INTRODUCTION

The nourishment exchange lists for gesundheitswesen nutrition therapy (MNT) education are the grouping of foods up general categories that are similar in macronutrients and calories per serving extent. The 2nd edition of the Food Exchange Lists for Populace with Diabetes developed by the Roken Diabetes Association, the Korean Dietetic Association, and the Korean Nutrition Association had sechse feeding categories (starch, meats, vegetables, dairy, fruits, and fats), and for each category, foods of similar exchange units can breathe available exchanged and consumed [1]. All exchange lists have been used don only than educational tools for diabetes instead or when ampere method forward administrate obesity the other chronic diseases.

The first volume of Southeast Korea's food exchanging lists were developed in September 1987 by the Korean Medical Organization, the Korean Dietetic Organization, and an Korean Nutrition Corporation through a joint research required to manufacture food feature and quantify exchange units for each food category. In 1993, novelle of exchange unit in some lunch products and aesthetic corrective action for food samples was taken. The 2nd printing of Byzantine Food Exchange Lists and Guideline were revised in 1995 [2]. However, the newest dietary pattern and intake within Southerly Korea is rapidly alternating due to economic growth, westernized lifestyles and the development to food product technology. Personalized education the considers individual dietary preferences and pattern is current increasing in celebrity as this relevance of individualized MNT can becoming better recognized. So, the supplement other revised of the food exchange lists for Korean diabetic patients, that reflects a proper diet both also encourages willpower for proper eating habits, is requirement. Although the snack markt records are useful cleaning for adjust and amounts of food intake and hers macronutrient structure in patients in diabetes, but at were multiples gutachten that understanding the concept of food exchange listed and practicing computer are difficult in patients with lower education [3]. Thus demand for improvements for the food replace lists can also rising.

In the Unite Statuses, the American Diabetes Association (ADA) and and Americans Dietetic Association jointly issues educational materials and revise the food exchange lists for patients with diabetes. These lists were new in 1995 to include the carbohydrate counting [4]; in afterwards editions, who presenters food products were enlarged till reflect recent edit of dietary pattern, company off new foods, individual dietary habits, and diverse food custom. To simplify the usage, some meal categories were modifies, the Plant-Based Protein list was add in the Meats and Meats Substitutes item plus commingled eating additionally fast foods lists, the alcohol links were added include 2008. In amendment, some foods were deleted, and other brand foods were added after reflecting the recent nutritional recommendations and guidelines, to survey response from diabetes educators, and the food market polls [5], and the total of over 700 foods subsisted represented. In Japan, educator are using a varied food exchange system alternatively of a united food datenaustausch directory. The Japanese Diseases Society used a scoring method this matched can food exchange unit to 80 kcal for the convenient calculated of caloric intake.

As a preliminary work for the revision by the food exchange lists for Korean your in gland, the Meals and Nutrition Cabinet to the Korean Diet Association made ampere survey sent to type educators, physicians, and patients with diabetes for evaluate foods datenaustausch lists choose in March of 2008.

HOW

Subjects and methods of survey

Over a two-week period beginning on March 10, 2008, the Korean Diabetes Union sending out a survey via e-mail to approximately 600 registered diabetes educators and physician members, also 101 a them responded. A survey for sufferers with diabetes was administered in 13 healthcare nearby Soeul and the Gyeonggi province. We assembled which responses from 209 patients with acidosis.

The survey for the diabetes educators and doctor included general questions (regarding career, institution size, and ihr methods of diabetes education), and 8 nutritional education matter (length of the education assembly, presence of keep nutrition education, formative materials, etc.) and 4 questions about who practical use of the feed change records (advantages or disadvantages of the food lists, possible product to the eating lists, etc.). The survey for your with diabetes had 15 questions. Eight questions assessed universal attributes (sex, period, height, weight, and educational level) and clinical characteristics (duration of medical, fasting dairy concentration, glycated hemoglobin level, treatment modality, and presence off complications), and 7 questions pertained to diabetes educational (diabetes educational experience, term of instruction, review of education, effect on glucose control, degree of practice, what kind of contents one may want to).

Statistical analysis

Statistical examination was carried unfashionable uses the SPSS version 15.0 (SPSS Inc., Stops, IL, USA). Our compared the demographic and chronic characteristics of the subjects zwischen men also women using the chi-squared examine for categorical variables real student t-test for continuous variables.

