|
Eating Well With Diabetes
|
|
Helpful tips for the newly diagnosed
|
By Natasha Persaud
|
May 2009
|
 |
If you’ve recently been diagnosed with diabetes, you probably feel overwhelmed and confused about what to do next. One of the thoughts that may cross your mind is “now what can I eat?” We talked with Theresa Garnero, a diabetes educator, registered nurse and author of Your First Year With Diabetes, to get practical answers to your essential questions:
“Having diabetes doesn’t mean eating like a saint,” says Garnero. “It’s about striking a balance. You need to start by making small steps toward healthier eating.
“As a diabetes educator, I ask patients to start by focusing on one area that will likely make the most impact in reducing their glucose levels. For example, drinking regular soda. Cutting it out of your diet or reducing your consumption to a half-can can make a dramatic difference in your blood glucose numbers. By not taking in that extra sugar, you’re preventing a flood of glucose into your bloodstream in a system that’s already overloaded. Another tip: Regular exercise will give you the best bang for your glycemic buck. It can be as simple as walking briskly 30 minutes a day.
“At mealtime, use this simple strategy called the Idaho plate method: Take a 9-inch plate and divide it into four sections. Fill half the plate with nonstarchy veggies; one-quarter with starch or whole grains; and the remaining quarter with lean protein. The food should be no more than an inch high on the plate.
“It’s important to see a dietitian for tailored advice. Two people having the exact same meal may wind up with different glucose numbers. A dietitian can help you create a personalized eating plan to get your glucose levels under control.”
“Fresh is best. Shop the perimeter of the store, and pick up fresh vegetables and fruits, whole grains, low-fat dairy products, tofu, white meat poultry and lean meats. Next, add legumes (like beans, peas and lentils) and unsalted nuts (such as dry roasted almonds, cashews or walnuts) to your cart. In small quantities, they help you feel full and may help reduce your cholesterol.
At the grocery store, spend less time in the middle aisles, where you’ll find packaged goods. You want to cut back on beverages and foods that are high in sugars, sodium or fats, including fruit juice, soda, sweets and junk food.”
“There are no taboo foods on a diabetic diet, but you do need to account for everything you eat. You want to limit sources that have a high concentration of carbohydrates, such as white and brown sugar; honey; maple syrup; and jams and jellies. One tablespoon of these sweets contains about 15 grams of carbohydrates.
“Some people go for calorie-free sugar substitutes made with artificial sweeteners. Stevia, a plant-based sweetener, is also gaining popularity.”
“Two out of three people with diabetes also have high blood pressure, which means they need to control their sodium intake. For general health, adults should consume no more than 2,300 mg of sodium a day, but many Americans need to lower their intake even further to 1,500 mg, including those with diabetes and/or high blood pressure.
“To add flavor to your food without adding salt, cook with spices, herbs and veggie broth. There are a wide variety of spices to choose from, everything from garlic powder to curry powder, cinnamon to clove.
“Avoid salt substitutes that contain potassium since they can interfere with certain medications you may be taking.”
“Before you buy a product, check out the nutrition facts. The first thing to look for is the serving size. It’s often a lot smaller than you might think. For example, one serving could be 8 small pretzels, not the whole bag.
“Next, pay attention to the total carbohydrates. Carbohydrates raise blood glucose more quickly than fat or protein, so people with diabetes need to closely monitor how much they are consuming. As a starting point, women should consume 45 grams of carbohydrates or less in a meal and men 60 grams or less. A snack should contain 15 or fewer grams.
“You also want less than a third of calories coming from fat. Multiply the number of fat grams on the label by 9 to get the number of fat calories. Next, divide that number by the total number of calories; if it’s 1/3 or less, great; if higher, you many want to skip it.
“Finally, look at the sodium content on the nutrition label. Many packaged foods are overloaded with sodium. Some of the offenders: roasted nuts, canned soups and beans, sauerkraut, meat pies, ravioli, macaroni, hot dogs, dill pickles, canned chili, soy sauce, season salt, spaghetti sauce, frozen pizza, canned fish, smoked meats and cold cuts.”
