Dietary Advice for Those with Underlying Health Conditions

• Diabetics should eat a healthy, balanced diet consisting of the 5 main food groups in moderation. They must not avoid or limit complex carbohydrates, nor should they skip meals because it could lead to a drop in blood glucose levels. 
• Patients with heart disease should avoid salty dishes and try not to eat more than one teaspoon’s worth of salt per day. In addition, their cholesterol consumption should also be very limited, as should foods high in trans and saturated fats. 
• The ideal body weight (IBW) for males is their height minus 100 and for females it is their height minus 105. However, each person’s exact calculation will be unique. 

‘You are what you eat’ is a classic refrain that most of you are bound to have heard at some point. It is used to warn people to take care of their diets because the things we put into our bodies each day can have a significant effect on our overall health. In addition to the body’s energy needs for its daily tasks and helping us maintain physical strength, our diets are comparable to medication that is used to provide vital care for our organs. 

Moreover, diets play a more crucial role in terms of health for those with chronic health conditions that require greater care and attention. In such cases, appropriate nutrition is considered a key factor with regard to improving health, supporting rehabilitation, delaying the degeneration of organs, and preventing their illness from deteriorating any further. Indeed, should these groups not exercise restraint when it comes to dietary choices or if they fail to select foods which help to manage their condition, it could exacerbate their symptoms and undermine their general health. 

1. Dietary advice for diabetics 

Diabetics must take great care to eat only high quality foods and manage the amount they eat each day to ensure their blood glucose levels do not become elevated. This can be achieved by avoiding sugary dishes and maintaining stable blood glucose levels with healthy carbohydrates that have a low Glycemic Index (GI) score. Foods that are high in fiber are also helpful in terms of regulating blood glucose levels. Fresh vegetables, high-quality proteins, and fruits that are not overly sweet can all be beneficial, however, the latter’s sugar levels should be carefully calculated before consumption. 

Should diabetics be craving a sweet dish, they are advised to get their fix in the form of products containing suitable amounts of artificial sweeteners as this will not negatively impact blood glucose levels. Refined simple carbohydrates are to be avoided, as are sugary or overly sweet dishes. Indeed, diabetics should be eating a healthy, balanced diet containing the 5 main food groups in moderation each day. They must not avoid or limit complex carbohydrates, nor should they skip meals because it could lead to a drop in blood glucose levels. 

• Recommended food and dishes for diabetics 
  • Foods containing complex carbohydrates, such as brown rice, wholegrain rice, wholegrain bread, brown rice noodles, and oats. 
  • Grains, such as millet, white sesame seeds, and black sesame seeds. 
  • Fresh fruit/vegetables with an emphasis on green leafy vegetables and fruits that are low in natural sugars, such as half a guava, half a Cacendish or 1 cultivated banana, 2 segments of grapefruit, 10 slices of watermelon, or 4 rambutans/mangosteens (per meal), which may be eaten over 2–3 meals a day. 
  • Root vegetables, such as potatoes, yams, pumpkins, and carrots, each of which should be consumed in moderation. 
  • Proteins and skinless meat, including pork tenderloin, chicken tenderloin, chicken breast, fish containing essential fatty acids, tofu, and eggs. 
•  Foods and dishes that diabetics should avoid or limit 
  • Fruit juices, sweetened drinks, fizzy drinks, western desserts, Thai sweets, ice cream, snow cones, coconut infused sticky rice, sweetened milk, and honey. 
  • Fruits that are high in sugars, such as longan, jackfruit, durian, rambutan, and ripe mango. These should all be limited. Even avoiding them altogether is advised. 
• Ideal menu suggestions for diabetic 
  • The ideal menu should contain a balance of complex carbohydrates, skinless meat containing unsaturated fats, and an appropriately sized portion of vegetables. Example dishes include brown rice topped with salmon, a wholewheat chicken breast sandwich, and wholegrain grain rice with pork tenderloin in a tamarind sauce. 

2. Dietary advice for patients suffering with heart disease 

Patients with heart disease should focus on managing their salt and fat intake because these two substances have a significant impact on the hematological system. Therefore, in addition to avoiding salty foods and not consuming more than one teaspoon’s worth of salt per day, this group should also ensure they have a low cholesterol diet, with high-quality proteins in moderation preferable over foods that contain high levels of saturated fats and trans fats. This is because these fats increase blood cholesterol levels and so could result in decreased cardiovascular health. However, if they cannot be avoided, the American Heart Association recommends that saturated fats make up less than 6% of the daily calories consumed each day as this will go some way to keeping the heart healthy. Moreover, preferred methods of cooking that can help reduce fat intake are steaming, baking, or shallow frying, with deep frying to be avoided as much as possible. 

