November is National Diabetes Awareness Month; therefore, I chose to focus on the nutritional aspect of this very serious, yet manageable disease.

When you have diabetes, your body cant use the food you eat in the proper way. Normally, when you eat food, namely carbohydrates, they are digested and changed into glucose, a sugar the body uses for fuel. The glucose is carried by the bloodstream, where it waits to be picked up by insulin to be taken to individual cells of the body. The pancreas is an organ in your body that houses the cells that make the hormone insulin. Insulin helps the glucose enter the cells of your body, much like the key that opens the door to let the blood sugar out so you can have energy to work and play.

In the case of diabetes, you may not be making any insulin at all, known as Type 1 diabetes. This type is typically seen in newborns up to young adults. The only way to manage this type is through insulin injections.

Type 2 diabetes is when the individual is still able to produce insulin, but not enough to manage a normal blood glucose level, or is unable to use the insulin he/she makes, called insulin resistance. This type generally occurs in adulthood, but is becoming more common in childhood. Treatment generally includes medication management along with lifestyle changes such as increased physical activity, weight loss and diet changes.

A meal plan should be designed to meet individual needs. It should consist of regular meals, with or without snacks to help control the amount of sugar (glucose) in your blood. A diabetics medical regimen may determine dietary modifications. In either case, the basic premise all foods can fit into a plan is taught. Some exceptions might include sugar-loaded beverages.

Learning how to carb count can make it easier to manipulate a diet plan. In order to master this, it will be helpful to have the education from a diabetes care and education specialist (DCES), formally known as a certified diabetes educator, who has had the training and passed the exam for the credentials. A physician referral is needed for this education.

A helpful tool to start using when first learning to count carbs is knowing the portion size of the food you are eating just as in weight management strategies. Make use of measuring cups and spoons for increasing awareness of the amount of food and beverage to be consumed.

Making use of the food labels is also helpful. Pay attention to the serving size listed along with the total grams of carbohydrate. This will make sense once a carbohydrate spending allowance is given. For instance, an average adult male might do well with 60 to 75 grams of carb per meal, while a female would do better with 30 to 45 grams per meal. An example of a 45-gram carb meal would be equivalent to a sandwich on two slices of bread and a fresh fruit. The carbohydrate spending allowance will be assigned based on the individuals needs using age, activity, height and weight.

Carbohydrate foods include natural sugars such as lactose, found in milk and yogurts; fructose, found in fruits; and starch, found in grains, potatoes, pastas, rice, etc. Sugar is a simple carb that is more readily broken down and can spike blood sugars. Its use should be minimized as possible.

Sugar alcohols such as mannitol, xylitol, sorbitol, isomalt, erythritol, isomalt and maltitol come from plant products such as fruits and berries. The carbohydrate in these plant products is altered through a chemical process. These sugar substitutes provide somewhat fewer calories than table sugar (sucrose), mainly because they are not well absorbed and may even have a small laxative effect. Therefore, they have little to no effect on raising blood glucose levels.

Artificial sweeteners are alternatives to giving sweetness to foods without adding calories and minimal to no added carbs. They include:

1. Saccharin: SweetN Low (pink packages)

2. Aspartame: Nutrasweet/Equal (blue packages)

3. Acesulfame-K: Sunett, Sweet One

4. Sucralose: Splenda (yellow packages)

5. Stevia: Sweet Leaf (green packages). This is the only all-natural, zero-calorie sweetener derived from a plant.

It is important to note that just because a food is listed as sugar-free does not make it carbohydrate-free, as it may contain other sources of carbs. You still need to check the labels and count the carbs.

Once carb counting is understood, it is important to learn to add protein (fish, skinless poultry, beef or pork), and heart healthy fats (olive oil, nuts) to meals and snacks to help balance out blood sugars. For example, when choosing to eat an apple, it may be beneficial to pair it with some peanut butter, nuts or cheese. Proteins and fats do not generally produce a glucose load. They can also help to provide satiety over a longer time frame.

Personal food preferences should be taken into account when planning meals. Here is an example of a generalized, healthy meal plan that we all can strive for, diabetic or not. It includes the Mediterranean style.

BREAKFAST

Greek-style yogurt mixed with walnuts and berries of choice

1 whole-grain slice of toast spread with avocado or nut butter

LUNCH

Tuna Salad on whole-grain bun or in mixed Lettuce greens; add almonds and toss with balsamic vinegar and olive oil

Orange slices and tomato and feta cheese marinated in olive oil

SNACK

Grapes and goat cheese

SUPPER

Broiled fish or skinless chicken or turkey

Brown rice, quinoa or sweet potato

Tossed greens with tomatoes, olives, avocado and olive oil-based dressing

SNACK

Mixed nuts and apple slices

Note: Beverages may include teas, coffee or other non-sugar drinks.

As with any upcoming holiday, please be mindful while you enjoy the family traditions you have.

Chris Willis is a clinical dietitian/certified diabetes educator at OSF HealthCare St. Mary Medical Center in Galesburg.

Go here to read the rest:
Chris Willis: Diabetes and nutrition - Galesburg Register-Mail

Comments are closed.