | > 19.9 | > 368 | > 0.4 Sweet Potato | > Sichuan | > 79.4 | > 2.2 | > 0.2 | > 15.7 | > 305 | > 2.5 Taro | > Guizhou | > 88.6 | > 0.9 | > 0.2 | > 7.6 | > 150 | > 2.5 Mung Bean | > Beijing | > 9.5 | > 23.8 | > 0.5 | > 58.8 | > 1400 | > 4.2 Mung Bean | > Shaanxi | > 10.0 | > 21.8 | > 0.8 | > 59.0 | > 1379 | > 5.2 Red Bean (Small Red Bean) | > Beijing | > 9.0 | > 21.7 | > 0.8 | > 60.7 | > 1409 | > 4.6 Red Bean (Crimson Bean) | > Jiangsu | > 14.9 | > 19.1 | > 2.7 | > 55.5 | > 1350 | > 4.4 Water Chestnut | > Beijing | > 74.5 | > 1.5 | > 0.1 | > 21.8 | > 393 | > 0.6 Lotus Root Powder | > Jiangsu | > 11.9 | > 0.2 | > 0.1 | > 87.2 | > 1463 | > 0.6 Dried Lotus Seeds | > Jiangsu | > 8.0 | > 17.0 | > 2.0 | > 66.8 | > 1476 | > 2.8 Continued Table
Category
Continued Table Continued Table

3. Food Exchange Portion Method
   First, calculate the total daily caloric requirement based on [standard body]{.underline} weight [and activity]{.underline} level. Then, take the weight of six major food categories (grains and tubers, vegetables, fruits, meat, fish, eggs, and beans, dairy products, cooking oils) that can provide approximately 334.4 kJ of calories as one food exchange unit. Next, according to the proportions of carbohydrates, proteins, and fats required by diabetic patients, consult the tables (see Table 8 and Table 9) to calculate the number of food exchange units needed for each of the six major food categories. Each exchange unit can be used to exchange foods within the equivalent table, and then allocate the food quantities for the three meals in the ratio of 1/5, 2/5, and 2/5.

Table 8: Weight of One Food Exchange Unit and Its Three Major Nutrient Contents

Food Category/Product Name | > Weight (g) | > Calories | > Carbohydrates | > Proteins | > Fats | | > | > | > (g) | > (g) | | > (kJ) | > (g) | | Grains and Tubers, Rice, Flour | > 23.0 | > 334.4 | > 18.0 | > 2.0 | > 0.3 Vegetables | > 300–500 | > 334.4 | > 15.0 | > 5.0 | Fruits | > 100–250 | > 334.4 | > 19.0 | > 1.0 | Meat, Fish, Eggs, and Beans | > 25.0 | > 334.4 | > 0.25 | > 4.0 | > 7.0 Dairy Products Fresh Milk | > 120 ml | > 334.4 | > 6 | > 4.0 | > 4.8 Whole Milk Powder | > 18 g | > 334.4 | > 6 | > 4.5 | > 4.2 Skim Milk Powder | > 22 g | > 334.4 | > 11.5 | > 8.0 | > 0.22 Soy Milk | > 200 ml | > 334.4 | > 3.0 | > 8.8 | > 3.6 Cooking Oil and Nuts | > 9 g | > 334.4 | | | > 9.0 Cooking Oil | | | | | (6) Traditional Chinese Medicine Dietary Therapy

According to Traditional Chinese Medicine, the early stage of diabetes is mainly characterized by yin deficiency and dry heat; the middle stage is mainly characterized by qi and yin deficiency; and the late stage is mainly characterized by yin-yang deficiency. Moreover, yin deficiency and dry heat persist throughout the entire course of the disease. Therefore, dietary therapy should also be tailored to the patient’s clinical manifestations at different stages of the disease.

1. Yin-Nourishing and Heat-Clearing Type ① Fresh Lotus Root: It has a cold nature and sweet taste, with the effects of clearing heat, moistening the lungs, generating body fluids to quench thirst, harmonizing the stomach, and stimulating appetite. When cooked and eaten, it is suitable for patients in the early stage of diabetes who present with lung-stomach heat excess syndrome.

