7-Way to Reduce Postmeal Blood Sugar

Peak Hannah Mitter

Nutritionist with BS & MS in NutritionBSRN, DNP-UIC Student, Diabetes Educator, Adjunct Faculty Ambria College of Nursing

Normal Blood Sugar ranges• Fasting: 80-99• 1-hr: <130• 2-hr: <120 • 3-hr: 90-100• 4-hr: 80-100• 5-hr: 80-100

Normal

Hypoglycemia

Pancreas

Blood Sugar Test, 1987 FBS 30m 1hr 90m 2hr 3hr 4hr 5hrHannah 84 220 212 - 149 89 68 -

Rebekah 81 93 66 82 69 72 80 80

Hannah-PrediabetesRebekah–Hypoglycemia due to Hyper-

insulism

Diabetes

Amputated Leg, Diabetes

Blood Glucose & Insulin

7-way1. 3 meals & 3 snacks: meal portion control2. Eat whole grain, whole some food3. Avoid simple sugars, & eat complex

carbs4. Eat a mixed meal w/carb, proteins, fats5. Increase soluble fibers6. Stress management: caffeine effects7. Postmeal exercise: walk for 15-30min

1. Meal Portion Control a. Meal pattern: 3 meals & 3 snacks b. Carb control by carb countingc. Serving numbers per meal & snack

Meal pattern: 3 meals & 3 Snacks Meal TimeBreakfast 7-8am

Am snack 10 am

Lunch 12 noon

PM snack 3 pm

Supper 6 pm

Evening snack 8-9pm

One Serving size Carbohydrates Protiens Fat 1 piece of bread 1 egg 1 teaspoon of oil 1/3 cup rice, noodle 1 ounce (30g) meat

or fish 1 table spoon of salad dressing

1/3 cup cooked beans 1 ounce of cheese 1 cup milk 1/4 cup of cottage

cheese or Tuna fish 1 small apple or or-ange1/2 large banana

A handful of nuts

1/2 cup apple or or-ange juice

1 table spoon of peanut butter

Meal & Snack Serving Numbers Carbohydrates Proteins Fats

Meal 1-3 servings 1-3 servings 1-3 servings

Snack 0-2 servings O-2 serving 0-2 servings

2. Whole grain • Compare Brown & White rice• Compare whole grain & white breads

• Two reasons to eat whole grain 1. Nutrients: Vitamin Bs & minerals in

fiber and germ 2. Lower Glycemic Index

Whole Wheat • Bran• Germ•

Carb, Fat, Protein Metabolism(B1, B2, B3, B5, B6, B12, folate, Biotin)

Low GI diet

Class GI Food High >70 White Bread 70

Medium 56-69 Milled barley 58

Low <55 Whole wheat bread 55

Glycemic Index Low GI <55, Med GI 56-69, High GI >70

• White bread 72 Whole grain bread 55 pumpernickel bread 49, Rye (whole) 50 Rye regular 64 Corn tortilla 70, French bread 96 Waffles 76• All Bran 43 Rice Krispies 82 Corn fakes 84 Oatmeal Quick 66 Soy bean 18 Black bean 30 Lentil (red) 25 kidney bean canned 52 Fava beans 80• White rice 70, Millet 71, rice instant 85-91 Brown rice 56, Buckwheat 54, Barley, pearled 25 Cornmeal 68, Bulgar 47, Chick pea 33, Pinto bean 39

GI cont• Milk regular 27 skim 32 Sweet potato 54 Potatoes russet baked 90 corn 55-60 Pasta whole grain 45 tomato 38 Corn chips 70, pretzel 82, Grapefruit 25 • Strawberries 32 Apple 39 Oranges 40 Water melon 72, Cantaloupe 65, Banana 60 Cherries 23 Pear 35, Raisin 64 pineapple 66 Grapes 43-50 Apple juice 41 Orange juice 45-57 Grape fruit juice 49• Graham cracker 74 Rice cake 77, stoned wheat thins 68

3. Avoid Simple sugar & eat com-plex carbohydrates

• Simple sugar: a. Single sugars -glucose, fructose -high fructose corn syrup: glucose 45%/fructose 55% b. Double sugars -Table sugar (Sucrose)= glucose (50%) +fructose(50%) -Honey=Glucose (52%) + Fructose (48%) *Milk sugar (Lactose)=glucose + galactose -Maltose=glucose + glucoseC. Complex carbohydrates: Starch (rice, noodle, bread, pota-

toes, beans)

