Читать книгу Practical Carbohydrate Counting - Hope S. Warshaw - Страница 15

A person’s need for carbohydrate relates to his or her calorie needs. Calorie and carbohydrate needs depend on numerous factors:

• Height

• Weight and weight history

• Usual food habits and daily schedule

• Level of physical activity

• Blood glucose control

• Blood lipid levels

The current American Diabetes Association (ADA) nutrition recommendations note that no optimal nutrient mix for carbohydrate, protein, and fat has been determined for people with diabetes (ADA 2008b) and that the Dietary Reference Intake (DRI) of 45–65% of total calories from carbohydrate is reasonable to follow (Institute of Medicine 2002). On average, Americans eat about 50% of their calories as carbohydrate, although a greater than desirable percent of these calories comes from less healthy carbohydrate sources (Institute of Medicine 2002; U.S. Department of Health and Human Services et al. 2005). It is optimal to individualize carbohydrate intake based on the above factors and healthy eating goals. Table 3-1 provides general guidelines for the amount of total daily carbohydrate intake and servings from food groups for various calorie ranges. As provided, these would supply approximately 50% of calories as carbohydrate, 20% as protein, and 30% as fat.

Notes:

1. The groups of people for whom these calorie ranges are appropriate generalizations.

2. The total grams of carbohydrate and servings of carbohydrate are from grains, beans, and starchy vegetables; fruits; and milk. Nonstarchy vegetables are not counted in the amount for carbohydrate servings, but are counted in the total grams of carbohydrate.

3. Based on fat-free milk (12 grams of carbohydrate and 8 grams of protein per 8 ounces). Children between 9 and 18 years old need 1300 milligrams of calcium per day. They should get at least three servings per day of milk. Adults from 19 to 50 need 1000 milligrams of calcium per day. This can be met with two servings of milk a day, plus another serving of a high-calcium food. Women over 51 years of age need 1200 milligrams of calcium per day. If milk or another excellent source of dairy is not regularly consumed, suggest the use of a calcium supplement to achieve the daily calcium goal. Then suggest adding another 24 grams of carbohydrate from either grains, beans, and starchy vegetables or fruit.

4. Calculated based on lean meat figures (7 grams of protein and 3 grams of fat per ounce). Use more or fewer grams or servings of fat based on the type of meats you tend to eat.

5. The calculation for the grams of fat is derived from the fat in meats plus the fat in the fat servings.

6. The servings of fat assume that each serving of fat provides 5 grams of fat.