Читать книгу Sex and Diabetes - Janis Roszler - Страница 9
ОглавлениеIn this chapter:
Explore some of the ways diabetes can affect your body.
Discover several of the things that you can do to help cope with your diabetes.
DIABETES CAN interfere with the intimate physical relationship that you have with your partner. Fortunately, there are many effective treatments available.
Many of the following physical changes that come with diabetes may be familiar to you. After all, you live with your diabetes every day and may have experienced many of them. Let’s consider how these symptoms can impact the relationship that you have with your partner.
UNEXPECTED WEIGHT GAIN
Insulin and certain oral medications can cause you to gain weight, which may change how attractive you feel and alter your desire to connect on a physical level with your mate. To help overcome these feelings, try the following:
Follow a healthy weight loss plan
Diabetes meal plans have changed dramatically over the past few years. When you were first diagnosed, you might have been told to avoid all sugar and sugar-containing products. Research has shown that sugar can safely be included in a diabetes meal plan in reasonable amounts. This means that many of the foods that you may have avoided in the past can now be enjoyed in measured portions. Newer, more effective meal planning methods such as carbohydrate counting have also helped individuals fine-tune their weight loss efforts, tame excessive hunger, and improve their diabetes control.
Insulin’s Positive and Negative Effects
“After about six years, my type 2 diabetes control became so bad that I had to finally give in and take insulin to help maintain my blood sugar level in a healthier range. The improvement was immediate and impressive. I felt so much better and my blood sugar numbers really started to improve. But then the weight gain began. I now feel so ugly. My clothes keep getting tighter and I hate how I look. To avoid having my husband see how much weight I’ve gained, I wear looser fitting outfits, change my clothes in private, and head to bed before or after he falls asleep.”—Rhonda
Here are two popular meal planning options that you might like to try—the Plate Method and carbohydrate counting:
The Plate Method
This meal planning program uses a typical 9-inch dinner plate as a measuring tool. Here is how you use it for your lunch and dinner.
The Plate Method: Lunch/Dinner
1. Take your plate and mentally draw a line through the center.
2. Fill half of the plate with nonstarchy vegetables. These won’t raise your blood sugar level significantly. Nonstarchy vegetables include tomatoes, onions, peppers, celery, lettuce, kale, collard greens, broccoli, cauliflower, zucchini, summer squash, spaghetti squash, green beans, etc. They can also be enjoyed as a soup or vegetable juice.
3. Visually separate the remaining half of your plate into two equal parts. One section is for your protein portion. Protein-rich foods include eggs, meat, cheese, fish, poultry, tofu, and nuts (and should be limited because they contain a significant amount of fat and calories).
4. Place starchy foods in the remaining quarter of the plate, such as rice, bread, pasta, potatoes, sweet potatoes, corn, peas, dry beans, and lentils. Starches and other carb-containing foods provide an important form of energy but can raise your blood sugar level significantly if too many are consumed.
5. Enjoy a small piece of fruit (the size of a tennis ball) or a glass of juice along with the foods that you have placed on your plate.
6. If desired, include an 8-ounce cup of milk (preferably skim) or 1 cup of low-fat yogurt with your meal. If you are not a milk drinker, you can enjoy a serving of starches in place of the milk and take a calcium supplement to help keep your bones healthy.
The Plate Method: Breakfast
1. Use ¼ to ½ of your plate for your starch serving (bread, cereal, etc.).
2. Enjoy an 8-ounce glass of skim or low-fat milk or 1 cup of low-fat yogurt. If you do not drink milk, replace that serving with an additional portion of starch, as mentioned above.
3. If you wish, you can use of the plate for an optional protein choice, such as lean sausages, Canadian bacon, or eggs. Include a piece of fruit (tennis ball size), cup of fruit juice, or cup dried fruit.
The Plate Method offers lots of flexibility. You can eat in any restaurant or at anyone’s home; just place the appropriate food choices on your plate in the areas mentioned above. For additional information, visit www.platemethod.com.
Carbohydrate counting
This method of meal planning requires you to identify carbohydrate-containing foods and estimate the amount that you plan to eat. The easiest way to know how many carbohydrates are in a particular food is to use the information located on its Nutrition Facts label (see opposite).
1. Find the serving size at the top of the label. All of the information included on the label is for this particular serving amount. If you eat twice as much, double the nutrition information. If you eat half of that amount, cut the nutrition values in half. The label to the left states that the serving size of this item is ½ cup.
2. Search for the Total Carbohydrate amount that is given. It is highlighted in bold lettering. That is the amount of carbohydrates found in one serving of this food. Our sample label shows that this item contains 13 grams of carbohydrates. Beneath the Total Carbohydrate, you will find additional details about this category that are not printed in bold. Ignore the sugar amount, as it is already included in the carbohydrate total. If you are just beginning to count your carbohydrates, you can start here. Once you feel more comfortable with this method, add the following two steps.
3. Check the dietary fiber amount that is listed. If it is greater than 5 grams, deduct it from the total carbohydrate amount. Fiber does not affect your blood sugar level. In our sample label, the product contains 3 grams of dietary fiber, so you don’t have to deduct this amount.
