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TRANSCRIPT
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