Diabetes and

Nutrition

Lesson 2

Expand Your Options, Improve Your Choices

Objectives

• Meal Plans for Diabetes

– Diabetes Pyramid/My Pyramid

– Exchange list

– Plate Method

– Carbohydrate Counting

• General Nutrition Recommendations

• Reading the Food Label

Managing Diabetes Successfully

Involves three things:

• Food

• Exercise

• Medication

Did You Know??

• Food raises blood glucose

• Exercise and medication lowers it

• Balance these three to keep blood glucose level close to normal.

Diabetes Facts

• You don’t need special foods

• The foods that are good for you are good for everyone

• Eat a variety of foods that contain the right amount of nutrients

Food choices can make a difference in bloodGlucose control.

The Diabetes Pyramid

Healthy Food Choices

A healthy daily meal plan includes at least…

• 2 to 3 servings of nonstarchy vegetables

• 2 servings of fruit

• 6 servings of grains, beans, and starchy vegetables

• 2 servings of low-fat or fat-free milk

• About 6 ounces of meat or meat substitutes

• Small amounts of fat and sugar

The Plate Method

Which Plate is Better??

A 10 inch dinner plate-a typical

dinner plate

A 8 inch dinner plate-

this is the recommended

plate to use

The Plate Method

Fruit = Milk = Starch

• Sometimes, if you want an extra starch during a meal, you just need to omit a fruit or milk from that meal.

Visualize Portion Sizes

• 1 cup pasta/rice is about the size of a fist.

• 1 oz of cheese is about the size of your thumb.

• 1 or 2 oz of crackers, nuts, or snack crackers equals a handful.

• 1 fruit is about the size of a tennis ball.

Exchange List for Meal Planning

• Oldest method for meal planning.

• Based on Dietary Guidelines and My Pyramid.

• Includes a variety of foods.

• Emphasizes label reading and most exchanges are listed under the food label.

Carbohydrate Counting

• Newest method of meal planning.

• Type 1 or Type 2 can use.

• Requires reading the food label.

• Requires constant blood sugar monitoring.

• When reading the food label, look at total carbohydrate grams only.

• Carbohydrates are found in milk, breads/starches, fruit and starchy vegetables only!

Know Your CarbohydratesFood Grams of

Carbs/Serving

Starch/Bread 15 grams

Fruit 15 grams

Milk 12 grams

Vegetables 5 grams

Meat 0 grams

Fat 0 grams

More on Total Carbs…

• Helpful for carb counters.

• Look at the total carbohydrates not the grams of sugar.

• Total carbohydrates include: sugar, complex carbohydrates, and fiber content.

• When a food has 5 g or more of fiber per serving:

– subtract half the fiber grams from the total grams of carbohydrate for a more accurate estimate of the carbohydrate content.

Sample 1800 calorie Carbohydrate Counting Meal Plan

• Breakfast: 2 servings of starch, 1 fruit serving, 1 milk serving, 1 meat serving, 1 fat serving.

• Lunch: 2 starch servings, 1 fruit servings, ½ milk serving, 2 vegetable servings, 2 meat servings, 2 fats.

• Dinner: 2 starch servings, 1 fruit serving, 2 vegetable servings, 3 meat servings, 2 fats.

• Snack: 1 starch serving, 1 fruit serving, ½ milk serving.

• This meal plan is approximately 60 g of carbohydrates per meal and 30 g of carbohydrates per snack.

Examples of One Carbohydrate Choice Snacks

• 1 ounce granola bar

• 3 graham crackers with 1 tbsp. peanut butter

• 3 cups popped non-fat popcorn

• 6 animal crackers

• 1 small muffin

• A 3 inch cookie

• 1 medium apple, orange, pear

• 12-15 cherries or grapes

• ¼ cup dried fruit

• 1 cup soy milk

• ¾ to 1 cup yogurt

• ½ cup sugar free pudding

Portion Control Is The Key To Managing Your Diabetes

• Which will have the greater effect on your blood sugar, 1 tsp of sugar or ½ cup potatoes??

– Potatoes have 15 g of Carbohydrate, while 1 tsp. of sugar has only 4 g of carbohydrate. Therefore, potatoes have 3 times the effect on blood sugar than table sugar would.

