Читать книгу 8 Weeks to Maximizing Diabetes Control - Laura Hieronymus - Страница 9
ОглавлениеHealthy eating to all of their patients, so having diabetes is not a prerequisite for good nutrition. In reality, healthful eating plays a role in the prevention, as well as the treatment, of type diabetes. In the Diabetes Prevention Program study, the most effective methods of preventing type 2 diabetes included a combination of making healthier food choices with a 7% weight loss (on average) and increasing physical activity to include 30-minute exercise sessions at least five days every week.
For people with diabetes, the American Diabetes Association has identified four primary goals for healthy nutrition:
• Achieving and maintaining blood glucose and blood pressure levels in the normal range, or as close to normal as safely possible, as well as a lipid (blood fat) profile that reduces the risk for blood vessel disease.
• Preventing (or slowing) development of diabetes-related complications by modifying nutrition intake and lifestyle behavior.
• Taking into account individual nutrition needs and willingness to change, as well as any personal and cultural preferences.
• Maintaining the pleasure of eating by limiting only those food choices indicated by scientific evidence.
Meal Planning
Meal planning can help you reach your blood glucose, blood pressure, and blood lipid goals while managing your diabetes. Adapting eating behaviors to balance carbohydrate intake throughout the day, along levels optimally controlled. Improvement in blood glucose control is proven to reduce the risk of long-term complications in type 2 diabetes.
Because food is such an important part of our lifestyle, as well as the cornerstone of diabetes management, you will want to take an aggressive approach to making the dietary changes that benefit your health. Gone are the days of buying special foods to meet your diabetes nutrition needs. You can eat the same foods that your entire family eats as long you pay particular attention to the nutrition content and the portion size. Because type 2 diabetes has a genetic component, your relatives are also at risk, so your entire family will benefit from healthier eating.
An RD can work with you to determine a meal plan that is healthy, fits your preferences, and helps provide balance within your diabetes treatment plan. Studies show that working with a dietitian, and learning about medical nutrition therapy, can lower A1C levels by 1 to 2%. When you schedule the appointment, ask about insurance coverage for the service. Most insurance, including Medicare, will cover the visit the dietitian is considered a provider of medical nutrition therapy or diabetes training.
There is no time like the present to start eating healthfully. You may feel that you have always tried to eat healthy but wonder why your blood glucose levels and your weight aren’t what they used to be. Keep in mind that type 2 diabetes is a progressive disease and, although some natural insulin is typically present when you are diagnosed, insulin production and diabetes control may decline over time. At some point, medication may need to be added alongside your meal plan to maximize blood glucose control.
A-Weigh We Go
Two out of three people with type 2 diabetes are overweight and may want to work toward a healthier body weight. Weight patterns describe where excess weight is located on the body and are typically described as an apple versus a pear shape. An apple shape is when more fat is distributed around the trunk or middle section of the body.
The apple shape is most common in type 2 diabetes, where excess weight is often concentrated in of weight can interfere the central (middle) part of the body. This type of weight can interfere with metabolism and the breakdown of nutrients, and may cause issues with blood glucose and blood fat breakdown. Therefore, excess weight in this area of the body is more dangerous to your health than weight distributed in the pear shape.
Body mass index and waist circumference
The measurements that may be most useful to you as you get started your body mass index (BMI) and waist circumference. Your BMI assesses your size in terms of your height and weight. BMI can help you understand how much total fat is in your body. A BMI of 25 or higher is considered overweight and a BMI of 30 or higher is considered a parameter for obesity.
To figure out your BMI, you will want to cross reference your height inches to your weight in pounds in the table BODY MASS INDEX TABLE and determine the BMI at the top of the table. For example, if you are 66 inches tall(5′6″) and weigh 192 pounds, then your BMI is 31. The BMI, according to the parameters above, indicate that this individual is obese.
Your waist circumference can help you figure out how much fat is around your middle section. To check your waist circumference, take a tape measure (one that is flexible and bends easily) and place at your belly button, pulling it snugly around the body. The total number of inches should be less than 35 inches for a woman and 40 inches for a man. If it is greater, there is too much weight in the middle section of your body. If your waist sags in the middle, your diabetes care prescriber may ask you to lie down prior to measuring your waist to help better determine the circumference.
What Should I Eat?
Asking the expert what you should eat is the best advice for dietary management in type 2 diabetes. No one person has the same eating habits, so the choices you make should be individualized to your likes and dislikes. When you make those choices, you should consider the main nutrients in the foods (carbohydrates, fat, and protein).
Nutrition experts recommend a healthful dietary pattern that includes carbohydrates from fruits, legumes, and low-fat milk. Carbohydrate-containing foods are important sources of energy, fiber, vitamins, and minerals. Limiting saturated and trans fat is vital to diabetes management because these types of fat contribute to low density lipoprotein LDL) or “bad” cholesterol. Daily recommendations suggest limiting your consumption of cholesterol to less than 200 mg and making sure that less than 7% of your calories come from saturated fat. Dietary protein for those with diabetes is based on the same standards as the general population—about 15–20% of your daily calories.
