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    Diet review: Picking the best diet for your patients


    Mediterranean diet

    The Mediterranean diet may be suggested to those with cardiovascular disease. This diet requires you to love eating plants. Increasing consumption of fruits, vegetables, whole-grain breads and cereals, beans, nuts, and seeds is also a requirement. Increased intake of omega-3 fatty acids such as walnuts, and flaxseeds, and fish is important.

    Most meals are cooked using only olive oil, a monounsaturated fat that is rich in polyphenols. Polyphenols reduce inflammation.3

    Patient information on this diet can be found here: http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating...

    Related: ODs must teach patients about proper nutrition

    Diet recommendations for diabetic patients

    Because we often see patients with diabetes, I have an update. The 2013 American Diabetes Association (ADA) guidelines include the following recommendations for people with diabetes4:

    • Limit or avoid beverages containing sugar or any caloric sweetener. Many yummy drinks include high-fructose corn syrup and sucrose, including energy drinks, flavored vitamin waters, and fruit drinks. That includes sweet tea, for everyone in the South, and sodas for ya’ll up North.

    • High-fiber, nutrient-dense sources of carbohydrates should be chosen over processed foods with added fat, sugar, and sodium.

    • Reduce sodium intake to <2300 mg/day, unless you have hypertension; then reduce it even more.

    • Two servings of fatty fish twice per week, at least. Omega-3 supplements were not supported.

    • Choose liquid fats instead of saturated or trans-fat varieties, and consume leaner sources of protein (poultry, nuts, beans, fish).

    • Vitamin or mineral supplements in individuals who do not have a vitamin or mineral deficiency were not supported. No evidence has been found that the various supplements that report to enhance blood sugar metabolism actually work. Cinnamon does enhance breath, however.

    Related: Nutrition’s role in eye care

    For those with diabetes and kidney disease, diets to reduce the amount of waste in their blood may be beneficial, but you should refer these patients to a nutritionist if they have not been referred already. Increased waste negatively affects electrolyte balance, resulting in progression of renal disease.

    In early stages, restriction of protein intake may be recommended to avoid high levels of urea, protein products, and amino acids in the bloodstream. These patients should select high-quality proteins, such as poultry, eggs, fish, beans, and dairy—and limit red meat. Processed meats should be avoided.

    Tracy Schroeder Swartz, OD, MS, FAAO
    Tracy Schroeder Swartz currently practices at Madison Eye Care Center in Madison, Alabama. She serves as Education Chair for the ...


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