Carbohydrate Intolerance Diet
Description
This diet is high in unrefined complex carbohydrates and fibers. It is designed to help stabilize blood sugar in those individuals who have blood sugar intolerances. This diet was designed by Dr. James Anderson, an endocrinologist at the University of Kentucky Medical School who has evaluated its effectiveness in maturity-onset diabetes. This diet is useful for the management of the obese insulin-insensitive diabetic and the non-insulin requiring diabetic.
The diet is built upon the recognition each food has its own glycemic index (a measure of how a food influences blood sugar after consumption). Foods with lower glycemic index result in lower postprandial, after-eating blood sugar levels. Such foods are those found in a Lente diet (as used by the Seventh Day Adventists) and include beans, peas, whole grain products and low-fat dairy products.
This diet abbreviated HFC, (high-fiber, high-complex carbohydrate diet) is adequate in protein, vitamins and minerals. Those individuals who are wheat or corn allergic may have a more difficult time with this diet due to the high grain composition of the diet. In these cases, management may be better achieved by use of the protein enriched diet.
Individualized treatment is essential for diabetics with specific metabolic complications associated with the disease. A physician and a dietician should be consulted in order to adjust meal patterns to the patient's needs and lifestyle while maintaining dietary modifications.
Because food, insulin, and exercise influence blood sugar concentration, these three factors must be taken into consideration when treating diabetes mellitus.
Insulin
When used, insulin determines the time of day when food intake is most critical.
Exercise
Physical activity promotes a more rapid absorption of glucose in the muscles which tends to decrease blood glucose. This reduces the need for insulin and increases food requirements. A planned snack should be included in the meal plan to provide for extra activity, following these guidelines:
For each hour of moderate activity, 10 to 15 grams of carbohydrates should be consumed.
For each hour of strenuous activity, 20 to 30 grams carbohydrates and 15 grams protein should be consumed.
Food
Meal and snack timing is essential for persons with diabetes, particularly those receiving insulin or oral hypoglycemic agents. Considerations include the number, time, and spacing of meals, with the primary objective being the prevention of hypoglycemia by supplying sufficient available glucose. For this reason, the individual's food intake is usually divided into three meals (four to five hours apart) and one to three daily snacks.
Glycemic Index
GLYCEMIC INDEX
Sugars and Honey
| Maltose | 105 |
| Glucose | 100 |
| Honey | 87 |
| Sucrose | 59 |
| Fructose | 20 |
Fruits
| Raisins | 64 |
| Bananas | 62 |
| Orange juice | 46 |
| Oranges | 40 |
| Apples (Golden Delicious) | 39 |
Vegetables
| Parsnips | 97 |
| Carrots | 92 |
| Instant mashed potatoes | 80 |
| White potato | 70 |
| Beets | 64 |
| Peas (frozen) | 51 |
| Sweet potato | 48 |
Beans
| Baked beans | 40 |
| Chick peas | 36 |
| Kidney beans | 29 |
| Lentils | 29 |
| Soybeans | 15 |
Dairy
| Yogurt | 36 |
| Ice cream | 36 |
| Whole milk | 34 |
| Skim milk | 32 |
Breads, Grains, Pasta
| Whole wheat bread | 72 |
| White rice | 72 |
| White bread | 68 |
| Brown rice | 66 |
| Sweet corn | 59 |
| Pastry | 59 |
| Kasha (buckwheat) | 51 |
| White spaghetti | 50 |
| Sponge cake | 46 |
Breakfast Cereals
| Cornflakes | 80 |
| Shredded wheat | 67 |
| All-Bran | 51 |
| Oatmeal | 49 |
Miscellaneous
| Mars Bar | 68 |
| Potato chips | 51 |
| Tomato soup | 38 |
| Fish sticks | 38 |
| Sausage | 28 |
| Peanuts | 13 |
Jenkins et al: "Glycemic index of foods: a physiological basis for carbohydrate exchange." Am. J. Clinical Nutrition, 1981,34:362 - 366.
