Mrs.

Swarna Latha

69 years

Diagnosis

Type 2 DM-25 years

Hypertension-25 years

Hypothyroidism

BMI-24.1 kg

Lifestyle Medicine goals

1. To control blood sugars effectively

2. To manage hypertension
3. To optimise health and well being

Generic Lifestyle Prescription to meet the nutrient needs

1. 1-2 servings fruits daily (low glycemic)

2. 4-5 veg serving daily (partially raw/steamed/ stir-fried)
3. 10-12nuts ( 10 almonds, 2 walnuts) daily
4. 1 tsp Chia/flax/pumpkin/hemp seeds daily
5. Include whole grains (Rice/upma/poha/roti etc) and limit it to 4-5 tbsp cooked grain
per meal.
6. Exercise regularly (45 min cardio min 5 days a week+ Balancing exercises 2 days a
week + flexibility/stretches on all days)
7. Sunlight exposure thrice a week. 20 min (ideal time 11 am to 3 pm)

DIETARY ADAPTATION
Nutrients to be limited/Monitored/Checked
1. Protein: 0.8-1 gm per kg of body weight, keep an upper limit as 40 gm per day
2. Sodium: <1500 mg per day
3. Saturated fat <12 gm per day
 4. Trans fat <1 gm per day
5. Limiting foods that are high in saturated fat, such as full-fat dairy products, and
tropical oils such as coconut and palm oils
6. Limiting sugar-sweetened beverages, sweets, jaggery and honey-
7. Limit processed food, fried food, snacks high in oil-

Eaten in Plenty Moderate Limit/Avoid

consumption

Grains Brown rice, rolled oats, millets Refined carbohydrates-white

rice, bread confectionary items

Proteins Legumes, nuts,seeds, low fat fish

milk, egg white

Vegetables Leafy vegetables,beans coloured Potato/Sweet

vegetables
Potato/Corn/Squash

Fruits Low to moderate GI fruits-apples, Moderate GI Avoid fruit juices with added
kiwi, oranges fruits sugar

Others Limit oil consumption

Snacks with added salt and oil
Pickles and dishes with added
salt

Food Plate Guideline

1/2 of the plate should be

occupied by Vegetables and
Fruits,

The other half, divided into 2,

1/4 quarter protein sources,

1/4 quarter Grains

The Aim is to

1. Prevent glucose spike by limiting processed food with minimal fiber, added sugar.
2. To avoid excess oil consumption which adds to extra calories and limit saturated fat,
transfat which are not heart healthy
3. Increase micronutrient content of the food by increasing the vegetable and fruit
intake. They prevent and modify disease progression. Added fiber in these foods is
also protective against diseases. The vegetables are to be eaten in different colours.
4. Protein intake must be adequate especially as the person ages which can be done in
vegetarian diet by having a variety of legumes and pulses. They should be rotated
daily and combined with grains to get the complete aminoacid profile
5. No added sugar and minimal salt

GRAINS
Choice: Whole grain
Advantage of the whole grain: They are rich in fiber, B vitamins, antioxidants, and trace
minerals (iron, zinc, copper, and magnesium).
Eg: Brown rice, Brown bread, oats, quinoa, millets-ragi, jowar etc
Avoid: Refined grain products such as White rice, White flour like maida, White bread,
anything made with maida

PROTEINS
Choice: Sources can be Legumes, Nuts and seeds
1. Egg white: up to 4 nos be consumed in a day. Limit whole eggs to max 5 a week
2. Low fat milk or yougurt 1 cup per day or 1/2 cup curd per day or equivalent of both
3. Legumes: 1/3 cup or 4-5 tbsp cooked legumes can be consumed for lunch. U can add
some spinach and other vegetables to the legume. Preferred ones are low
phosphorus containing Bengal gram (Chana/Kadala) and Green peas. U can also have
green gram/horse gram/dal/rajma etc 2-3 times a week. Dal/Lentils: Make it watery
and have 1/2 cup. Soya products: Max 100 gm per week.
4. Nuts and Seeds: Almonds, Walnuts, Cashews, Peanut, Flax seeds, Chia seeds are all
good sources of omega 3 fatty acids other than proteins. U can have 1-2 tbsp nuts a
day. A good choice would be 6 almonds and 1-2 walnuts. A tbsp of flax seed powder
can be added on to your salads/soups regularly
VEGETABLES
Choice:
Green leafy vegetables, Coloured vegetables like red bell peppers, tomato, etc. Try
incorporating vegetables half of the plate for both lunch and dinner.

