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ОглавлениеDirector, Book Publishing, Robert Anthony; Managing Editor, Book Publishing, Abe Ogden; Editor, Greg Guthrie; Production Manager, Melissa Sprott; Composition, Circle Graphics, Inc.; Cover Design, Jody Billert; Printer, R.R. Donnelley.
Nutritional Consulting: Clara Schneider, MS, RD, RN, LD, CDE
©2009 by the American Diabetes Association, Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.
Printed in the United States of America
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The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Association—its officers, directors, employees, volunteers, and members—assumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.
The paper in this publication meets the requirements of the ANSI Standard Z39.48-1992 (permanence of paper).
ADA titles may be purchased for business or promotional use or for special sales. To purchase more than 50 copies of this book at a discount, or for custom editions of this book with your logo, contact the American Diabetes Association at the address below, at booksales@diabetes.org, or by calling 703-299-2046.
American Diabetes Association
1701 North Beauregard Street
Alexandria, Virginia 22311
Library of Congress Cataloging-in-Publication Data Higgins, Jaynie. The ultimate diabetes meal planner / Jaynie Higgins with David Groetzinger. p. cm. Includes index. ISBN 978-1-58040-299-6 (alk. paper) 1. Diabetes—Diet therapy—Recipes. I. Groetzinger, David. II. Title. RC662.H54 2008 641.56314—dc22 2008033680 eISBN: 978-1-58040-377-1
Contents
Winter Cycle Week 1 Week 2 Week 3 Week 4
Spring Cycle Week 1 Week 2 Week 3 Week 4
Summer Cycle Week 1 Week 2 Week 3 Week 4
Fall Cycle Week 1 Week 2 Week 3 Week 4
Appendix 1: Choose Your Foods: Exchange Lists for Diabetes
Appendix 2: Common Cooking Measurement Equivalents
Thanks are due to my friends and my clients. I couldn’t have completed this book without the support of my folks, Victor and Joan Hanington; my two girls, Geneva-Beth and Haleigh; and my husband, Hal Higgins, Jr., who persevered with me for more than eight years. I must also thank God, who gave me the gifts and talents to help others through the example I set in my life with diabetes.
Thanks also go to my dear friend, David Groetzinger. Without him, the Ultimate Diabetes Meal Planner would never have become a reality.
Lastly, special thanks go to the staff of the American Diabetes Association for their collaboration and support in publishing this book.
—Jaynie Higgins www.Jaynie.me
Thanks go to Jaynie Higgins, who has been a tireless and supportive partner in bringing this book to publication. It’s been a long, excellent adventure.
I must also acknowledge Greg Guthrie, our editor at the American Diabetes Association, whose professionalism and expertise led us from a wonderful idea to a tremendous book.
I owe a deep and loving thanks to my wife. Without her vigorous and endless encouragement, I would have never stopped procrastinating and eventually finished this project. It only took 10 years, Vix!
—David Groetzinger www.ResidentialCareSolutions.weebly.com
Although diabetes can be treated, it still has no cure. Turning this obstacle into opportunity goes beyond having a vision. It is more like having a mission. Your quality of life does not have to suffer because of diabetes, disability, or age. Proper nutrition and exercise can help you manage diabetes and bringing wellness into your life. Through proper fitness and diet, I have been able to not only improve my life with diabetes, but I’ve also been able to pass on the secrets of my success to other people with diabetes.
I never imagined that I’d be where I am today. At first, my chosen career was in gerontology, and I was the owner of a licensed assisted-living facility. But life took me in a different direction when my evening job as a certified fitness instructor turned into a full-time career.
I got involved in teaching fitness and weight training when my daily exercise routine became stale and burdensome. Because I have type 1 diabetes, exercise is something that I have to accomplish to stay healthy. One night, after crying through my entire five-mile run, I decided that variety and change needed to become a priority. I designed my own free-weight program, and after a few months of strength training (and running two to three times a week), people started asking me how I did it. I began training people in my home, but my client list quickly grew so large that I found myself scouting for a larger location for my gym.