Table 9: Common Food Exchange Unit Weight (Approximately 334.4 kJ)

Intermediary Food Product Name | > Weight (g) | > Food Name | > Weight (g) Rice Flour, Cornmeal | > 23 | > Salted Bread | > 35 Millet, Buckwheat Noodles, Oatmeal | > 23 | > Soda Crackers | > 25 Dried Noodles, Wet Noodles, Machine-Made Noodles | > 25 | > Yam, Sweet Potato, Potato | > 100–125 Handmade Wet Noodles | > 30 | > Taro (Cold Taro) | > 225 Wet Rice Noodle Skin | > 50 | > Dried Lotus Seeds, Mung Beans, Red Beans | > 25 Lotus Root Powder | > 22 | > Water Chestnut | > 85 Chinese Cabbage, Small Cabbage, White Cabbage, | > 300–500 | > Green Pumpkin, Cauliflower, String Beans | > 200–300 Garlic Tomb, Leek Tomb, Blue Onion | | > 300–500 | > White Radish, Water Bamboo, Fresh Winter Shoots_ | > 200–300 Spinach, Leek, Chrysanthemum | | > 300–500 | Onions, Four Seasons Beans, Flat Beans, Blade Beans | > 200–300 Cucumber, Loofah, Bitter Melon | | > 300–500 | Carrots, Taro, Green Peppers, Amaranth | > 100–200 Winter Melon, Gourd, Eggplant | | > 300–500 | > Soybean Sprouts, Pickled Vegetables, Large Turnips | > 100–200 Tomatoes, Mung Bean Sprouts, Dragon | Must Vegetables | > 300–500 | > Edamame, Fresh Broad Beans, Peas | > 100–200 Seaweed soaked in water, Mushrooms, Gold | Needle Mushrooms | > 200–300 | > Old Pumpkin, Garlic Sprouts, Lotus Roots | > 100–200 Lean Pork | > 0. | | > -25 | | > Eel, Squid | > 100 Beef, Lamb 0. Small | | > 40 | | > River Shrimp, Sea Shrimp Crab | > 80–100 Chicken, Duck, Goose Meat 1 | | > 50 | | > Eggs, Duck Eggs, Crane Quail Eggs | > 50 Rib Bones | | | > 60 | | > Dried Soybeans |

<!-- translated-chunk:5/18 -->

Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: | | | > 80 | > 豆腐 ...000 | > 100 +-----------+-----------+----------+ | |

