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Do You Make the 3 BIG Diet Mistakes?
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Diabetes Focus 2006
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Christine Gerbstadt, M.D., is a registered dietician and spokesperson for the American Dietetic Association |
A: The three BIG diet mistakes that can sabotage any weight loss plan are:
Portion sizes that are too large
Excess calories
Too much fat Too many calories in the diet can be attributed mostly to the fact that portion sizes are much larger than they should be. When people see three to four ounces of meat (the size of a deck of cards), they complain. They’re used to food dripping over the edges of the plate. And the recommended starch portion—a half-cup—is not something that you’re likely to see in a restaurant. Half a cup of pasta? Have you ever been to a restaurant where they actually serve half a cup of pasta? But that’s one serving, and so is four ounces of meat.
A: A lot of the fat that you eat isn't really visible to you. It may be hidden in foods that you may not think of as being that fatty. At least one third of all American meals are eaten out of the home. And in fast food restaurants, or even what I call "intermediate" fast food restaurants, the food is much higher in fat than the recommended 30 percent.
A: Avoid anything fried, and realize that whatever you order will have added fat. Don’t have sauces and gravies on the side; leave them off altogether. Even red sauces have a lot of added fat in them. You may think, “Oh I’m doing so well with my chicken cacciatore or broiled chicken breast with red sauce.” But the chicken breast is probably equal to two servings of meat sautéed in saturated fat, and it has a red sauce on it that’s probably made with fat. It’s also important to avoid trans fats—any kind of oil that’s partially hydrogenated. Restaurant-grade soybean or canola oil usually has trans fats, which make the fat semi-solid. They also increase shelf life and the palatability of food, but they raise LDL (“bad”) cholesterol. If you have diabetes, trans fats are a real problem—they do everything that you don’t want a food to do. And it’s really hard to find restaurants that serve trans fat–free food. It’s important to read labels and ask at fast-food restaurants for the nutritional information. I recommend that everyone adopt a no-trans fat or low-trans fat diet. A diet low in trans fats includes two grams or less a day. Most of us are eating more than 10.
A: Several recent studies have indicated that walnuts, which taste good to most people, help control blood sugar. But check with your primary care physician and with a diabetes educator before going nuts for walnuts. Counting calories and especially counting carbohydrates remain very important for weight control.
A: We're recommending 20 to 30 grams a day of carbohydrates—or around half of a day's calorie intake—which is much more than most people are used to eating. The typical American diet includes less than 10 grams. Those with type 2 should also focus on getting lots of fiber and complex or unrefined carbohydrates. The balance of one's daily intake should consist of 10 to 20 percent protein and 30 percent fat, with less than 15 percent from saturated fat.
A: I can tell you firsthand that when I was pregnant, I was put on a diabetic diet and it totally disrupted my eating habits. At the time, I thought I was eating a pretty okay diet. After all, I'm a registered dietitian and a doctor. But I was told I could only eat one serving of fruit in the morning, which might not even be a whole piece. I always thought I could snack on a whole piece of fruit, but that was literally off the table. And you have to eat protein in the morning meal. Skim milk doesn't cut it. You need some kind of lean meat, which was not my pattern. If you're a vegetarian it takes even more work.
A: I recommend that people make sure to eat proteins at every meal, and by proteins I mean lean meats, lean fish, lean poultry, eggs or half a cup of legumes, such as pinto beans. Every meal and every snack should contain protein. The second important step is to avoid refined carbohydrates and go for complex carbohydrates from whole grains. Opt for brown rice instead of white rice. And corn is considered a whole grain, as are rolled oats, but not the quick-cooking oats. Also avoid white and brown sugars and anything with high-fructose corn syrup. It takes a lot of label reading, kitchen preparation and planning.
A: They'll lose weight. Documented studies show that if most people with type 2 diabetes lost 5 percent of their body weight they might be able to take less or even no insulin and/or less or no oral antidiabetic agents. Just 5 percent makes such a difference, even if you are still nowhere near your ideal body weight. You also help slow down or prevent the development of complications such as retinopathy, cardiovascular disease, neuropathy and kidney disease. And you feel better overall–which is also important.
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