In order to keep fit, I was also eating healthfully. Soon, people were asking me about my nutrition, too. Before I knew it, I was spending endless hours writing meal plans to help others transform their lives. Seeing the fruits of their success reminded me of something that I learned at my assisted-living facility—the menu is always number one! It’s always easier to follow a healthy meal plan if the menus include variety and taste. The fruits of those years of labor are now here in your hands, the Ultimate Diabetes Meal Planner.
Diabetes ABCs (and Ds)
The content of this manual is based on what worked for me in getting my diabetes under control, but I also think it’s important to keep in mind the Diabetes ABCs.
A is for A1C. This test measures your average blood glucose levels over the previous three months. You should have an A1C test regularly.
B is for Blood Pressure. Diabetes and high blood pressure (hypertension) often go hand in hand. High blood pressure can lead to kidney damage, heart attacks, and stroke.
C is for Cholesterol. There are two kinds of cholesterol you’ll want to watch: LDL (or bad) cholesterol and HDL (or good) cholesterol. LDL cholesterol can build up and clog your blood vessels, leading to heart attacks and stroke. HDL cholesterol can remove other cholesterol from your blood vessels.
It is important to keep these care goals in mind and to speak with your health care providers about where to set your goals. However, my own experiences taught me that many diabetes self-care problems revolved around the plate. By eating healthfully and exercising regularly, I began bringing health into my life. You can, too! It was my goal of following a nutritious diet and getting regular exercise that changed my diabetes story into a life-abetes success journey.
That’s why I like to add another letter to these ABCs: D for Diet. The Ultimate Diabetes Meal Planner should give you most of the information and guidance you need to bring healthful meals into the lives of you and your loved ones.
Even better, if you’ve picked up this book, you’re already on your way there. Remember these ABCs, and know that by following the D for Diet, you can begin to make all of those other building blocks of strong diabetes self-care fall into place. It’ll take work and a lot of time, but you have a long life in front of you to enjoy.
Living life-abetes,
Jaynie Higgins, A.C./C.P.T.
Being diagnosed with diabetes does not mean your life is over or even that your entire life will be radically different. The diagnosis is a wake-up call that from now on you may need to make some lifestyle changes, such as eating healthy foods and being physically active. You may need to watch what you eat, how much you eat, and when you eat. And really, all of us need to do that.
This book has been designed to make eating much simpler for people with diabetes. The menus are designed so that everyone in your family eats the same meal. Each meal has different calorie levels, but the menus are the same, so the only difference for people at the table is how much food they’re getting, depending on their daily calorie allowance.
There are thousands and thousands of food choices and an equal number of diet books promising quick fixes and making questionable claims about the miraculous power of following their diets…this book isn’t one of them. This book is all about helping you make the right choices in the foods that you eat and is based solely on the established principles of healthy nutrition.
Despite all the books on diets, we remain a society that is undernourished and overweight. Obviously, the quick fixes and unrealistic promises are not working, so let’s get back to the tried-and-true basics. This book is not about trying to follow a “diet” of only grapefruit or cabbage or some other food or food group while excluding all of the other food groups. It is unrealistic to think people could follow such a diet for a lifetime and still enjoy themselves. We need all the varieties of the food groups to live well, and we should enjoy eating.
One of the main themes of this book is that “live foods” (grains, fruits, and vegetables) are very good for you. All of the scientific research shows us that plant-based foods and whole grains should be the foundation of a healthy diet. The great thing is that all three of these are low in calories and dense in nutrients. They pack a wallop nutritionally without adding a lot of calories or fat.
There are two ways in which you can approach using the Ultimate Diabetes Meal Planner. After following the menu plans, you can simply start over again or you can strike out on your own because you may feel more comfortable making your own healthy food choices. You will likely begin to recognize what a healthy serving size is and how it fits into a sensible meal plan. And, if you feel that you need more work, you can easily go back and reference the meal plans in this book.
HOW TO USE THIS BOOK
The Ultimate Diabetes Meal Planner has been designed to take the heavy lifting of meal planning out of your hands and to give you some help in bringing a healthy meal plan to your lifestyle. For that purpose, there are 16 weeks of meal plans.