2008 ADA Recommendations for General Meal Planning for Persons with Diabetes

• Meal plan should include fruits, vegetables, legumes, low-fat dairy products, lean meats, and whole grains.

• You can eat sugar containing foods, but your meal plan will be adjusted.

• Monitor carbohydrate intake.

• Consume 25-35 grams of fiber.

• Avoid Skipping meals.

More Recommendations

• Sugar alcohols and artificial sweeteners are safe.

• Limit saturated fat intake.

• Limit trans fat intake.

• Eat fish at least 2x’s per week.

• Moderate alcohol intake.

• Consume a meal plan that if low in fat, cholesterol, sodium, and calories

• Increase physical activity or exercise.

• Continuously monitor blood sugar levels.

• Check with physician for vitamins.

• Lose weight if you are told to.

Alcohol

• Limit/control your intake of alcohol.

• Ask yourself the three questions to determine if you can drink.– Is my diabetes under control?– Does my doctor agree that I do not have any

other problems that alcohol can affect?– Do I know how alcohol can affect my diabetes

and me?

A Drink Is Defined As:

Avoid Low Blood Sugar When Drinking

• Never drink on an empty stomach.

• Limit yourself to 1 or 2 drinks.

• Test your blood sugar before you drink and once while drinking.

• Make sure to test before going to bed and eat a snack!

• Serving Size

• Servings Per Container

• Calories and Calories from Fat

• Nutrients with % Daily Value

• Footnote (Only found on larger packages)

Stated in Household and Metric Measures

Servings Per Container tells you how many servings are

in a package.

There are 2 servings in this package.

The label shows that 1 cup is a serving.

If you consume 2 cups you are having two servings.

Labels include the total calories as well as the calories from fat

General Guide to Calories per serving:

– 40 calories is low

– 100 calories is moderate

– 400 calories or more is high

Based on Daily Value recommendations

Only for a 2,000 calorie diet

Trans Fats

Sugars

Protein

Limit these nutrients

Get enough of these

Based on 2,000 and 2,500 calorie diets

Only found on larger packages

Nutrient *DV %DV Goal

Total Fat 65g 100% DV Less Than

**Sat. Fat 20g 100% DV Less Than

Cholesterol 300mg 100% DV Less Than

Sodium 2400mg 100% DV Less Than

Total ***CHO 300g 100% DV At Least

Dietary Fiber 25g 100% DV At Least

*DV = Daily Value; **Sat. Fat = Saturated Fat; ***CHO (carbohydrate)

List of ingredients found in the food product

Listed in descending order by weight, from the most to the least

Be informed.

Determine the best choices.

Eat a variety of foods.

Points To Remember About Diabetes Meal Planning

• Actual amounts of each depend on the number of calories you need.

• Calorie needs depend on your gender, size, age, and activity level.

• Meal planning with diabetes is very individualized.

• Get a personalized meal plan from a Registered Dietitian or Certified Diabetes Educator.

References

• American Diabetes Association, www.diabetes.org• American Dietetic Association, www.eatright.org• Mahan,L.K. and Escott-Stump, S. Krause’s Food, Nutrition, and Diet

Therapy. 10thed. 2000.• Diabetes Medical Nutrition Therapy. American Dietetic and Diabetes

Association. 2002.• LSU AgCenter’s Diabetes Education and Awareness Program.• University of Illinois Extension Service.• American Dietetic Association & American Diabetes Association Guide to

Diabetes Medical Nutrition Therapy, CD-ROM 2008.• Amercian Diabetes and Dietetic Association’s “Choose Your Foods:

Exchange Lists for Diabetes.” 2008.• University of Idaho Extension Service. “The Idaho Plate Method.”

References

• University of Georgia Extension Service. http://www.fcs.uga.edu/ext/food/diabetes.php

• U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition - www.cfsan.fda.gov

• Keeping Up with the Changing Food Label: International Food Information Council (IFIC) – www.ific.org

• Understanding Food Labels, American Dietetic Association

• Food Label Presentation Developed By: Cathy Agan, Extension Agent (FNP), Ouachita Parish and Adapated by Bertina McGhee, MPH, RD, LDN; Extension Agent, Orleans Parish.

Diabetes and Nutrition

Prepared By:

Mandy G. Armentor, MS, RD, LDN

Assoc. Extension Agent-FCS (Nutrition)

Vermilion Parish