NOTE :  Yellow Boxes to be filled by user.

NAME *

AGE *

Sex*

Male Female

Female Pregnant Female Lactating

MODE OF WORK *

NORMAL CALORIE REQUIRED

CLINICAL CONDITION

CALORIE TO BE INTAKEN

BLOOD GLUCOSE (AFTER MEALS) *

STANDARD BLOOD GLUCOSE (AFTER MEALS)

BLOOD GLUCOSE (FASTING) *

STANDARD BLOOD GLUCOSE (FASTING)

AMOUNT OF NUTRIENTS TO BE CONSUMED (gram/day) : Refer Below
(If cooking, the nutrients should be weighed and then cooked)

NATURE OF FOOD *

GRAINS

LENTILS

FULL FAT MILK ( ml / day )

DAIRY PRODUCTS

NUTS & OILSEEDS

VEGETABLE OIL

GREEN LEAFY VEGETABLES

OTHER VEGETABLES

FRUITS

SALT

MEAT AND FISH

EGGS

MULTIVITAMIN  MINERAL TABLET ( One / Day )

TYPE OF NUTRIENTS TO CONSUME / NOT TO CONSUME

WHOLE GRAINS AND PRODUCTS

TO CONSUME

Rice, Wheat, Oats, Corn, Bran, Whole grain, Brown rice, Grits, Rice kanji, Wheat flour or any grain flour, Salty Biscuits (from any grain), Brown bread, White bread (limit) Parched rice, Noodles, Semolina, Salty Muffins from any flour.

NOT TO CONSUME

Any processed sweet grain products, Sago, Cream biscuits, Oily biscuits, Cookies made with butter and oil, Sweet muffins etc.

LENTILS

TO CONSUME

Whole green gram, Split green gram, Whole black gram, Split black gram, Whole chick peas, Split chick peas, Dry field beans, Dried peas, Garbanzo beans, Red lentils, Soybeans, Sprouts (from any lentils).

NOT TO CONSUME

Lathyrus peas.

FULL FAT MILK / WHOLE MILK / TONED MILK

TO CONSUME

Cow’s milk, Buffalo’s milk or goat milk. If not consuming milk, use milk powder instead.

DAIRY PRODUCTS

TO CONSUME

Any or all types of salty cheese. Yogurt, Buttermilk, Tea and Coffee without addition of sugar or any kind of sugar products.

NOT TO CONSUME

Avoid all sweetened Dairy Products.

NUTS AND OILSEEDS

TO CONSUME

Groundnuts, Cashew nuts, Almonds, Pistachios, Walnuts, Pine nuts.

NOT TO CONSUME

Any type of sugar coated nuts.

VEGETABLE OILS AND FATS

TO CONSUME

Olive oil, Sunflower oil, Groundnut oil refined, Corn oil, Sesame seed oil, Grape seed oil.

NOT TO CONSUME

Coconut oil, Palm oil, Mustard oil, Ghee, Dalda, Vanaspathi, Butter (limit), Mayonnaise (limit), Margarine (limit), Lard (limit).

GREEN LEAFY VEGETABLES

TO CONSUME

Amaranth, Cabbage, Cilantro (Coriander leaves), Curry leaves, Drumstick leaves, Fenugreek leaves, Lettuce, Mint, Spinach, Kale, Collard greens, Celery leaves, Parsley, Mustard spinach, Cress, Chard, Endive, Mustard greens.

OTHER VEGETABLES

TO CONSUME

Ash gourd, Bitter gourd, Eggplants, Broad beans, Cluster beans, French beans, Double beans, Cucumber, Cauliflower, Broccoli, Asparagus, Drumstick, Kohlrabi, Green plantain, Ridge gourd, Snake gourd, Bottle gourd, Tomato (green and red), Bell peppers (Capsicum).

NOT TO CONSUME

Okra, Yellow pumpkin

ROOTS AND TUBERS

NOT TO CONSUME

Diabetics should avoid all vegetables that grow under soil.

FRUITS

TO CONSUME

Gooseberry, Apple, Grapes, Guava, Pear, Tangerine, Musambi, Orange, Water melon, Ripe papaya, Pine apple (limit), Pomegranate (limit), Peaches, Grapefruit, Cantaloupes, Apricots, Nectarines (limit).

NOT TO CONSUME

Figs, Prunes, Raisins, Banana, Plantain, Custard apple, Dates, Jackfruit, Ripe mango, Plum, Chickoo, Tender coconut water, Fruit juices (if consuming whole fruits, no fruit juices are allowed).

SUGAR, JAGGERY AND SUGAR PRODUCTS

NOT TO CONSUME

All to be avoided like White sugar, Brown sugar, Candy, Jaggery, Molasses, Soft drinks, Syrups, Jams, Jellies, Artificial sweeteners, White sugar, Puddings, Desserts, Custard, Chocolate, Honey and any kind of sugar products.

MEAT AND FISH

TO CONSUME

Small portions of chicken without the skin, Lean meat. Meat should be boiled, steamed or baked without butter and not fried. Fresh and salt water fish to be boiled, grilled, steamed or baked with oil and without butter and not fried.

NOT TO CONSUME

Red meats like pork, beef, lamb, goat. Organ meats like liver, heart, brain, and kidney. Processed meats (like salami, sausages, hot dogs, pepperoni, bacon, and ham) should be taken in limited amounts. Shell fish like crabs, prawns, shrimps, oysters, lobsters also to be taken in limited amounts. Avoid too much frying of meat or fish.

EGGS

TO CONSUME

Hens egg preferably.

NOT TO CONSUME

Ducks egg

SODIUM OR SALT

TO CONSUME

10 – 15 grams per day of iodized salt.

MULTIVITAMIN MINERAL TABLET

TO CONSUME

– One tablet per day rich in Vitamin B1, B2, B6, B12 and minerals. Should contain iron in ferrous (Fe2+) form. Iron in the ferrous form is better absorbed by the body than the ferric form (Fe3+).

NOT TO CONSUME

Avoid all diabetic drugs and tablets or take in limited amounts. Instead, focus on the intake of natural food ingredients as mentioned above and also practice doing moderate exercise every day. For example, walking 3 miles a day will expend about 300 calories.