Step 1: Meet with Your Health Care Team
Before you begin anything that will affect your diabetes self-care routine, you should meet with your health care providers and tell them that you are planning on using the meal plans contained in this book. Ask them how many calories you should be eating daily and whether this is a good approach for you to take. Your health care team should include a registered dietitian (or RD); if not, now is the time to ask your primary care physician or diabetes educator for a referral to a dietitian with experience in diabetes. An RD is an expert in nutrition who can help you create a healthy and safe meal plan.
Find out if it will be safe for you to begin following the healthy meal plans included in this book and if there are any specific foods or activities that you should avoid. For example, some people with diabetes will have to eat more snacks than others and people with high blood pressure may need to reduce their sodium intake. If these apply to you, you can still use the meal plans contained in the Ultimate Diabetes Meal Planner, but you’ll need to use a little more care in choosing your recipes. Some people can’t drink milk or eat dairy products; if this applies to you, you may have to use soy products or something else. For those with special dietary needs, the expertise of an RD will be very helpful.
Step 2: Choose a Calorie Level
During the meeting with your health care team, you should ask how many calories you should be eating per day. The meal plans in the Ultimate Diabetes Meal Planner fall into four daily calorie levels: 1,500, 1,800, 2,000, and 2,200 calories per day. Find out which of these levels will work best for your health needs.
The meal plans in this book have been developed with a keen eye toward carbohydrate intake and also use the exchange list/food choices system, so if your dietitian or educator suggests that you use these methods of meal planning, you can still use the Ultimate Diabetes Meal Planner. You’ll find complete nutrition and exchange list information for each individual serving of a recipe on that recipe’s page. In some cases, you may have to adjust the daily meal plans; however, in most cases, you’ll find that the plans in this book will meet the needs of most people with diabetes.
Planning Snacks
You will notice that each daily meal plan comes with a number of snacks, labeled A and B. For most people, the A snack will be eaten during the middle of the day and the B snack will be eaten before bedtime. You’ll also see that the 1,500-calorie plan doesn’t include snacks, whereas the 2,200-calorie plan consists of the biggest snacks. It is important that you discuss with your health care team how many snacks you should be having every day and when you should be eating these snacks, especially if you’re taking medications to treat your diabetes. To keep things simple, the snacks are listed together in the Ultimate Diabetes Meal Planner, so you can find them easily.
“But…I’m cooking for a family of four!”
Not a problem. If you are cooking for two or more, you can still use the meal plans in this book! Most of the recipes in this book yield four servings. You’ll simply change how much of a certain dish each person gets. In many cases, the only difference will be the portion sizes of the side dishes.
Step 3: Become Familiar with the Ultimate Diabetes Meal Planner
Now that you’ve chosen your calorie level, you’re ready to get started using the Ultimate Diabetes Meal Planner. You’ll notice that this book is divided into four seasons: winter, spring, summer, and fall. Don’t worry about starting your healthy meal plan in January; start with the season that you’re currently in. It’s never too early or too late to get your eating on a healthier track.
Further, each season is divided into four weeks of meal plans. You’ve probably already recognized that a season contains more than four weeks. What you will need to do is repeat each week a few times each month. You probably won’t become bored with the same dishes over and over because there are four weeks separating each meal, but if you do, try swapping out days from other weeks. For example, if you don’t want the Whole-Grain Waffle for breakfast on the first Sunday of Week 1 of the Winter Cycle, use the Whole-Grain Muffin from Tuesday of that week or the Whole-Wheat Pancakes from Sunday of Week 2 of the Winter Cycle. The thing to remember is that you’ll need to use the entire day’s meal plan to keep your nutritional levels carefully balanced. As you become more accustomed to using this book, substitutions and improvisations will become natural and easy.
If you don’t want to follow a Winter Cycle meal plan and prefer a Spring Cycle meal plan instead, go ahead and do it. Just remember to stick with the whole day’s meals and you will be fine.