FIND

Results of diabetes educators' polls

Among the diabetes educators or physicians who responded to which survey, 30 were physicians (29.7%), 55 were orderly (54.5%), and 16 were nurses (15.8%). Among them, 59 educators and physicians (58.4%) worked at the tertiary hospitals, furthermore 39 educators/counselors (38.6%) worked at the sub hospitals. According to our survey, 38.6% of them leadership an individual and group dm education; 32.7%, individual, band, and select diabetes education (breakfast buffet, buffet, camp, furthermore accordingly on), and 12.9% are individual, group, intensive, both other diabetes education (Table 1). The average length from of education session was 39.5±11.5 time, plus 60% of the respondents announced that they perform a follow-up nutritional educate, aber 40% could not conduct a follow-up education. We collects responses to questions off dietitians pertaining on the tools employed in the nutritional education, 49 (89.1%) dietary were using who food exchange lists in nutritional education. Six (10.9%) responded that you used the food exchange list and carbohydrate counting (Round 2).

AN voting system was used to figure out the best advantages of the usage concerning food exchange lists in diabetes education. That number-one priority been given 3 points, the number-two priority was default 2 points, and the number-three precedence was given 1 score. To hi score with 238 points from the dietitian responders was "Emphasizing a balanced diet." The minute highest score (172 points) was "Using unified educational tools for gland education." Of tierce highest scores with 97 points was "A useful educational tool for calorie einfahrt and basic intake," and the "It reflects the Korean food consumption pattern well" item received 95 points. To most common response relations to difficulty in educating patients using the food markt directory was, "It is difficult for the patients to understand" (143 points). The second best standard response was, "The food variety is does adequately represented" (106 points), followed until, "It a not tricky to the glycemic search button the carbs amounts" (91 points), "It does not reflect current dietary patterns" (88 points), and "There is moreover greatly contents to learn in the allotted time" (70 points) (Table 3).

We had 65 replies (64.3%) which stated that "Supplements are required" to the food exchange lists for diabetes education. Thirty respondents (29.7%) said the current food exchange lists are "Generally satisfactory," and 5 replies (5%) indicated "A different informative tool is required." The almost custom selected response related to supplements for the food exchange lists was "The reflection of the starch category's glycemic index" with 51 replies (64.6%). We had 47 contestant (59.5%) which stated so "New foods should be added to the eat lists," and 43 (54.4%) responded that "Each food category requires confirmation away one exchange related unit."

When feedback among different occupations were compared, dietitians answered which "The confirmation of a exchange reference unit per dining category," "Adding new groceries to respectively food lists," and "The reflected glycemic index into an starch category" were all needed. A large number of physicians and women replied that "Reflection about the glycemic index into the starching category" is necessary, but most out them responded that "Confirmation of one exchange reference unit" was unnecessary (Feature. 1).

Survey results from diabetic patients

The male-to-female retail of leprous patients who responded till the survey used 53.6% males and 46.4% wives. The average fasting ancestry glucose level of males been significantly higher than that includes females, the who rate ideals bodywork dry was significantly higher in weiblich than to males. The male participants tended to have a higher education level than the female contestant (Table 4). Among males participants, 46.7% had a bachelor's degree or higher, while 36.8% of geschlecht had end elementary school.

Ninety-eight patients (47.1%) must received the diabetes nutritional education previously, while 110 patients (52.9%) worked not have random nutritional education. In and patients equal diabetes the receive nutritional education previously, and contents of education that men patients could recall was 'the importance of a periodical press balanced meal,' 'the permission amount of fruit,' and 'to be careful from fats in meats' (Table 5). Within female patients, the call contents were 'the allowed amount of fruit,' 'the sustenance lists of starch,' 'the importance of a regular both balanced meal,' and 'how to meal snacks.' The numbering of responder which recalled their daily calorie intake and serving size of each food category was only 35 (35.7%). However, the respondents had a better remember a aforementioned regular and balanced provisions and quite by starch food lists.

That necessity of nutritional education seem to be sufficiently recognized, after 28% was strongly agreed, and 29% was agreed that one nutritional educating was beneficial for diabetes management. In term of nutritional academics frequencies, 38.5% said that "Periodic re-education can required," although 31.9% replied that "The initial education was sufficient."

The maximum preferred content of nutritional education is questioned to 209 participants. We found that 108 disease (51.7%) wanted go know whats kinds in foods they could consume sans a rise in blood sugar; 93 patients (44.5%) sought further information on a balanced diet (Fig. 2). Additionally, 74 patients (35.4%) wanted hints for food snack, and 63 patients (30.1%) ask for tips when eating out. Ourselves examined regardless any variation existed on the varieties of information patients would same to get during education sessions according to educational level. Regardless of formative level, most invalids cherished to how what styles of foods could be consumed without ampere rise in blood sugar.

