From food and cookery for the sick and convalescent (1904):
Seems pretty much like high fat paleo diet. Lots of good advice for everyone.
DIABETES means grape sugar in the urine on an ordinary diet. In the first stage of the disease starch turns to sugar; in the second, albumen; and in the third, fat.
Diabetes is essentially a dietetic disease. No drug or medicinal remedy has yet been found which is a curative, but prescribed diet keeps the disease under control, and unless the case is severe and of long standing sugar may entirely disappear from the urine. It might seem from this statement that diabetic cures have been accomplished, though such is the case only with the rarest exception. If the patient returned to his ordinary mixed diet, sugar would reappear in the urine.
When the disease develops in childhood, but little can be done to help the sufferer, and the patient lives but a few weeks, or at best a few months. There is a case reported by Naunyn in his work on Diabetes mellitus, however, which is an exception to this rule. When the disease develops in adults, life may be prolonged and made pleasurable for many years, and death often follows from other causes than diabetes.
The average daily diet of a man weighing one hundred and fifty-four pounds has been estimated to include:
[Illustration: A graph that shows the average daily diet of a man weighing 154 pounds. Has 3 vertical lines lines with the words 500 grammes- Carbohydrates, 125 grammes- proteids, and 50 grammes- Fats, written upwards on the lines in that order.]
Grammes. Calories. Calories.
500 * 4.1 == 2050
125 * 4.1 == 512.5
50 * 9.3 == 465
It may be seen from the above table that the chief source of heat and energy comes from carbohydrates, and it is this class of food that yields the most of the sugar in the body, a small part only being obtained from the proteids.
It is therefore necessary to eliminate the carbohydrates as far as possible, to increase the proteids and to a greater extent the fats in diabetic diet, allowing two hundred grammes more fat than the daily dietary of a healthy person requires. The change in diet must be a gradual one, as a too sudden reduction of the carbohydrates might prove fatal. Acids are constantly being formed within the body, and these burn in a carbohydrate fire, and acid formation increases when carbohydrates are cut down. By the use of a larger amount of meat the amount of acids in the body is still further increased, while by restricting vegetables the salts are diminished which neutralize these acids, and if not kept under control the patient will die of acid poisoning. It is an imperative need that there be a movement of the bowels every day. If there be a neglect in this direction patients are more liable to succumb to acid poisoning. Bicarbonate of soda is used as a safeguard to aid in the neutralization of the acids.
The first duty of the physician is to decrease the quantity of sugar in the urine, and as far as possible restore the power to assimilate carbohydrates, which is accomplished by resting those functions of the body which are used in the digestion of the same. If the latter is not accomplished the power to assimilate such foods gradually diminishes.
> Proteids in Diet.
The proteids in the diet of the diabetic must be obtained from animal foods, from which he can choose almost without restriction. Meats, fish, and eggs may be indulged in freely. Four to six eggs may be taken daily. Clams, oysters, and mussels contain glycogen (animal starch), which is a carbohydrate, therefore they must be avoided, except in mild forms of the disease, or allowed in restricted amounts. Liver contains so little glycogen that it is practically never necessary to restrict its use.
> Fats in Diet.
Many people have a great repugnance to the use of much fat, therefore the problem of supplying a sufficient quantity to the diabetic is a perplexing one. It must be so combined with other foods as to disguise it as far as possible, and thus avoid the impression on the patient that he is eating a large quantity of fat.
The best fats are butter, cream, eggs, cheese, olive oil, and the fat from bacon, meat, marrow-bone, and oily fish. A diabetic should take at least one-fourth pound butter per day, and one-half pint cream. There is but little tendency to gastric disorders among diabetics, which proves of much assistance in arranging menus.
Green vegetables prove the most efficient butter carriers, spinach heading the list: Other examples, cabbage, asparagus, string beans, etc. If a small quantity of potato is allowable it may take up one-half its weight in butter and one-fourth its weight in heavy cream.
Cream is preferable to milk, and should be used as a substitute for it as far as possible. There is about five per cent of lactose in milk, but only three to four per cent of lactose in cream.
Cheese and olive oil form a very important article in the dietary and may be introduced without much difficulty.
> Vegetables allowed on all Strict Diets.
Cabbage (red & white).
