By Jeanne Cahill, MS, RD, CDE, Center for Diabetes Management at Mercy Gilbert Medical Center
Diabetes makes a serious impact on your life, but know that you are not alone. According to the American Diabetes Association, 29.1 million children and adults in the U.S. have diabetes and another 86 million Americans have pre-diabetes, a condition where blood sugars are higher than normal but not yet at the point of being diabetes.
The good news is the old “diabetic diet” no longer exists. Healthy eating recommendations made for people who have diabetes are the same as those for people who don’t. They include:
- Modest carbohydrate intake
- Increased fiber
- Limited saturated fats, trans fats and refined sugars
- Increased helpings of non-starchy vegetables
Let’s look at these recommendations in a bit more detail:
- Carbohydrates: Begin reading labels to know what foods contain carbohydrates. They include bread, noodles and pasta, rice, crackers, cereal, tortillas, fruits and fruit juices, milk and yogurt. Your doctor or a diabetes educator can help you determine the proper amount of carbohydrate for you.
- Fiber: Fiber is a type of carbohydrate, but the goal is to increase fiber, not limit it. High fiber foods are digested more slowly; therefore, they raise blood sugar more gradually, and possibly lessen the increase in blood sugar. Fiber has also been shown to lower blood cholesterol. The daily goal for fiber is 25-30 grams per day. Unfortunately, many Americans do not consume that amount. You can increase fiber in your diet by avoiding products made with white flour; try switching to 100 percent whole wheat and multigrain products such as 9-grain bread, whole wheat crackers, and multigrain tortillas. Beans, fruits, and vegetables are also good sources of fiber. You will find the fiber content of a product listed just below the total carbohydrates field on the nutrition facts label. Foods that contain five grams or more of fiber per serving are considered an excellent source of fiber.
- Fats: To keep your heart healthy, limit saturated fats and trans fats. These “bad” fats can clog our arteries. They are found in animal products (eggs, cheese, meat, and milk), margarines, oils, baked goods, and some snack foods. To cut saturated fat, choose lean cuts of meat, trim visible fat, remove skin from chicken and eat mostly the white meat, opt for low-fat or nonfat dairy products, and avoid deep fried foods.
- Sugar: Although you have diabetes, sugar does not have to be off limits. Moderation is key. Dessert items like cakes, cookies, ice cream, and pastries should be an occasional treat, not a daily indulgence. Portion size matters, too. Limit yourself to no more than three small cookies instead of a row of cookies, and savor each delicious bite.
It is wise to limit “liquid” sugar found in soft drinks, sport drinks, sweetened teas, juices, and smoothies. These drinks spike blood sugar rapidly.
- Starch: Starchy vegetables like potatoes, corn, peas, and dried beans contain carbohydrate and they will raise your blood sugar, so it is important to have modest portions of these vegetables (roughly a ½ cup). However, you do not need to limit the non-starchy vegetables. These include broccoli, cauliflower, asparagus, tomatoes, radishes, spinach, carrots, green beans, eggplant, and many other choices. Aim to fill half of your plate with these non-starchy vegetables which have vital nutrients that are filling, good sources of fiber and relatively low in calories. For more tips on planning your meals, visit MyPlate.gov
It is helpful to remember that no food is completely off limits. Start to make small changes in your diet and see big results in your blood sugar control.
Healthy eating is one of the best tools we have for controlling blood sugar, but I would be remiss if I did not mention the second great tool available to you — physical activity. Exercise and any kind of physical activity, including yard work, shopping, and household chores, helps to lower blood sugar and makes us less insulin resistant, which is one of the causes of high blood sugar in type 2 diabetes. Most people will notice an immediate drop in blood sugar after exercising, and they will use their insulin much better for the whole day, which translates to lower blood sugars. If you currently have a sedentary lifestyle, think of ways to add in small amounts of activity. Begin by walking around the block, take stairs instead of the elevator, walk around while talking on the phone, and park a little farther back in parking lots. Set small, achievable goals for increasing physical activity.
