The main goals of nutrition according to the “Table No. 9” system are to reduce the amount of fast carbohydrates and control daily calorie intake. This is achieved by selecting certain products and calculating the amount of energy consumed. At first glance, such rules may seem complicated. But in practice, many people cope with the diet without feeling any restrictions. They asked the doctors what the “Table No. 9” diet is, what is possible and what is not allowed for type 2 diabetes, and what recipes they can prepare at home.
- What is this
- The essence
- What is possible
- What not to do
- During pregnancy
- Menu for the week
Artem Zhukov, therapist, endocrinologist at the Rassvet clinic;
Alexey Zhito, therapist, endocrinologist, cardiologist, candidate of medical sciences, deputy head physician of the Mprofiko clinic on Zemlyanoy Val;
Ekaterina Dragunova, gynecologist, ultrasound diagnostics doctor at the Semeynaya network of clinics.
Diet “Table No. 9” for type 2 diabetes mellitus
Special nutrition is one of the therapeutic ways to control diabetes of any type
Diet “Table No. 9” is a special diet developed for patients with mild to moderate type 2 diabetes mellitus (1). The author of the diet is the Soviet therapist Manuil Pevzner, who compiled a system of 15 numbered treatment tables.
Type 2 diabetes is a chronic disease that may not manifest itself for a long time. It is often diagnosed at older ages and in overweight people (2). Such patients do not require regular injections of insulin, a hormone that opens the way for glucose into the cell. But either the pancreas produces too little of it, or the cells do not recognize it properly (so-called insulin resistance).
For patients with type 2 diabetes, it is first of all important to monitor their diet, in particular carbohydrates – the main source of glucose. The “Table No. 9” diet limits the amount of carbohydrates, sugar and total calories in general. This helps minimize blood sugar spikes and keep weight under control.
Back in the middle of the 20th century, nutrition according to Pevzner was widely used in medical practice, but since 2003, “Table No. 9” has not been included in the official recommendations of the European Ministry of Health (3). The numbered diets were replaced by five standard diets intended for different groups of diseases. Some of the principles overlap with Pevzner nutrition.
Standard diet system (4)
|Options for standard diets||Designations||Numbered diets|
|The main version of the standard diet||ATS||1, 2, 3,4 5, 6, 7, 9, 10, 12, 13, 14, 15|
|Diet option with mechanical and chemical sparing (gentle diet)||Shd||1b, 4b, 4c, 5p (1 option)|
|Diet option with increased amounts of protein (high protein diet)||VBD||4е, 4аг, 5п (option II), 7в, 7г, 9б, 10б, 11, R-1, R-II|
|The second option for a high-calorie diet||MIA||11|
|The second option for a high-calorie diet||NBD||7b, 7a|
|Reduced calorie diet option (low calorie diet)||NKD||8, 8a, 8o, 9a, 10s|
What is the essence of the “Table No. 9” diet?
A common companion to type 2 diabetes is excess weight.
The main essence of nutrition according to the “Table No. 9” system is the normalization of carbohydrate metabolism and hypoglycemic therapy, says Alexey Zhito, internist, endocrinologist, cardiologist, candidate of medical sciences, deputy head physician of the Mfiko clinic on Zemlyanoy Val. The diet helps control sugar spikes, maintain a feeling of fullness, improves metabolism, and also stabilizes and maintains weight.
“As for the disadvantages, it requires constantly counting calories and preparing food. Considering that many diabetics work full-time, it is difficult for them to adhere to all dietary parameters, which can ultimately affect the intended outcome,” adds the doctor.
The main nutritional rules for type 2 diabetes and the “Table No. 9” diet (2):
- Regular meals. Breakfast, lunch and dinner should occur at approximately the same time every day. This regimen stimulates the secretion of gastric juice and improves food absorption, explains Alexey Zhito.
- Fractional meals. Taking into account snacks and afternoon snacks, there can be up to six meals per day. The portion size is small. According to the doctor, fractional meals prevent strong feelings of hunger and help not to overeat.
- Food temperature. Any dietary food should not be very hot or cold. Recommended temperature range: 15–65 °C.
- Cooking method. All food is prepared in the most gentle and healthy way possible. Frying in oil, breading and other aggressive processing options are prohibited. Dishes are served boiled, steamed, stewed or baked.
- Water balance. Drinking regime is no less important than the main meals of solid food. According to current standards, a person must drink at least 1.5 liters of still water per day.
Modifications of the “Table No. 9” diet (9A and 9B)
In the “Table No. 9” diet developed by Pevzner, there are two subtypes – 9A and 9B. This or that option depends on the severity of the disease.
- “Chair No. 9A”. Indicated for prediabetes and overweight patients. The diet limits the intake of fats, carbohydrates and cholesterol. Sugar, cream, mayonnaise, wild bird meat, and chocolate drinks are completely excluded.
- “Table No. 9B”. Designed for moderate to severe type 2 diabetes with normal body weight. Restrictions apply to easily digestible carbohydrates, fatty soups and concentrated broths, as well as semi-finished meat products.
What is possible with the “Table No. 9” diet
In type 2 diabetes, the balance of vitamins and minerals is also important
Despite the word “diet”, “Table No. 9” is based on good nutrition, with a balance of all essential microelements. Preference is given to healthy food, but with some nuances.
Products allowed in “Table No. 9” and the diet for type 2 diabetes (5).
- Bread: whole grain, rye.
- Meat: lean poultry, beef, veal.
- Fish: pollock, pike perch, carp.
- Vegetables: potatoes, zucchini, cucumbers, tomatoes and…