Diet Principles

Grasping the principles of diet and nutrition is pivotal for several reasons. It equips you with the knowledge to select foods that aid your body with vital nutrients, promoting overall health and preventing nutritional deficiencies.

Hydration

Nutrition Label

Food Portion

Glycemic Index

Hydration

Water doesn’t offer nutritional value. However, it is essential for our body. Water helps the absorption of nutrients and excretion of unwanted substances from our body. It also helps regulate body temperature, cellular transport, and metabolism. Dehydration is a serious problem that could lead to fatigue, weakness, severe temperature imbalance (e.g., heat stroke). 

A healthy individual may require up to 1.5 Liters of fluid, but the exact amount of water depends on many factors such as weather conditions, underlying medical status, and exercise intensity. Trying to drink only when one gets thirsty” is not a good idea as one is already dehydrated when thirsty. So, it would be best if one stayed hydrated gradually throughout the day by drinking fluids. 

Understanding Nutrition Labels and Food Ingredients

When looking at the food label, one should first look at the serving size and the number of servings in the container.
Second, one should look at the number of calories per serving.
Third, essential nutrients are listed with their daily percentage values.
Pay close attention to sodium and added sugars. The % Daily Value tells you the percentage of each nutrient in a single serving in the daily recommended amount.
To consume less of a nutrient (i.e., sodium, sugar), choose foods with lower % Daily Values (<5%) and to consume more of a nutrient (protein), choose foods with higher % Daily Values (>20%).

Understanding of Food Portion

The portion is how much food one eats at one time, but the serving size is the amount of food listed on the nutrition facts label. Therefore, all the nutritional values on the label are for the serving size the manufacturer suggests.

Portion control is essential for a healthy diet. Use small plates or bowls and use these as a portion guide.

Roughly half of the plate or bowl should be vegetables or salad.
The other half should be lean protein and complex carbohydrates with a quarter each, along with a tablespoon of healthy oil.

When eating out in a restaurant, one should ask for a half portion which will prevent overeating. Do not eat straight from the container or the package; instead, lay it out on a plate or bowl.

Using a food diary to note down the total intake in a day will increase awareness and motivate you to make healthier food choices.

Cooking at home and avoiding eating out should be the most important mantra for healthy living.

Daily Requirement of calories

Daily calorific requirement depends on weight, gender, pregnancy, activity level, and other health conditions.

Generally, 2500 calories a day for men and 2000 calories a day for women is considered adequate.

Glycemic Index

The glycemic index (GI) is a value of foods (on a scale of 1-100) based on how quickly the blood glucose level changes after you eat. Foods with a low GI have a longer digestion period with slower blood glucose release, while foods with a high GI are quickly digested, followed by larger increases in blood sugar levels.

Low GI food can promote weight loss and better blood glucose control, while high GI food helps those in the recovery phase after intense exercise or hypoglycemic episodes. If you have diabetes, it would be better to eat low GI food to promote sugar control.

The test is a two-day study and performed under a standardized protocol. A healthy individual was given 50 grams of carbohydrate (test), followed by blood glucose measurement after two hours. On the second day, the same individual was given 50 grams of pure glucose (reference), followed by glucose level measurement.

Then, the GI of the test food is calculated by dividing the glucose AUC for the test food by the glucose AUC for each person’s reference food, and the final GI value will be an average of the total participants. [1] University of Sydney, Australia, maintains the GI database.

The level of GI can be divided into 3 groups: low GI (0-50), medium GI (51-69), and high GI (70+).

Glycemic index is failed to specify the amount of particular you would need to eat to reach a certain level. E.g., watermelon has a GI of 80, which puts this food into a high GI category. However, watermelon has few digestible carbohydrates in a regular serving, and you would need to consume a lot of watermelons to raise your blood glucose level.

To modify this limitation, researchers developed a new measurement system called glycemic load (GL). GL calculates both the quality and quantity of the food being eaten.

Glycemic Load = GI x Carbohydrate (g) content per portion ÷ 100

GL can be classified as following (Per Sydney University):

Low: 10 or less
Medium: 11 – 19
High: 20 or more

Knowing the glycemic index of various foods would help you choose a diet that wouldn’t cause a sudden increase in blood sugar levels.

Carbohydrate consumption is critical for those who are aiming for bodyweight control or weight loss. The researcher attempted to compare effects of various diet compositions (a low-protein and low-glycemic-index diet, a low-protein and high-glycemic-index diet, a high-protein and low-glycemic-index diet, a high-protein and high-glycemic-index diet, or a control diet) on weight loss maintenance. In this study, the best result for weight loss and maintenance was achieved in high protein and low GI food. [2]

A meta-analysis of six randomized controlled trials was performed to compare the effect of a low glycemic index or load diet with a higher diet or other diets in overweight or obese people. It reported that lowering the diet’s glycemic load seems to be an effective method for weight loss and improving lipid profiles. [3]