Also note how this book is organized. Each section begins with a week of meal plans, which includes pages of daily meal plans broken down into calorie levels, followed by a shopping list, and then the recipes in the order that they are used. After you have finished with that week’s meal plans, the next week’s meal plan is presented, along with its daily meal plans, the shopping list, and the recipes. This structure repeats itself throughout the book, so you won’t have to flip through the whole book when you’re preparing meals. It’s that easy!
How do I make individual recipe substitutions?
Maybe you have a food allergy or condition that prevents you from having a specific food, such as milk, fish, nuts, or wheat gluten. Maybe you’re really tired of having waffles for breakfast. Or maybe you really can’t handle eating anything with mayonnaise in it. If any of this applies to you, there is a tool out there that can help you make healthy substitutions: the food choice/exchange lists found in Choose Your Foods: Exchange Lists for Diabetes (Appendix 1).
The food choice/exchange list system is an easy way of making healthy, nutritionally sound meal substitutions. Put simply, this system categorizes a single serving of a food item based on its nutritional content. Foods in the same exchange list have about the same amount of calories, carbohydrates, and other nutrients. So, if you want to change a recipe or a food item in your daily meal plan, determine the exchange list that the food is in and swap it out with another food from the same list. Foods with the same exchanges will generally affect your blood glucose levels in the same manner.
However, not every recipe or meal has the same exchange value. If this is the case, you can adjust your exchanges through the day’s meals to fit in the recipe you want. The table on page xiii provides the number of exchanges in every meal of this book. If your recipe uses more exchanges than the previous one, all you need to do is “borrow” an exchange from somewhere else in that day’s meal plan and use it for the recipe you want to prepare. What you cannot do is “borrow” exchanges from one day and add them to another.
You can find the choice/exchange value for each recipe in this book with its nutrition data. Also, every cookbook published by the American Diabetes Association provides the choice/exchange value for its recipes. So, if you don’t want to substitute a recipe from the Ultimate Diabetes Meal Planner, you can use any of the recipes from other American Diabetes Association cookbooks.
To take full advantage of the choice/exchange system, you may want to pick up a nutrition guide that provides exchanges for common foods, such as The Diabetes Carb & Fat Gram Guide by Lea Ann Holzmeister (available at http://shopdiabetes.org; order #4708-04), so that you can make substitutions with all of the items in your daily meal plan. As always, it won’t hurt to discuss exchange lists with your dietitian or diabetes educator, too. He or she will be able to give you valuable guidance in bringing balanced meal plans into your lifestyle.
Example Substitution Using the Food Choice/Exchange System
Don is on the 1,800-calorie meal plan, and he’s on Tuesday of Winter Week 1. Don is allergic to peanuts, so he can’t eat Spicy Whole-Grain Rice with Peanuts for lunch. Rather than just replace the peanuts with a different type of nut that he can eat, Don decides to prepare something else. He will have to use the exchange list to do this. Looking at the recipe for Spicy Whole-Grain Rice with Peanuts, he sees that it has the following exchanges: 2 Starch and 2 Fat. So he looks around the recipes for something that will use these exchanges. He decides that the Parmesan Potatoes look good. This recipe has 2 Starch and 1 1/2 Fat exchanges. That leaves him with 1/2 Fat exchange left over for the day.
Looking at the rest of the meal plan, Don sees that he’s assigned 10 peanuts for his A Snack. He refers to Appendix 1—Choose Your Foods: Exchange Lists for Diabetes—and sees that 10 peanuts are equal to 1 Fat exchange. He can’t eat that, either. However, Don loves black olives, and he sees that 8 large black olives are equal to 1 Fat exchange, too. He also knows that he’s going to have an additional 1/2 Fat exchange left over from his lunch. So, for his A Snack, he has 12 large black olives (8 olives [1 Fat] + 4 olives [1/2 Fat] = 12) instead of the peanuts. Don’s daily meal plan is still balanced, and he gets to eat the foods he wants.
DAILY MEAL PLANS Choice/Exchange Values
Step 4: Go Grocery Shopping
Now that you know what you’ll be cooking throughout the week, you’ll need to pick up the ingredients for your meals. For each week, you’ll find a shopping list containing the names of each ingredient you’ll need to have on hand to prepare all of those meals.
