Diabetes And Nutrition

NUTRITION AND DIABETES

People with diabetes have to make sure that the carbohydrate content in their food is balanced with insulin, oral medications, and exercise to help manage their blood sugar (glucose) levels. A healthy diabetes nutrition plan is one of the most important things you can do to help manage your diabetes.

DIABETES MEAL PLANNING

In spite of what you might have heard, having diabetes does not mean you have to give up all the foods you enjoy! However, learning to eat healthier, satisfying meals is an important part of your treatment.

A good diabetes meal plan includes:

Understanding how different foods and the amounts you eat affect your blood sugar (glucose)
Choosing healthy foods
Eating your meals at the times appropriate for your diabetes treatment
Eating well-balanced meals in the correct amounts may help you keep your blood sugar level within the target range set by your health care provider. This might sound like a lot of work, but your doctor and/or dietitian can help you create a meal plan that is best for you.

EAT THE RIGHT AMOUNT OF FOOD AT THE RIGHT TIMES

Several factors affect how much food you need each day. One of them is how much you weigh in relation to how tall you are (this is called your body mass index, or BMI). Another is how much exercise you get. People who exercise a lot or whose jobs involve heavy labor use more energy than people who are less active. Most people eat better, feel better, and have more energy if they eat regular meals. Spacing food throughout the day also can help you stay at a healthier weight and get the nutrition you need.


TIPS FOR HEALTHIER MEAL CHOICES

When planning your meals, keep the following in mind:

Keep it colorful. Include a wide variety of fruits and vegetables in your diet. When selecting vegetables, it is best to choose from nonstarchy ones such as spinach, carrots, broccoli, or green beans

Keep it whole-grain. Choose whole-grain foods instead of processed grain products. Start including brown rice instead of white rice, and serve whole-wheat spaghetti with pasta sauce

Swap out the soda. Choose water and calorie-free diet drinks instead of regular soda, fruit punch, sweet tea, and other sugar-sweetened drinks.

Switch to nonfat dairy products. Replace full-fat milk, yogurt, and cheese with nonfat dairy like skim milk, nonfat yogurt, and nonfat cheese

Use liquid oils only. When cooking, use liquid fats instead of solid fats. Any fat that is solid at room temperature is higher in saturated and trans fats than liquid alternatives.

Remember: fats are high in calories, so be mindful when cooking.

Trim the fat. Choose leaner cuts of meat and try to remove visible fat. Remove skin from poultry. If you roast food, use a rack to let the fat drip off. If you make soup, prepare it a day in advance and place in the refrigerator overnight so the solid fat on top can be removed before serving. Avoid meats that are high in fat, like bacon. Reserve ribs and pork-containing meals for special occasions
Cut back on dessert. Cut back on high-calorie snack foods and desserts. Cookies, cakes, and full-fat ice cream are loaded with calories and fat
Watch your portions. Portion control is a very important part of a healthy meal plan. Eating too much food, even if it is healthy, can lead to weight gain. One great way to learn about portions is to measure how much you serve with measuring cups. You may be surprised how much rice, pasta, meat, or desserts you put on your plate.

HOW FOOD AFFECTS BLOOD SUGAR

Understanding how different foods and amounts of food affect blood sugar levels after eating is one of the first steps toward making healthier food choices. Food is made up of carbohydrates, protein, and fat—and all of these have some effect on your blood sugar levels after eating.

CARBOHYDRATES
Foods with carbohydrates, or carbs, have the most effect on your blood sugar levels. Carbohydrates are found in starchy foods (like bread, cereal, potatoes, corn, rice, pasta) and in fruit, milk, yogurt, and sweets. Since many healthy foods contain carbohydrates, they are important to include in your diet.

PROTEIN
Protein usually has only a small effect on your blood sugar levels. Protein is found mostly in animal products, nuts, some dairy products, and beans. Your body needs protein to work properly.

FAT
Foods with fat slow down how fast the stomach empties. This can make blood sugar a little lower soon after meals and a little higher longer after meals. Choose healthier fats and limit high-fat foods to help reduce your risk of heart disease, a major health threat for people with type 2 diabetes.

KEEPING TRACK OF CARBOHYDRATES
Keeping track of the carbohydrates you eat is a key factor in managing your blood sugar. Carbohydrates have the greatest impact on your blood sugar after meals, and your blood sugar level can go too high when you eat more carbohydrates than your body can use. By keeping track of the carbohydrates you eat and spreading them throughout the day, you can help manage your blood sugar. Check with your doctor or dietitian for help in learning how your blood sugar is affected by carbohydrate intake.