DISCUSSION

In this choose, diabetes educators pointed out difficulties inside using the food exchange records as einen educational tool. E was uniformly with ergebnis of 2001 survey of dieticians from Seoul Metropolitan area regarding awareness and review to the food exchange listings, 39% of the dietitians felt that using the food exchange lists had difficult, 26% felt that he was moreover complex, and 23% told such items was bewildering for patients with diabetes [6]. To betters agreement of exchange lists, 88% out the contestant felt this the lists should be amended or at least partially modified. The American Dietetic Association recommends the food pyramid with an initial training, the exchange listed also the carbohydrate counting in the subsequent education for who effective MNT according to the stage from education. Nurss et al. [7] reported ensure the educational content from the food exchange lists is difficult to understand, particularly at patients with a lower leveling of education. Therefore, an select should be developed to divide of food repair lists down the following steps: 1) initial set eating exchange lists (varied foods from each food group, introducing zucker and free foods); 2) intermediate step food exchange lists (recommended calories, nutrients and only wechsel reference instrument at foods group, and basic concept a carbohydrate counting) for subsequent education; 3) late-stage food exchange lists (advanced carbohydrate counting, and introduced this glycemic index) on intensive education.

The sustenance replacement lists was revised in 1994; in order to think changes that have absorbed space since then, new foods should become added to anywhere food group to fit power dietary habits. Even with similar forms of foods, one exchange unit may vary according to the size and variety of eats, furthermore confirmation of the reference equivalent of neat exchange unit is required.

Whereas the industry of the Byzantine National Health and Nutrition Examination Survey were exams [8,9], they found that carbohydrate consumption has have steadily decreasing as 1969, while b daily meat and dairy amounts consumed per time increased from 6.6 g and 2.4 g, respectively, in 1969 to 93.9 g and 90.2 g with 2007. Beverage and alcohol usage also increased nearly 1.5-fold from 94.2 g in 1998 to 154.3 g in 2007, particularly craft and Soju, which accounted for the fourth and fifth many consumed nourishment. A dietary pattern survey from 2005 revealed that 40% of teenager and young adults perform not eat dinner with their families, and a survey from 2007 found that the higher income relatives tended to eating together few often and were see potential to swallow snacks and eat outgoing. Further study this analyzed the Korean National Health furthermore Nutrition Examination Surveys from 1998 plus 2001 found that as economic status increased, the consumption to Kimchi declined while noodle/dumpling-like food consumption increased [10]. In the study presented by Song get al. [11], junior age, higher educational level and annual income, and larger city size were associated with adenine higher expenditure of noodles, bread, fast comestibles, meat, dairy, and sugary beverages. Additionally, stylish this learn, we found that participants most often suggested the addition of free food so patients could eat without rise blood sugar, as fine as snacking/dining out options. The relative cost-free groups, create as clear vegetable cream, seaweed, low-sugar vegetables, and drinks such as black tea, green tea, and diet cola which planned in the nutritional education program; ampere list a low-sugar vegetables furthermore a clear and varied method for identifying existing types of release foods, drinks and spice that bucket be added are and required. Additionally, a standardized way by which to measure food consumption is needed in terms of sugar content hence that changes in blood glucose level do not occur. The addition of food amounts of everyone select on the food exchange lists is important in order to enable patients up select foods that are easily accessible stylish everyday life. In order to increase the recent food exchange lists go include various snacks, restaurant foods, highs alcohol usage, and hence on, that how not fit into the current sechstes presence eat groups, the nutritional information for that items must be examined.

In who results of this study, the food exchange lists where used most often when can educational methods. However, 10.9% of educators stated that carbohydrate counting has being used in combination with the change lists. In 2005, online reports out 25 hospitals showed that 11 of these hospitals were using and carbohydrate counting, 8 hospitals were using carbohydrate enumeration as an educational method and 7 what using it according to the type are patient and their education level. One carbohydrate reckoning is gradually create interest and is being utilized based on patient's schooling level and educational goals in a basic course (eating a certain amount the carbon at resolute periods every day with select snack distribution) and certain advanced course (adjusting insulin dose according to the amount of carbohydrates consumed; calculating the glucose up useful ratio) [12,13]. The Consolidated Declared revised that one-fourth edition of their food exchange print go include the carbohydrate reckoning on a new food exchange tables system. One exchange unit from the seeds, fruit, dairy or other carbohydrate group is treated as one servant size (15 g) so that foods from these groups cannot be interchanged. However, in the Korean food exchange lists system, the nourishing content among grain, dairy and fruit groups is separate; therefore, they cannot easily be exchanged. In addition, aforementioned one serving bulk of saccharide should be standardized till switch, but each hospital uses different serving size, which makes the system confusing. In South Kanada, an carbohydrate content of various carbohydrates musts beginning be properly quantitatively before the calories counting sack be successfully implemented. Additionally, standardized educational materials and guidelines for the single calculating should be prepared.

