What was once a rigidly controlled, semi-starvation diet in the early days is now the “all foods can fit” meal plan that is tailor made for each person’s food likes and dislikes, lifestyle, health risks, and diabetes medications. The “all foods can fit” motto balances food intake for people with diabetes and is now called medical nutrition therapy instead of a “diabetic diet.” Health experts are no longer convinced that achieving an ideal body weight is a primary goal for managing your diabetes. Instead, you may be encouraged to maintain a reasonable weight or strive for a weight that you and your health care provider feel is realistic and achievable. We now know that even a moderate weight loss of 10–20 pounds for those who are overweight can result in improved blood glucose and blood fat levels.
As you read over the American Diabetes Association’s medical nutrition therapy goals below, keep in mind that the 2005 U.S. Department of Agriculture (USDA) dietary guidelines for Americans and the American Heart Association recommendations are also very similar. Don’t forget that these are guidelines for all healthy Americans.
Summary of the 2006 American Diabetes Association’s Updated Medical Nutrition Therapy (MNT) Recommendations
People with diabetes should
• receive individualized nutrition education, preferably provided by a registered dietitian who is a diabetes educator
• make lifestyle changes, including weight loss, reduced fat intake, and regular physical activity
• increase their daily fiber intake
• minimize trans-fat and saturated fat intake
• monitor carbohydrate intake to regulate blood glucose levels
• limit daily alcohol intake
HERE ARE THE FACTS
The American diet clearly has too much fat, cholesterol, and sodium and too little fiber and healthy carbohydrates. Your overall health reflects many things, such as your environment, heredity, and regular health care. These are things that you do not always have complete control over. However, your food choices, which are controllable, can help you improve your health. Take a look at the following Dietary Guidelines for Americans:
Eat a variety of foods—diabetes still requires the same nutrients, vitamins, and minerals as for those without diabetes.
Maintain a healthy weight—excess body fat makes it more difficult to use insulin, which in turn can lead to high blood glucose levels.
Choose a diet low in total fat, trans-fat, saturated fat, and cholesterol—diabetes increases the risk for heart and blood vessel disorders.
Choose a diet with plenty of fresh vegetables, fruits, and whole-grain products—high fiber can help lower blood glucose and blood fat levels.
Use sugars only in moderation—with 16 calories per teaspoon, sugar is not particularly fattening, but many high-sugar foods contain less fiber and a lot of added fat that does contribute to weight gain.
Use salt and sodium in moderation—high blood pressure is common among people with diabetes, and too much salt may cause water retention.
If you drink alcoholic beverages, do so in moderation—alcohol can affect blood glucose and blood fat levels, as well as supply a lot of “empty calories.”
DESIGNING YOUR OWN EATING PLAN
You will be happy to learn that registered dietitians offer a positive message that emphasizes the importance of healthy eating and daily physical activity. With the help of a registered dietitian, you’ll be taught how to include foods you like to eat in your meal plan, identify what food groups these foods belong in, and make the best choices in quantity and quality for good health. You do not have to restrict foods that are high in fat, cholesterol, sugar, and sodium completely, but you do have to watch them. It is your overall intake of these foods over time that makes a difference, not a single food or meal. In the course of a day, it is important to know which foods are in each food group and the suggested food amounts from each food group.
The amount of food you should eat in a day depends on your age, gender, weight, and level of physical activity. Together with a registered dietitian, you will work to design an eating plan just for you that provides healthy calorie sources while still allowing you to eat many of your favorite foods. You will be assured of enough good sources of fiber and healthy carbohydrates and of how to cut down on the more unhealthy sources of fat, cholesterol, and sodium.
However, the most important point to remember is that actual “serving sizes” are usually smaller than what you are used to seeing on your plate. Instead of regularly eating smaller homemade meals, many Americans eat more restaurant meals and convenience foods, which provide larger portions than the standardized portion sizes found in Choose Your Foods: Exchange Lists for Diabetes. As these large portions become more familiar to us, portion sizes on our plates continue to grow bigger.
Let’s briefly review the actual serving sizes of some common foods. These portion sizes are standardized and apply to all Americans, not just those with diabetes.
WHAT COUNTS AS ONE SERVING?
Carbohydrate
Including bread, cereals, grains, dry beans, crackers, snacks, and desserts.
• 1 slice bread
• 1/2 cup potato
• 1/2 cup cooked cereal
• 1 cup regular cereal
• 1/2 cup corn or peas
• 1/2 cup lentils or beans
• 1/3 cup pasta or rice
• 1 low-fat granola bar
• 1/4 large bagel (1 oz)
• 3 cups air-popped popcorn
• 2 rice cakes
• 1/2 cup low-fat ice cream
Fruits and Vegetables
• 1 small fresh fruit
• 1/2 cup canned fruit or juice
• 1 cup berries
• 17 grapes
• 1/2 grapefruit
• 1/4 cup dried fruit
• 1 cup raw vegetables
• 1/2 cup cooked vegetables
• 1/2 cup vegetable juice
Milk and Yogurt
• 1 cup nonfat or low-fat milk
• 6 oz nonfat or low-fat yogurt
• 1 cup sugar-free cocoa
•
