101 Tips on Nutrition for People with Diabetes. Patti B. Geil
diabetes. Eating 1–3 cups of cooked beans a day will lower total cholesterol by 5–19%. Beans are also an excellent source of folate, which may help reduce the risk of cardiovascular disease.
Packed with protein, fiber, vitamins, and minerals, beans are also low in fat, cholesterol, and sodium. They can be included in all types of diabetes meal plans. Beans can be used in salads, soups, or entrées. Canned beans require less preparation time and have the same beneficial effects as dried beans, but they are higher in sodium than beans “cooked from scratch.”
Soak dried beans overnight and rinse well before cooking. Introduce beans gradually into your diet, chew them thoroughly, and drink plenty of liquids to aid digestion. Enzyme products such as “Beano” can also help you avoid gastrointestinal distress.
TYPE 1 & TYPE 2
I keep hearing about carbohydrate counting. Is it still okay to use exchanges?
Yes. The exchange system is a valuable way for people with diabetes to plan meals. It can also help if you want to count carbohydrates. The Exchange Lists for Meal Planning group foods with similar carbohydrate content, so the “carb” counting is already done for you. For example, all the foods on the starch list (1 slice of bread, 3/4 cup dry cereal, etc.) contain 15 grams of carbohydrate.
To use exchanges, you need an individualized meal plan that tells you how many exchanges from each list to eat daily for meals and snacks. You can choose a variety of foods from the exchange lists to fit into your meal plan. An RD can help you design a meal plan and teach you how to use this system. In 2003, the Exchange Lists were updated. The food groupings were changed and more foods were included. A pocket-sized guide is now available.
Many people prefer to use exchanges because it helps keep their food choices balanced and healthy. If this system works for you, there is no reason to switch to another.
TYPE 1 & TYPE 2
What is carbohydrate counting?
Carbohydrate counting is a precise method of meal planning for people with diabetes. Foods containing carbohydrate (grains, vegetables, fruit, milk, and sugar) have the largest effect on blood glucose levels. A small amount of carbohydrate (1 apple) raises blood glucose some; a larger amount of carbohydrate (3 apples) raises blood glucose more. You track how the carbohydrate affects you by monitoring your blood glucose. You’ll have to invest some time in monitoring blood glucose, record keeping, measuring food servings, and learning about nutrients in foods.
Carbohydrate counting has two levels: basic and advanced. Basic carbohydrate counting is generally used by people with type 2 diabetes and consists mostly of counting and eating consistent amounts of carbohydrate. Advanced carbohydrate counting is often used by people taking insulin and is based on recognizing and managing patterns in blood glucose, food, medication, and exercise for intensive management of blood glucose. You may only need to learn about basic carbohydrate counting. The amount of work may seem overwhelming at first, but most people find that the improvements in their blood glucose levels are worth it! An RD can help you learn about carbohydrate counting.
TYPE 1 & TYPE 2
Do I need special vitamins and minerals because I have diabetes?
You don’t need special vitamins because of diabetes. You do need vitamins and minerals for a well-functioning body, whether you have diabetes or not. If you are eating a variety of foods, you don’t need a special vitamin or mineral supplement. There is currently no scientific evidence to show that certain vitamins or minerals can improve your blood glucose management, except in rare cases of deficiencies of the minerals chromium, copper, magnesium, manganese, selenium, or zinc (see Should I take chromium supplements or can I get enough from foods?).
Discuss your diet with your physician or RD. You may need a vitamin and mineral supplement if you are
on a diet of fewer than 1,200 calories a day
following a strict vegetarian diet
at risk for bone disease
over age 65
pregnant or breastfeeding
taking diuretics
having trouble keeping your blood glucose levels on target
TYPE 1 & TYPE 2
I really don’t feel like eating in the morning. Do I have to eat breakfast?
Yes. Breakfast is crucial for people with diabetes. Your body has been without food for 8–12 hours. If you have type 1 diabetes, you need food to balance your injected insulin. If you have type 2 diabetes, you may skip breakfast to cut calories and lose weight, but it can lead to overeating later. In fact, research shows that breakfast skippers have higher blood cholesterol levels and extra pounds!
The best breakfast has carbohydrate, protein, and fiber. Save high-fat foods like bacon, sausage, and eggs for special occasions. You can choose whole-grain cereal or an English muffin, low-fat milk or yogurt, and fruit, but there’s no rule that says breakfast can’t be whole-wheat pasta tossed with low-fat ricotta cheese or a leftover chicken breast with a piece of fruit.
Once you experience the dividends that breakfast pays in mood, performance, and diabetes management, you’ll never skip your morning meal again!
Hint: People who eat a smaller evening meal (and spread their calories out over the day) are more likely to wake up hungry for breakfast.
TYPE 1 & TYPE 2
I’ve heard I’m supposed to eat five fruits and vegetables a day. Why?
Increasing the fruit and vegetables in your diet may lead to better health, particularly in the prevention of cancer and heart disease. Fruits and vegetables are low in fat and are rich sources of vitamin A, vitamin C, and fiber. The average American eats only one serving of fruit and two servings of vegetables a day. You can find ways to put five or more servings in your salads, soups, sandwiches, main dishes, and snacks.
Fruits and vegetables affect diabetes in different ways. Fruit has 15 grams of carbohydrate per serving and affects your blood glucose within 2 hours. The amount your blood glucose rises depends on whether you eat the fruit on an empty stomach, the form of the fruit (cooked or raw, whole or juice), and your blood glucose level when you eat. Check your blood glucose level after eating fruit to see what it does to you. Nonstarchy vegetables contain only 5 grams of carbohydrate per serving, few calories, and lots of vitamins and minerals. Moderate portions of vegetables have little effect on blood glucose but major effects on your health. Eat up!
TYPE 1 & TYPE 2
Why does it seem that I need less food—and enjoy it less—now that I’m older?
If you are not as active as you were when you were younger, you probably don’t need to eat as many calories. However, it may be that your appetite and enjoyment are being affected by changes in one of the following:
Taste buds—affecting taste and interest in food
Smell—affecting interest in food and the amount you eat
Vision—making it difficult to read labels or recipes
Hearing—affecting your ability