• Recommended food and dishes for patients with heart disease 
  • Rice or breads containing complex carbohydrates, such as brown rice, wholegrain rice, oats, and wholegrain bread. 
  • Proteins and skinless meat, including pork tenderloin, chicken tenderloin, chicken breast, fish containing essential fatty acids, tofu, and eggs. 
  • Fresh fruit/vegetables with an emphasis on green leafy vegetables and fruits that are low in natural sugars. 
  • Olive oil, rice bran oil, and canola oil. 
• Foods and dishes that heart disease patients should avoid or limit 
  • Foods that are high in saturated fats, such as red meat, offal, egg yolks, pork belly, and fish roe. 
  • Foods containing trans fats, such as chocolate, baked products, cookies, cakes, and bread. 
  • Foods containing high levels of salt, such as meat broths and sauces or seasonings, including chili sauce, tomato sauce, and monosodium glutamate. 
  • Processed meat, such as all forms of sausage, bacon, and processed meat balls as these are high in both salt and fat. 
  • Palm oil, coconut oil, lard, and coconut milk. 
• Ideal menu suggestions for heart disease patients 
  • Dishes that contain high-quality proteins but are low in cholesterol or that contain minimal red meats and are not too rich. Examples include brown rice soup with shrimp, brown rice with spicy tuna and a boiled egg, baked sea bass in an Asian-style sauce, and shallow fried chili chicken. 

3. Dietary advice for patients suffering with kidney disease 

The most important aspect to consider when planning a diet for kidney disease patients is the reduction of salt because their sodium intake must be managed carefully. Additionally, kidney disease patients have unique needs regarding their recommended daily intake of protein, potassium phosphorus, as well as other vitamins and minerals depending on the stage their disease is in. Hence, planning their diets at the outset of their condition, especially in patients suffering with stage-3 kidney disease, is vital to slowing the disease’s onset and development.  

Foods that kidney disease patients must avoid altogether as well as those which can aid their condition are as follows: 

• Sodium 
  Reducing sodium consumption is the most vital aspect of the diet for those with kidney disease. It is recommended that no more than 1 teaspoon’s worth, or 2,000mg, of salt be consumed per day. In addition, reducing seasoning with fish sauce, light soy sauce, oyster sauce, salt, and monosodium glutamate can all help to reduce sodium intake. Patients should also avoid processed meats, such as all forms of sausage and bacon, because these contain both salt and fat in high quantities, as do baked goods due to the process involving baking soda which has sodium as one of its main ingredients. Furthermore, frozen products, pickled goods, crunchy snacks, chili sauce, and tomato sauce are all high in salt and should therefore be avoided where possible. 
• Protein 
  Sources of quality protein should be consumed in amounts suited to the disease’s stage, such as egg whites and skinless meats like fish, chicken breast, chicken tenderloin, and pork tenderloin. The levels of protein recommended for patients at each stage of kidney disease are as follows: 
  • Kidney disease stages 1–3A: There is no need to limit protein intake at this stage, with patients advised to consume protein as usual, meaning 1.0–1.2g of protein per 1kg of body weight each day. 
  • Kidney disease stages 3B–5 that are not yet undergoing dialysis: There may be a need to be careful in selecting the type and managing the amount of protein consumed at these stages to ensure the kidneys are not overworked while also providing nourishment and slowing the disease’s development. At these stages, it is advised that patients consume no more than 0.6–0.8g of protein per 1kg of body weight each day. 
  • Kidney disease involving dialysis treatment: Patients may be required to consume protein as usual or increase their intake to 1.3–1.4g of protein per 1kg of body weight each day to compensate for the proteins lost through dialysis treatment. 
• Phosphorus* 
  Patients with kidney disease at stages 3 and beyond must limit their phosphorus intake, which means that those patients or those with elevated phosphorus levels should avoid foods that are high in this substance, including milk products, yogurts, soymilk products, egg yolks, offal, fried fish, tofu, oats, brown rice, wholewheat bread, white sesame, black sesame, pumpkin seeds, various types of nut, carbonated drinks, mineral water, bread, and ice cream.  
  Instead, patients are advised to consume foods in moderation that are low in phosphorus, such as white rice, white bread, glass noodles, yellow noodles, flat noodles, white noodles, egg white, skinless meat, ginger tea, and lime soda. 
•  Potassium* 
  Patients with kidney disease at stages 3 and beyond must limit their potassium intake, which means that those patients or those with elevated potassium levels should avoid foods that are high in this substance, including vegetables like broccoli, kale, banana flower, cauliflower, and carrot. Fruits that are high in potassium include oranges, durian, watermelon, papaya, dragon fruit, guava, and jackfruit. 
  Instead, patients are advised to seek out vegetables that are low in potassium, such as cabbage, chayote leaf, Chinese cabbage, morning glory, and eggplant, while suitable fruits in this regard include rambutan, mangosteen, pineapple, and apples. 
• Fats 
  It is recommended that these patients choose foods and products containing unsaturated fats, including rice bran oil, canola oil, soybean oil, olive oil, and sea fish. On the other hand, foods and products containing saturated fats should be avoided, such as palm oil, lard, coconut oil, butter, coconut milk, offal, and streaky pork cuts. 
•  Ideal menu suggestions 
  Dishes containing high-quality proteins are ideal, as are those that are not too rich in flavor, such as rice soup with chicken, shallow fried chili chicken, mushroom galangal soup, glass noodle spicy salad, sea bass steak, sweet and sour salad, stir fried chayote leaf with minced pork, and Chinese cabbage soup with glass noodles.  