CONTROL YOUR PORTION SIZE
Eating large amounts of foods that contain carbohydrates can cause higher after-meal blood sugar levels. Measure portions at home until you learn to estimate. Eating less can help reduce your after-meal blood sugar and your weight. Talk to a registered dietitian or other diabetes educator about how many carbohydrates you should have at each meal.

"RATE YOUR PLATE" TEST
A quick way to make sure you are eating a variety of healthful foods at each meal is to "Rate Your Plate." When you sit down for a meal, draw an imaginary line through the center of your plate. Then draw a line to divide one section into two.

You may need to count the carbohydrates in your meal so you can be sure your insulin and exercise are on target. But rating your plate can help you get started.

CHOOSING HEALTHIER FOODS FOR DIABETES

TIPS FOR MAKING HEALTHIER FOOD CHOICES

The best choices for the rest of the family are also the best choices for people with diabetes. Choosing foods according to the MyPlate model will help you and the rest of the family follow these guidelines for healthier eating:

Eat a variety of foods from the different food groups

Eat plenty of fruits and vegetables. All fruits and most vegetables contain carbohydrates, but their high content of vitamins, minerals, and fiber make them great choices

Choose a diet low in fat, saturated fat, and cholesterol. For best health, these should make up only a small portion of overall food choices. Most saturated fats (animal fats and shortenings, for example) tend to raise blood cholesterol levels and are poor choices for the health of your heart

Use salt (sodium) in moderation. Most people eat more salt than they really need. For some people, extra salt adds to their risk for high blood pressure. High blood pressure (greater than 130/80 mm Hg) is more common in people with diabetes and greatly increases the risk for various health complications. Here are ways to cut down on salt:

Choose foods "close to nature." Processed foods usually have more salt

Avoid foods canned, boxed, or frozen with extra salt. Try the "no-salt-added" varieties

Use herbs, spices, and salt-free seasoning mixes for added flavor, instead of salt

Use sugar in moderation. High-sugar foods should make up only a small part of the diet. However, small amounts of sweet foods can be a part of a healthier diet, even for people who have diabetes. Learn how to fit the sweets you enjoy into your overall plan

Use alcohol in moderation. Alcohol can dangerously lower blood sugar (glucose) in people with diabetes who take insulin or diabetes pills. If you choose to drink alcohol, talk to your doctor or dietitian about how to drink safely. Pregnant women should not drink alcoholic beverages

HEALTHIER EATING ON-THE-GO

When going out to eat, don't leave your healthy habits at home. Restaurant meals, and some fast-food meals, can offer healthier choices for your diet. It's still important to eat a wide variety of foods and control your portions. In addition, you need to be on the lookout for food that can be loaded with calories, fat, cholesterol, and sodium.

MORE HEALTHY EATING TIPS

Balance fast food with healthier food. If you're having a fast-food meal, focus your other meals for the day on healthier foods like fruits and vegetables
Consider the cooking method. Chicken and fish are good choices as long as they are not breaded or fried. Choose grilled or broiled meats or fish instead
Choose healthy toppings. Avoid rich toppings like sauces, mayonnaise, and cheese on sandwiches. Add flavor with mustard and tasty veggies like tomato, onion, and lettuce
Be salad bar savvy. While salad bars are a great option at fast-food restaurants, creamy dressings and toppings like bacon and croutons can add too much fat and salt. Check the nutritional information on salad dressings before you create your salad, and stick mostly with vegetables for toppings
Choose thin crust pizza. Occasionally, pizza can be part of your healthy diet when managing type 2 diabetes, as long as you opt for thin crust and vegetable toppings. Limit your portion to 1 or 2 slices, keeping in mind that meat toppings and extra cheese add extra fat and salt to your meal
Say no to soda. At mealtime, drink water or calorie-free drinks instead of regular soda, fruit punch, sweet tea, and other sugar-sweetened drinks

SWEETS AND DESSERTS IN MODERATION

While it will take some planning, you can still enjoy sweets and desserts. Because the purpose of your specific diet is to help meet your blood sugar goals, you want to make sure you eat nutrient-rich foods most of the time. Otherwise your body misses out on important vitamins and minerals. This means saving sweets or desserts for special occasions, like a birthday or anniversary. When you do enjoy a sweet or dessert, have a small portion.

