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| ORIGINAL ARTICLE |
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| Year : 2013 | Volume
: 2
| Issue : 2 | Page : 103-105 |
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The two minute weight ÷ 10 diabetes diet
Sanjay Kalra1, Bharti Kalra2
1 Department of Endocrinology, Bharti Hospital and Research Center, Karnal, Haryana, India
2 Department of Gynaecology, Bharti Hospital and Research Center, Karnal, Haryana, India
| Date of Web Publication | 6-Jul-2013 |
Correspondence Address:
Sanjay Kalra
Bharti Hospital and BRIDE, Karnal, Haryana
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2278-019X.114724
Background: The diabetes pandemic puts an unmanageable load on exisiting health care services, especially in resource challenged settings. It is necessary to create simple, easy-to-administer, and easy-to-understand dietary prescriptions which can be explained in a short period of time, by diabetes care providers without formal training in nutrition, to patients .
Aim: This study assesses the accuracy and utility of an easy-to-administer diet, termed as the Bharti Hospital, weight ÷ 10, two minute diet.
Materials and Methods: This prospective, unicentric, observational study was performed at an endocrine center in Haryana, north India. Two hundred consecutive persons with diabetes were explained a simple diet, with a single page visual aid, by a multipurpose diabetes worker, supervised by the consultant dietician and endocrinologist. Accuracy of the dietary prescription was assessed by calorie and nutrient content, measured by the dietician. Efficiency was measured by the time taken to administer the dietary prescription. Acceptability of the diet therapy was judged as a patient-reported outcome, using a pre-tested structured questionnaire, self-administered by the subject after undergoing nutritional counseling.
Efficacy was assessed in all patients who returned at one month for follow-up, using a 24-hour dietary recall questionnaire.
Results: Without counting calories from cooking fat/oil, the calorie content of the diet was 17.5 calories/kg/day, with a balanced mix of carbohydrates, proteins, and fat. The times taken to administer this diet ranged from 1.0 to 7.5 minutes (mean average, 3.15 ± 2.46 minutes). Patients rated acceptability of this prescription at 4.1 ± 0.7 on a 5-point Likert scale. Forty patients, followed up at 1 month, reported caloric intake of 24.3 ± 4.51 cals/kg/day.
Conclusion: The Bharti Hospital 2 minute weight ÷ 10 diet provides a simple framework upon which a dietary prescription can be based. It provides a fast, yet effective method of explaining dietary management by staff who do not have formal qualification in nutrition, and is acceptable to patients. This diet should be customized and studied in different culinary regions across the world. Keywords: Developing world, diabetes, diet, India
How to cite this article:
Kalra S, Kalra B. The two minute weight ÷ 10 diabetes diet. J Med Nutr Nutraceut 2013;2:103-5 |
| Introduction | |  |
Dietary therapy, along with other lifestyle modifications, is the cornerstone of all diabetes management, and is placed as first-line therapy in current guidelines. [1] Dietary therapy, also known as medical nutrition therapy (MNT), is the treatment of choice not only for the management, but also for prevention of various types of diabetes. [2]
While MNT is an economical and effective means of therapy, it is a time-consuming and labor-intensive exercise for the healthcare provider who administers it. The challenge is even more acute in healthcare settings which have to provide diabetes care to a large number of patients, without the help of having any qualified diabetes care paramedical staff to assist physicians.
With the increasing number of people with diabetes across the globe, this situation is bound to become more critical. Unique and innovation strategies have been used to overcome this challenge. Multipurpose diabetes workers and physiotherapists have been utilized to provide diabetes care in under-served regions of the world. [3],[4] Even for these workers, however, administering appropriate dietary therapy may become a daunting task.
