david m. rider, md august 2010. this talk is not: a substitute for an individualized plan designed...
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David M. Rider, MDAugust 2010
This talk is NOT:A substitute for an individualized plan
designed by a nutritionist, dietician or your personal physician
Universally applicable for all people with Diabetes, especially those with “brittle” diabetes
A set of hard and fast rules that you MUST obey
The final say on the subject of diabetes and diet
Who am I?I’m not a nutritionist
I’m not an expert chef
I’m also learning
Who am I?I have many, many diabetic patients
who I have guided to success in controlling their diabetes
One of them had “success” through medicine alone
Most of them exercise a LOTMost of them eat a LOT of saladsNone of them count carbs
The bottom line:
We all want to look good and feel good
The bottom line:
And most diabetics ended up that way because food makes us feel good
The bottom line:
We need to re-define “good food.”
Good food not only feels good to eat but is ALSO protective against diabetes AND makes you look and feel great.
Some universal truths:Americans eat too many calories every day
with not enough exercise
Some universal truths:Not only do we eat too many calories, but the
ones we choose are not the ones we are designed to eat.
How Colorful is your Plate?
Some universal truths:Sorry!
You can’t lose and keep off significant weight/fat without exercise, and lots of it. Sustainable success is not only about burning fat, but about building muscle.
The Meat of This ProgramCarbohydrates:
Simple: table sugar, bleached flour, white rice Turn right into sugar
Complex: Whole Grains, vegetables Take longer to digest
Sugar SubstitutesSucralose / Splenda:- No calories, not recognized
as sugar or carbohydrate but 600 times sweeter than sugar. No aftertaste, very heat stable, ideal for baking.
Aspartane / NutraSweet- No calories, 200 times
sweeter than sugar, does not hold up as well under heating.
Fiber: AKA yummy plant stuff you can’t digestBulky and Absorbs Water Fills you up faster
Slows Down DigestionProlongs satiation
Binds together wasteKeeps you regular
Reduces fat and cholestrol
in your blood Protects your heart
Keeps blood sugar levels steady
avoid post-meal spikes
Helps maintain high energy
Fluctuations wear you out
Full of PhytochemicalsThe REAL vitamins
Delicious
Fillin’ up with Fiber (20-30g/day)1. It’s Whole Wheat or Nuthin’. Period.2. Don’t Peel the Skins!3. Add Wheat Germ or bran to meat loafs,
casseroles, yogurt4. Beans, beans, they’re good for your heart (half
cup with up to 10 grams of fiber!) Add beans to salad, just open up a can!
Chickpeas!
5. White vs Wheat.. Wha? The first ingredient should be “Whole Wheat
Flour”
ProteinAlmost any natural food (vegetables, grains,
nuts, beans) is chock full of proteins. Protein takes a lot of work to break down, so it is digested slowly.
Causes a more gradual rise in sugar levels
Decreases Hunger! (no one knows why, but it seems carbs stimulate it)
What about Fat??Fat is Yummy.It’s true, don’t deny the truth, and don’t deny yourself some FAT.
Fat helps us feel satiated (full). Most people on low-fat diets end up consuming far more calories than they do when they allowed themselves to eat some steak. And most gain the weight back.
Bad Fat, Good Fat
Is it solid at room temperature? Is it from an animal? It’s probably bad in excess.
Unsaturated Fats
Saturated Fats
Is it liquid, from fish, avocado or nuts? It’s probably great for you – Eat up!
Worst Fat
Counting Carbs
Beyond the scope of this talk.
I have approximately zero patients that do this regularly.
But that doesn’t make it okay to NOT think about what you eat.
Instead of Counting What we CANT eat… Eat these a LOT!
Non-starchy Vegetables Beans!(eat 5 a day!)
Nuts! Avocados and Good Fat!
14 Foods to EatGreen Leafies most mealsLean, not Mean protein
(seafood, chicken)Seafood 2-3 x weeklyBeans (at least half a cup a
day)Whole grain or Skip the
grain (eating out? If it’s not whole wheat rice then get double veggies)
Cruciferous Veggies (broccoli, cauliflower, cabbage, turnip, radish, watercress)
Handful of Nuts Every day (lower cholesterol and improve satiety)
BerriesSoy products (chorizo,
facon)Garlic and herbsGreen TeaNon-fat yogurtChocolate and Cacao
(dark, semi-sweet 60-70% cacao. 1st ingredient should not be sugar!)
Fiber…
FIBER!Improves insulin levelsDecreases cardiovascular diseaseFills you upDecreases weight5 cups of vegetables and fruits per dayPlate should be COLORFULThe best food predictor of losing weight is
FIBER
Can I give a shout out to Salad?
… And throw some beans or chickpeas in there!
Serving SizesOur serving sizes are TOO BIG! Two tricks to
limiting size:
1. Don’t go out to dinner, cook at home instead.
Is your food touching itself on your plate?
Too much!
2. Go out to eat and share an entrée.
The bottom line:
We all want to look good and feel good
A (sort of) Simple EquationWant to maintain your weight?
Multiply by 10 and adda) 300 if you are totally sedentaryb) 500 if you are moderate activec) 700 if you are very active
(example: 200 lbs and moderately active = 2500 calories)
A (sort of) Simple Equation
Want to LOSE weight?One pound is 3500 calories.
Half a pound a week is 250 calories less per day
One pound per week is 500 calories less per day
Two pounds per week is 1000 calories less per day
A (sort of) Simple Equation
Want to have some look good and lose weight?One pound of muscle burns 40 calories a day just sitting there.
That’s 40 x 365 = 14,600 calories a year or 4.17
pounds. Just sitting there.
The Nutrition Facts Label
The Percent Daily Value
The % DV is based on 100% of the daily value for each nutrient.
No % Daily Value
Trans Fat
Sugars
Protein
Conclusions
We need to re-define “good food.”
Good food not only feels good to eat but is ALSO protective against diabetes AND makes you look and feel great.
Number One
Conclusions
Eating healthy is important, but it’s not enough. You have to sweat regularly.
Number Two
Focus on what you CAN eat!
Non-starchy Vegetables Beans!(eat 5 a day!)
Nuts! Avocados and Good Fat!
Number ThreeConclusions
Conclusions
Some basic background can allow you to adjust most any decent recipe to one that is SUPER diabetic friendly
Number Four
Questions?
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