Maintaining a healthy diet is important for everyone,
but it is especially important for people with diabetes
. Following the right
meal plan can make all the difference to a person struggling to keep
their blood sugar under
control. But, what is the right meal plan?
How much of which food group should you eat?
Along with a visit to a dietician, this guide should help answer
questions you may have.
Understanding Carbohydrates and
Carbohydrates are one of the
major food categories (the others include proteins and fats). They provide fuel for the body in the
form of glucose. Glucose is a
sugar that is the primary means of
energy for all of the body's cells.
There are two ways to classify carbohydrates -- simple and
complex. Simple carbohydrates are sugars -- like glucose, sucrose,
lactose and fructose. They are found in refined sugar and in fruits.
Complex carbohydrates are the starches, which are the simple sugars
bonded together chemically -- they are found in beans, nuts,
vegetables and whole grains. Complex carbohydrates are considered
healthier mostly because they are digested by the body slowly,
providing a steady source of energy. They also contain valuable
amounts of fiber.
Carbohydrates, rather than fats or proteins, have the most
immediate effect on your blood glucose since carbohydrates are broken down directly into sugar early during
digestion. It is important to eat the suggested amount of carbohydrate at each meal,
along with some protein and fat.
Carbohydrates are mainly found in the following food groups:
- Milk and yogurt
- Bread, cereal, rice, pasta
- Starchy vegetables
What Is Carbohydrate Counting?
Carbohydrate counting is a method of meal planning that
is a simple way to keep track of the amount of total carbohydrate you eat each
day. It helps allow you to eat what you want. Counting grams of carbohydrate and
evenly distributing them at meals will help you control your blood glucose.
Instead of following an exchange list, with carbohydrate counting
you monitor how much carbohydrate (sugar and starch) you eat daily.
One carbohydrate serving is equal to 15 grams of carbohydrate.
With carbohydrate counting, you plan your carbohydrate intake
based on what your pre-meal sugar is and your intake or insulin dose
can be adjusted. Carbohydrate counting can be used by anyone and not
just by people with diabetes that are taking insulin. If you eat
more carbohydrates than your insulin supply can handle, your blood
glucose level goes up. If you eat too little, your blood glucose
level may fall too low. These fluctuations can be managed by knowing
how to count your carbohydrate intake.
A registered dietitian will help you figure out a carbohydrate
counting plan that meets your specific needs. For adults, a typical
plan generally includes three to four carbohydrates at each meal,
and one to two carbohydrate servings as snacks.
With carbohydrate counting, you can pick almost any food product
off the shelf,
the label, and use the information about grams of carbohydrates
to fit the food into your meal plan.
Carbohydrate counting is most useful for people who take multiple
daily injections of insulin, use the insulin pump or who want more
flexibility and variety in their food choices. However, it may not
be for everyone, and the traditional method of following food
exchange lists may be used instead.
How Much Fiber Should I Eat?
Fiber is the indigestible part of plant foods. It plays an
important role in the digestive process as it helps move foods along
the digestive tract, adding bulk to stool to help it pass through
the bowel. In addition, diets high in fiber are associated with
lower risks of obesity, hypertension, heart disease and strokes.
- Delays sugar absorption, helping to better control
blood glucose levels.
- Binds with cholesterol and may reduce the level of
'bad' LDL cholesterol in the blood.
- Is a good source of vitamins and minerals.
- Helps prevent constipation and reduces the risk of
certain intestinal disorders.
- Promotes weight loss by helping to decrease caloric intake. (It adds bulk to the food we eat, making you feel fuller.)
The goal for all Americans is to consume 25 to 35 grams of fiber
per day. The best way to increase your fiber intake is to eat more
of these fiber-rich foods:
- Fresh fruits and vegetables
- Cooked dried beans and peas
- Whole grain breads, cereals, and crackers
- Brown rice
- Bran products
Since diabetes increases your risk of developing heart
disease, eating foods lower in fat -- especially saturated fat
-- is particularly important to keep that risk as low as possible.
In addition, limiting calories from fat can help you lose any extra
weight, especially when combined with an exercise program.
