foods are not needed—all foods can fit!
• Fats are now categorized as “healthy” or “unhealthy,” and avoiding all fat is not the best option.
• Registered dietitians provide meal-planning options that are individualized and realistic, based on what you are willing and able to do.
• Moderate weight loss can result in improved blood sugar control and reaching an “ideal” body weight is not necessary.
• Eliminating carbohydrate from your diet and eating large amounts of protein is not a good substitute for healthy eating and weight loss.
• Snacks between meals and at bedtime are optional and certain types of foods work best to achieve satiety.
• Special vitamins and minerals are not needed for people with diabetes.
• Exercise does not have to involve a gym and spandex!
• Creating a plan before dining out can help you choose healthy options that are available at most restaurants.
• Old family recipes can be modified to make them lower in fat, carbohydrate, sodium, and calories.
One of the most important messages offered by your diabetes team is how to fit diabetes into your lifestyle rather than fitting your lifestyle into your diabetes. An important part of doing that is through learning the updated facts about healthy food choices for you and your family. We hope this book will serve as an important resource where you can find the most current information and research about nutrition and diabetes. Explore the 16 most common misconceptions about a diabetic diet—the first being that there even is such a thing! Moving beyond these myths is the best way to ensure the best management of your diabetes and ensure that you continue to enjoy the pleasures of the table.
MEDICAL NUTRITION THERAPY VERSUS THE DIABETIC DIET
NATE: My family doesn’ understand that I can’ eat the same meals that they eat because I now have diabetes! There are so many foods that I need to avoid, and I feel restricted and limited with my food choices!
DIETITIAN: Why do you think you have to avoid many foods and only eat “special foods” when you have diabetes?
NATE: My cousin, who has had diabetes for 20 years, told me he can’ eat any foods with fat or sugar and that I should stay away from my family’s favorite staple foods such as pasta and bread. I tried some of those “diabetic foods” but they are so expensive and the flavor isn’t the same.
DIETITIAN: I’m happy that you came to see me today. I am confident that I can clear up a lot of the misconceptions that you and your family may have about diabetes and food. It’s not uncommon for many people to think of a diabetic diet as lists of foods labeled “good” and “bad,” while avoiding desserts and “sugar” foods. That is not how meal planning for people with diabetes works today. To put it simply, it is not about restriction! A person with diabetes can eat anything a person without diabetes eats, as long as he or she thinks about what they eat in terms of healthy eating and has accurate up-to-date education. The American Diabetes Association’s goals for healthy eating aim at reducing fat and calories, including healthy carbohydrate foods, increasing fiber, moderating your protein intake, limiting alcohol intake, and fitting in regular physical activity. This is what anyone should be striving for—not just people with diabetes.
NATE: Do you really mean that I can continue to eat the foods that my family and I enjoy with just a little bit of tweaking?
DIETITIAN: Of course! There are no foods that are off limits, although some food choices are healthier than others. My job is to teach you to eat normally, but healthfully, so you can maintain your energy and blood glucose levels and understand how foods affect your blood glucose and weight. At the same time, doing this will help lower your risks of heart disease, high blood pressure, and kidney disease.
NATE: When can we start? I can’t wait to begin eating like a “normal person” again.
WHAT’S NEXT?
There continues to be much confusion and debate about what foods to eat when you have diabetes. “What can I eat?” is the most often asked question, and Nate’s thinking about a rigid “diabetic diet” and “forbidden foods” is all too common. Nate soon discovered that the “diet” for healthy living is based on flexible meal planning. Because his family was also at an increased risk of developing diabetes, such a meal plan would be helpful for them, too. What Nate perceived as a major challenge is now nothing more than learning how to enjoy his favorite foods balanced with new foods and that all foods can be part of a balanced diet.
THE OLD AND THE NEW
You may recall family members and friends describing nutrition guidelines for people with diabetes as being inflexible and tedious. To control blood glucose levels, doctors and dietitians had to provide strict, standardized “diabetic diets” to all people with diabetes. This diabetic diet was rigid and limited and distributed calories from carbohydrate, protein, and fat based on scientific research available at that time, which is now out of date. The biggest restriction, however, was the strict avoidance of sugar endorsed by a diabetic diet. Foods with added sugar, such as dessert foods, were prohibited, and even the amount of fruit, vegetables, and milk, which contained natural sugar, was severely regulated. People with diabetes often lost their motivation to stick with these preplanned diets, and their interest in nutrition diminished. Furthermore, the primary goal for blood glucose management back then was to reach an ideal body weight based on height and frame size.
Current nutrition guidelines are flexible and offer a wide variety of food choices. What was once a rigidly controlled, semi-starvation diet in the early days is now the “all foods can fit” meal plan that is tailor made for each person’s food likes and dislikes, lifestyle, health risks, and diabetes medications. The “all foods can fit” motto balances food intake for people with diabetes and is now called medical nutrition therapy instead of a “diabetic diet.” Health experts are no longer convinced that achieving an ideal body weight is a primary goal for managing your diabetes. Instead, you may be encouraged to maintain a reasonable weight or strive for a weight that you and your health care provider feel is realistic and achievable. We now know that even a moderate weight loss of 10–20 pounds for those who are overweight can result in improved blood glucose and blood fat levels.
As you read over the American Diabetes Association’s medical nutrition therapy goals below, keep in mind that the 2005 U.S. Department of Agriculture (USDA) dietary guidelines for Americans and the American Heart Association recommendations are also very similar. Don’t forget that these are guidelines for all healthy Americans.
Summary of the 2006 American Diabetes Association’s Updated Medical Nutrition Therapy (MNT) Recommendations
People with diabetes should
• receive individualized nutrition education, preferably provided by a registered dietitian who is a diabetes educator
• make lifestyle changes, including weight loss, reduced fat intake, and regular physical activity
• increase their daily fiber intake
• minimize trans-fat and saturated fat intake
• monitor carbohydrate intake to regulate blood glucose levels
• limit daily alcohol intake
HERE