and sodium and too little fiber and healthy carbohydrates. Your overall health reflects many things, such as your environment, heredity, and regular health care. These are things that you do not always have complete control over. However, your food choices, which are controllable, can help you improve your health. Take a look at the following Dietary Guidelines for Americans:
Eat a variety of foods—diabetes still requires the same nutrients, vitamins, and minerals as for those without diabetes.
Maintain a healthy weight—excess body fat makes it more difficult to use insulin, which in turn can lead to high blood glucose levels.
Choose a diet low in total fat, trans-fat, saturated fat, and cholesterol—diabetes increases the risk for heart and blood vessel disorders.
Choose a diet with plenty of fresh vegetables, fruits, and whole-grain products—high fiber can help lower blood glucose and blood fat levels.
Use sugars only in moderation—with 16 calories per teaspoon, sugar is not particularly fattening, but many high-sugar foods contain less fiber and a lot of added fat that does contribute to weight gain.
Use salt and sodium in moderation—high blood pressure is common among people with diabetes, and too much salt may cause water retention.
If you drink alcoholic beverages, do so in moderation—alcohol can affect blood glucose and blood fat levels, as well as supply a lot of “empty calories.”
DESIGNING YOUR OWN EATING PLAN
You will be happy to learn that registered dietitians offer a positive message that emphasizes the importance of healthy eating and daily physical activity. With the help of a registered dietitian, you’ll be taught how to include foods you like to eat in your meal plan, identify what food groups these foods belong in, and make the best choices in quantity and quality for good health. You do not have to restrict foods that are high in fat, cholesterol, sugar, and sodium completely, but you do have to watch them. It is your overall intake of these foods over time that makes a difference, not a single food or meal. In the course of a day, it is important to know which foods are in each food group and the suggested food amounts from each food group.
The amount of food you should eat in a day depends on your age, gender, weight, and level of physical activity. Together with a registered dietitian, you will work to design an eating plan just for you that provides healthy calorie sources while still allowing you to eat many of your favorite foods. You will be assured of enough good sources of fiber and healthy carbohydrates and of how to cut down on the more unhealthy sources of fat, cholesterol, and sodium.
However, the most important point to remember is that actual “serving sizes” are usually smaller than what you are used to seeing on your plate. Instead of regularly eating smaller homemade meals, many Americans eat more restaurant meals and convenience foods, which provide larger portions than the standardized portion sizes found in Choose Your Foods: Exchange Lists for Diabetes. As these large portions become more familiar to us, portion sizes on our plates continue to grow bigger.
Let’s briefly review the actual serving sizes of some common foods. These portion sizes are standardized and apply to all Americans, not just those with diabetes.
WHAT COUNTS AS ONE SERVING?
Carbohydrate
Including bread, cereals, grains, dry beans, crackers, snacks, and desserts.
• 1 slice bread
• 1/2 cup potato
• 1/2 cup cooked cereal
• 1 cup regular cereal
• 1/2 cup corn or peas
• 1/2 cup lentils or beans
• 1/3 cup pasta or rice
• 1 low-fat granola bar
• 1/4 large bagel (1 oz)
• 3 cups air-popped popcorn
• 2 rice cakes
• 1/2 cup low-fat ice cream
Fruits and Vegetables
• 1 small fresh fruit
• 1/2 cup canned fruit or juice
• 1 cup berries
• 17 grapes
• 1/2 grapefruit
• 1/4 cup dried fruit
• 1 cup raw vegetables
• 1/2 cup cooked vegetables
• 1/2 cup vegetable juice
Milk and Yogurt
• 1 cup nonfat or low-fat milk
• 6 oz nonfat or low-fat yogurt
• 1 cup sugar-free cocoa
• 1 cup low-fat soy/rice milk
• 1/3 cup dry low-fat milk
Protein
Including meat and meat substitutes.
• 1 oz lean fish, meat, or poultry
• 1 oz low-fat cheese
• 1 egg
• 1/4 cup egg substitute
• 1/4 cup low-fat cottage cheese
• 2 oz tofu
• 2 Tbsp natural peanut butter
Fat
• 1 tsp butter/margarine
• 1 Tbsp lite margarine
• 1 Tbsp salad dressing
• 1 tsp oil
• 1 tsp mayonnaise
• 1 Tbsp light mayonnaise
• 6 almonds/cashews
• 1 Tbsp sunflower seeds
• 2 Tbsp light sour cream/cream cheese
Alcohol
• 1 1/2 oz liquor
• 12 oz lite beer
• 5 oz dry wine
Variables
Now that you have reviewed the appropriate serving sizes of some common foods, it is important to note that you may eat more than one serving. For example, a dinner portion of meat (protein) for a young, active male could be five to six servings (5–6 oz), whereas a dinner portion for a middle-aged, non-active woman may be two to three servings (2–3 oz). This is all determined by working together with a registered dietitian who can personalize a meal plan to meet your specific needs. If you have type 2 diabetes and control your diabetes by diet and exercise alone, or in combination with diabetes medications, you may be asked to eat consistent amounts of carbohydrate at meals as well as regulate the timing of your meals to coincide with the action of your diabetes medication(s). If you have type 1 or type 2 diabetes and are on insulin, you may be asked to eat a consistent amount of carbohydrate at meals or you may learn how to precisely match your insulin to the amount of carbohydrate you plan to eat for more flexibility. So, there are certain considerations that should be taken into account depending on the type of medication you are on for your diabetes as well as how your specific insulin dose is calculated at each meal.
HERE’S WHAT YOU CAN DO
1. You are a normal, healthy person who just happens to have diabetes. Don’t think of your diabetes as a disorder that takes all of the pleasure and taste out of eating. Remember, there are no foods that are off limits.
2.