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Nutrition Plan: Gestational Diabetes, Research Paper Example

Pages: 6

Words: 1671

Research Paper

  

Table 1.  3 Day Meal Plan for Woman with Gestational Diabetes
Day 1
Meal Type Calories     (kcal) Protein (g) Carbohydrates (g) Fat          (g) Fiber       (g) Sodium (mg)
Breakfast Milk 1% (250ml) 108 9 3 13 0 113
   2 slices whole wheat bread 186 9 3 30 5 294
  50 g cottage cheese 69 11.8 2.6 1 0 388
Mid-Morning Snack 1 medium pear 96 1 0 26 5 2
 
Lunch 1 large whole wheat pita 186 7 38 2 5 372
  1 ounce cheddar cheese 127 12 8 1 0 310
  125 ml chopped tomato 10 1 0 1 1 3
Afternoon Snack 2 slice whole wheat toast 186 9 3 30 5 294
  32 g peanut butter 190 7 7 16 2 150
  Milk 1% (250ml) 108 9 3 13 0 113
Dinner 1 small skinless chicken breast 251 51.8 0 0 3.3 117
100 ml low sodium soy sauce 5 0.6 0.7 0 0 505
1 cup instant rice 218 5 2 46 4 2
125 ml broccoli 16 1 0 3 1 15
Snack Mozzarella Cheese stick (non-fat) 67 15.1 1.7 0 0.9 355
Day 2
Meal Type Calories     (cal) Protein (g) Carbohydrates (g) Fat          (g) Fiber       (g) Sodium (mg)
Breakfast Milk 1% (250ml) 108 9 3 13 0 113
  2 slice whole wheat toast 186 9 3 30 5 294
  1 hardboiled egg 70 5.9 0.9 5 0 63
Mid-Morning Snack 1 medium apple, raw with skin 27 1 7.3 0.1 0.1 1
  32 g peanut butter 190 7 7 16 2 150
  Milk 1% (250ml) 108 9 3 13 0 113
Lunch 2 slice whole wheat toast 186 9 3 30 5 294
  1 small skinless chicken breast 251 51.8 0 0 3.3 117
  100ml  mayonnaise 219 0.3 15.1 0 18.2 104
Afternoon Snack 1 medium peach 28 0.7 6.9 1.4 0.2 0
  Milk 1% (250ml) 108 9 3 13 0 113
Dinner 250 ml pasta 183 8 1 39 5 4
  Tomato, sauce 1 cup canned 59 3 0 13 4 1264
  1/2 cup broccoli 16 1 0 1 0 15
  125 ml strawberries 29 1 0 7 2 1
Snack Mozzarella Cheese stick (non-fat) 67 15.1 1.7 0 0.9 355
Day 3
Meal Type Calories     (kcal) Protein (g) Carbohydrates (g) Fat          (g) Fiber       (g) Sodium (mg)
Breakfast Milk 1% (250ml) 108 9 3 13 0 113
  2 slice whole wheat toast 186 9 3 30 5 294
  1 hardboiled egg 70 5.9 0.9 5 0 63
Mid-Morning Snack 1 small banana 102 1.2 26.2 0.4 2 1
  32 g peanut butter 190 7 7 16 2 150
  Milk 1% (250ml) 108 9 3 13 0 113
Lunch 1 large pita 186 7 2 38 5 372
  75 g cooked beef 200 25.7 0 9.9 0 46
  125 ml chopped tomato 10 1 0 1 1 3
Afternoon Snack 1 medium apple, raw with skin 27 1 7.3 0.1 0.1 1
  32 g peanut butter 190 7 7 16 2 150
  Milk 1% (250ml) 108 9 3 13 0 113
Dinner 1 small skinless chicken breast 251 51.8 0 0 3.3 117
  1 large potato 145 3.1 33.6 3.4 0.2 8
  1/2 cup broccoli 16 1 0 1 0 15
2 slice whole wheat toast 186 9 3 30 5 294
1 medium peach 28 0.7 6.9 1.4 0.2 0
Snack Mozzarella Cheese stick (non-fat) 67 15.1 1.7 0 0.9 355

 

Table 2.  Per Canadaian Food Guide.  Recommended number of servings for pregnant female at 30 years of age

  Female 30 years
Vegetables and Fruit 10
Grain Products 8
Milk and Alternatives 2
Meat and Alternatives 2

 

Table 3.  Grocery List

  • 1 Gallon of 1% Milk
  • 1 Loaf of Whole Wheat Bread
  • 1 Package of Whole Wheat Pita Bread
  • 1 Dozen Eggs
  • 1 small package Cottage Cheese
  • 1 package of shredded cheddar cheese
  • 1 pear
  • 2 raw tomatoes
  • 1 jar creamy peanut butter
  • Package of frozen or fresh skinless and boneless chicken breasts
  • Bottle of low sodium soy sauce
  • Box of White Instant Rice
  • 1 Bunch of Broccoli
  • 3 Medium Apples
  • 1 Jar Mayonnaise
  • 2 Medium Peach
  • 1 Box Pasta
  • 1 Jar Pasta Sauce
  • 1 Small Container of Strawberries
  • 1 Banana
  • 1 small package of Beef, steak, chopped
  • 1 Large Potato

 

Christine March (made-up character).  A 30 year old pregnant female with gestational diabetes onset during the 2nd trimester of her pregnancy.  The 30 year old woman has a high carbohydrate/sugar intake.

