12
Dietary Factors in Healing and Specific Nutrients
Carbohydrate and Fats
• Carbohydrates and fats provide a patient's energy needs.
• Both fats and carbohydrates help support inflammatory response, cellular
activity, angiogenesis, and collagen deposition in the proliferative phase of
healing process.
• For patients who have poor glycemic control and/or diabetes their
carbohydrate requirements will require focused attention throughout
treatment.
▶ In a patient with elevated BMI and poor diabetes management, one should
minimize energ y intake while optimizing protein intake.
▶ Only in patients of low BMI will it likely be necessary to set specific minimal
caloric goals.
• Important fats to consider are mono and poly-unsaturated fatty acids that
play a major role in cell membranes.
▶ Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid,
are fatty acids that contribute to membrane fluidity, membrane and intracellular
signals, and the modulation of apoptotic pathways.
• Carbohydrate daily recommendations will vary from patient to patient
based on maturity of T2DM, daily glycemic control and if patient is on insulin
therapy or oral hypoglycemics.
• The average woman needs about 3–4 choices (45–60 g), while men may need
4–5 choices (60–75 g) at each meal.
▶ This number could vary more or less depending on the individual calorie needs
(i.e., pregnant/nursing, ill, etc.), medication, and level of physical activity.
▶ Carbohydrates are measured in grams: 4 kcal/g of carbohydrate.
▶ Every carbohydrate food type has a specific serving size.
▶ 1 carbohydrate serving = 15 g of carbohydrates
