Glucose Control - Diabetic Diet
If you've been diagnosed with diabetes, your doctor has probably mentioned that you should pay careful attention to nutrition and diet as part of your treatment program. Nutrition experts say that there is no one diet for diabetes, but people with diabetes should follow the nutrition guidelines in the Food Pyramid, while paying special attention to carbohydrate intake. People with diabetes should also eat about the same amount of food at the same time each day to keep blood sugar levels stable.
Getting Started With Nutrition Treatment
If you've never attempted to eat a healthy, well-balanced diet before your diabetes diagnosis, it can be difficult to know where to get started. Try these tips from the American Dietetic Association:
Eat more starches such as bread, cereal, and starchy vegetables. Aim for six servings a day or more. For example, have cold cereal with nonfat milk or a bagel with a teaspoon of jelly for breakfast. Another starch-adding strategy is to add cooked black beans, corn or garbanzo beans to salads or casseroles.
Eat five fruits and vegetables every day. Have a piece of fruit or two as a snack, or add vegetables to chili, stir-fried dishes or stews. You can also pack raw vegetables for lunch or snacks.
Eat sugars and sweets in moderation. Include your favorite sweets in your diet once or twice a week at most. Split a dessert to satisfy your sweet tooth while reducing the sugar, fat and calories.
Soluble fibers are found mainly in fruits, vegetables and some seeds, and are especially good for people with diabetes because they help to slow down or reduce the absorption of glucose from the intestines. Legumes, such as cooked kidney beans, are among the highest soluble fiber foods. Other fiber-containing foods, such as carrots, also have a positive effect on blood sugar levels. Insoluble fibers, found in bran, whole grains and nuts, act as intestinal scrubbers by cleaning out the lower gastrointestinal tract.
After a diabetes diagnosis, consider seeing a dietitian and developing a meal plan to get started. Taking into account your lifestyle, your medication, your weight and any medical conditions you may have in addition to diabetes as well as your favorite foods, the dietitian will help you create a diet that will prevent complications of diabetes and still give you the pleasure you've always had in eating. To find a diabetes teacher (nurse, dietitian, pharmacist and other health care professional), call the American Association of Diabetes Educators at 1-800-342-2382. If you want to find a dietitian near you, call the American Dietetic Association's National Center for Nutrition and Dietetics at 1-800-366-1655 or visit their Web site at www.eatright.org/find.html.
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A Healthier Weight and Lifestyle
Reaching and maintaining a healthy weight is important for everyone with diabetes. Weight control is extremely important in treating type 2 diabetes because extra body fat makes it difficult for people with type 2 diabetes to make and use their own insulin. If you are overweight, losing just 10 to 20 pounds may improve your blood sugar control so much that you can stop taking or reduce your medication.
If you smoke and have been diagnosed with diabetes, your doctor will recommend that you quit because smoking makes problems caused by diabetes worse. People with diabetes can experience blood flow problems in the legs and feet, which can sometimes lead to amputation. Smoking can decrease blood flow even more. Smoking can also worsen sexual impotence in men, cause high levels of LDL cholesterol (the bad type of cholesterol), and can raise the risk of heart attack and stroke. If you have diabetes and you smoke, you need to quit.
Although alcohol in small amounts can be fit into your meal plan if your blood sugar is under good control, drinking alcohol on an empty stomach can cause low blood sugar. Alcohol can contribute to complications of diabetes, so ask your doctor how much alcohol can be included in your meal plan and then stick to it.
Moderating Sugar, Fat and Carbohydrates
If you've been diagnosed with diabetes, you may have a lot of lifestyle changes to make. Does that mean you have to give up sugar, fat and carbohydrates forever?
The body breaks down different types of foods at different rates. Carbohydrates (be it potato or table sugar) typically take from five minutes to three hours to digest, whereas protein takes three to six hours and fat can take eight or more hours. That's why different foods have different effects on blood sugar, such as why ice cream (higher in fat) raises blood sugar levels more slowly than potatoes. But people with diabetes don’t always have to forgo desserts and sweets. They just have to be sure not to eat moderate amounts more than once or twice a week.
