Diabetes andDiabetes andNutritionNutrition

Lesson 2Lesson 2Expand Your Options, Improve Your ChoicesExpand 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 ChoicesA 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 recommendationsOnly for a 2,000 calorie diet

Trans FatsSugarsProtein

Limit these nutrients

Get enough of these

Based on 2,000 and 2,500 calorie dietsOnly 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, LDNAssoc. Extension Agent-FCS (Nutrition)Vermilion Parish