These shopping lists don’t contain the precise amounts of each ingredient—everyone’s needs will be different—but they do give you a pretty complete list of items to make sure that you have everything on hand for the week’s meals. When it comes time to go shopping, take out the upcoming week’s shopping list, look closely at the meal plans and recipes, and write down how much of each item you’ll need in the space provided. It is important to note that snacks are not included in the shopping lists, because snacks will vary greatly for every person. Also, the shopping lists were built on the items in the 2,000-calorie plans, so not every item from the list may apply to you if you’re on the 1,500- or 1,800-calorie plans; the same applies to you if you’re on the 2,200-calorie plan, because these plans sometimes have a few extra items over the course of the week.
It is best to purchase most of your food on a weekly basis; doing this will ensure that very little of your food will spoil and save you money. When you first begin using the Ultimate Diabetes Meal Planner, you may have to pick up several staple items, such as spices, nonstick cooking spray, and sauces. You won’t have to buy these every week. After a while, you will have a fully stocked, healthy pantry!
Reading Food Labels
An excellent tool for keeping your shopping smart and healthy is printed on just about everything you will buy at the grocery store—the Nutrition Facts label. With this little label, you can find out just about anything you need to know about a food before you put it in your shopping cart. Here’s a short breakdown of what you should be looking at.
• Serving Size. This is the first thing you should look at when picking up a food product. Does the serving size seem realistic? The nutrition information on the food label corresponds directly to the size of the serving. For example, a jar of pasta sauce may say that it has 6 servings in it and each serving is 1/2 cup. What happens if you have 1 cup of pasta sauce? Well, instead of getting 12 grams of total carbohydrate for that serving (as it says on the label), you’ll be getting 24 grams, because you’re having two servings of the sauce. That’s a big difference!
• Servings. This is another handy tool that gives you tons of information about whether a food will fit into your meal plan. This item tells you how many servings are in the package. Every other bit of data in the food label is based on one serving. If a small bag of potato chips says it has 2 1/2 servings and you eat the entire package, then you’re taking in two and a half times the amount of calories, fat, and carbohydrate listed in the food label. If you look at that bag of chips and can see yourself eating the whole thing in one sitting, it may be best to avoid temptation and not purchase it.
• Calories. Keep an eye on the number of calories in the foods you buy. The meal plans in this book are based on calorie levels throughout the day, so you’ll want to purchase foods that will fit into your daily calorie limit. It’s also important to note how many of the food’s calories come from fat, which is listed right below the entry for calories. If most of the calories come from fat, then it’s probably not a good choice for a healthy diet. If you’re trying to lose weight, paying attention to the number of calories in a food is essential.
• Total Fat. This entry shows you how much total fat is contained in the food you’re thinking about buying. There are several types of fat that can be found in food, including monounsaturated, polyunsaturated, saturated, and trans fat. In general, try to avoid foods that contain a lot of saturated and trans fat in each serving. None of the recipes in the Ultimate Diabetes Meal Planner contain more than 3 grams of saturated fat and most contain almost no trans fat. Fat packs more calories per gram than any other nutrient, so if you’re aiming to lose weight, it is especially important to lower the amount of fat in your daily meals.
• Total Carbohydrate. Because you have diabetes, it is very important to take a look at how much carbohydrate is included in every food you buy, especially if you’re counting your carbohydrates. You should pay more attention to this than to the amount of sugar in a food, because total carbohydrate is what ultimately affects your blood glucose levels the most. Also make it a point to check out how much dietary fiber is included in each food. Dietary fiber is an essential part of a healthy diet, and Americans don’t get nearly enough of it. You don’t need a lot of it (about 25–30 grams a day), so make this a daily goal.
• Ingredient list. Ingredients are listed in descending order by weight, so the first ingredient comprises the majority of any food item. Check out the ingredient list for things you’re trying to avoid, such as coconut or palm oil, which is high in saturated fat. Also try to avoid hydrogenated oils that are high in trans fats. The ingredient list is also a good place to look for heart-healthy ingredients, such as whole-wheat flour and oats.