To control carbohydrates, try a technique called carbohydrate counting. Carbohydrate counting means counting the total number of grams of carbohydrate you should eat at a meal or planned snack time based on your medication and exercise habits. Then you can choose how to meet those carbohydrate needs. You'll probably use a carbohydrate counting book, which you can get at a supermarket or bookstore. If you want to learn how to count carbohydrates accurately, make an appointment with a dietitian or a diabetes educator.
Because people with diabetes are at higher risk for heart problems, it's often recommended that they limit fat below 30 percent of total daily calories by eating less overall fat and less saturated fat. They also need to watch cholesterol, choose smaller portions of lean meats, poultry and fish, and low or non-fat dairy products. Because high-protein diets such as the Atkins diets are high in fat, they are not usually recommended for people with diabetes.
Remember that it will take a while to learn how to adjust to the changes in your diet and lifestyle after a diabetes diagnosis. With practice and help, you can have a satisfying diet and keep your blood sugar under control, too.
The Diabetes Food Pyramid divides food into six groups. These groups or sections on the pyramid vary in size. The largest group -- grains, beans, and starchy vegetables -- is on the bottom. This means that you should eat more servings of grains, beans, and starchy vegetables than of any of the other foods. The smallest group -- fats, sweets, and alcohol -- is at the top of the pyramid. This tells you to eat very few servings from these food groups.
NEW!! On April 19, 2005 the United States Department of Agriculture (USDA) released a new food guidance system replacing the former Food Guide Pyramid. The new system, called "MyPyramid," provides a set of tools based on caloric requirements to help Americans make healthy food choices. Read the ADA's response.
The Diabetes Pyramid gives a range of servings. If you follow the minimum number of servings in each group, you would eat about 1600 calories and if you eat at the upper end of the range, it would be about 2800 calories. Most women, would eat at the lower end of the range and many men would eat in the middle to high end of the range if they are very active. The exact number of servings you need depends on your diabetes goals, calorie and nutrition needs, your lifestyle, and the foods you like to eat. Divide the number of servings you should eat among the meals and snacks you eat each day.
The Diabetes Food Pyramid is a little different than the USDA Food Guide Pyramid because it groups foods based on their carbohydrate and protein content instead of their classification as a food. To have about the same carbohydrate content in each serving, the portion sizes are a little different too. For example: you will find potatoes and other starchy vegetables in the grains, beans and starchy vegetables group instead of the vegetables group. Cheese is in the meat group instead of the milk group. A serving of pasta or rice is 1/3 cup in the Diabetes Food Pyramid and ½ cup in the USDA pyramid. Fruit juice is ½ cup in the Diabetes Food Pyramid and ¾ cup in the USDA pyramid. This difference is to make the carbohydrate about the same in all the servings listed.
Following is a description of each group and the recommended range of servings of each group.
Grains and Starches
At the base of the pyramid are bread, cereal, rice, and pasta. These foods contain mostly carbohydrates. The foods in this group are made mostly of grains, such as wheat, rye, and oats. Starchy vegetables like potatoes, peas, and corn also belong to this group, along with dry beans such as black eyed peas and pinto beans. Starchy vegetables and beans are in this group because they have about as much carbohydrate in one serving as a slice of bread. So, you should count them as carbohydrates for your meal plan.
Choose 6-11 servings per day. Remember, not many people would eat the maximum number of servings. Most people are toward the lower end of the range.
Serving sizes are:
1 slice of bread
¼ of a bagel (1 ounce)
½ an English muffin or pita bread
1, 6 inch tortilla
¾ cup dry cereal
½ cup cooked cereal
½ cup potato, yam, peas, corn, or cooked beans
1 cup winter squash
1/3 cup of rice or pasta
Vegetables
All vegetables are naturally low in fat and good choices to include often in your meals or have them as a low calorie snack. Vegetables are full of vitamins, minerals and fiber. This group includes spinach, chicory, sorrel, Swiss chard, broccoli, cabbage, bok choy, brussels sprouts, cauliflower, and kale, carrots, tomatoes, cucumbers, and lettuce. Starchy vegetables such as potatoes, corn, peas, and lima beans are counted in the starch and grain group for diabetes meal planning.