Carbohydrate Awareness
Carbohydrates are the sugars and starches in the foods you eat. Regardless of the source, carbohydrates affect your blood glucose level more than protein or fat. Carbohydrates are broken down into blood glucose, which enters your bloodstream and causes your blood glucose level to rise after you eat. Although protein and fat don’t affect blood glucose immediately, attention to fat intake is important for heart health when you have diabetes.
Because carbohydrate-containing foods affect blood glucose levels shortly after eating, be careful to avoid more carbohydrates than the medication to help control blood glucose levels; therefore, it is important to understand how the medication works. Carbohydrate intake may be modified to work with a particular diabetes medication (see Chapter 5). Spreading carbohydrates out over the course of the day is helpful strategy to keep fairly minimal amounts eaten at any given time and to help maintain blood glucose levels and prevent hunger.
My Pyramid
It will take some time but you will want to get a handle on the food sources that contain carbohydrates. Experts typically use the My Pyramid, the USDA’s new food guide system, to help the general public (age 2 and older) determine patterns for eating. It is recommended, as discussed earlier, that those with a chronic condition—such as diabetes—consult with health care provider to find the dietary plan that is the right one to meet their health needs. The My Pyramid is a specialized food guide system that determines how many servings of each food group you should consume each day depending on your age, sex, weight, height, and normal physical activity levels. Looking at the My Pyramid can give you a good idea of the various nutrients recommended in the meal plan.
Understanding what foods are considered sources of carbohydrates will help identify where carbs come from. The My Pyramid is divided into grains, vegetables, fruits, milk, meat and beans, and oils. To get your specialized food pyramid, ask your nutrition expert to assist you.
Grains
Any food made from wheat, rice, oats, cornmeal, barley, or other grains is a grain product. Bread, pasta, oatmeal, breakfast cereals, tortillas, and grits are examples of grain products. Fifteen grams of carbohydrate is typically considered a serving of these particular foods. Grains are divided into two subgroups: whole grains and refined grains. Whole grains contain the entire grain kernel, which includes the bran, germ, and endosperm. Some common examples include whole-wheat flour, cracked wheat, oatmeal, and brown rice. Milling, or the process that removes the bran and germ, is the requirement for creating a refined grain. This is typically done to give the grains a finer texture and improve their shelf life, but it also removes dietary fiber, iron, and many B vitamins. Some examples of refined grains are white flour, white bread, and white rice. Many of the refined grains are enriched, which includes adding certain B vitamins (thiamin, riboflavin, niacin, folic acid) and iron back into the product after processing. Experts will usually recommend the whole grain over the refined grain since fiber is not added back into the refined product.
Vegetables
Any vegetable or 100% vegetable juice counts as a member of the vegetable group. Vegetables may be raw, cooked, fresh, frozen, canned, dried, or dehydrated and may be whole, cut up, or mashed. Vegetables are organized into 5 subgroups based on their nutrient content. The subgroups are dark green vegetables, orange vegetables, dry beans and peas, starchy vegetables, and other. It is important to know that the subgroups of dark green, orange, and other vegetables typically contain about 5 grams of carbohydrate for every 1 cup of raw and every 1/2 cup of cooked vegetables. These are considered “free” foods because they have very little impact on blood glucose control when eaten in reasonable serving amounts. The subgroups which contain dry beans and peas and starchy vegetables contain more total carbohydrates and must be accounted for in the meal plan. One-half cup of these two subgroups is typically about 15 grams of carbohydrates.
Fruits
Any fruit or 100% fruit juice counts as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut up, pureed. While fruits are fat free and contain healthy vitamins and minerals, they also contain carbohydrates. You will want to be attentive your fruit intake and the total amount of carbohydrates in the foods that you eat. Common fruits eaten that are equivalent to 15 grams of carbohydrate include: a small apple (2 inches in diameter), a small banana (about 4 inches long), 1/2 cup (4 oz) orange juice, or 17 grapes.
Milk
All milk products this food group. Foods made from milk that retain their calcium content are part of the group, while foods made from milk that have little no calcium—such as cream cheese, cream, and butter—are not. The healthiest milk group choices are those that are fat free or low fat. Many the foods from the milk group contain carbohydrates, such as milk and milk-based desserts like ice cream, ice milk, pudding, and yogurt products. An 8-oz glass of milk is about 12 grams of carbohydrates. Checking the nutrition facts label is key to helping you determine total carbohydrate content, as well as maintaining your awareness of the fat content for these items. Cheese is another product that contains milk, however, it is generally lower in carbohydrates per serving.
Meat and beans
All foods made from meat, poultry, fish, eggs, nuts, legumes, and seeds are considered part of the meat and beans group. These foods contain very little, if any, carbohydrates. Dry beans and peas are part of the meat and beans group as well as the vegetable group because they may regularly substituted for meat (as a protein substance) by those individuals who eat very little or no meat. Dry beans and peas do contain carbohydrates and need to be counted. Most meat and poultry choices should be lean or low fat. Fish, nuts, and seeds contain healthy oils, so choose these foods frequently instead of meat or poultry.
