Читать книгу Practical Carbohydrate Counting - Hope S. Warshaw - Страница 19

The current ADA (2008b) nutrition recommendation about the inclusion of sucrose and sucrose-containing foods reads as follows:

Sucrose-containing foods can be substituted for other carbohydrates in the meal plan or, if added to the meal plan, covered with insulin or other glucose-lowering medications. Care should be taken to avoid excess energy intake.

This recommendation is based on the scientific evidence that dietary sucrose does not increase glycemia more than the same amounts of starch. Sucrose-containing foods do not need to be limited because of a concern about exacerbating hyperglycemia (ADA 2008b). However, it is common for sucrose-containing foods to contain fat, saturated fat, and cholesterol as well as excess calories.

With these recommendations in hand, it is reasonable to teach people with diabetes that sugary foods and sweets have not been forbidden since the publication of the 1994 ADA nutrition recommendations. However, to maintain a healthy eating plan and achieve their diabetes and nutrition goals, sugary foods and sweets usually need to be limited. This recommendation is in sync with the Dietary Guidelines for Americans (U.S. Department of Health and Human Services et al. 2005).

In providing individual guidance about sweets, the educator should consider the person’s food habits and preferences along with their weight, glycemic, and lipid status. It is reasonable to assume that most people will want to include some sucrose-containing foods in their eating plan and it is important to help them learn how to do this within the context of achieving their nutrition and diabetes goals.

These tips can help people eat fewer and smaller portions of sweets:

• Choose a few favorite desserts and decide how often to eat them based on personal diabetes and nutrition goals.

• Take note of the calories, total fat, saturated fat, and cholesterol of preferred desserts. Make healthier choices.

• Recognize that smaller portions can satisfy the sweet tooth just as much as large portions. For this reason, split desserts when eating out. Take advantage of smaller portions when they are available, such as in ice cream shops, when you can choose the kiddie, junior, single, or regular scoop.

• Use the Nutrition Facts on the food label to learn the grams of carbohydrate per serving. Then use this information to appropriately swap a sucrose-containing food for another carbohydrate-containing food.

• Learn the impact of sucrose-containing foods on blood glucose. Check blood glucose 1 to 2 hours after eating to see the effect. People may find that sucrose-containing foods with more fat raise blood glucose more slowly.

• Explore palatable sugar-free options that are sweetened with no-calorie sweeteners.