Healthy Eating with Diabetes. An introduction to nutrition and meal planning

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1 Healthy Eating with Diabetes An introduction to nutrition and meal planning

2 Healthy eating with diabetes Eating healthy foods is important for everyone but even more so for people with diabetes. Consuming a variety of foods in the right amounts, eating regularly, and matching how much you eat with your activity level will help you manage your blood glucose. You do not need to ban any foods from your meal plan, but you will need to limit the amounts you eat of some of them. This booklet will help you understand: The American Academy of Family Physicians Foundation has favorably reviewed this material through Favorable review means that medical information is accurate, but does not imply endorsement of any conclusions presented. How to use the Food Guide Pyramid as a guide to healthy eating How to determine serving sizes The principles of healthy eating How to read nutrition labels, and How to dine out and stay within your meal plan The Keeping Well With Diabetes patient education materials were developed using information from the following sources: The American Association of Diabetes Educators, The American Diabetes Association, The American Dietetic Association, and The American Association of Clinical Endocrinologists. These booklets do not replace the advice of your healthcare provider. Be sure to consult your healthcare provider regarding your individual diabetes treatment plan. 1

3 The nutrients in food All foods contain nutrients, substances that are needed by the body to stay healthy. The nutrients that provide calories are carbohydrate, protein, and fat. These 3 nutrients, along with vitamins and minerals, are present in different foods. Eating a wide variety of foods will help you get enough of each nutrient in your diet. Carbohydrate Protein Fat Carbohydrate is your main source of energy. Protein helps to build and repair your body tissues. Both protein and fat provide energy when carbohydrate is not available. Fat has several roles in your body. For instance, it is necessary for healthy skin and hair, and it carries certain vitamins throughout the body. Your meal plan goals Following your meal plan, getting regular exercise, and taking your diabetes medicine as prescribed (if you need it) are the cornerstones of good diabetes self-care. Your meal plan should be something you will enjoy and be motivated to follow. Your healthcare provider or registered dietitian will work with you to create your personal meal plan. The goals of your plan are to help you: Keep your blood glucose within your target range Lose weight or maintain a healthy weight Eat the recommended number of servings from each food group each day Include many of your favorite foods in your meal plan, and Reduce your risk of heart disease and stroke 2 3

4 The Food Guide Pyramid The Food Guide Pyramid is your foundation for healthy eating. Most of your food choices should be made from the food groups in the lower part of the pyramid. These are the grains, beans, fruits, and vegetable groups. Try to limit your intake of foods at the top of the pyramid. The number of servings you should eat daily from each group will depend on how many calories are in your meal plan. Vegetables 3 to 5 servings a day Dairy 2 to 3 servings a day Fats, Oils & Sweets Limit these foods Meat, Fish & Poultry 2 to 3 servings a day Fruits 2 to 4 servings a day Bread & Grains 6 to 11 servings a day Adapted from the U.S. Department of Agriculture and the U.S. Department of Health and Human Services guidelines. A meal plan is balanced if you eat the right amount of food servings from each of the food groups every day. Have 2 to 3 servings each day of high-protein foods like meat, fish, or poultry. Also, have 3 to 5 servings of fruits and vegetables. Be sure to spread your food choices among each day's meal and snack plan. 4 5

5 What is a single serving? The size of a single serving varies with the type of food. Serving sizes are often smaller than what you are used to eating. At first you ll find it helpful to weigh or measure your food to determine serving sizes. Once you see how 1 serving of a food looks on your plate or in a cup, you may be able to eyeball correct serving sizes rather than measure them. Here are some examples of 1 serving: 1/2 cup cereal, rice, or pasta 1 slice of bread or a small roll 1 medium piece of fruit 1/2 cup cooked or 1 cup raw vegetable 1 cup milk or yogurt 3 ounces of meat, fish, or poultry Easy ways to estimate portions You can estimate serving sizes by using your hand: Your fist equals 1 cup Your palm equals 3 ounces Your thumb equals 2 tablespoons or 1 ounce Your thumb tip equals 1 teaspoon A handful equals 1 or 2 ounces of a snack food, such as nuts Another way to estimate portions is by using the plate method. The amount of food you eat at lunch or dinner should fit easily on a 9-inch plate. Vegetables should take up half the plate. Starches (e.g., rice, pasta) should take up one-fourth of the plate. Meat, fish, or another protein-rich food should take up one-fourth. Add 1 serving each of fat-free milk and fruit for a balanced meal. 6 7

6 Snacks Snacks between meals or at bedtime may be part of your meal plan. Snacks can help prevent low blood glucose, and they can help satisfy hunger between meals. Eating a snack before or during intense or prolonged exercise can also help keep your blood glucose within your target range, if necessary. A typical snack for an adult with diabetes, such as a medium-sized apple or orange, contains about 15 grams of carbohydrate. Food exchanges and carbohydrate counting For more specific information about meal planning, ask your registered dietitian. For information about meal planning using the food exchange method or the carbohydrate counting method, ask your healthcare provider for a copy of Carb Counting and Exchange Lists, part of the Keeping Well with Diabetes series. Guidelines for healthy eating Healthy eating doesn t have to be complicated. Here are some basic guidelines to keep in mind when making food choices: Eat a wide variety of foods to ensure you get all the nutrients you need. Balance the number of calories you consume with your activity level so that you will lose excess pounds or maintain a healthy weight. Choose a diet rich in grain products, vegetables, and fruits. These foods are high in fiber and may help lower your blood glucose and cholesterol levels. Be sure to drink several glasses of water every day to help your body use the fiber you eat. 8 9