There are several classes and outreach groups available that include information about healthy eating, exercising, medications, and monitoring and managing blood sugar levels. Learn as much as you can about diabetes and take advantage of your local resources.
Photo credit: andresr/iStock, mphillips007/iStock, Susan Chiang/iStock
Stacy Nelson RN, RD is a certified diabetes educator with Mercy Gilbert Medical Center at Center for Diabetes Management. For information about classes for people with pre-diabetes and diabetes, please call 480-728-3535.
Controlling Blood Glucose When Eating Out
By Stacy Nelson, RN, RD
People with diabetes are encouraged to choose healthy foods and portions for optimal blood glucose, blood pressure, blood fats, and healthy weight. The ultimate goal is to prevent or delay diabetes complications.
Larger portions at fast food restaurants add up to more calories, fat, sodium, and carbohydrates than needed. Carbohydrates raise blood glucose more than protein and fats. Thus, many people with diabetes will try to reduce carbohydrate intake and portions to improve blood glucose and lower calories.
Some carbohydrate-containing foods include pasta, rice, dried beans, bread, cereals, fruit, milk and milk products like yogurt or ice cream, starchy vegetables like potatoes, peas, corn, and desserts like cookies, pies, and chocolates.
Here are a couple fast food fixes to consider to save on carbohydrates, calories, and fat.
- Eat an open-faced sandwich (using lettuce instead of a top piece of bread in a sandwich or burger).
- Order a side salad (light vinaigrette dressing is best) in place of french fries or order the small fries versus large fries.
- Choose grilled versus “crispy” chicken or fish to save on carbs, calories, and fat from the breading that ends up absorbing lots of cheap oil.
- Choose carbohydrate-free drinks like water, unsweetened iced tea, or diet soda instead of sugar-sweetened beverages.
- Pick a burrito bowl. Enjoy the insides of a burrito with a lot less carbohydrate.
- Think thinner crust pizza slices with vegetable toppings or just one meat topping.
- Control rice portions as it is big source of carbohydrates. Just 1 cup of cooked rice has almost 200 calories and around 45g carb. You may also choose to skip the rice and build a meal around a protein and unlimited vegetables, as there will likely be some carbohydrate in the cooking sauces.
- Try a piece of fruit for dessert.
Helpful Hints About What to Pick at the Flick
By Stacy Nelson, RN, RD
Many people try to eat at home or at a nearby restaurant first so they will not be hungry at the theatre. It can be easy to undergo a kind of “mindless eating” while sitting in the dark, captivated by the movie. There is no “one-size-fits-all” eating plan for people with diabetes.
However, it is known that blood sugar is impacted by the amount of carbohydrate eaten and the amount of available insulin (that your body makes and/or that you take). In other words, there is not one “magical” amount of carbohydrate that will work the same for all people with diabetes at the movies.
As a reference point, the American Diabetes Association recommends about 45–60 grams of carbohydrate at a meal, with snacks ranging from 5 grams to upwards of 20–30 grams of carbs as a good place to start.
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- Look at several websites or apps beforehand to get a “guesstimate” of the nutritional information for your favorite movie foods (calorieking and myfitnesspal are popular choices).
- Spend your carbohydrates and calories on “chewable” foods versus sugar-sweetened beverages. Healthier beverages include water (the best), unsweetened tea, or diet drinks.
- Many theatres are popping their popcorn in healthier oils. Popcorn also contains some dietary fiber. A small popcorn will usually be under 300 calories and around 30g carbohydrate without extra butter topping.
- One hot dog is fairly reasonable in calories and carbohydrate (usually around 30g carb). However, it is still a food to eat less often as it is high in sodium and saturated fat.
- Consider sharing that large bag or box of candy since many are 3–4 ounce portions that provide around 400–500 plus calories and can easily be more than 50–60 g carbohydrate.