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NUTRITION THERAPY: CARBOHYDRATES
The nutrition recommendations do not specify the amount of carbohydrates. This should be individualized according to current eating habits, treatment goals, metabolic control and the presence of other medical conditions.
Although various carbohydrates produce different glycemic responses, from a clinical perspective the total amount of carbohydrates consumed is more important than the source of the carbohydrates. The daily total carbohydrates and its distribution should be individualized based on each patient\'s eating habits, blood glucose and lipid goals. Quality of food is also determined by \'Glycemic Index\' (GI), which is a measure of the blood glucose response of a particular food. The lower the GI, lower is the blood glucose response, and hence such food is recommended. Several factors affecting GI include the following:
1. Nature of starch and its digestibility: Amylopectins are rapidly digested, and amylose is slowly digested. Therefore, foods with higher amylose content are recommended (Amylose content of bengal gram = 33%, wheat = 25%, potato = 23%).
2. Physical characteristics of foods/starch are the following:
(a) Form: Raw and large particles are better than cooked and homogenized particles.
(b) Size: Large particle size is better than small particle size.
3. Fibre content of food: Many whole grains are often processed into refined products like rice, sago, cornstarch, arrowroot, etc. During this processing the useful fibre present in the unprocessed foods is removed to varying extent. The beneficial effects of food fibre include reduction of blood sugar, reduction of serum cholesterol and reduction of body weight. The common sources of dietary fibre are whole cereals, whole dais and grams, etc.
The soluble fibre present in legumes, beans, peas, vegetables and fruits is more beneficial.
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GENERAL HEALTH
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