While conditions such as high cholesterol and diabetes are often treated with pharmaceuticals, there is a new push in a medical community to consider lifestyle changes – such as diet and exercise – before prescribing drugs.
Two documents that highlight this philosophy are the newly published 2012 Update of the Canadian Cardiovascular Society Guidelines for the Diagnosis and Treatment of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult,and the Canadian Diabetes Association’s Clinical Practice Guidelines.
Updated dyslipidemia guidelines
The widely used 2009 CCS Dyslipidemia Guidelines were recently updated to account for medical developments over the last three years. For the first time, the guidelines include nutrition recommendations. Dietary strategies such as reducing saturated fat; increasing intake of plant sterols, nuts and viscous fibre; and following a Mediterranean type diet are outlined in the guidelines.
If your residents have high cholesterol levels, nutrition can make a big difference. The guidelines offer the following nutrition recommendations to help lower LDL-cholesterol (the bad kind of cholesterol):
|Intervention (minimal does for effect)||Lowers LDL-C by:|
|Keep dietary cholesterol <200 mg/day||12-16%|
|Keep dietary cholesterol <300 mg/day||10-12%|
|Keep saturated fat intake at <7% of daily calories||5-10%|
|Incorporate phytosterols – 1-2 g/day||5-8%|
|Incorporate soy proteins with isoflavones – 25 g/day||3-5%|
|Add soluble fibre – 10 g/day||3-5%|
|Add nuts – 30-67 g/day||5-7%|
|Use a Portfolio type diet||8-14%|
|Use a Mediterranean type diet||5-10%|
New Clinical Practice Guidelines for diabetes
In April 2013, the Canadian Diabetes Association (CDA) released Clinical Practice Guidelines (CPG) for diabetes management. The robust Nutrition Therapy section emphasizes individualized nutritional therapy for people with diabetes and includes an overview of healthy dietary patterns including the DASH diet, Mediterranean diet and Canada’s Food Guide.
The nutrition guidelines recommend that people with diabetes should work with a registered dietitian and combine dietary modification and increased physical activity to help control blood sugar levels and reduce heart disease risk.
If you are meal planning for a population of residents who have diabetes, here are some things to keep in mind:
- Timing is everything: people with diabetes should maintain regularity in timing and spacing of meals to optimize blood sugar control. Meals should be no more than six hours apart.
- Calories matter: Reducing caloric intake should be a treatment goal for people with diabetes who are overweight or obese.
- Plate model: Plan plates that contain ¼ grains, ¼ protein and ½ vegetables.
- Bump up the fibre: Adding soluble dietary fibre (e.g. eggplant, okra, oat products, beans, psyllium, barley) can help improve post-meal blood sugar levels.
- Fat matters: Restrict saturated fats to <7% of total daily energy intake. Trans fatty acids arising from industrial hydrogenation should be kept to a minimum. Meal plans should favour unsaturated fats.
- Ensure adequate protein intake: Aim for 1 to 1.5 grams of protein per kilogram of body weight per day – that’s about 15% to 20% of total energy intake from protein.
Helpful, healthy meal items
To make your menu planning easier, choose from any of Maple Leaf’s Healthy Selections products including Original Sliced Roast Beef, Original Sliced Roast Pork, Sliced Roast Turkey, Meatloaf, Grilled Chicken Thigh and Pork Chop Loins. All are high in protein, low in total fat, saturated fats, cholesterol and contain zero trans fat!