Avoid
Try and limit starchy vegetables (Potato/Sweet Potato/Corn/Squash) or replace them
for grains

FRUITS
Choice:
Try and go for Low to Moderate GI Fruits. Include fruit for breakfast and as a snack in
the evening
Avoid
The one with High GI values can be eaten less frequently (once a week)

OILS n FAT:
Choice: Sources can be Nuts and seeds, avocado. Consume whole food sources of fat
Avoid: Butter, Ghee, coconut oil, Palm oil, etc to be avoided. If you are very particular about
oil usage, add 1 tsp or less olive oil per meal
Dairy: Low-fat dairy products, Low-fat milk, low-fat cheese.

Cooking suggestions: Ideal to cook without oil, Use herbs to stir frying vegetables. If you are very
particular about oil, use 1 tbsp per dish (for the whole family). This is the first trick you need to learn.

1. Fruits to be eaten raw whole as much as possible. once a while you can try a juice or
smoothie without added sugar
2. Vegetables: Include a variety of vegetables in your meal. For every lunch, have a katori salad
(onion/tomato etc) and a vegetable subzi. Stir fried vegetables are a great choice too. Let
1/2 of your plate be vegetables. Stir frying a cup of vegetables in 1/2 tsp oil. U can also
steam some of the vegetables and add lemon and salt. Strictly avoid deep fried vegetables
3. Legumes should be soaked overnight (12-18 hours) and cooked and eaten.
4. Nuts seeds etc to be bought without added salt or sugar coating. They can be dry roasted at
home

The Dietary Approaches to Stop Hypertension (DASH) diet rich in fruits and vegetables and
reduced in saturated fat can assist with blood pressure control in hypertensive persons.

1. Vegetables and fruits accounted for approximately half of the blood-pressure-

lowering effect of the diet.
2. Restricting sodium intake enhances the blood-pressure-lowering effect.
3. Limit outside foods and snacks.
4. less use of salt in food preparation or consumption
5. Eating foods rich in potassium-Beet greens, spinach,beans,
banana,brocolli,cucumber
6. Whole grain consumption 2-3 servings per day-brown rice, oats, millets, whole
wheat

Cooking suggestions:
1. Ideal to cook without oil or if you are very particular about oil, use 1 tbsp per dish (for the
whole family). Cook at home mostly to attain the health outcomes as it enables portion
control, limits oil, salt and added sugar.
 2. Use herbs to stir frying vegetables. Using herbs and spices to the dish enhances nutrient
value and taste. Limit adding added salt and dressings.
3. Fruits to be eaten raw whole as much as possible. once a while you can try a juice or
smoothie without added sugar
4. Vegetables: Include a variety of vegetables in your meal. For every lunch, have a katori salad
(onion/tomato etc) and a vegetable subzi. Stir fried vegetables are a great choice too. Let
1/2 of your plate be vegetables. Stir frying a cup of vegetables in 1/2 tsp oil. U can also
steam some of the vegetables and add lemon and salt
5. Legumes should be soaked overnight (12-18 hours) and cooked and eaten.
6. Nuts seeds etc to be bought without added salt or sugar coating. They can be dry roasted at
home

Meal Plan-

Breakfast-
1. Fruit with seeds powder/ Yogurt with chia powder
2. 2 idli/1 dosa/1 moongdal dosa/wheat upma with veggies with chutney(1
tbsp)/4-5 tbsp poha

lunch and dinner

3. Quarter plate with salad of veggies/green leafy veggies cooked
4. Quarter plate with any veg curry with less oil
5. Quarter plate with dal/legumes/tofu
6. 4-5 tbsp rice/quinoa/millets or 1 roti

Breakfast…………………………………………………………………………………………………………

Option-1
1 bowl Fruit Salad (add 1 tbsp flax seed powder)
1/2 cup Oats Porridge or Daliya Porridge or Ragi Porridge(avoid whole fat milk)

Option-2
1 cup cubed fruit /vegetable salad (any fruit with mild to moderate GI)
plain greek yogurt-half cup

Option-3
Dal Sambar 1/2 cup + 1 tbsp Groundnut + Coriander chutney
1 medium-sized Dosa or 2 idli
Option-4
½ Cup Chana Masala (Gravy 2 tbsp) or ½ cup moong bean curry or ½ cup dal
1 Roti/Moong dal Cheela

Option-5
1 cup cubed fruit (any fruit with mild to moderate GI) with added flax and chia seed powder
5 tbsp poha

Lunch……………………………………………………………………………………………………….