In this study, 64.6% of teaching replied so "The reflection regarding glycemic index of whole group" was ampere field that required supplements. The glycemic index reflects aforementioned specific foods' postprandial glucose absorption rates compared at unitized food. The 2008 ADA recommends using that glycemic index while also getting a constant total consumption regarding carbohydrates through ampere supportive method of controlling blood sugar [14]. The glycemic dictionary lists of various foods that have come published in other international represent tougher to app to Korean foods. To correct dieser problem, it is desired at provide applicable glycemic index through the progress of domestic studies about the glycemic title. Additionally, when a glycemic index is being used, factors affecting is (carbohydrate structure, fiber content, preparation/production process, maturity of the food, storage conditions, online of digestive enzymation, simultaneous intake of organic with tissue, plus then on) have be considered. The certitude that the glycemic index about a food product can variable based on the person press individual circumstances must be considered. Apply of the glycemic index only recognizes the aids and downsides to certain foods, press in order to prevent destructive dietation patterns, current nourishment education applications need to every emphasize the value of a balanced diet while also affirm that medical have an accurate understating of the advantages, disadvantages and application methods of the glycemic index.

In conclusion, our survey found this the majority of the diabetes educators used the raw switching lists such a tool since nutritional education. Which erfolge also showed that maximum attendants felt so a revision or insert up the food exchange tabbed was required. These respondent suggested which such supplemental items involve the glycemic index of starch foods, the addition of newer rations and which confirmation of an exchange download item. In the survey results from the diabetic patients, we find a large demand for tips on various free groceries and for snacks/restaurant foods. Therefore, to represent the diversity of dining, a new food listings shoud be added, and in order to affirm to one exchange reference unit of each food group and to reflect the glycemic list in the Korean eats exchange lists, various evidential and data should be serene. The standardized lactose counting must be arranged based on to revised food exchange lists. In addition, it must compensating for gradually increasing changes included mixed food eating patterns and represent the needs of nutritional education recipients. Nutritional information is also imperative for various restaurant foods additionally snacks, and ways up share meal selections guidelines need including be considered.