兔肉 | > 只 | | | | 黄鱼、鲈鱼、鲫鱼 | | > 80 | > 嫩豆腐 类桌区 | > 虚55 黑鱼、青鱼、鲤鱼 | | > 80 | > 豆腐干 | > 50 草鱼、鳊鱼、带鱼 | > 80 | > 千张皮(豆腐皮) | > 65 苹果、鸭梨、橘子 | > 200 | > 西瓜 | > 350～600 桃子、李子、杏子 | > 200 | > 草莓、杨梅 | > 空 | > 250~300 鲜荔枝、葡萄、猕猴桃 | > 200 | > 鲜枣 | > 100 香蕉、柿子 | > 100~150 | > 干桂圆 | > 30 鲜牛奶 | > 120ml | > 全脂奶粉 | > 15 豆浆 | > 200~400ml | > 脱脂奶粉 | > 22 烹调油 | > 9 | > 核桃仁、杏仁、松子松 | > 12.% 芝麻酱 | > 15 | > 西瓜子、南瓜子、开心果 | > 25 腰果、花生仁 | > 12.5 | > 葵花子(炒) | > 13 病人食用。主要证候为口干舌燥，多饮尿多，大便干燥。②茭白： 味甘性寒，功效清热利湿、止渴除烦。适用于糖尿病挟湿热证型， 表现烦渴喜冷饮，易饥多食，口舌生疮，牙龈肿痛，心烦失眠。③南 瓜：性温味甘，功效清热润肺、解毒利湿，适用于糖尿病初期肺胃热 盛型的病人，与鲜藕调配食用。④苦瓜：性寒味苦，功效清热明目、 止渴。适用于糖尿病中期"三多"症状明显的病人食用。⑤黄瓜： 性寒味甘，功效清热利湿、生津止渴。适用于糖尿病并发高血压、 高脂血症及水肿病人食用。⑥瓠瓜：性寒味甘，功效清热、利湿止 渴。适用于糖尿病烦渴多饮，皮肤易生疮疖的病人食用。⑦菜瓜： 性寒味甘，功效清热解毒、利水生津。适用于糖尿病心烦口渴、小 便短少、疮痈疖肿的病人，与瓠瓜调配食用。⑧丝瓜：性凉味甘，功 效清热凉血解毒。适用于糖尿病并发下尿道感染的病人，表现为 尿急、尿频、尿痛、腰酸痛。⑨冬瓜：性凉味甘，功效清热止渴，利水 消肿。适用于糖尿病并发下尿道感染的病人，与丝瓜调配食用。 ⑩西红柿：性微寒、味甘、酸、功效清热利水、生津止渴、健胃消食。 适用于糖尿病并发高血压、高脂血症、冠心病的病人，可与黄瓜调 配食用。①旱芹(芹菜):性凉味甘、苦，功效平肝清热、祛风利湿。 适用于糖尿病并发高血压、高脂血症的病人，表现头晕耳鸣、急躁 易怒、口渴多饮为主的证候，可与西红柿、黄瓜调配食用。 ⑫西瓜 翠衣：性凉味甘，功效清热解暑、除烦止渴、利水。适用于糖尿病并 发高血压、肾病水肿者，可与西红柿、黄瓜、芹菜调配食用。⑬薤菜 (空心菜):性平味甘，功效清热、除烦、止渴。适用于糖尿病阴虚燥 热型，主要表现为心烦口渴、溲赤便秘者食用。其中以紫色雍菜效 果更好。 2.健脾益气类 ①蘑菇：为黑伞科植物蘑菇的子实体菌盖及 柄，性凉味甘，功效补脾益胃、化痰理气。适用于糖尿病并发高脂 血症，表现为倦怠乏力、胸膈满闷、口干、食欲不振的病人食用。② 香蕈(香菇):为侧耳科植物香蕈的子实体，性平味甘，功效益气、健 脾、止血。适用于糖尿病并发高血压、高脂血症、冠心病患者，表现 为气短乏力、食欲不振、小便频数或失禁的病人食用。③豆腐：性 凉味甘，功效益气和胃、生津润燥、清热解毒。适用于糖尿病肾功 能正常而有便秘的病人食用。④扁豆、豇豆、豌豆：性平味甘，功效 健脾益气和中、清热利湿。适用于糖尿病并发胃肠功能紊乱者，主 要表现为食欲不振、恶心呕吐或腹泻、上腹饱胀、倦怠乏力的病人 食用。⑤牛奶：性平味甘，功效补气养血、益脾胃、生津、止渴、润肠 通大便。适用于糖尿病并发高血压、冠心病，主要表现食欲减退、 瘦弱乏力、口渴便秘的病人食用。⑥胡萝卜：性温味甘、辛，功效健 脾行气、润肠通便。适用于糖尿病并发高血压、高血脂症，主要表 现胸闷不畅、上腹胀满的病人食用。 3. 阴阳双补类 ①山药：性平味甘，功效补脾胃、益肺肾。适 用于糖尿病并发胃肠功能紊乱者，表现食欲减退，口渴多饮、腹泻， 体倦乏力的病人食用。②韭菜：性温味辛，功效温中行气，温肾固 精。适用于糖尿病并发冠心病、高脂血症、便秘及性功能减退的病 人食用。③羊奶：性温味甘，功效益气补肾，养血润燥。适用于老 年糖尿病久病体弱、脾肾两虚、腰酸乏力、口渴便秘的病人食用。 第二节运动治疗