Each recipe in the Ultimate Diabetes Meal Planner has its own Nutrition Facts label printed on the same page. Just like when you’re buying foods at the grocery store, you’ll need to look at these details when preparing your meals. Keep an eye out for the number of servings that each recipe yields, so you know how much of the dish you should be eating. And just like with a packaged food item, the nutritional information for each recipe applies to one serving only.
Also, there are a lot of similar products out there with differing nutritional contents. We don’t want you to go out and feel that you can buy only one kind of sugar-free jam, because that makes grocery shopping difficult and it’s unnecessary. Diabetes is difficult enough to manage without having to worry about which store carries that one specific brand of canola oil mayonnaise called for in the recipe. So please be aware that the nutritional information for each recipe is a very close approximation to what you’ll be getting from your cooking, but it may not be exactly the same.
How do I shop smart?
First off, don’t shop when you’re hungry. When you are hungry, you’re more liable to make impulse purchases because something looks good at the moment. Save yourself some extra calories and some money, and avoid the grocery store when you haven’t eaten.
Another great shopping rule is to approach a grocery store by circling the outside walls first and then moving to the interior aisles. Foods that perish require refrigeration, and those foods tend to be along the walls of a grocery store because that’s where they plug in the refrigerators. Also, foods that perish have fewer additives and preservatives, which means that they are healthier and pack fewer hidden calories. So, when you hit the store, start at the edges.
When you’ve finished picking up your perishable goods, head toward the aisles. Remember to stick with your shopping list and avoid last-minute purchases. With the meal plans in the Ultimate Diabetes Meal Planner, you won’t eat or need those foods anyway, so save the money you might spend on those items for a healthier gift to yourself—like a trip to the spa or a visit to a museum. Try to buy the best-quality ingredients you can find (remember that a high price does not always mean high quality), so you can get the best taste out of your dishes.
Step 5: Start Cooking
Now it’s time to get started with cooking. If you’ve become a take-out meal addict, then now is the time to reconnect with cooking at home. In our busy workaday world, it’s nice to take a breather at the end of the day and spend some quality time with yourself preparing meals. Sharing meals with family and friends can be a great way to bring everyone closer and take pause at the end of a long day. Give it a chance—you may find that you like it quite a bit. If you’ve been cooking at home and loving it, then you may have to make a few changes to your current cooking habits.
The recipes in the Ultimate Diabetes Meal Planner use the healthiest cooking methods and ingredients available and still offer great taste. With these recipes—and definitely on the first time through—try to avoid substitutions or adding ingredients because you feel that it needs more flavor. An extra dash of oil or another pat of butter dramatically increases the amount of fat and calories in each dish you prepare. Give the recipes a chance to stand on their own, especially if you’re using fresh, high-quality ingredients. You may find that you’ve been relying on salt and butter in the past when you didn’t really need it.
Step 6: Repeat Cycles as Desired
It’s generally best if you follow the weekly cycles as they are written during your first time through the book. Following a healthy meal plan takes practice and experience, so let the Ultimate Diabetes Meal Planner gradually teach you how to do this. As you become more comfortable with meal planning and making healthy food choices, you’ll be able to create your own meal plans and adjust your own favorite recipes. In the meantime, let this book do all of the hard work for you.
If you do come across recipes that don’t quite suit your fancy, swap out that day with another one in the book. Be sure to use the entire day’s meal plan, so you can keep your diet balanced and your nutrient intake consistent. In some cases, an entire week’s worth of meals may not appeal to you. If that’s the case, then swap out the entire week with a different one. If you feel like eating a summer meal and it’s only spring, go ahead and do it! Following a healthy meal plan should be fun and flexible, so don’t feel like there are rules carved in stone with this book.
Remember, your goal in using this book is to bring a healthy, diabetes-friendly meal plan into your life. Don’t get discouraged or frustrated. It is a tool to help you, so make changes as you see fit to make it work for you.