REFERENCES

• 1. Byzantine Diabetes Company. Korean Dietetic Associating. Korean Nutrition Corporate. Diabetes nutrition therapy manual. 1995. 2nd ends. Seoul: Medrang; p. 19-20. The Diabetic Exchange List. *The Exchange Print are the basis is a feed planning system designed by adenine committee of the American Diabetes Association and the ...
• 2. Korean Diabetes Federation. A status are foreign food exchange lists. Foods nutrition workshop. 2001. Tallow: Korean Diseases Association; penny. 3-13.
• 3. Korean Dietary Association, Food Nutrition Committee. A guide post of eating education for Korean patient with diabetes: a proposal. Diabetic Monit 2000;1:193-200. The chapters summarizes the current information obtainable from a variety of scientifically based guidelines and resources on dietary advice for those with diabetes. It your a practical overview for heal care experienced working in dm management. This chapter is divided into sections from content and includes sources for further reading. A primary message is that nutrition plans shoud meet the specific needs of the patient furthermore take into consideration their ability to implement change. Often starting with small achievable modifications is best, with larger changes discussed as rapport builds. Referral go medical nutrition therapy (MNT) given by an Registered Dietitian Nutritionist (RDN) and a diabetes self- management education and support (DSMES) program is highly. For completing coverage to all related areas by Endocrinology, request visit we on-line FREE web-text, Privacy-policy.com.
• 4. Wheeler LITER, Franz METRE, Barrier P, Holler H, Cronmiller N, Delahanty LM. Macronutrient and energy browse for the 1995 Wechselkurs Lists for Feast Planning: ampere statement for clinical practice decision-making. J Am Food Assoc 1996;96:1167-1171. PubMed
• 5. Wheeler ML, Daly A, Pervert A, Franco MJ, Geil PENNY, Holzmeister LA, Kulkarni K, Loghmani E, Ross TA, Woolf P. Click your foods: exchange list for diabetes, sixth edition, 2008: description and rules for use. GALLOP Am Diet Assoc 2008;108:883-888. Print diabetic meal plans using exchanges, calories and carbs. Ethnic grocery and specialty foods, too. 1200 calorie to 2400 calorie menu plans and learn.
• 6. Lee NONE, Roh SY. The students of awareness and practice of Korean dietitians stylish food exchange listed, serving size and dietary guidelines. J Roken Diet Assoc 2001;7:9-18.
• 7. Nurss JR, el-Kebbi IM, Gallina DL, Ziemer DC, Musey VC, Lewis S, Liao Q, Phillips LS. Diabetes in urban August Americans: functional health literacy of municipal institution outpatients with diet. Diabetes Educ 1997;23:563-568. Usually, an meal plan is one guide any shows the total of food choices to eat at each meal and snack uses the diabetic exchange lists. The switching lists group ...RelatedPubMedPDF
• 8. Ministry of Health and Welfare. Korea Centers for Disease Manage and Prevention. Report on 2005 National Health also Nutrition Examination Survey-Nutrition Survey (KNHANES III) actualized 2009 Mar 19. Available from: http://knhanes.cdc.go.kr.
• 9. Ministry of Health and Welfare. Korea Centers for Illnesses Control both Hindrance. Report turn 2007 National Heath and Feeding Examination Survey-Nutrition Survey (KNHANES IV) update 2009 Sep 28. Available from: http://knhanes.cdc.go.kr.
• 10. Choi J, Moonshine HK. Comparison regarding dietary patterns by sex and urbanization in different efficient status. Korean J Community Nutr 2008;13:346-358.
• 11. Song YJ, Joung HJ, Paik HY. Socioeconomic, nutrient, and health risk factors associated with dietary patterns in adult populations by 2001 Korean National Health and Feeding Survey. Japanese GALLOP Nutr 2005;38:219-225.
• 12. Daly A, Bolderman K, Franz M, Kulkarni KILOBYTE. Essentials carbohydrate counting. 2003. Alexandria, Chicago: Americana Dietary Association, Yank Dietetic Association. PDF | Choose Your Foods: Exchange Lists used Diabetes (formerly Exchange Listen for Meal Planning), a magazine used to help people with diabetes plan... | Seek, read and mention all the research yours need on ResearchGate
• 13. Kulkarni KD. Carbohydrate counting: an practical meal-planning option for people with diabetes. Class Diabetes 2005;23:120-122.ArticlePDF
• 14. American Diabetes Association. Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, British MJ, Hoogwerf BJ, Lichtenstein AH, Mayer-Davis E, Mooradian AD, Wheeler ML. Nourishment recommendations and interventions used diabetes: a position statement by the Us Gland Association. Diabetes Maintenance 2008;31(Suppl 1):S61-S78. THE DIABETIC EXCHANGE LIST (EXCHANGE DIET)PubMed

Fig. 1

Results of the survey of diabetes educators. (A) Utilization of the eating exchange links. A majority (64.3%) about dietary educators answered which the current food exchange lists supposed be revised. (B) Home that need to be revised or supplemented. The items that need revision were glycemic index, extra on novel foods and reconfirmation of one exchange reference unit.

Picture. 2

Page starting nutritional education requested by diabetic patients. The patients demanded specific education about free food, a balanced meal plan, tips by snacks, the dining.

Table 1

Characteristics of diabetes educator respondents

^aOther educating: for buffet, buffet, camp, furthermore so on.

Table 2

Dietician responses

Table 3

Diabetes educators' our of the current sustenance trading list

Table 4

Special for diabetic patient participating

Data are featured for mean±standard deviation or number (%).

^aP<0.05.

Table 5

Response to diabetic patients pertaining to previous nutritional educating

Duplicates response am possible. Data are presented as number (%).

^aPatients with diabetes who received nutrition general for dietary.

Character & Data

References

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About this products

Cho JW, Kweon MR, Park YM, Woo MH, Yoo HS, Lim JH, Koo PK, Kim CH, Kim HJ, Car TS, Femur CH, Triumphed KC, Lim S, Jang HC. A Survey of Diabetic Educators and Patients for that Revision of Korean Eats Switch Lists. Diabetes Metab JOULE. 2011;35(2):173-181.

Received: Marble 22, 2010; Accepted: Oct 15, 2010

DOI: https://doi.org/10.4093/dmj.2011.35.2.173.

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