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Common Sense Guide to Eating

For People With Type-2 Diabetes

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What You Will Learn Today

• 2 most important eating strategies

• Carbohydrates, protein and fat tips

• How to read a food label

• Supplement FAQs

• Meal planning to better your health

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What Are The 2 Most Important Eating Strategies?

1. Lose Weight:– Reduces insulin resistance– Lowers blood pressure– Improves blood sugar control– Improves blood lipids– Reduces risk of heart disease & stroke– Reduces need for blood-sugar lowering

medication

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What Are The 2 Most Important Eating Strategies?

2. Eat A Heart-Healthy Diet:– 2/3 of all people with type 2 diabetes die of

heart disease– The risk of dying of a heart attack is at least

2-3 times greater in people with diabetes

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The Importance of Weight Control

The risk of developing diabetes increasesas body mass index goes up

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The Importance of Weight Control

Insulin resistance goes up as percent of idealbody weight goes up

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Weight Loss and a Heart Healthy Diet Go Hand in Hand

• Eat more fiber– Lower your cholesterol– Feel fuller on fewer calories

• Eat less fat, especially trans fat and saturated fat– Makes weight loss without hunger easier– Improves blood lipids– Reduces the risk of heart attack & stroke

• Eat fewer refined foods & more whole foods– Better blood lipid profile– Better weight control

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Carbohydrates

• The body’s main energy source

• Some carbohydrate-rich foods are much better choices than others

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Where Are Carbohydrates Found?

• Starchy Vegetables– Corn– Potatoes– Sweet potatoes

• Grains – Cereals– Breads

• Fruits• Milk• Sugars

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Choose Preferred Carbohydrates

• Whole grains – Whole wheat

pasta– Oatmeal– Barley– Whole grain

cereal– Brown rice

•Vegetables– Raw– Steamed– Salad– Stir fry

•Whole fruit– Fresh– Frozen– Unsweetened

These are minimally processed, whole plant foods

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Limit Refined Carbohydrates

• Candy• Brownies• Cookies• Bagels• Croissants• Biscuits• Danish• Pretzels• White bread• Fat free chips

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Make a Better Choice

Instead of: Choose:

white rice brown rice

white pasta whole grain pasta

sugared cereal oatmeal

French fries baked potato, yam

candy whole fruit

fruit juice whole fruit

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Advantage of Whole Plant Foods

Carbohydrate: Calories:Bagel Breakfast:1 bagel (4 ounces) 60 g 311 Light cream cheese (2 Tbsp) 2 g 70 Milk, skim (1 cup) 12 g 85 Total 74 g 466Total weight: 12.5 ounces

Oatmeal Breakfast:Cooked oatmeal (2 cups) 48 g 281 Skim milk (1 cup) 12 g 85 Orange (1) 15 g 61 Total 75 g 427Total weight: 28 ounces

You Get To Eat MORE!

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Advantage of Whole Plant Foods

Carbohydrate: Calories:Macaroni & Cheese Dinner:Macaroni & Cheese (1 cup) 40 g 390Salad (2 cups) 13 g 81Apple sauce (1/2 cup) 22 g 86Total 75 g 577Total weight: 22 ounces

Stirfry & Brown Rice Dinner:Broccoli Stirfry & Brown Rice (2 cups) 48 g 259Salad (2 cups) 13 g 81Diced Fresh Fruit (1 cup) 13 g 55Total 74 g 396Total weight: 27 ounces

You Get To Eat MORE!

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Should I Avoid Sugar?

• You should try to limit refined sugars:– Weight gain and obesity– Provides “empty” calories– Displaces nutrient-rich

carbohydrates– Dyslipidemia and cardiovascular

disease• Natural sugars in fruits,

vegetables and nonfat dairy products okay

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Calorie Free Sugar Substitute Tips

• Do not raise blood glucose levels

• Sweet taste without calories

• People with PKU should not use aspartame

• Sugar alcohols found in “diabetic foods” contain empty calories and may cause diarrhea

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Protein Tips

• Most Americans eat too much protein

• Portion control – deck of cards = one serving

• People who have kidney problems or nephropathy may have to limit their intake of protein

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Heart Healthy Sources of Protein

• Very lean meat, fish, shellfish, and skinless poultry breast

• Beans, peas, and lentils

• Nonfat dairy products

• Nuts and seeds

• Egg whites

• Some soy products

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Fat Facts• Limit high fat foods for weight loss • Limit or omit saturated, trans fats, e.g.

cheese, cream, fatty meat, fried foods• Choose liquid oils and use sparingly

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Food Label Basics• Look beyond the claim on the

front of the box:– Cholesterol or trans fat free – doesn’t

mean saturated fat free or low in sodium

– Heart healthy – generally okay– Fat free, sugar free – doesn’t mean

calorie free– Baked doesn’t mean low in fat or

calories– Good source of calcium – doesn’t

mean sugar or fat free

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• Calories related to serving size?