7 Less is best Health experts recommend you limit your intake of fat and cholesterol. Over time, eating too much of these can lead to heart or circulatory problems. Most saturated ( bad ) fats come from animal products such as meat and milk products. Saturated fats are solid at room temperature. Unsaturated fats, like olive oil and canola oil, are a healthier choice for cooking and for use in salad dressings. It s okay to enjoy a sugary food once in a while. However, foods high in sugar usually have a lot of calories and little or no nutritional value. Sugar substitutes such as saccharin and aspartame can be used if you want a sweet taste without the calories. Be aware that some foods that contain sugar substitutes still have calories. Your healthcare provider may suggest you eat less salt (sodium). Look for low-sodium foods when shopping. Processed foods like cold cuts, canned soups, pickles, and olives are loaded with sodium. The easiest way to reduce the sodium in your diet is to taste your food before adding salt. To make foods tastier, use herbs and spices instead of salt. Try pepper, lemon juice, vinegar, or garlic to add flavor to your food. Alcohol is high in calories, has no nutrients, and can interact with certain medicines. If you want to drink alcohol, talk to your healthcare provider. The recommended daily limits (for people with or without diabetes) are 1 drink for women and 2 drinks for men, taken with food

8 Reading nutrition labels All packaged foods have a Nutrition Facts label. The label lists a serving size, the calories per serving, and the number of grams of fat, cholesterol, sodium, carbohydrate, and protein per serving. The % Daily Value (DV) on the nutrition label tells you whether the nutrients (fat, carbohydrate, etc.) in 1 serving contribute a lot or a little to your total daily intake. Check serving size Limit these nutrients Get enough of these Portion of Daily Value, 5% is low 20% is High The nutrients listed first (fats, cholesterol, etc.) on a nutrition label are the ones Americans generally eat in adequate or too high amounts. Limit your intake of these nutrients. When reading a nutrition label, keep in mind that the serving size given may be larger or smaller than that recommended in your meal plan. Fiber and vitamins in your diet Many Americans do not eat enough dietary fiber. Be sure your meal plan includes plenty of high-fiber foods. You need at least 20 to 35 grams of fiber daily. American diets tend to be low in vitamins A and C, calcium, and iron. Be sure you eat foods rich in these vitamins and minerals each day. Tell your healthcare provider if you are taking any vitamins, minerals, or other nutritional supplements. 12 Illustration only. 13

9 Dining out When dining in restaurants, ask your server questions about the menu and make food preparation requests. Choose foods that are grilled, broiled, or baked. Avoid fatty meats and fried foods. Look for heart-healthy or lite meals on the menu. They usually contain less fat, cholesterol, and salt than other choices. However, they may be high in carbohydrate, so check portion sizes carefully. Serving sizes in restaurants tend to be large. Sharing a meal with someone else is a good way to avoid overeating. You can also ask the waiter to wrap some of the food and take it home. If a dish comes with a rich sauce or dressing, skip it or ask for the sauce on the side. Be careful when ordering meals or snacks from fast-food restaurants. These restaurants tend to feature tempting high-calorie, high-fat, salty foods. Before ordering, ask to see a list of the calorie and fat content of the foods offered. Many fast-food chains have low-calorie, low-fat meal choices such as grilled chicken or fish. If you are invited to someone s home for a meal, watch your portion sizes. Ask for water or a diet soft drink if the beverages offered during the meal do not fit your meal plan. Also, find out in advance what time the meal will be served. You may need to eat a snack before you leave home or, if you take insulin, to adjust the timing of your pre-meal injection

10 What have I learned? This booklet has explained the principles of healthy eating with diabetes, what types of food you should eat every day, and what foods you should avoid or eat only in small amounts. You have also learned why it is important to watch how much food you eat and to space your meals throughout the day. Finally, tips on how to stick to your meal plan and eat healthy foods when you are eating outside the home are discussed. Eating right, with or without diabetes, is a daily challenge for everyone. Following your meal plan will help you look and feel your best, manage your blood glucose levels, and reduce your risk of diabetes complications. Keeping Well With Diabetes We re pleased to offer you this booklet as part of the Keeping Well With Diabetes patient education program. But Keeping Well With Diabetes can bring you so much more. When you become a member of Keeping Well With Diabetes, a FREE program just for people who take insulin, you'll receive tools and materials that can make a difference in your daily life. Simply complete and return the postage-paid card in this booklet, call KWWD ( ), or visit our website at At Keeping Well With Diabetes Online, you ll find useful information on living with diabetes, online newsletters, and NovoTrack, a unique site that provides you with your own Personal Scorecard to keep track of your diabetes management. Novo Nordisk has been a world leader in diabetes care and treatment for more than 80 years. We do all we can every single day to continue to bring you new products and new services designed to help you keep well with diabetes. 16

11 For additional information on Novo Nordisk products designed to make living with diabetes easier, or to become a member of Keeping Well With Diabetes, a free program just for insulin users, call us at Visit us online at Any change in insulin should be made cautiously and only under medical supervision. Novo Nordisk is a worldwide leader in diabetes care. NovoPen, Novolin, PenFill, InnoLet, Innovo and NovoTrack are registered trademarks of Novo Nordisk A/S. InDuo is a trademark of LifeScan, Inc., a Johnson & Johnson company. The photographs used in this booklet are for illustration only. The models in the photographs do not necessarily have diabetes or other ailments or use or endorse any products mentioned. Copyright 2003 Novo Nordisk Pharmaceuticals, Inc. 1/ R Printed in the U.S.A.

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