Further Reading...
Put the food pyramid to work for your busy lifestyle. Diabetes Meal Planning Made Easy helps you learn about the new diabetes nutrition recommendations and master the intricacies of each food group in the new pyramid.
Choose at least 3-5 servings per day.
A serving is:
1 cup raw
½ cup cooked
Fruit
The next layer of the pyramid is fruits, which also contain carbohydrates. They have plenty of vitamins, minerals, and fiber. This group includes blackberries, cantaloupe, strawberries, oranges, apples, bananas, peaches, pears, apricots, and grapes.
Choose 2-4 servings per day
A serving is:
½ cup canned fruit
1 small fresh fruit
2 tbs dried fruit
1 cup of melon or raspberries
1 ¼ cup of whole strawberries
Milk
Milk products contain a lot of protein and calcium as well as many other vitamins. Choose non-fat or low-fat dairy products for the great taste and nutrition without the saturated fat.
Choose 2-3 servings per day
A serving is:
1 cup non-fat or low-fat milk
1 cup of yogurt
Meat and Meat Substitutes
The meat group includes beef, chicken, turkey, fish, eggs, tofu, dried beans, cheese, cottage cheese and peanut butter. Meat and meat substitutes are great sources of protein and many vitamins and minerals.
Choose from lean meats, poultry and fish and cut all the visible fat off meat. Keep your portion sizes small. Three ounces is about the size of a deck of cards. You only need 4-6 ounces for the whole day
Choose 4-6 oz per day divided between meals
Equal to 1 oz of meat:
¼ cup cottage cheese
1 egg
1 Tbsp peanut butter
½ cup tofu
Fats, Sweets, and Alcohol
Things like potato chips, candy, cookies, cakes, crackers, and fried foods contain a lot of fat or sugar. They aren't as nutritious as vegetables or grains. Keep your servings small and save them for a special treat!
Serving sizes include:
½ cup ice cream
1 small cupcake or muffin
2 small cookies
The Diabetes Food Pyramid makes it easier to remember what to eat. For a healthy meal plan that is based on your individual needs, you should work with a registered dietitian (RD) with expertise in diabetes management. To find an RD with diabetes expertise, read the section below titled For More Help and Support.
For More Help and Support
To find out exactly how much of what types of foods you should eat, we suggest you work with a registered dietitian (RD) who has experience working with people who have diabetes. This person can help support your efforts to change your eating habits and control your blood glucose level. To find a registered dietitian near you:
1. Locate the names of American Diabetes Association Recognized Diabetes Education Programs in your area or call 1-800-DIABETES (1-800-342-2383).
2. Call The American Dietetic Association at 1-800-366-1655. Ask for the names of dietitians in your area that specialize in diabetes.
3. Call the American Association of Diabetes Educators, at 1-800-TEAM-UP4 (1-800-832-6874). Ask for the names of several diabetes educators in your zip code.
Glossary
Dig into Diabetes - http://www.urbanext.uiuc.edu/diabetes2/...
Introduction General Overview of Diabetes and Food Food Groups and Diabetes Eating for Target Blood Glucose Levels Eating for Cardiovascular Health Resources and Recommended Websites About the Authors Test Your Knowledge Diabetes Central
Diabetes Life Lines Recipes for Diabetes General Overview of Diabetes and Food Meal planning
The purpose of meal planning is to help you reach your personal blood glucose or weight goals. These goals should be discussed with your health care provider. How these goals are achieved will be different for everyone. Some may reach their goals by spacing their food intake and limiting portion sizes. Others benefit from a more specific meal plan. Serving sizes are always important when you plan your meals. Day-to-day variation in meals and snacks leads to uneven glucose pattern.