Consumption of low glycemic index food appears to have cardiovascular risk factor modification by having better blood pressure and cholesterol control. The concept was tested by comparing the effects of low- and high-GI foods on 24-hour ambulatory blood pressure. The research study included 30 women who were given two different GI foods followed by 24-hour blood pressure measurement and revealed a significant reduction of BP (systolic –10.6 mmHg and diastolic –7.5 mmHg) with low GI foods. [4] Moreover, a meta-analysis of low GI diet effect on blood cholesterol level showed a reduction of total and LDL-cholesterol but no effect on HDL-cholesterol or triglycerides. [5]

On the contrary, another meta-analysis, including fourteen studies with 229,213 participants, reported that high GL and GI diets were associated with a significantly increased risk of cardiovascular disease, specifically for women. [6] Recently, Dr. Jenkins and his colleagues performed an analysis on a large, geographically diverse population living on five continents, with a median follow-up of 9.5 years. The result demonstrated again that a diet with a high glycemic index was associated with an increased risk of cardiovascular disease and death regardless of underlying comorbidities.[7]

The impact of various glycemic effects is thought to be one of the contributing factors to the development of diabetes. Meta-analysis showed that high GI diets could increase the risk of developing Type 2 diabetes by up to 87%. [8] Low GI diets were associated with better glycemic and body weight control in those with prediabetes or diabetes.[9] Although there is a concern for hypoglycemia with low GI diets, another study showed that low GI diets improve glucose control in diabetes individuals without increasing hypoglycemic events than conventional healthy diets.[10]

Pregnancy can cause various medical problems such as elevated blood pressure and gestational diabetes mellitus. As dietary control is the mainstay treatment of diabetes patients, clinicians wonder about the utility and safety of low GI diets in pregnancy. A meta-analysis of 9 randomized controlled trials of low GI diet in pregnancy-related DM showed a beneficial effect of less frequent insulin use and lower birth weight than control diets. [11]

Glycemic Index chart of Various Foods (Fruits, Vegetables, Legumes, Dairy, Grains/Starches, Sweets)

Vegetables	Glycemic Index
Beetroot	64
Green Beans	15
Tomatoes	15
Spinach	15
Lettuce	15
Kale	5
Brussels Sprouts	6
Cabbage	10
Tomato	15
Onions	10
Peppers	15
Cucumber	15
Broccoli	15
Asparagus	15
Celery	15
Carrot (Cooked)	39
Mushroom	10
Potato	56
Sweet Potato	61
Baked Potato	85
Parsnips	97

Fruits	Glycemic Index
Apple	38
Peach	42
Oranges	44
Grapes	46
Banana	54
Mango	56
Pineapple	59
Watermelon	72
Grapefruit	25
Cherries	22
Pear	38
Kiwi	53
Apricots	57
Raisins	64
Raspberries	30
Cantaloupe	65

Legumes	Glycemic Index
Peanuts	21
Lentils	41
Kidney Beans	41
Split Peas	45
Black Beans	59
Lima Beans	46
Chickpeas	47
Pinto Beans	55
Soybeans	16
Dried Beans	40
Green Peas	48

Dairy	Glycemic Index
Cheese	0
Butter	0
Plain Yogurt	14
Low-fat yogurt	14
Whole Milk	27
Skim Milk	32
Soy Milk	30
Fat-Free Milk	32
Fruit Yogurt	36
Plain Ice Cream	61

Grains/Starches	Glycemic Index
White Rice	85
Brown Rice	50
Wild Rice	57
French Fries	75
Cheerios	74
Cornflakes	80
Popcorn	55
Quinoa	53

Sweets	Glycemic Index
Fructose	15
Agave Syrup	15
Coconut Sugar	35
Maple Syrup	54
Caramel	60
Honey	61
Sucrose	65
Splenda (artificial)	80
Coca-Cola	70
Jelly Beans	80
Chocolate Bars	70
Glucose	100

Glycemic Index of various foods based on level

Type of Food	Glycemic Index
Cheese	0
Butter	0
Kale	5
Brussels Sprouts	6
Spinach	6
Onions	10
Mushroom	10
Broccoli	10
Cabbage	10
Plain Yogurt	14
Low-fat yogurt	14
Green Beans	15
Tomatoes	15
Lettuce	15
Peppers	15
Cucumber	15
Asparagus	15
Celery	15
Tomato	15
Fructose	15
Agave Syrup	15
Soybeans	16
Artichokes	20
Peanuts	21
Cherries	22
Grapefruit	25
Whole Milk	27
Raspberries	30
Soy Milk	30
Skim Milk	32
Fat-Free Milk	32
Coconut Sugar	35
Fruit Yogurt	36
Apple	38
Pear	38
Carrots, cooked	39
Dried Beans	40
Lentils	41
Kidney Beans	41
Peach	42
Bran Cereal	42
Spaghetti	42
Oranges	44
Split Peas	45
Grapes	46
Lima Beans	46
Chickpeas	47
Green Peas	48
Brown Rice	50
Kiwi	53
Quinoa	53
Banana	54
Corn, sweet	54
Maple Syrup	54
Pinto Beans	55
Popcorn	55
Mango	56
Potato	56
Apricots	57
Wild Rice	57
Basmati Rice	58
Pineapple	59
Black Beans	59
Caramel	60
Sweet Potato	61
Plain Ice Cream	61
Couscous	61
Sweet Potatoes	61
Honey	61
Raisins	64
Beets	64
Cantaloupe	65
Sucrose	65
Coca-Cola	70
Chocolate Bars	70
Whole Bread	71
Watermelon	72
Mashed Potatoes	73
Cheerios	74
French Fries	75
Cornflakes	80
Splenda (artificial)	80
Jelly Beans	80
Baked Potato	85
White Rice	85
Baked Potatoes	85
Instant Oatmeal	87
Parsnips	97
Taco Shells	97
Glucose	100
Bagel, white	103