Sample Menu
Menu For One Day
Breakfast
| 1/2 cup orange juice | 2 slices whole wheat bread (toasted) |
| 1/2 cup cooked oatmeal | 1 cup skim milk |
| 2 tablespoons raisins |
Lunch
1/2 cup apple juice
1/2 cup steamed carrots
3 ounces sliced turkey breast
1 apple
2 slices whole wheat bread
1/3 cup cooked sweet corn
Sliced lettuce and tomato for sandwich
1 cup skim milk
Afternoon Snack
1 cup popcorn (no butter)
1 apple
Dinner
| 1/2 cup grapefruit juice | 2 tsps oil & vinegar dressing |
| 4 ounces broiled halibut | 2 slices whole wheat bread |
| 1 cup brown rice | 1 tsp margarine or butter |
| 1 cup steamed broccoli | 1 banana |
| 1 cup salad: romaine or Boston lettuce; 1/2 cup skim milk sliced carrots, cucumbers, mushrooms, bell pepper, celery |
Evening Snack
| 1/2 cup skim milk | 1 small pear |
| 6 rye wafers | 1 small apple |
| 1 tablespoon peanut butter |
Total Calories For the Day: 2,400
Nutrient Content:
| Calories: | 2400 | Fat: | 20% |
| Protein: | 15% | Cholesterol: | 200mg |
| Carbohydrate: | 65% | Fiber: | 17g |
Food Exchange List
Recommended Foods and Portions
The number of food exchange list units shown apply to a 2,400 calorie Diabetic Prudent Diet. The calorie levels and number of food exchange list units are provided only as examples; it should not be assumed they apply to all diabetics.
Bread and Cereal Exchange List: 12 servings/day
Recommended
| Whole wheat bread | Sweet potato |
| White bread (enriched) | Beans (dried) |
| Cereals | Green pea |
| Pastas | Lentil |
| Potato |
Avoid
Refined, fiber-free breads and cereals
Sugarcoated cereals
Baked goods containing large amounts of fats and sugar such as doughnuts and sweet rolls
Fat Exchange List: 7 servings/day
Recommended
Polyunsaturated salad oils such as:
Corn oil
Safflower oil
Avoid
Saturated fats such as:
| Lard | Saturated oils |
| Coconut oil | Butter |
Fruit Exchange List: 9 servings/day
Recommended:
Fresh, frozen and canned fruits, both whole and juice
Avoid:
Fruits canned (syrup pack)
Meat and Meat Substitute Exchange List: 7 servings/day
Recommended
| Lean meat | Egg |
| Poultry | Low fat cheeses such as: |
| Fish | Cottage cheese - 2% fat |
| Shellfish | Mozzarella - part skim |
Avoid
| Sausages | Fatty cheeses such as: |
| Any luncheon meat | cream cheese |
Milk Exchange List: 3 servings/day
Recommended
Skim milk
Milk - 2% fat
Evaporated skim milk
Buttermilk made from skim milk or milk - 2% fat
Yogurt - lowfat plain or yogurt - nonfat plain
Avoid
Whole milk - fresh or whole milk products
Ice cream (see liquid and clear liquid substitutions for exceptions)
Vegetable Exchange List: 3 servings/day
Recommended
Fresh, frozen, or canned fruits, whole or juice
Avoid
None
Miscellaneous Exchange List
Recommended
Homemade, fat-free soups and broths
Avoid
Refined and processed sweets, such as candy
Note: Be sure to include six to eight cups of fluids, such as water, per day.
Liquid and Clear Liquid Substitutes
When a diabetic is unable to eat solid food, it may be necessary to substitute liquid and/or clear liquid foods. To contribute towards the patient's caloric requirements, the physician or dietitian may suggest the use of sweetened liquids. In such a case refined, highly concentrated sources of sugar are permitted. The following show carbohydrate and calorie values for selected foods from the liquid diet:
| Calories | Carbohydrates | |
| 1 cup ginger ale or lemon-lime drink | 70 | 18g |
| 1/2 cup cereal cream of wheat with 1/4 cup skim milk | 55-65 | 8g |
| 1/2 cup soft custard | 160 | 18g |
| 1 cup eggnog | 230 | 20g |
| 1/2 cup fruit-flavored gelatin dessert | 70 | 17g |
| 1/2 cup ice cream | 150 | 15g |
| 1/2 cup orange sherbet | 130 | 30g |
| 1 tablespoon sugar | 45 | 12g |
References
Anderson, J., T. Kiehm & Ward. Beneficial Effects of a High Carbohydrate, High Fiber Diet on Hyperglycemic Diabetic Men. Am. J. of Clin. Nutri.
Kirby, R., J. Anderson, B. Sieling, E. Rees, W. Chen, R. Miller & R. Kay. Oat-bran Intake Selectively Lowers Serum Low-Density Lipoprotein Cholesterol Concentrations of Hypercholesterolemic Men. Am. J. of Clin. Nutri.
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