Four commonly used methods of meal planning include:
The Plate Method
The Food Guide Pyramid (MyPyramid.com)
Exchange Lists
Carbohydrate Counting
The Plate Method
The plate method is one way that meals can be planned. For breakfast, starch should take up half of the plate, and meat or non-meat protein may take up 1/4 of the plate if desired. In the lunch and dinner plate method, vegetables should take up half of the plate, starch should take up 1/4 of the plate and meat or non-meat protein should take up another 1/4 of the plate. One serving of fruit and a cup of low-fat milk may accompany your meal. Although the plate method is relatively easy, portion sizes are still critical. The amount of food on your plate should vary according to the number of calories that you need each day. A recommended plate size is about 9 inches across (9 inch diameter). Try measuring your plates!
Starchy foods include: bread, rolls, rice, pasta, potatoes, yams, corn, lima beans, and cereals.
Vegetables include: lettuce, tomatoes, mushrooms, spinach, green beans, and broccoli.
Meat and non-meat protein foods include: chicken, beef, pork, fish, cheese, beans, tofu, and soy products that resemble meat or chicken.
Fruits include: oranges, applesauce, grapes, and peaches. More information on the plate method available at www.platemethod.com
Food Guide Pyramid
The Food Guide Pyramid is a tool used to show the type and the amount of food that you need daily. Recently modified to take into consideration the new Dietary Guidelines for Americans, the new Food Guide Pyramid was renamed MyPyramid, and now has six colored bands which represent food groups, and steps up the side to emphasize physical activity. Listed below are the foods groups that the colored bands of the pyramid represent:
Orange – Grains
Green – Vegetables
Red – Fruit
Yellow – Oils
Blue – Milk
Purple – Meat and Beans
By visiting the website www.mypyramid.gov, you can enter your age, gender, and physical activity level and learn the amount of foods from each group that you should be eating each day. This website also offers tips about the types of foods within each group that are particularly important to eat. For example, MyPyramid suggests that you:
Make half your grains whole grains
Vary your veggies
Focus on fruit
Get your calcium-rich foods
Go lean with protein
Find your balance between food and physical activity
Exchange Lists
Adapted from the American Dietetic Association www.eatright.org and the American Diabetes Association www.diabetes.org
The Diabetic Exchange List is a program that was developed by the American Dietetics Association and the American Diabetes Association. Exchange Lists are used to balance the amount of calories, carbohydrate, protein and fat eaten each day. The Exchange List book can be ordered from the American Diabetes Association website. To use the Exchange Lists, individuals must first talk with their doctor or dietitian about their dietary requirements and the number of calories that they need each day. Then the doctor or dietitian can explain how many servings from each group are needed to meet these daily requirements. Individuals can then use the Exchange Lists to determine what foods and in what amounts they need to eat each day.
There are six different Exchange List groups including the starch groups, the fruit group, the milk group, the non-starchy vegetable group, the meat and meat substitutes group, and the fat group. Each serving of food within an exchange group has about the same amount of carbohydrate, protein, fat, and calories as the other foods in that group. For this reason, foods within an exchange list group can be substituted for each other, but foods on one group list cannot be substituted for foods on another group list. For example, you may substitute eating a small apple for a small orange, because they are both one serving in the fruit group. However, you could not substitute eating a small apple for one slice of bread, because these foods are in different groups.
The amount and type of exchanges recommended each day are based on individual calorie needs, weight goals and the amount of physical activity performed daily
Exchange List Groups
The following are the six groups of the Diabetic Exchange Lists:
Starches List (Includes breads, cereals, grains and starchy vegetables)
One exchange from this group has 15 grams of carbohydrates, 3 grams of protein, and 0-1g of fat for a total of 80 calories per serving.
Examples of one serving from this group include 1 slice of bread, 1/3 cup cooked rice, or 1/3 cup cooked pasta.
Fruit List
One exchange from this group has 15 grams of carbohydrate for a total of 60 calories per serving. Foods in the fruit list do not contain any protein or fat.
Examples of one serving from this group include 1 small apple, 17 small grapes, or ½ cup of orange juice.
Non-starchy Vegetable List
One exchange from this group has 2 grams of carbohydrates, and 5 grams of protein for a total of 25 calories per serving. Non-starchy vegetables contain no fat.