COUNTING CARBOHYDRATES

Carbohydrates (carbs) from the food you eat are broken down by the body into glucose (sugar) to use for energy. If you eat more carbohydrates than your body can use, your blood sugar can increase to an unhealthy level. Keeping track of how many carbs you eat—counting carbohydrates—and checking your blood sugar levels regularly (before and after meals) will let you know if you are eating too many carbohydrates.

Learning to balance your carbohydrate intake with your insulin needs will help you manage your blood sugar. To do this, you and your doctor will need to determine how much insulin you need to cover a certain amount of carbohydrates.

TIPS FOR EASIER DIABETES CARB COUNTING

Just about anyone can learn the basics of carbohydrate counting in a short time. Below are a few tips that can help speed your learning.

TIP 1: GATHER A FEW TOOLS THAT CONTAIN THE FACTS YOU NEED

You need to know which foods have carbs and how many they contain. Most foods sold at a grocery store have the Nutrition Facts printed directly on their packaging. The labels show how much Total Carbohydrate is in a single serving of the food. If you eat out, you'll need details about those foods, too. Most restaurant chains have nutrition brochures, although most local restaurants do not. Diabetes food exchange lists can help, too. They show an average amount of carbs for standard servings of many foods. If you need even more information, look for books that contain carb counts.

More Nutrition Label Tips to Keep in Mind

Always check Total Carbohydrate. The total carbohydrate amount listed for a food includes starch, fiber, sugar, and sugar alcohols. If you are counting your carbohydrates, the amount of total carbohydrate can provide you with the information you need for meal planning

Read sugar-free labels carefully. A sugar-free food is not necessarily a calorie- or carbohydrate-free food. Check the Nutrition Facts label for the amount of total carbohydrate and calories

Pay attention to serving size. Certain packaged foods contain more servings than you might expect. The serving size information on the left side of the Nutrition Facts label provides total amounts of different nutrients per serving. The serving size on the label may not be the same as the serving size in your meal plan or the serving you normally eat. If you eat twice the serving size listed on the label, you need to double all the numbers listed in the Nutrition Facts.

TIP 2: LEARN THE CARB COUNTS FOR ONLY THE FOODS YOU EAT

You don't need to know about the carbohydrates in ALL foods, just in the foods you eat. Many people eat the same foods over and over. Start with the foods you eat most often or with the ones you enjoy the most. You can use this helpful sheet to make a list of these foods, and then determine how many carbs are in the portion size that you usually eat for each. Knowing the carb counts for the foods on your list is a great start.

TIP 3: MEASURE OR ESTIMATE HOW MUCH YOU EAT

If you eat more than a single serving of a particular food, you will need to make that adjustment in your carb count. Some foods are easy to count, like bread. The label shows a clear serving size—1 slice. But the labels of some foods show a measured serving size, such as 1 cup or a half cup, or it may list the serving size in grams (g). In those cases, you will need to measure or estimate. A digital kitchen scale might be useful for weighing a serving in grams. It's certainly much easier to measure at home than in a restaurant!

Some people become very good at estimating. If you are going to estimate, remember this handy tip: a fist is about 1 cup in volume. Ball up your fist and lay it next to your plate. Ask yourself, "Is that pile of rice more or less than a cup?" You can adjust the portion size accordingly, or adjust your carb count to reflect how much you are actually eating.

TIP 4: PRACTICE,PRACTICE,PRACTICE

Write down everything you plan to eat. Pick out the foods that have carbs. Measure or estimate how much you will eat of each one. Look up the carb value on a nutrition label, in a book, or use the list of "Favorite Foods" you made. Do this for a couple of days. Once you have learned how to count carbs, you can start looking at your blood sugar levels before and after meals. That will show you whether the foods you are eating match well with how much insulin your body makes or how much insulin you are taking.

DIABETES CARB COUNTING FOR RECIPES

Once you learn how to do it, counting carbohydrates in foods that have the nutrition information printed on their labels will probably seem easy. But how do you count carbs in recipes or prepared foods? In this situation, it may be easiest to look at the carbohydrate counts for individual ingredients that make up a particular food. For example, if you are eating a sandwich, you will need to count the carbohydrates for the bread (both slices) and for each item that goes in the sandwich, including condiments. At first, you will probably want to measure the portions of everything that you put on your sandwich so you will know how the amounts you are using measure up to a true serving size.
For other foods that may contain many ingredients, such as a casserole, or for foods that you did not prepare for yourself, there are books available to help. There are also cookbooks and computer software programs that will give you the counts for many different types of food.

Just remember: there are many resources available to help you. Carb counting is a great method for diabetes meal planning, and the more successful you are at accurately counting carbohydrates, the better you can be at managing your diabetes.