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Biomedical subjects

M J Franz

Publications and source records attributed to M J Franz.

27 records · Page 2Linked to original sources
PubMed1987

Exchange lists: revised 1986.

A committee composed of members of The American Dietetic Association and the American Diabetes Association has revised Exchange List for Meal Planning. Changes were made, as deemed necessary, on the basis of nutritional recommendations for persons with diabetes as understood in 1986. Major changes include rewriting the text to make it more useful in the education of persons with diabetes; changing the order of the exchange lists to emphasize a high-carbohydrate, high-fiber diet, as well as to better reflect the order of foods in menu planning; adding symbols to foods high in fiber and sodium; changing nutritive values for the starch/bread and fruit lists; adding lists of combination foods, free foods, and foods recommended only for occasional use; developing a data base; and initiating a plan for field testing and evaluation. The committee also developed a simplified meal planning tool, Healthy Food Choices, to be used for initial or "survival" level education. In poster format, foods are grouped by calories into six food groups. Approximate portion sizes of commonly used foods are listed. Blank lines are provided for the nutrition counselor to write in a suggested menu or meal plan for the client. Because the booklet does not use the word "diabetes" specifically, it is appropriate as a general teaching tool.

Diabetes Mellitus↗
PubMed1986

Practical aspects of implementing increased dietary fiber intake.

Two hundred twenty dietitians participated in a workshop conference on Health Implications of Dietary Fiber. They were given lectures to increase their knowledge base, and then in group sessions answered questions and wrote concensus opinions. The results are the content of this paper. The topics covered and responses are reported in four categories, diabetes and obesity, hyperlipidemia, hypertension and coronary heart disease, gut function and gastrointestinal disease, and cancer. Specific recommendation for implementing high fiber diets are made in each category. However, the dietitians expressed caution on accepting all of the conclusions expressed in the literature on the value of fiber and believed much education and instruction is needed in order to increase dietary fiber intake.

Colonic Neoplasms↗
PubMedDate not supplied

How enthusiastically should the use of monounsaturated fats be encouraged?

The Garg study diet supplied 50% of the calories from fat (33% from monounsaturated fat), which eliminates much of the bulk from the diet. Substituting monounsaturates for carbohydrates in the diet translates into giving up 120 calories from a carbohydrate source (very large potato, 1 1/2 slices of bread, 1 cup of cereal, etc) for a tablespoon of olive oil. Somehow that doesn't seem like a good exchange. Abbott et al substituted complex carbohydrates for saturated fat in the diet and accomplished the same result as Coulston et al with a low-carbohydrate (40%), moderate-fat (40%) diet. The American Diabetes Association suggested that if diabetes was poorly controlled and hypertriglyceridemia a problem, monounsaturates might be useful to maintain caloric balance. However, in light of the high incidence of obesity in persons with NIDDM and recent studies on the ease of dietary fat storage in adipose tissue, should fat of any kind, including monounsaturated fats, be substituted for carbohydrates in the diet of persons with diabetes?

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

Spaseeba balshohyi--kharohshiyi! (Thank you very much--it was great!).

In January 1990, as partial fulfillment of a 5-year contract to train Soviet health professionals, a six-person team from the International Diabetes Center went to Moscow to present a program on diabetes education and management to 45 of the USSR's leading endocrinologists and 20 physicians from Moscow's Central Institute for Advanced Medical Studies. The IDC team found a nation faced with major problems and shortages but filled with physicians and patients eager to learn and ready to act. Diabetes education as practiced in the United States is unknown in the Soviet Union, but through training programs such as this, the Soviets are updating and expanding their knowledge of diabetes education and management.

Delivery of Health Care↗
PubMedDate not supplied

Protein, diabetes, and nephropathy.

Evidence suggests that a low-protein diet (0.8 g/kg) is beneficial in persons with diabetes with the onset of macroalbuminuria. Despite problems with existing studies, preliminary evidence suggests that vegetable proteins are not detrimental to renal function and may be used to supplement or replace animal proteins.

Diabetic Nephropathies↗
PubMedDate not supplied

Protein: metabolism and effect on blood glucose levels.

Insulin is required for carbohydrate, fat, and protein to be metabolized. With respect to carbohydrate from a clinical standpoint, the major determinate of the glycemic response is the total amount of carbohydrate ingested rather than the source of the carbohydrate. This fact is the basic principle of carbohydrate counting for meal planning. Fat has little, if any, effect on blood glucose levels, although a high fat intake does appear to contribute to insulin resistance. Protein has a minimal effect on blood glucose levels with adequate insulin. However, with insulin deficiency, gluconeogenesis proceeds rapidly and contributes to an elevated blood glucose level. With adequate insulin, the blood glucose response in persons with diabetes would be expected to be similar to the blood glucose response in persons without diabetes. The reason why protein does not increase blood glucose levels is unclear. Several possibilities might explain the response: a slow conversion of protein to glucose, less protein being converted to glucose and released than previously thought, glucose from protein being incorporated into hepatic glycogen stores but not increasing the rate of hepatic glucose release, or because the process of gluconeogenesis from protein occurs over a period of hours and glucose can be disposed of if presented for utilization slowly and evenly over a long time period.

Blood Glucose↗