“Think of the banners on the front on food packages as advertisements. While there are strict definitions governing the terms, they don’t necessarily mean the food is healthy.
“Packages that read ‘Sugar-free’ or ‘No Sugar Added,’ for example, can still contain carbohydrates. Sugar-free cookies are made with flour, which is a carbohydrate.
“Likewise, ‘fat-free’ products are not exactly fat-free. By definition, they can contain up to a half-gram of fat and still carry the label. The same goes for ‘No trans fat’ products. Any label with the word ‘reduced’ simply means that the product contains less sodium or fat than the original.
“When labels compare two different products, the picture gets even muddier. A pretzel bag that reads ‘25 percent less fat than potato chips,’ for example, can still be an unhealthy choice if it has too much sodium. For those reasons, stick to looking at the nutrition facts at the back of the package.”
Here are healthier suggestions for the top five junk foods:
Junk Food
| Better Option
| | Soda | Diet soda; seltzer; carbonated water (with no added flavoring); diluted fruit juice | | Cake or cookies | One square of dark chocolate; a 40-calorie frozen fruit bar | | Fast food burger and fries | A healthy wrap with half the fries and a side salad | | Pepperoni pizza | Veggie pizza with a whole wheat crust and a sprinkling of cheese | | Regular potato chips | Baked chips or pretzels |
“If you are completely craving a particular treat, and nothing else will do, give yourself 15 minutes before you have it to tame the impulse. While it’s fine to have an occasional treat, you want to avoid making it a habit.
“Also, don’t keep treats in the house. Take a walk to the store instead to sneak in some exercise. Physical activity can lower your blood glucose, blood pressure and cholesterol.”
“If you’re eating healthy foods but not measuring your glucose levels with a glucose monitor, you’re just guessing. To stay healthy, the American Diabetes Association recommends that your glucose levels stay between 90 and 130 mg/dl before meals and less than 180 mg/dl two hours after a meal.”
Your healthcare provider will also order an A1C blood test every three months. This measures your average blood glucose over the past several months. The target to prevent diabetes complications is less than 7 percent. If you’ve been eating well, exercising and taking your diabetes medications, and your A1C is still above 7 percent, consider seeing an endocrinologist for additional treatment.
“To some extent, finding out what you can or can’t eat is a detective game. If you enjoy a particular meal at a restaurant, have it—skipping extras like rolls and dessert—and see how it affects your glucose numbers. If your glucose levels go up more than 50 mg/dl, then you need to adjust. On the next occasion, have a slight variation of the meal, such as less pasta and no cheese, and test your blood glucose levels again.
“If your numbers consistently are too high, don’t hesitate to reach out and talk to your doctor. Medication may be needed for more control. It’s also vital to get regular amounts of exercise. The American Diabetes Association suggests aiming for at least 30 minutes of physical activity a day. If you’re trying to lose weight, the NIH suggests 60 to 90 minutes a day.
“By making these changes, you can help move your glucose numbers in the right direction. Talk to your doctor, a diabetes educator and a dietitian for additional advice. Also, check out diabetes support groups online and in your local community.”
When you need a little something to tide you over, reach for one of these options:
• A small yogurt cup
• A handful of plain nuts, such as almonds, hazelnuts, peanuts or pine nuts
• Veggies with 2 tablespoons of hummus or lowfat dip
• 2 to 3 graham crackers
• 2 to 3 cups of light microwave popcorn
• 2 plain rice cakes
• A small glass of milk (4 ounces)
• A small fruit
• A ¼ cup dried fruit
• A fruit cup packed in juice or light syrup
• A protein or granola bar (Choose one that contains 15 g of carbohydrate or less.) |
 | Theresa Garnero is an award-winning Certified
Diabetes Educator (CDE) and Advanced Practice Registered Nurse (APRN),
with Board Certification in Advanced Diabetes Management (BC-ADM) and a
Master’s of Science in Nursing (MSN). She is a cartoonist and the author of Your First Year With Diabetes.
|
|
|
|
|
|
|