The dietary analysis indicated below is based on the nutritional needs for Christine March.  Christine March is a 30 year old female in her 2nd trimester (20 weeks) of pregnancy.  Christine is 5’6 ft. (1.676 m) and weighs 77 kg(170 lbs).  Christine was diagnosed with gestational diabetes after taking the required glucose testing during pregnancy.  Christine’s amount of body fat measured with BMI is considered overweight for her height.  Her BMI was 27.41 and the estimated energy requirements were measured to be a necessary 2284.8 calorie intake per day.   In addition, Christine is not sure of the proper nutritional diet that is necessary for the health of herself and her baby during this pregnancy and after being diagnosed with gestational diabetes.  Since Christine is pregnant and a larger woman, she should intake 2,000 to 2,400 calories per day and include two milks, four vegetables, 5 to 7 ounces of meat and meat substitutes, four fruits, and up to five fats.  (NIDDK, 2013)  Canada’s food guide will be implemented into the diet plan as well.  According to the Canadian Diabetes Association it is important for woman to undergo gestational diabetes screening and eat healthy with gestational diabetes in order to decrease the risk of miscarriage, pregnancy malformation in fetus, heart attacks, strokes, and damage to eyes or kidneys (Canadian Diabetes Association).  In addition, Moses (et al., 2009) suggests that a low-glycemic index diet is recommended for women diagnosed with gestational diabetes. Therefore, the goal is to create a diet plan that will help Christine proceed with a healthy pregnancy.

 

 

Table 4.  BMI for Christine March

BMI Mass(kg)/height (m)2
77kg/1.676m2
77kg/2.809m
27.41

 

Table 5. Estimated Energy Requirements

EER 662-(9.53 x Age(yr))+PAx(15.91 x Weight (kg) + (539.6  Height (m)
662-(9.53 x 30) +1.25 x{(15.91x77kg)+ (539.6x 1.676m)}
662-(285)+1.25x(1225.07+904.37)
662-(285)+1.25x(2129.44)
662-(285)+2661.8
2284.8

 

 

Gestational diabetes mellitus (GDM) is a medical condition where there is an onset of glucose intolerance during pregnancy.  According to the American Diabetes Association, women who are diagnosed with GDM are recommended to have some type of nutrition therapy in order to maintain their blood glucose levels (American Diabetes Association, 2008).  In this paper, a low-glycemic diet was chosen for Christine March since she was diagnosed with gestational diabetes during her second trimester of pregnancy.  Previous research has shown that implementing a low-glycemic index diet for women for gestational diabetes has decreased the number of pregnant women needing to use insulin, in addition to no complications in fetal outcomes (Moses et al., 2009).   Therefore, a low-glycemic index diet was prepared for Christine.

Foods that contain a low glycemic index (GI) are at 55 or less and consist of 100% ground whole wheat, dairy products, cereals, pasta, barley, sweet potatoes, yams, peas, legumes, lentils, most fruits, and non-starchy vegetables.  (Atkinson et al., 2008)  In addition to the low-glycemic index, the diet for Christine was prepared to put the fat percentages in the food in moderation, while controlling the amount of carbohydrates in the fruits and vegetables, as well as the complex carbohydrates in the bread, pasta and rice.  One of the main implementations and changes to Christine’s diet was to lower the amount of sugar.  In this case, all sugar from soft drinks juices, candy and pastries were eliminated from the diet.  Christine was also put on a diet recommended for women diagnosed with gestational diabetes.  According to Kaiser Permanente, there are five diet successes to gestational diabetes.  For one, the carbohydrates should be distributed over three small to moderate meals with three snacks and the eating time spaced every 2-3 hours.  The total amount of carbohydrates should only be around 40-45%.   Secondly, since insulin resistance is highest in the morning hours, breakfast carbohydrates should be restricted to no more than 30 grams. Thirdly, fruit or milk incorporated in limited quantities.  Fourth, no more than 10 hours between bedtime snack and breakfast.  Finally, the diet is high in fiber.  (Kaiser Permanente)

As seen in the 3-day diet plan, there are six meals per day, with the total amount of carbohydrates at around 40%, low fat, balanced proteins, as well as foods obtained from the low-glycemic index.  As found in the study conducted by Moses (et al., 2009), women assigned to the low-glycemic index diet were in fact able to reduce the glycemic index of their diet quickly and maintain the low level for the duration of their pregnancy; whereas, women who consumed an increased level of glycemic foods, were advised to change to the lower glycemic diet in order to maintain their levels throughout their pregnancy.  Given the research on low glycemic foods and gestational diabetes it is suggested that Christine follow the diet plan provided.

 

References

 

American Diabetes Association.  (2008).  American Diabetes Association Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care.  31( Suppl. 1): S61– S78.

 

Atkinson FS, Foster-Powell K, Brand-Miller JC. (2008).  International tables of glycemic index and glycemic load values. Diabetes Care. 31: 2281– 2283.

 

Canadian Diabetes Association.  Gestational Diabetes management.  Retrieved on July 3, 2013 from:  http://www.diabetes.ca/documents/about-diabetes/Gestational_Diabetes_Fact_Sheet.pdf

 

Kaiser Permanente.  GESTATIONAL DIABETES DIET 1800 Kcal – 2500 Kcal.

California North Division.  Retrieved on July 3, 2013 from: http://www.permanente.net/homepage/kaiser/pdf/63656.pdf.

 

Moses, R.G., Barker, M., Winter, M., Petocz, P.PHD., Brand-Miller, J.C. PHD.  (2009).

Can a Low-Glycemic Index Diet Reduce the Need for Insulin in Gestational Diabetes Mellitus?  Diabetes Care. 32(6):996-1000.

 

NIDDK.  (2013).  What I need to know about Eating and Diabetes.  Retrieved on July 3,

2013 from: http://www.diabetes.niddk.nih.gov/dm/pubs/eating_ez/index.aspx

 

 

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