Glycemic Index • Sugar 61 – Honey 55• Milk sugar 46 - Milk 27• Apple 34 – Orange 42• Peach 45• Grape 46-Banana 52 • Watermelon 72- Pineapple 59

• Proteins & Fats: all Zero ex) Egg, Chicken, Fish, Beef, Pork, Oil-

4. Eat a Mixed meal• A meal mixed with Carbohydrates, Proteins,

Fats• Benefits:-Fat & protein food delay stomach emptying,

You feel full longer.-The meal digested slower and increase blood

sugar slowly. -A mixed carb, protein & fat meal takes 4 hrs to

complete emptying stomach, while carb food alone take only 2 hrs

Heart Diseases Prevention

Saturated Fat, Unsaturated fats

5. Increase soluble fiber 1. Reduce post meal blood sugar peak - delay emptying stomach - absorb glucose like sponge in small intestine; prevent high

blood sugar peak

2. Lowering cholesterol - bind bile acids (cholesterol) like sponge- remove cholesterol

through bowel movement • Soluble fiber: oat, barley, beans, apple skin, orange, guar gum,

sea weeds, asparagus, egg plants • Insoluble fiber: celery, broccoli, lettuce, whole grain, seeds

6. Stress management • Manage physical, emotional, & spiri-

tual stress • Stress hormones increase blood

sugar 1. Adrenalin 2. Cortisol • Physical stress: lack of sleep, caf -

feine, nicotine, street drugs, alcohol• Reduce “Fight or Flight Response”

스트레스 현상 Fight or Flight Response

Sleeping Stages: 7.5 hours/night

7. Postmeal exercise • Walk for 15-30min after a meal • Start by 20mn from the first bite of the

meal: rise high from 30min- highest peak is at 1 hour after a meal

• Aeorobic- blood sugar control• Muscle strengthening- increase mus-

clen sizes- then increase number of in-sulin receptors. Better insulin function

Walking, Swimming Muscle Strengthening Exercise

References • Brand-Miller, J. C., Stockmann, K., Atkinson, F., Petocz, P. & Denyer, G. (2009). Glycemic Index, Postprandial

glycemia, and the shape of the curve in healthy subjects: analysis of a database of more than 1000 foods. American Journal of Clinical Nutrition, 89, 97-105.

• Brand-Miller J., Wolver T. M., Foster-Powell, K. & Colagiuri, S. ( 2003a). The New Glucose Revolution, Marlow & Company, New York• Evagelidou, E. N., Kiortsis, D. N., Bairaktari, E. T., Giapros, V. I., Cholevas, V. K. et al. (2006). Lipid profile,

glucose homeostasis, blood pressure, and obesity: Anthropometric markers in macrosomic offspring of non-diabetic mothers. Diabetes Care, 29, 1197-1201.

• Galgani, J., Aguirre, C., Diaz, E. (2006). Acute effect of meal glycemic index and glycemic load on blood glu-cose and insulin responses in humans. [Electronic version] Nutritional Journal, 5( 22), 1475-1482 Retrieved July 15, 2009, from http://www.nutritionj.com/content/5/1/22

• Leipold H., Kautzky-Willer, A., Ozbal, A., Banchaer-Todesa, D., Worda, C. (2004). Fetal hyperinsulism and ma-ternal one-hour postload plasma glucose level. Ostetrics & Gynecology (104), 1301-1306

• Moses, R.G., Barker, M, Winter, M. Petocz, P. & Brand-Miller, J. C. (2009). Can a low glycemic index diet re-duce the need for insulin in gestational diabetes mellitus: A randomized trial. Diabetes Care, 32 (6), 995-1001.

• Moses, R. G., Luebcke, M., Davis, W. S., Coleman, K. J., Tapsell, L.C. Brand-Miller, J.C., et al. (2006). Effect of a low-glycemic-index diet during pregnancy on obstetric outcomes. The American Journal of Clinical Nutri-tion, 84, 807-812.

• Pederson, J. (1954). Weight and length at birth of infants of diabetic mothers. Acta Endocrinologica, 16, 330-342.

• Rolfes, S.R., Pinna, K., & Whitney, E. (2012). Understanding normal and clinical nutrition (9th ed.). Belmont, CA:Wardworth

• Nix, S. (2013) William’s basic nutrition and diet therapy (14th ed.). St Louis, Missouri: Elsevier Mosby

Thank You !!