Base your diet recommendations on treatment goals designed specifically for your patient . Consider the various roles of proteins, carbohydrates, fats, sweeteners, fiber, sodium, and alcohol in your patient’s diet.

Cultural and Ethnic Considerations

Each patient’s cultural and ethnic background strongly influences her food customs, eating rituals, food preparation, and body image. Religion also can affect dietary habits. For example, Hindus are vegetarians, and Orthodox Jews follow kosher dietary laws.

Family traditions may dictate mealtime habits and foods to be eaten or avoided. A patient’s finances, social status, and geographic region affect the type and availability of foods she eats, as well. The health care team performs a thorough nutritional assessment of cultural and ethnic practices and incorporates them into a personalized nutritional plan.

Food Labels

The Food and Drug Administration’s requirements for food labels have made a big difference to patients with diabetes as they shop for food. The information on labels is useful not only for assessing individual products but also for comparing ingredients of similar products and of different brands of the same product.

Show your patient several labels of healthful and less healthful foods. Point out that many imported foods lack nutritional information.

Ingredients on food labels are listed in descending order by weight. Determining total sugar content may take some analysis, however, because different forms can be listed separately. Give your patient a list of sugar’s many names, including sorghum, sucrose, lactose, and maple syrup. Explain that foods labeled dietetic aren’t necessarily sugar-free and that natural doesn’t mean sugar-free. Cane sugar, for example, is natural. Dietetic foods are usually more expensive, and they’re unnecessary for patients who make an effort to choose foods intelligently.

Food labels also list the number of calories, total fat content, and amount of saturated fat per serving. The difference between total fat and saturated fat is the portion that consists of polyunsaturated or monounsaturated fats. The polyunsaturated and monounsaturated fat content should be greater than the saturated fat content. Also listed are levels of cholesterol, sodium, total carbohydrate, fiber, sugar, and protein.

A food label promising no cholesterol can be misleading. Vegetable oils containing no cholesterol, for example, may be high in saturated fats. Also, teach your patient to scrutinize labels claiming that a food is a certain percentage fat free. A product that is 75% fat free contains 25% fat by weight-and even more than 25% of the total calories may come from fat. The total calories from fat, listed next to the total calories on the label, will give your patient a clearer picture of fat content. Teach her to carefully read labels boasting fewer calories, light, or lite.

Besides ingredients, food labels now list details of nutritional content. This information makes it easier for your patient to choose foods in accordance with her treatment goals.

The information on the food label is based on the serving size, which appears at the top of the food label. Make sure your patient understands that the nutritional content of the entire package isn’t being described unless the label states that the container has only one serving. The percent of daily value listed on the label is based on a 2,000-calorie diet; teach patients with a different calorie plan to take this into consideration.