4. Consider the sugar alcohol content. If an item contains any of this sweetener, it will be listed beneath the Total Carbohydrate amount. Take half of that amount and add it to the Total Carbohydrate. Sugar alcohols raise blood sugar levels, but not as much as sugar will. That is why you only add half.
To learn more about carbohydrate counting, read Guide to Carb Counting, 2nd edition, by Hope Warshaw and Karmeen Kulkarni (ADA, 2004). A great source for carbohydrate information is www.calorieking.com. It contains the nutrient content of many different foods.
Watch your food portions
Restaurants today offer portions that are far larger than ever existed in the past. While out, you can easily estimate food portions with your hands. Several of the measurements are listed Easy Portion Estimations.
Easy Portion Estimations
Palm of your hand = 3 ounces. Use this measurement to estimate cooked meat or fish. A 3-ounce piece should be approximately the size and thickness of your palm minus your fingers and thumb.
A tightly held fist = cup. This can help you estimate a serving of pasta or rice. It is also a reasonable serving of cut fruit.
A cupped hand = 1 cup. If you wish to estimate a single cup of vegetables or noodles, estimate with this measurement.
The tip of your thumb = 1 teaspoon. Use this measurement to estimate fatty condiments, such as mayonnaise or margarine.
Your entire thumb = 1 Tablespoon. The distance that runs from the tip of your thumb down to your second knuckle can help you estimate salad dressing or any item that you’d like to keep limited to a single tablespoon.
Your first two fingers = 1 ounce. A single ounce of cheese or meat can be measured easily by matching it to the length and width of your two fingers when they are held together.
Consume a healthy amount of fiber
Fiber-rich foods can help fill you up so that you are better able to meet your weight goals and may help control your blood sugar levels by slowing down digestion. Increase your fiber intake slowly or you may experience some unpleasant gastrointestinal discomfort and flatulence. Here are the 10 best sources of fiber in different food categories.
Best Sources of Fiber
| STARCHES | Serving | Fiber (g) |
| Bran cereal (for example: All Bran, cup 10–18 100% Bran, Bran Buds, Fiber One) | ½ cup | 10–18 |
| Acorn Squash, boiled or baked | 1 cup | 7–11 |
| Butternut squash | 1 cup | 6–7 |
| Dried beans, peas, lentils | ½ cup | 5–8 |
| Bran Flake cereals | ¾ cup | 4–6 |
| Rye wafer cracker | 4 | 5 |
| Peas, green, frozen, boiled | ½ cup | 5 |
| Bulgur, cooked | ½ cup | 4 |
| Corn, cooked | ½ cup, 1 (5-oz) cob | 4 |
| Air popped popcorn | 3 cups | 4 |
| VEGETABLES | Serving | Fiber (g) |
| Brussels sprouts, cooked | ½ cup | 4 |
| Artichoke | ½ | 3 |
| Spinach, cooked | ½ cup | 3 |
| Broccoli, cooked | ½ cup | 3 |
| Jicama, raw | ½ cup | 3 |
| Pea pods/snow peas, cooked | ½ cup | 2 |
| Okra, cooked | ½ cup | 2 |
| Green beans, cooked | ½ cup | 2 |
| Tomato products | 1 serving | 2 |
| FRUITS | Serving | Fiber (g) |
| Red raspberries | 1 cup | 5 |
| Blackberries | ¾ cup | 5 |
| Blueberries | ¾ cup | 4 |
| Strawberries | 1 X cups | 3 |
| Prunes | 3 | 3 |
| Dried apricots | 8 halves | 3 |
| Dried figs | 1 ½ | 3 |
| Apple | 1 small | 3 |
| Orange | 1 small | 2 |
| Pear | ½ large fresh | 2 |
The Diabetes Food & Nutrition Bible, by Hope Warshaw, MMSc, RD, CDE, and Robyn Webb, MS
To help you update your current eating plan, meet with a registered dietitian in your area. To find one, contact your local hospital or visit www.eatright.org, the official website of the American Dietetic Association.
Try what has worked for others
The National Weight Control Registry (NWCR) was established in 1994 by Rena Wing, PhD, from Brown Medical School, and James O. Hill, PhD, from the University of Colorado, and is the largest study of long-term successful weight loss maintenance. It records the behaviors of individuals who have successfully maintained a weight loss of over 30 pounds for at least one year. The following are some of the eating behaviors that worked for many of the folks they interviewed.
1994 NWCR Weight Loss Maintenance Study Results
93.6% restrict their intake of certain high-sugar and high-fat foods.
78% eat breakfast each day.
50% rely heavily on portion control.
39% limit their fat intake.
36% count their calories.
The participants use numerous weight loss techniques. Many lost weight on their own, but the majority participated in commercial programs and self-help groups and used the help of registered dietitians and psychologists. To maintain their loss, they weighed themselves regularly, limited their restaurant visits to less than three times per week, and participated in regular physical activity. To be part of this registry or to get additional information, visit www.nwcr.ws