*Importantly, however, kidney disease requires highly customized treatment planning. If you would like to understand more about your condition, it is advised that you seek medical consultation with a specialist before making any further plans.  

People without any underlying health conditions can eat normally but they are advised to do so in accordance with the principles of the ‘plate method’. This means ensuring meals are made up of food types in the following ratios: 

• Half the plate should be made up of fresh/cooked colored vegetables. 
• A quarter should be made up of complex carbohydrates, such as brown rice, wholegrain rice, or wholewheat bread. 
• A quarter should consist of high-quality proteins found in skinless meats, such as fish, pork tenderloin, chicken tenderloin, or chicken breast. 
• Any fruits eaten should not have high sugar content, with oranges, guavas, apples, dragon fruit, and berries the most preferable in this regard. 

The following methods are the healthiest way to cook foods: boiling, steaming, baking, or shallow frying in oils consisting of unsaturated fats, such as rice bran oil, soybean oil, olive oil, or canola oil. Avoid dishes that have been deep fried but, if they are unavoidable, try to make sure they are fried using rice bran oil instead of palm oil, which is full of saturated fats.  

All diets should limit the consumption of processed meat, including all forms of sausage and bacon products. Those looking to snack on something throughout the day should seek out nuts and grains, such as almonds and pistachio nuts, although no more than a handful of these should be consumed per time, 1–2 times a day at most. Eating more than that will increase intake of healthy fats which, despite being better than saturated fats, are still high in calories and could lead to weight gain. 

Generally, basic steps toward good health require an emphasis on nutrition. This means that a balanced diet consisting of the 5 main food groups in moderation is essential. Even so, the following issues should also be taken into consideration:  

• Daily calorie intake: Our daily calorie intake should be between 25–30 kilocalories per kilogram of body weight. However, this number could change depending on a range of associated factors, such as daily activity levels, age, and other related aspects. 
• Ideal body weight (IBW): Do your best to keep your body weight within what is considered a healthy range. For males, subtracting 100 from their height (in centimeters) should give them their IBW, while women should subtract 105 to find their own IBW. Nevertheless, IBW is hugely dependent on the individual’s unique situation. 
• Sleep quality and getting plenty of rest: This means sleeping for between 6–8 hours a night and trying to avoid exposure to stress. 
• Staying hydrated: Drink between 8–10 glasses of clean drinking water per day (patients with kidney disease should consult their doctor about their own recommended daily liquid intake). 
• Exercising regularly: In addition to diet and sleep, a lifestyle that consists of regular exercise is hugely important. This means keeping the body in motion where possible, exercising at the correct intensity levels or lightly exercising where necessary, which could mean brisk walking, water aerobics, or using a stationary bike. Indeed, it is recommended that we all get at least 150 minutes of exercise each week or at least 30 minutes per day for no fewer than 5 days a week. 
• If you are a coffee drinker, it is recommended that you drink black coffee with no added sugar or coffee with plain, unsweetened milk. Avoid 3-in-1 coffee sachets or artificial creamers as they often contain high levels of fats and sugar. 

This advice is suitable for use with people in generally good health just as it is for those with underlying health conditions. However, it is more crucial that the latter group follow this advice as our diets can be another form of medication. If we can take the right medication, it can improve our health or at least ensure we steer clear of illness. 

As you can see, those with underlying health conditions must pay a greater level of attention and detail to their diets than the general population as some conditions impact their organ function. This means that it is essential they understand how their lifestyle and dietary choices can make a positive difference. Eating a healthy, suitable diet can play a key role in helping their organs function normally, preventing their condition from deteriorating, and ensuring they receive adequate nutrition from the food they eat. Nonetheless, once the diet is taken care of, these groups of people should also ensure they partake in regular, light exercise as well as getting plenty of rest, as these factors combine to strengthen immunity and improve overall health. 

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