Читать книгу Guide to Healthy Fast-Food Eating - Hope S. Warshaw - Страница 7
ОглавлениеDuring the 1990s, diabetes eating goals underwent a minor revolution. In fact, the phrase “a diabetic diet” has become a misnomer. No such diet exists. No longer must you ax sugary foods and sweets from your list of acceptable foods. Now you can savor the taste of a few slices of pizza at your local pizza parlor or cruise to the drive-thru for a hamburger or grilled chicken sandwich when time is not on your side. The bottom line is that today’s diabetes eating recommendations echo the healthy eating goals for everyone—whether the goals are from the government or respected health associations.
As a person with diabetes, you want to eat healthy to get to, and stay at, a healthy weight. You want to eat healthy to keep your blood glucose levels in the normal range as much as possible. Today, it’s well known that eating and staying healthy with diabetes isn’t just about blood glucose control. Recent research and recommendations suggest that you also get and keep your blood pressure and your blood lipids under control (check out the annually published Standards of Medical Care for Diabetes published each January within the Clinical Practice Recommendations found at www.diabetes.org).
Your diabetes eating and care plan should work around your needs and lifestyle and not vice versa. Your health care providers have many more medications and monitoring tools today to help you formulate a diabetes care plan that fits your lifestyle needs. The end goal, of course, is to keep you healthy and prevent or slow down long-term diabetes complications, such as eye, heart, and kidney problems.
Diabetes Eating Goals in a Nutshell
The latest American Diabetes Association (ADA) Nutrition Recommendations and Interventions for Diabetes put forth these key goals:
1. Achieve and maintain healthy ABCs
A: Blood glucose levels in the normal range or as close to normal as is safely possible
A1C: <7%
Fasting and before-meals blood glucose:
70—130 mg/dl
2 hours after the start of a meal: <180 mg/dl
B: Blood pressure levels in the normal range or as close to normal as is safely possible:
At or under: 130/80 mmHg
C: A [blood] lipid and lipoprotein profile [includes total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides] that reduces the risk for vascular disease [diseases of the blood vessels in the circulatory system]
LDL: under 100 mg/dl
HDL: above 40 mg/dl (men), above 50 mg/dl (women)
Triglycerides: under 150 mg/dl
2. Prevent, or at least slow, the rate of development of the chronic complications of diabetes by modifying nutrient intake and lifestyle.
3. Address individual nutrition needs, taking into account personal and cultural preferences and willingness to change.
4. Maintain the pleasure of eating by only limiting food choices when indicated by scientific evidence.
Those are the key nutrition goals. But what foods should you eat to achieve them? Here are general pointers to focus on:
Eat six or more servings of grains, beans, and starchy vegetables each day. Make at least three servings of whole grains.
Strive for at least 2 1/2 cups of vegetables and 2 cups of fruit a day.
Include two to three servings of fat-free or low-fat dairy foods each day—milk, yogurt, and cheese—within your calorie allotment. They provide calcium and other important nutrients. (Children, pregnant and breastfeeding women, and some adults have higher requirements for dairy foods.)
Eat a moderate amount of meat and other protein foods. Two 3-oz servings each day are enough for most people. Not only does eating less meat help you eat less protein, it also makes it easier for you to eat less total fat, saturated fat, trans fat, and dietary cholesterol.
Go light on fats and oils. Limit fats and oils high in saturated fat and trans fat, such as butter, cheese, solid shortenings, and partially hydrogenated fats, which contain trans fats. Trans fats find their way into restaurant food mainly in the frying oil (therefore fried foods). Limiting fried foods is a good way to limit trans fats, as well as many calories, when you eat in restaurants.
Limit foods that contain cholesterol (such as red meats; seafood; poultry; whole-milk, full-fat cheeses; egg yolks; and organ meats).
Enjoy small amounts of sugary foods and sweets once in a while. If you have some pounds to shed or your blood glucose or blood fats are not in a healthy range, eat sweets more sparingly. If you’re on the slim side, you can splurge on sweets a bit more often if you want to as long as you can control your blood glucose adequately.
Drink no more than one alcoholic drink a day if you are a woman and two drinks a day if you are a man. One drink is defined as 1 1/2 oz of hard liquor (a shot), 12 oz of beer, or 5 oz of wine.
To obtain detailed information about the amounts of foods you need based on your specific situation, consider consulting with a dietitian expert in diabetes care.
Everybody Sings the Same Song
ADA recommendations for healthy eating echo the recommendations from health organizations and government agencies. Whether it’s the American Heart Association, the American Cancer Society, or the United States Department of Health and Human Services, they’re all singing the same tune.
This means that as a person with diabetes, you don’t need to stick out like a sore thumb because you strive to eat healthfully. There will be times that you’ll feel like a fish swimming upstream because it’s challenging to eat healthy restaurant meals and reasonable portions. It’s not easy to eat healthfully. This is particularly true when it comes to restaurant foods—whether you are eating in or taking out.
How Much Should You Eat?
In order to make the long-term changes in your eating habits that will get and keep you healthy, you’ll want to continue to eat at least some of the foods you have enjoyed for years, albeit in smaller quantities. The quantities of food you eat and when you eat need to match your lifestyle and schedule. Another critical element is to determine what foods and times for meals and snacks work best to help you keep your blood glucose, blood lipids, and blood pressure in control. Lastly, what’s best for your diabetes is what allows you to feel good day to day and what helps prevent or slow down the development of diabetes problems.
No set number of calories or amount of foods or nutrients is right for everyone with diabetes. Your needs depend on many factors. A few of them are your height, your age, your current weight, and whether you want to lose weight or are at a healthy weight, whether you have a hard or easy time losing weight, your daily activity level, the type of physical activity you do, and more.
To develop an individualized eating plan and/or set healthy eating goals to make lifestyle changes, you may want to work with a registered dietitian (RD) with diabetes expertise, such as a certified diabetes educator (CDE). A dietitian can help support your efforts to change your eating habits over time.
Several books on the topic of food, nutrition, and meal planning published by the ADA give more indepth information about how much and what you should eat (To order a book from ADA’s extensive library of titles, visit http://store.diabetes.org).
Help Is Nearby
Whether you have just found out you have diabetes or you have been doing the diabetes balancing act for years, you can always learn more and benefit from a supportive diabetes educator. Get to know a diabetes educator. A diabetes educator will most likely be a nurse or dietitian but could be a pharmacist or exercise physiologist. Many diabetes educators have obtained the Certified Diabetes Educator (CDE) credential. A diabetes educator can help you tailor your diabetes management plan and offer tips for dealing with diabetes. The following resources are a good start to link you up with quality diabetes care:
To find a Recognized Diabetes Education Program (a teaching program approved by the American Diabetes Association at which one or more diabetes educators work) near you, call 1-800-DIABETES (1-800-342-2383) or go straight to http://www.diabetes.org/education/eduprogram.asp.
To find diabetes educators near you, call the American Association of Diabetes Educators (AADE) tollfree at 1-800-TEAMUP4 (1-800-832-6874) or go to www.aadenet.org and go to “Find an Educator.”
It’s now easier than ever for you to take advantage of the services of a diabetes educator or diabetes self-management education (DSME) as well as medical nutrition therapy (MNT) services from an RD under Part B Medicare services. Medicare has been covering DSME and MNT since the early 2000s for people with diabetes. Also, in nearly all states across the country, private insurers and managed care organizations that are regulated by the state must cover DSME and MNT. It’s best to check with both the health care provider from whom you want to receive these services and your health care plan to determine the details on this coverage and ask if you need a referral.
