likes to eat and then work together to design her own meal plan.
Your meal plan needs to fit your schedule, your likes and dislikes in foods, how active you are, when you like to eat, and where you go when you eat out. You and your dietitian will then design a meal plan that will fit the way you live and will include the foods you and your family like.
Luckily, a diabetes meal plan is good for the whole family. Making one dinner is hard, but making two—one for you and one for your family—just won’t work. The foods you choose for taking care of your diabetes are the same foods that we all need to eat to stay healthy, whether we have prediabetes or diabetes or not. It’s been great that Dad has been part of Mama’s diabetes team. He’s helping her count carbs. In fact, he’s lost about 10 pounds by rating his plate and counting his carbs, too. And he’s starting to walk some. Mama has been a good role model for him.
The first day of Mama’s classes, a nurse educator talked to the group about diabetes in general, about checking blood glucose, and about things that affect blood glucose. Many family members, like me, were there to learn about diabetes care. They asked lots of questions and learned from each other.
Mama then worked with Marion, a dietitian and CDE. Marion started by talking about Carb Counting with Mama. Marion was pleased to learn that Mama had already started counting her carbs. Marion agreed that 3 carb choices at meals and 1 carb choice for a bedtime snack was a good starting point for her. Marion told Mama the next step was to start checking her blood glucose to see how this plan was working for her. For more on checking your blood glucose, see Chapter 7.
Next, Marion had Mama look at a food label. The Nutrition Facts label can help with meal planning. It can also help you make better food choices when you’re shopping.
In the food label shown below, let’s go through the steps together to see how it can help you.
Steps in Using a Food Label
Step 1—Serving size.
Look first at the serving size. All of the numbers in the Nutrition Facts box are based on this serving size. Is this the serving size you will be eating? How many servings are in the container or bag? In the sample label, one serving of macaroni and cheese equals 1 cup. If you ate the whole package, you would
eat 2 cups. That doubles the calories and other nutrients.
Step 2—Calories.
Now look at the calorie section of the label. It can help you with your weight. On this label, one serving of macaroni and cheese is 1 cup and 250 calories. If you eat 2 cups, it will be 500 calories. Eating too many calories will lead to weight gain.
Step 3—Total fat, saturated fat, trans fat, cholesterol, and sodium.
Look at the grams of total fat, saturated fat, trans fat, and cholesterol. Eating too much of these fats may increase your risk of heart disease, some cancers, or high blood pressure. The same is true for sodium (salt). Experts suggest eating as little saturated fat, trans fat, cholesterol, and sodium as you can.
Step 4—Total carbohydrates.
How many grams of carbohydrate are there in one serving? Mama said 31 grams, and she was right! If you eat two servings, it would be 62 grams, which is too high for most meals. Divide total grams of carbohydrate by 15 to find out the number of carb choices. One serving of the macaroni and cheese would be 2 carb choices because 31 grams divided by 15 equals 2.
Step 5—Fiber, vitamins A and C, calcium, and iron.
Most of us don’t have enough dietary fiber, vitamins A and C, calcium, or iron in our meal plans. They are identified in the food label. Eating enough of these nutrients can improve your health and help reduce your risk of some diseases. For example, getting enough calcium may reduce the risk of brittle bones as we get older. That condition is called osteoporosis. Eating plenty of dietary fiber promotes healthy bowel function. Make an effort to choose fruits, vegetables, and grain products that contain dietary fiber.
You can use the Nutrition Facts label to compare products. Let’s say you’re shopping for canned soup. By looking at the Nutrition Facts label, you will be able to tell which brand is lower in calories, total fat, trans fat, cholesterol, and sodium.
You may be thinking that using the Nutrition Facts label will take more shopping time. That’s true the first few times you use the label. But over time, you will find that it is a great tool to use for healthier shopping and eating.
Making Healthy Food Choices
Marion, the dietitian, and Mama then talked about making healthy food choices when planning meals. Marion suggested eating a wide variety of foods daily. Marion said this meant:
• Eating some fruit each day.
• Eating lots of vegetables that aren’t starchy, such as tomatoes, cabbage, asparagus, cauliflower, green beans, broccoli, carrots, mushrooms, okra, leafy greens, and turnips.
• Trying to eat different colored fruits and vegetables, such as dark green (collards or broccoli), orange (cantaloupe, apricots, or carrots), red (watermelon or tomatoes), blue (blueberries), and white (banana, cauliflower, or turnips). Some people call this “eating the rainbow.” Research shows that eating colorful fruits and veggies also helps prevent cancer and heart disease.
• Choosing different kinds of starches, such as corn tortillas, black or pinto beans, hominy, whole-grain breakfast cereals and breads, and sweet potatoes.
• Eating high-fiber foods, like beans, whole-grain breads and cereals, and fruits and vegetables.
• Checking food labels for breakfast cereals that have at least 4 grams of fiber per serving.
• Looking for breads that have 2 to 3 grams of fiber per slice.
• Choosing dairy products that are low in fat. Nonfat (or skim) milk and 1% milk are the good choices. Light yogurts are also great when you want something sweet. Check the Nutrition Facts label for yogurts that are sweetened with a calorie-free sweetener.
Mama and Marion decided to choose only one or two changes for Mama to work on. Mama decided she wanted to eat more colorful fruits and vegetables. She thought it sounded like fun to eat the rainbow.
You may want to think about doing some of these things—one at a time—along with Rate Your Plate or Carb Counting. Read through the list of ideas above, and pick one action item you want to work on.
Marion gave Mama a longer list of carb choices. That list is at the end of this book in Chapter 21, Diabetes Tools. If you decide to count your carbs, this longer list may come in handy later on.
Glycemic Index
Mama heard about the glycemic (gly-SEE-mik) index on TV. The glycemic index is a number that tells you how much a carb food will raise blood glucose. A carb food may raise blood glucose a lot, a little, or somewhere in between.
Mama called and said, “I’m confused by this glycemic index. I thought all carbs raised blood glucose.”
“You’re right,” I said. “All carbs do raise blood glucose, but some carbs raise blood glucose levels more than others. For example, corn flakes raise blood glucose more than oatmeal. For some people, using the glycemic