The major contributors of saturated fats in our diet come from
cheese, beef, milk and baked items. Transfats also contribute to the
increase risk of heart disease. These fats are vegetables oils that
are harder; we recognize these as solid oils -- lards, margarines
etc. Many of these are used in baking and frying.
Here are some general guidelines for selecting and preparing
- Select lean meats including poultry, fish, and lean
red meats. When preparing these foods, don't fry them. Instead, you can bake,
broil, grill, roast or boil.
- Select low-fat dairy products such as low-fat cheese,
skim milk and products made from skim milk such as nonfat yogurt, nonfat
frozen yogurt, evaporated skim milk, and buttermilk. Remember to include dairy
products in your daily carbohydrate count.
- Use low-fat vegetable cooking spray when preparing
foods or consider using cholesterol lowering margarine containing stanols or
sterols. Examples include "Take Control" and "Benecol."
- Use liquid vegetable oils that contain poly- or
monounsaturated fats which can help lower your 'bad' LDL cholesterol.
- Select lower fat margarines, gravies and salad
dressings and remember to watch the carbohydrate count on condiments and
- All fruits and vegetables are good low-fat choices. Remember to include fruit and starchy vegetables in your daily carbohydrate count.
Diabetes: What Raises and Lowers Your Blood Sugar Level?
A registered dietitian can provide more information on how to
prepare and select low-fat foods.
Diabetes increases your risk for
blood pressure. High levels of sodium (salt) in your
diet can further increase that risk. Your health care provider or dietitian
may ask you to limit or avoid these high-sodium foods:
- Salt and seasoned salt (or salt seasonings)
- Boxed mixes of potatoes, rice or pasta
- Canned meats
- Canned soups and vegetables (with sodium)
- Cured or processed foods
- Ketchup, mustard, salad dressings, other spreads and
- Packaged soups, gravies or sauces
- Pickled foods
- Processed meats: lunch meat, sausage, bacon and ham
- Salty snack foods
- Monosodium glutamate or MSG (often added to Chinese
- Soy and steak sauces
Low-Sodium Cooking Tips
- Use fresh ingredients and/or foods with no salt
- For favorite recipes, you may need to use other
ingredients and eliminate or decrease the salt you would normally add.
- Try orange or pineapple juice as a base for meat
- Avoid convenience foods such as canned soups, entrees
and vegetables; pasta and rice mixes; frozen dinners; instant cereal; and
pudding, gravy and sauce mixes.
- Select frozen entrees that contain 600 milligrams or
less of sodium. However, limit yourself to one of these frozen entrees per
day. Check theNutrition Facts label on the package for sodium
- Use fresh, frozen, no-added-salt canned vegetables or
canned vegetables that have been rinsed before they are prepared.
- Low-sodium canned soups may be used.
- Avoid mixed seasonings and spice blends that include
salt, such as garlic salt.
What Seasonings Can Replace Salt?
Herbs and spices are the answer to improving the natural flavors
in food without using salt. Below are some mixtures to use for
meats, poultry, fish, vegetables, soups, and salads.
2 tablespoons dried savory, crumbled
1/4 teaspoon freshly ground white pepper
1 tablespoon dry mustard
1/4 teaspoon ground cumin
2 1/2 teaspoons onion powder
1/2 teaspoon garlic powder
1/4 teaspoon curry powder
2 teaspoons garlic powder
1 teaspoon basil
1 teaspoon oregano
1 teaspoon powdered lemon rind or dehydrated lemon juice
2 tablespoons dried dill weed or basil leaves, crumbled
1 teaspoon celery seed
2 tablespoons onion powder
1/4 teaspoon dried oregano leaves, crumbled
A pinch of freshly ground pepper
1 teaspoon cloves
1 teaspoon pepper
2 teaspoons paprika
1 teaspoon coriander seed (crushed)
1 tablespoon rosemary
Reviewed by Certified Diabetes Educators
in the Department of Patient Education and Health Information and by physicians
in the Department of Endocrinology at The Cleveland Clinic.
Edited by Cynthia Haines, MD, WebMD, September 2005.
Portions of this page © The Cleveland Clinic 2000-2005
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