• Number of servings?

• Fat, saturated fat, trans fat and cholesterol content?

• Sodium?• Fiber?

Limit TheseNutrients

Start here

5% orless is low; 20% or more ishigh

Get Enough of These Nutrients

Food Label Basics

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Food Label Tip

• This food is considered high in sodium – look at the number of calories relative to the mg of sodium – ideally, they should be about the same

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Food Label Success

• Label reading may seem hard at first, but it gets easier with time

• Start with one section of the grocery store and become familiar with those products

• Fill up with produce!

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Dining Out

• Eat a light snack before you go• Avoid bread basket• Choose low-fat items• Keep portions small

– Order appetizers, soups, salads– …Or Share– …Or Take half home

• Skip dessert and alcohol

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Mineral Supplements

• Supplements are not a substitute for a healthy diet

• Chromium - more research is needed on the long-term safety and efficacy

• Vanadium - not clinically justifiable• Magnesium – may be good for

people who do not consume enough whole grains

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Vitamin Supplements • Vitamins E and C – some patients may benefit

from supplementation of these antioxidants• B12 - Many diabetic patients 50 years or older

may benefit• B Vitamins - Elevated homocysteine levels

can be reduced with supplements of folic acid, vitamins B-6 and B12

• Niacin – improves blood lipids but may have adverse effects on blood sugar regulation, more research is needed

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Other Supplements • L-Argnine:

– Has been shown to promote insulin secretion

– High doses may cause diarrhea and are not justifiable by current research

– More research is needed• Omega 3 fatty acids:

– Favorable effects on triglyceride levels – May help lower blood pressure – More research is needed to determine long-

term effects

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Herbs

• Growing interest for blood sugar regulation

• Ginseng has shown some promise

• It is likely that some herbs may have medicinal effects, but most will have little impact and some may prove harmful

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Spices

• Use spices in place of salt• Some evidence suggests that

some spices, such as cinnamon, cloves, bay leaves and turmeric, may have a small but favorable effect on carbohydrate metabolism

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What If I Overeat?

• There may be times when you overeat

• Rather than feeling guilty, take a long walk

• Exercising after a big meal will help blunt the rise in glucose

• May require extra insulin or oral agents to prevent excessively high blood sugar

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Meal Planning

• Breakfast starters:– Cooked oatmeal– Whole grain cereal– Fruit– Skim milk– Herb tea or decaf coffee

• Whole grains are preferable to products made with white flour

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Meal Planning

• Lunchtime good choices:– Salad with low-fat dressing– Stir fry with vegetables, brown

rice– Bean soup– Low-fat chili– Baked sweet potato, yam or

potato– Fish– Leftovers from healthy dinner– Whole grain pasta

• Avoid deli-type items that are high in fat and sodium

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Meal Planning

• Dinner ideas:– Vegetables– Salad– Soup– Baked potato– Stir fry– Whole grain pasta– Bean dishes e.g. chili, salad, soup, pasta, etc.– Fish– Lean poultry or meat

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Meal Planning• Snacks for your heart:

– Fruit– Vegetables– Baked potatoes– Baked sweet potatoes– Soup– Nonfat light yogurt– Peanut butter on whole grain cracker*– Nuts*– Smoothie (heart healthy)*not ideal for weight loss, look for unsalted

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What Should I Eat?

• Whole grains – whole wheat pasta, oatmeal, barley, whole grain cereal, brown rice

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What Should I Eat?

• Vegetables– Raw– Steamed– Salad– Stir fry

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What Should I Eat?

• Whole fruit– Fresh– Frozen– Unsweetened

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What Should I Eat?

• Lean poultry, fish, lean meat, some soy foods, beans and legumes

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What Should I Eat?

• Nonfat dairy:– Milk– Ricotta– Yogurt

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What Should I Eat?

• Nuts, seeds, avocados and small amounts of unsaturated oils

• Minimize if weight loss is a goal, especially with oils

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What You Will Learn Today

• 2 most important eating strategies

• Carbohydrates, protein and fat tips

• How to read a food label

• Supplement FAQs

• Meal planning to better your health

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“Bite off more than you can chew, then chew it. Plan more than you can do, then do it.”

Anonymous