food servings maybe different from those used on food packages or in other serving definitions.
These meal plans contain about 50% of calories from carbohydrate, 20% from protein, and 30% from fat. These percentages fall into the ranges suggested for healthy eating. They also reflect the way many people split their calories.
Here are some other factors to keep in mind when using the chart to figure your calorie needs:
• Use calorie ranges as a general guide only. To learn how many calories and other nutrients you need to achieve your diabetes and nutrition goals, work with a dietitian who specializes in diabetes.
• Your activity level affects the amount of calories you need. A sedentary lifestyle is defined as one that includes only the light physical activity you do to complete the daily tasks of life, such as getting to work, doing laundry, fixing meals, and so on. An active lifestyle includes physical activity equal to walking more than 3 miles a day at 3 to 4 miles per hour, in addition to the activities of daily living.
• Some older women who are small in stature and sedentary may need to eat no more than 1,200 calories to lose weight. At 1,200 calories, however, you may need a vitamin and mineral supplement to meet your nutrition needs.
• The servings and calculations in the milk group are based on fat-free milk. Children between 9 and 18 years of age need 1,300 mg of calcium per day. They should get at least 3 servings of milk per day. Adults ages 19 to 50 need 1,000 mg of calcium per day. You can meet this goal with 2 servings of milk a day plus another serving of a high-calcium food. Women over age 50 need 1,200 mg of calcium per day. To make up for the carbohydrate in 2 cups of milk, add 24 grams from starches, non-starchy vegetables, or fruit.
• The calories and nutrient information for meats are based on average figures for lean meat (7 grams of protein and 3 grams of fat per ounce). Adjust the grams or servings of fat based on the type of meats you tend to eat. Choose lean sources of meat and meat substitutes as often as possible (see chapter 13 for more information). Consult with your health care providers if you have questions about your daily calorie needs.
Be Realistic! Aim for a Calorie Range
The actual calories you eat are not exact and greatly depend on the fat content of the foods you choose. One day, you might be on the low side because you chose grilled chicken or fish and ate vegetables with little to no added fats. The next day the opposite may be true because you’re dining out and choosing a higher-fat meat or adding dessert to your meal. Another big factor is how exact you are about your portions. Research shows that people can be off in their calorie counts by 500 calories at the end of a day simply by eating a little more than they realized, or guessing portions rather than weighing and measuring them precisely.
Your main goal, over the course of a week or month, is to average out your target calorie level. If you eat a few higher-fat choices one day, choose lower-fat choices the next. Over the long-term, change your eating habits and make healthier food choices to improve your diabetes management. Remember to focus your behavior changes on healthy eating strategies.
The Food Groups
This book groups foods into six main groups. Foods are divided into these groups based on the nutrients they provide and their effect on blood glucose levels. Grouping foods this way makes it easier for you to put together and eat healthy meals. You’ll learn much more about each food group in the chapters in section 2.
• Starch: This group includes all foods made from grains, such as bread, hot and dry cereal, rice, pasta, and crackers. The group also contains starchy vegetables like potatoes, corn, peas, and legumes (beans). You should aim to eat at least three servings of foods made from whole grain each day. It is also important to pack plenty of dietary fiber into the starches you choose.
• Vegetables: This group includes all fresh, frozen, and canned vegetables and vegetable juices. Note that the starchy vegetables are in the starch food group. Consider the vegetables in this group nonstarchy.
• Fruits: This group includes all fresh, frozen, canned, and dried fruits and fruit juices.
• Milk and yogurt: These foods are your best sources of calcium. Fat-free or low-fat milk and yogurt are the healthiest choices. Foods made from milk that have little or no calcium, such as cream cheese, cream, and butter, are generally found in the fat group. You’ll find cheese, another good source of calcium, in the meat and meat substitute group.
• Meat and meat substitutes: This group includes meats, poultry, seafood, eggs, cheese, and peanut butter. These foods provide you with much of the protein you eat. Choose lean sources of protein and prepare them in low-fat ways.
• Fats: These are the fats and oils you use when you prepare or eat foods. The foods in this group include the oil that you sauté vegetables in, the margarine you spread on toast, salad dressings, nuts, and bacon.
Not included in these six basic groups are sugars and sweets and alcohol and other beverages (with or without calories).
From Servings to Meals and Snacks
The next step is to figure out how to divide your allotted servings of food into balanced and tasty meals and snacks. Eating three meals a day is the foundation of a healthy eating plan that will help you keep your blood glucose on target. Note the meal skipped most regularly, breakfast, is the one found to be most important in weight control! It’s best not to skip meals, especially if you take a blood glucose-lowering medicine that can cause low blood glucose.
Snacks
People with diabetes used to be told to eat every few hours to make sure their blood glucose didn’t get too low. Times have changed dramatically! Some people take one or more diabetes medications that don’t cause low blood glucose, and some use a combination of long-and rapid-acting insulins that tend to cause fewer problems with hypoglycemia.
With these therapies the messages about the need to snack have changed. Snacks are not a must. You may want to include snacks because they help you achieve your diabetes and healthy eating goals, or you might be thrilled to do away with the bothersome preparation and toting of snacks.
Putting Together Your Plan
To plan which foods to eat at your meals and snacks, ask yourself these questions about your daily life:
• What foods do you enjoy, and when do you want to eat them?
• What is your schedule for your blood glucose-lowering medications?
• How often and at what times do you have low blood glucose (hypoglycemia)?
• How much do you like to eat at different meals and snacks?
• Do you want or need snacks?
• What other nutrients do you need to consider? For example, do you have concerns about sodium and blood pressure or saturated and trans fat and blood lipids?
• How often do you eat meals away from home, and what types of foods do you eat when you eat out?
• Do you take vitamin and mineral supplements? Which ones and how much?
• What is your weight history?
• What is your usual activity level?
• What is your usual life schedule? If you work, what are your work hours? How do your weekdays vary from weekends? Are there other regular events in your schedule to consider?
If you wonder whether to keep snacks in your eating plan or not, remember that you should include them only if
• you want them
• you need them to prevent your blood