Sit down with a registered dietitian to find out where most of your calories are coming from. Are you eating too many fat-filled and animal foods and not enough whole grains, fruits, and vegetables? Have you eliminated carbohydrate foods from your diet? What do you need to eat more of? What do you need to eat less of?
3. Eat a variety of fresh fruits and vegetables every day.
4. Eat fewer animal products. Doing this will reduce your risk of heart disease.
5. Eat more fiber. Choose whole-grain breads and cereals. Eat the skins and peels of fresh fruits and vegetables. Add dried beans and lentils.
6. Eat less fat. Try to cut down on trans-fats and saturated fats, which are harmful to your arteries.
7. Cut down on your salt intake. Cut down on the salt you use when cooking and at the table.
8. Make a healthy grocery shopping list. Be sure to include more of the foods you have been missing and make an effort to include these foods on a regular basis.
9. Get help with weight loss. If you are trying to lose weight, let your registered dietitian help you tighten up your portion sizes and increase activity. Doing this will allow you to eat fewer calories and burn more calories.
10. Use teamwork. Work with your diabetes team and dietitian to coordinate your food intake with your activity level and diabetes medication(s).
11. Plan on eating meals that fill you up for longer periods. Such meals contain moderate amounts of protein and healthy fats and contain fiber-rich carbohydrate foods, such as whole-grain starches, fruits, and vegetables.
12. Educate your family and support system. Help your family members understand how to eat in a healthy way by bringing variety and balance from all of the food groups to your shared meals.
COMMONLY ASKED QUESTIONS
Will I still be able to keep good control of my blood glucose if I eat the same foods as the rest of the family?
If you work with your diabetes team and your registered dietitian to match your food intake with your diabetes medications and activity level, you won’t have to eat any differently than the rest of your family, assuming they are also eating a healthy, balanced diet.
How can I make wise food choices to lower my risk for heart disease and other problems caused by diabetes?
Keep your blood glucose in your target range and stick with your healthful eating plan, regular physical activity, and, if needed, diabetes medications.
Isn’t it more important for a person with diabetes to follow healthy eating guidelines than for the rest of the family?
Healthy eating guidelines are important for all Americans because we tend to eat too much fat, cholesterol, and sodium and not enough fiber and healthy carbohydrates. Because of excesses in our diets, all Americans are at a greater risk for heart disease, high blood pressure, stroke, diabetes, obesity or overweight, and some forms of cancer.
YOUR TURN
Now it’s your turn to recall some key points from this chapter. Let’s see how you do!
1. Instead of the term “diabetic diet,” we now call meal planning for those with diabetes ________________________ (3 words).
2. Achieving a “reasonable body weight” rather than “ideal body weight” is now one of the primary goals for diabetes self-management. True or false?
3. Please fill out what counts as one standardized serving size, for each of the following foods:
| Rice/pasta: | ________ |
| Cooked oatmeal: | ________ |
| Lentils/beans: | ________ |
| Berries: | ________ |
| Milk: | ________ |
| Light margarine/mayonnaise: | ________ |
| Olive oil: | ________ |
4. Currently, nutrition guidelines are flexible and offer a wide variety of food choices. True or false?
See APPENDIX A for the answers.
People with diabetes must avoid all foods that contain sugar.
JUDY: I was just diagnosed with diabetes right before moving to this area. My former doctor told me to stay away from any foods with sugar—I can’t even eat carrots! She also told me to see a registered dietitian but didn’t tell me how to find one.
DIETITIAN: You must be feeling completely overwhelmed by your new diagnosis. You must also feel very limited with your food choices. The good news is that the main goal of medical nutrition therapy for those with diabetes is not to avoid sugar, but to eat a healthy balance of foods spread out over the day.
JUDY: I remember that my grandmother had diabetes for years and could never eat desserts or foods with sugar. Even after depriving herself for years, she still had many complications related to diabetes. And to make matters worse, I’m addicted to sugar!
DIETITIAN: Actually, new nutrition guidelines were introduced by the American Diabetes Association in the 2000s. Each year, the nutrition guidelines are updated based on the most current research. So, not only can sugar be added into any healthy eating plan, but we now have many new treatment options for people with diabetes to prevent or delay the complications of diabetes. There are two other pieces of good news. One is that you can certainly eat carrots! The second is that although people do like and desire foods with sugar, this does not qualify as an addiction.
WHAT’S NEXT?
The need to avoid sugar is one of the biggest misconceptions in diabetes management today. Like Judy, many people with diabetes mistakenly work extremely hard to eliminate all foods with sugar. Judy learned that this was nearly an impossible task because many healthy foods have some form of sugar in them. Some foods contain “added sugars,” whereas other foods naturally contain sugar. Many research studies completed over the past 30 years have shown that foods containing sugar can be part of a healthy diet, even for those people with diabetes, and can be fit into an eating plan, just like any other carbohydrate food.
After several diabetes appointments with the dietitian, Judy learned that sugar is not forbidden or harmful and began to feel more comfortable about fitting many new foods that contained sugar into her eating plan. Instead of feeling guilty about eating sugar and trying to avoid it at all costs, Judy was able to take control of her situation and manage to fit some foods with sugar into her eating plan.
THE OLD AND THE NEW
Nutrition therapy has always been the cornerstone in the self-management of diabetes; however, some people with diabetes have had little training in medical nutrition therapy and may have been told to “watch their diet” and to “stay away from sugar.”
A brief historic review reveals that hundreds of years ago, diabetes was attributed to eating an excessive amount of food with sugar and flour. This