Examples of one serving from this group include 1/2 cup cooked green beans, 1 cup raw lettuce, or 1/2 cup vegetable juice.
Milk List
Items on the milk list are divided into fat-free/low-fat milk, reduced-fat milk, and whole milk categories.
One fat-free/low-fat milk exchange has 12 grams of carbohydrates, 8 grams of protein, and 0-3g of fat for a total of 90 calories per serving. One reduced-fat milk exchange has 12 grams of carbohydrates, 8 grams of protein, and 5g of fat for a total of 120 calories per serving. One whole milk exchange has 12 grams of carbohydrates, 8 grams of protein, and 8g of fat for a total of 150 calories per serving.
Examples of one serving from the fat-free/low-fat milk exchange are 1 cup of non-fat skim or 1% milk, or 2/3 cup (or 6 ounces) of fat-free plain yogurt.
Meat and Meat Substitutes List
Meats are divided into very lean, lean, medium-fat, and high-fat lists based on the amount of fat they contain. High-fat exchanges should be eaten a maximum of three times a week.
One very lean meat exchange has 7 grams of protein, and 0-1 gram of fat for a total of 35 calories per serving. Examples of one very lean meat exchange are 1 ounce white meat chicken or turkey with no skin.
One lean meat exchange has 7 grams of protein, and 3 grams of fat for a total of 55 calories per serving. Examples of one lean meat exchange are 1 ounce lean beef or lean pork.
One medium-fat meat exchange has 7 grams of protein, and 5 grams of fat for a total of 75 calories per serving. Examples of one medium-fat meat exchange are 1 ounce dark meat chicken with skin, 1 egg, or 1 ounce of fried fish.
One high-fat meat exchange has 7 grams of protein, and 8 grams of fat for a total of 100 calories per serving. Examples of one high-fat meat exchange are 1ounce pork sausage, 1 ounce American cheese, or 1ounce of a hot dog.
Whereas one exchange from this list only refers to a 1 ounce portion of meat or meat substitute, a serving refers to 2 - 3 ounce portions of the foods in this list. A serving is often used in referring to the foods in this group because most people eat more than one ounce of meat or meat substitutes at a time.
Fat List
One exchange from this group has 5 grams of fat for a total of 45 calories per serving. Most items in the fat exchange list do not contain protein or carbohydrate.
Examples of one serving from this group include one teaspoon oil, one teaspoon butter, one teaspoon mayonnaise, or one tablespoon salad dressing.
Carbohydrate Counting
The Carbohydrate Counting method is similar to the Exchange List method in that they both use food groups. However, when you use Carbohydrate Counting, you keep track or “count” servings equal to 15 grams or 1 unit of carbohydrate The food groups that have carbohydrate and are counted are:
The Starch and Starchy Vegetables Group
The Fruit Group
The Milk Group
One serving from any of these three groups would count as one carbohydrate unit. For example if you ate two pieces of buttered toast and an 8 ounce glass of milk for breakfast, you would count that breakfast as having three carbohydrate units. Carbohydrate Counting differs from the Exchange List in that the amount of protein and fats in foods is not taken into consideration. So the butter on the toast consumed at breakfast would not be counted, because butter is in the fat group and does not contain carbohydrate.
Some examples of one carbohydrate unit would be:
Starch and Starchy Vegetables Group – 1 slice of bread, 1/3 cup of cooked rice or pasta, 1/2 of a small bagel
Milk Group – 1 cup milk, 2/3 cup fat-free-yogurt, 3/4 cup low-fat yogurt
Fruit Group – 1 small piece of fruit, 3/4 cup berries, 1/2 cup apple juice
If you are planning to use the Carbohydrate Counting method, you and your health care provider should decide how many servings of carbohydrate you should consume each day and at each meal for optimal health.
Source(s):
http://www.lifeclinic.com/focus/diabetes...
http://www.diabetes.org/nutrition-and-recipes/nutrition/foodpyram
http://www.urbanext.uiuc.edu/diabetes2/subsection.cfm?SubSectionID=14
2006-09-01 18:21:37
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