Option-1
1 cup partially Stir-fried Vegetables (Coloured capsicum/Broccoli/Cauliflower/beans). Add lemon and
salt. Max oil per 1 cup veggies is 1/2 tsp (2.5 ml)
½ Katori (<100 ml dal)
1 medium-sized Roti

Option-2
1 cup carrot cucumber tomato salad
½ cup Sprout curry/ Boiled/cooked sprouts
6 tbsp rice or Cooked Quinoa

Option-3
½ cup beetroot Pan-roasted or long bean sautéed 1/2 cup
1/2 cup horse gram cooked
5 tbsp millet or 5 tbsp brown rice cooked

Option-4
1 cup Sautéed Beans n Carrots: Oil <1/2 tsp + 1/2 cup Tomato salad
1/2 cup cooked Rajma or 1/2 cup cooked dal (120-150 ml)
1 medium-sized Ragi Roti

Option-5
1/2 cup cabbage stir-fried or cauliflower roasted + 1/2 cup Cucumber salad
1/2 cup masoor dal cooked
1 Bajra roti or any mixed roti

Option-6
1 large bowl steamed or sautéed Vegetables
1/4 cup Rajma+ ¼ cup blackeyed bean
4-5 tbsp rice (Make it like a Burrito bowl) or same quantity of Quionoa

Option-7
1 Large bowl Salad
100 gm Palak soup, 1 medium Sized Roti

Dinner………………………………………………………………………………………………………..

Option-1
Legume Palak Dal 1 cup
(Dal 1/3 cup made with mixed legumes, 1/3 cup veggies and rest palak soup)
4-5 tbsp quinoa/millets

Option-2
Quinoa Salad (4 tbsp Quinoa, rest salad)
100 gm tofu can be added

Option 3
Moongdal Khichdi with Veggies 1 cup

Option-4
Cooked chana Veg soup
(1/4 cup cooked chana) or Peanuts (15 nos.) + Cabbage+ Cauliflower (Grated1/2 cup) + Grated Tofu
4-5 tbsp rice

Option-5
Palak Paneer (50 gm max)
Roti 1 no or bread 1 nos

Option -7
Veggie soup. different veggies like capsicum,brocolli, cauliflower, beans

Ideal to go ahead with a Whole Food Plant-based meals.

Snacks

1. Chia seed pudding (1tbsp chia seed soaked + 2 dates + 4 almonds + 1/2 banana + Soyamilk)

2. 2-3 Mixed Seed Ladu (Mixed seed dry roasted + Jaggery)

3. 50 gm makhana without oil

4. 50 gm chana chaat without oil +lemon juice + Salt

5. 1 bowl fruit salad with nuts (1 tsp flax powder/ 1 tsp chia/ 4 walnuts/ 6 almonds)

6. 1 bowl green gram sprouts + 1/2 tbsp olive oil +lemon juice + Salt
 7. Carrot cucumber slices 1/2 cup + 2tbsp hummus

8. Roasted black chana, Roasted Lentil

Physical activity
Exercise recommendations
a) 30 min walking 5 days a week
b) Balancing exercises 4-5 days a week
c) Flexibility/stretches on all days

Meditation and breathing exercises are encouraged atleast 10 min in a day

Sleep recommendations

a) Stick to a sleep timing and try waking up and sleeping at the same time\
b) Avoid taking naps in the afternoon if you can
c) Avoid caffeine after 4-5 pm
d) Avoid phones and television atleast one to 2 hours before bedtime.
e) Exercise preferably in the mornings or afternoon.
f) Eat light dinner Dinner: Easily digestive, half stomach only to be filled. A moderate
protein food + soups/fruit should help
g) Few stretches post exercise advised (not strenuous though). 
h) Make your bedroom quiet, dark, and a little bit cool.
i) Recommending use of a pinch of nutmeg powder or flower for its sleep inducing and
de-stressing effects with milk
j) If you find it difficult to fall asleep, reading a good book (paper print) may help to
some extent
k) Practising or listening to guided sleep meditation/listening to soothing music/
breathing exercises as sleep routine to relax half hour before sleep time

Dr.Prapthi
MBBS,MD,DipI BLM (board certified in lifestyle Medicine)