It is imperative, therefore, to create simple, easy-to- administer, and easy-to-understand dietary prescriptions which can be explained in a short period of time to patients. This original work studies the accuracy and utility of such a diet, termed as the Bharti Hospital, weight ÷ 10, two minute diet. This dietary therapy is planned for a north Indian patient population, but can easily be customized to other regions of the world.
| Materials and Methods | | |
This prospective, unicentric, observational study was performed at an endocrine center located in the Hindi- and Punjabi-speaking belt of Haryana, north India. Two hundred consecutive persons with diabetes were explained a simple diet, with a single page visual aid, by any of the five multipurpose diabetes workers on duty. The details of the dietary prescription are mentioned in [Box 1], [Box 2] and [Box 3]. This activity was supervised by the consultant dietician and consultant endocrinologist. The only information needed to customize this was the weight of the patient. The only skill demanded of the multipurpose diabetes worker was the ability to divide weight by 10, and further divide this number by 5.
The aims and objectives of this study were to assess the accuracy, efficiency, efficacy, and acceptability of a simple diet prescription. It was hypothesized that this dietary prescription could be shared within 2 minutes with a patient of diabetes, by a trained paramedical staff, without a formal qualification in nutrition, working as a multipurpose diabetes worker.
Accuracy of the dietary prescription was assessed by calorie and nutrient content, measured by the dietician. Efficiency was measured by the time taken to administer the dietary prescription. It was measured, using a stop watch, by a receptionist designated for this purpose. Acceptability of the diet therapy was judged as a patient-reported outcome, using a pre-tested structured questionnaire, self-administered by the subject after undergoing nutritional counseling.
Efficacy was assessed in all patients who returned at one month for follow-up, using a 24-hour dietary recall questionnaire.
| Results | | |
Without counting calories from cooking fat/oil, the calorie content of the diet was 874 calories for a person weighing 50 kg, 1311 calories for a 75 kg heavy patient, and 1748 calories for a 100-kg individual. This provided 17.5 calories/kg/day for an individual. Adding 10% or 20% increased the caloric content to 19.25 or 21.0 calories/kg/day, while subtracting 10% or 20% created a 15.75 or 14.0 calories/kg/day diet. The diet provided a balanced mix of carbohydrates, proteins, and fat. Adding three teaspoonfuls of cooking oil added 135 calories to a 50-kg person's diet. The detailed nutrient content of a diet for a 50-kg person, based upon this formula, is given in [Table 1].
The times taken to administer this diet ranged from 1.0 to 7.5 minutes (mean average, 3.15 ± 2.46 minutes). Patients rated the acceptability of this dietary prescription at 4.1 ± 0.7 on a 5-point Likert scale.
Forty patients were followed up at 1 month, with a 24-hour dietary recall questionnaire. In these patients, the caloric intake was 24.3 ± 4.51 cals/kg/day, implying appropriate energy consumption.
| Discussion | | |
The Bharti Hospital 2 minute weight ÷ 10 diet provides a simple framework upon which a dietary prescription can be based. Given alone, it does not meet calorie requirements of patients. To do so, patients need to be counseled to take extra snacks and follow a 3 + 3 meal pattern.
While it does not live up to its "two minute" moniker in the average patient, it does provide a fast, yet effective method of explaining dietary management.
It is easy to understand and administer, can be explained by staff who do not have formal qualification in nutrition, and is acceptable to patients. Such a dietary prescription is an appropriate method of delivering MNT in resource-challenged medical care settings which grapple with the twin burdens of staff shortage and patient overload. This diet should be customized and studied in different culinary regions across the world.
| References | | |
| 1. | Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycemia in type 2 diabetes: A patient-centered approach: Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012;35:1364-79. 
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| 2. | Kalra S, Joshi S, Baruah M. Medical nutrition therapy for diabetes: The challenge in India. J Med Nutr Nutraceut 2012;1:3-4.
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| 3. | Kalra S, Kalra B. Answering the urgent need for diabetes care professionals in Northern India. Diabetes Voice 2006;51:11-3.
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| 4. | Kalra S, Kumar B, Kumar N. Prevention and management of diabetes: The role of the physiotherapist. Diabetes Voice 2007;52:12-5.
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[Table 1]
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