The lower the glycemic index, the lesser effect on blood glucose and insulin levels while the higher GI score can result in higher blood sugars level quickly.

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7. Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med. 2005 Mar 15;142(6):403-11. doi: 10.7326/0003-4819-142-6-200503150-00006. PMID: 15767618.

8. Walton CM, Perry K, Hart RH, Berry SL, Bikman BT. Improvement in Glycemic and Lipid Profiles in Type 2 Diabetics with a 90-Day Ketogenic Diet. J Diabetes Res. 2019 Aug 14;2019:8681959. doi: 10.1155/2019/8681959. PMID: 31485454; PMCID: PMC6710763.

9. Westman, E. C., Yancy, W. S., Jr, Mavropoulos, J. C., Marquart, M., & McDuffie, J. R. (2008). The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & metabolism, 5, 36. https://doi.org/10.1186/1743-7075-5-36

10. Weber, D. D., Aminazdeh-Gohari, S., & Kofler, B. (2018). Ketogenic diet in cancer therapy. Aging, 10(2), 164–165. https://doi.org/10.18632/aging.101382

11. Rusek, M., Pluta, R., Ułamek-Kozioł, M., & Czuczwar, S. J. (2019). Ketogenic Diet in Alzheimer's Disease. International journal of molecular sciences, 20(16), 3892. https://doi.org/10.3390/ijms20163892

12. Phillips, M., Murtagh, D., Gilbertson, L. J., Asztely, F., & Lynch, C. (2018). Low-fat versus ketogenic diet in Parkinson's disease: A pilot randomized controlled trial. Movement disorders : official journal of the Movement Disorder Society, 33(8), 1306–1314.

13. Ułamek-Kozioł, M., Czuczwar, S. J., Januszewski, S., & Pluta, R. (2019). Ketogenic Diet and Epilepsy. Nutrients, 11(10), 2510. https://doi.org/10.3390/nu11102510

References

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10. Seidelmann SB, Claggett B, Cheng S, Henglin M, Shah A, Steffen LM, Folsom AR, Rimm EB, Willett WC, Solomon SD. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. Lancet Public Health. 2018 Sep;3(9):e419-e428. doi: 10.1016/S2468-2667(18)30135-X. Epub 2018 Aug 17. PMID: 30122560; PMCID: PMC6339822.

11. Knight, E. L., Stampfer, M. J., Hankinson, S. E., Spiegelman, D., & Curhan, G. C. (2003). The impact of protein intake on renal function decline in women with normal renal function or mild renal insufficiency. Annals of internal medicine, 138(6), 460-467.

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TOP Antioxidant-Rich Foods

Avocado
Artichokes
Apricots
Berries
Beans
Broccoli
Carrots
Capsicum
Coffee
Dark Chocolate
Green Tea
Garlic
Grapes and Grapefruit
Kale
Kiwi
Mango
Nuts
Oranges
Onion
Poultry
Parsley
Pumpkin
Red Wine
Red Cabbage
Strawberries
Spinach
Seafood
Tea

Foods that contain Omega-3 FA

The American Heart Association recommends eating two servings of fish (particularly fatty fish) per week. A serving is 3.5 ounces cooked or about a cup of flaked fish.

Common fish and seafood products rich in Omega-3 [5]

Seafood	Serving Size	Omega-3 FA (mg/serving)
Anchovy	2.0 oz	1,200
Catfish (farmed)	5.0 oz	253
Clams	3.0 oz	241
Cod (Atlantic)	6.3 oz	284
Crab	3.0 oz	351
Fish sticks (frozen)	3.2 oz	193
Halibut	5.6 oz	740
Lobster	3.0 oz	71
Mahi mahi	5.6 oz	221
Mussels	3.0 oz	665
Oysters	3.0 oz	585
Pollock (Alaskan)	2.1 oz	281
Salmon (wild)	6.0 oz	1,774
Salmon (farmed)	6.0 oz	4,504
Sardines	2.0 oz	556
Scallops	3.0 oz	310
Shrimp	3.0 oz	267
Swordfish	3.7 oz	868
Trout	2.2 oz	581
Tuna (albacore)	3.0 oz	733
Tuna (light, skipjack)	3.0 oz	228