> Fruits allowed.
Only in measured quantities. They contain about ten per cent sugar.
Grape fruit and oranges are exceedingly popular and seem especially to agree with diabetics. There is rarely a stage of the disease when an orange or grape fruit cannot be taken once a day.
The use of condiments is not restricted. Salt, spices, flavoring extracts, vinegar, and table sauces may be used as desired, and are of much help in preparing menus.
Brandy, whiskey, rum, gin, claret wine, sour cider, and Bollinger dry champagne are all used, the preference generally being shown for brandy; three to six teaspoons are taken daily, while eight may be allowed. Brandy assists in the digestion of fats. While brandy is constipating under ordinary conditions, it does not prove so with the diabetic on account of the large quantity of fat in his diet.
One of the symptoms of diabetes is great thirst. Water may be drunk freely; also tea, coffee, and cocoa nibs, without sugar.
> Diabetic Breads.
The most difficult of all starchy foods to take from the diet is ordinary white bread. Many diabetic flours have been placed upon the market which have proved unsatisfactory, and before using them continuously it is best to have them analyzed. A flour to make palatable bread must of necessity contain a large quantity of starch.
> Table showing Composition of Diabetic Flours.
Gluten flour, Rand & Rhines................ 67.17% starch.
Special diabetic flour, Rand & Rhines...... 68.18% "
Gluten flour, New York Health Food Co.......... 66.18% "
Gluten wafers, New York Health Food Co......... 66.96% "
Diabetic flour, No. I., Boston Health Food Co.. 62.94% "
Diabetic flour, No. II., Boston Health Food Co. 54.88% "
Dr. Johnson's Educators (starch free).......... 71.43% "
Fine granulated wheat.......................... 61.64% "
Soya bean meal................................. 26.67% "
DR. CHARLES HARRINGTON.
Barker's Gluten...................... Practically starch free.
Bread made from these flours is never liked, and if it is tolerated and eaten in considerable quantity, as large a quantity of starch is taken as when wheat bread is used sparingly,--one small slice or an unsweetened cracker daily.
> Sugar Substitutes.
Saccharine, a cold-tar product three hundred times sweeter than cane sugar, is added to foods for the diabetic. It is usually purchased in the form of tablets. SÃ¼stoff, also a chemical substitute, is similar to saccharine, and is just being introduced from Germany into our country. Saccharine is introduced to sweeten beverages and desserts. When used in desserts it must be added at the end of cooking, otherwise a bitter taste is developed. Most patients, after a few months of dieting, prefer to get on without saccharine. When added to sour fruits it is of benefit in making the food less sour rather than making it taste sweeter; therefore, avoid the use of too large a quantity. Dissolve a one-half grain tablet in one teaspoon luke-warm water and use as needed, adding cautiously.
The one who prepares the food for the diabetic should be in close touch with the doctor, and ever ready and willing to carry out his suggestions. The patient had better not be consulted as regards the menus, nor have his attention called to what he is eating.
It is most unfortunate if it is necessary for the invalid to prepare his own meals, as an appetite for the foods he most needs is greatly diminished. A diabetic should be in the open air as much as possible, and if the condition of the patient admits, walking is preferable to riding.
Frequent feeding is desirable for the diabetic, and besides the three meals, several lunches should be introduced.
> Diabetic Dietary for a Patient whose Urine by Dieting has become Sugar Free.
6.30 A.M. (before rising). One cup of coffee with egg.
7.30 A.M. Breakfast.
Fruit--peach, plum, orange, or one-half grape fruit.
Eggs and fish, or eggs and meat.
One cup of coffee with cream.
10 A.M. Lunch.
Fruit or cream egg-nog or one cup broth with cream.
12.30 P.M. Dinner.
Soup, fish, meat, two vegetables, or one vegetable and salad; dessert.
3.30 P.M. Lunch.
Cheese sandwich or egg-nog.
6 P.M. Supper.
Eggs, sliced cold meat or fish, cheese, and vegetable or salad.
9 P.M. Lunch.
Williamson's Diabetic Milk.
A small piece of white bread, diabetic bread, almond cake, or unsweetened cracker is usually served daily at the time which seems to best please the patient. The quantity is determined by the presence or absence of sugar in the urine.
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