A key to eating healthy is to make changes you can live with. In other words, diabetes is around for life and since healthy eating is a part of your treatment plan, your goal should be to learn strategies that work best for you. Divide and conquer! Think about and move forward with the changes you want to make—keeping in mind the week by week suggestions mentioned here.
WEEK 1
Know Your Personal Eating Habits
Perhaps the best place to start is figuring out what you are eating now. Successful weight-loss programs ask individuals to be accountable for what they eat. One way to accomplish this is to keep a diary foods eaten on a daily basis and then review the records to determine what, how much, and when you are eating. Sharing your food diary with your RD may be a helpful way to create problem-solving strategies to make healthier choices. To get started, include the following information as you track your food intake:
• Date
• Time you eat
• Food consumed (including all food, all day long)
• Amount of food eaten (as close as possible)
• Reason for eating
• Total carbohydrate content
• Calorie intake
Date
Along with the date, write down the day of the week. Do you see any trends on certain days of the week? For example, does your food intake change the busier you are? If so, how does it change? As you write down the amounts of food you are eating, are you surprised? the days go by, do you see yourself changing your intake at all?
Time you eat
Are you taking time for breakfast? How often are you eating on a daily basis? Did you realize when and how often you were eating (or not eating)?
Food consumed
Be specific about the types of food you eat. For example, if you have slice of bread, what kind of bread—White? Whole wheat? Whole grain? Honey wheat? This can help you and your dietitian better evaluate how nutritious your choices are.
Amount of food eaten
Be as honest and specific as possible. Use a measuring cup and spoons to determine the number of servings in a packaged food to accurate as possible.
Reason for eating
Add comments about the reason you are eating any amount of food. Are you hungry? Is everyone else eating (one, two, or three servings) and does that influence you? Do you eat when you feel nervous? Bored? Depressed? Do you eat when you watch television?
Total carbohydrate content
It may be helpful for you to track the carbohydrate content in terms of the number of carbohydrate choices in a particular food (one choice 15 grams of total carbohydrates), or simply the total number of grams carbohydrate in the item consumed. Tracking carbohydrates may help you create an awareness of total carbohydrate content in foods that you typically eat, and determine if you are consistent with carbohydrates from meal to meal.
Calorie intake
It many cases, monitoring calories can be beneficial. You may find that some of your favorite foods are loaded with calories. While you might not be willing to totally give up these foods, perhaps you might be willing to eat them less frequently, or in smaller amounts, means making positive changes toward better health. You may find that some foods are higher in calories than you suspected, or that by taking some steps to modify a recipe you can lower the fat and calorie amounts without sacrificing the good taste. By looking at your caloric comparison from day to day, you may notice patterns to help you make decision that can improve overall calorie consumption and provide better consistency in caloric amounts on a daily basis. Also, the information can create an awareness of the nutrition content, as well as the portion sizes, of the foods you are eating.
WEEK 2
Carbohydrate Target Amounts
It is a known fact that carbohydrates are the nutrients that most directly influence blood glucose levels. As a person with diabetes, you need to know the target amount of total carbohydrates as you work with your meal planning. Work together with your RD to determine the healthiest number of carbohydrate grams with each meal and snack that you eat. By considering your age, body weight, activity level, any other medical problems you might have, as well as any desire you have to lose weight, the two of you can set up a plan that you can live with.
KEEPING CARBS CONSISTENT
Using the table below, find the adult that best describes you. Try and stay close as possible to the number of grams of total carbohydrate listed each meal and snack. Spreading carbohydrates out through the day can help minimize the load in your body at any given time. Snacks can help prevent hunger from meal to meal. This information does not replace expert advice. The best plan is one developed by you and your RD.
(Carbs counted in grams.) Adapted from A Field Guide to Type 2 Diabetes. American Diabetes Association, 2004.
To get started until you see the RD, set a target to maintain as consistent of a carbohydrate intake as possible. As you begin to have questions about your meal planning, keep notes so your RD can help you better understand your meal planning effort. Keep in mind that meal planning is an important part of your treatment plan, so don’t look upon it lightly. Just as you would follow up with your physician if he prescribed a medication for you, be sure you do the same with the RD. Follow-up visits with the RD can help you get your carbohydrate and nutrition needs adjusted to help you get the best possible glucose control.
WEEK 3
Know Your Nutrition Facts
Nutrition labeling of foods is required by the Food and Drug Administration (FDA), under the Nutrition Labeling and Education Act of 1990—which identifies the nutrients that must be listed on food labels, other ingredients that may be listed, health claims, and standard portion sizes. The Act also defines terminology commonly used on labels such as light, low fat, and sodium free. The nutrition information on food labels can be found in several locations—the nutrition facts panel, the ingredients list, and other areas of the label where health claims may be displayed. As a consumer with diabetes, skill at reading food labels and recognizing the nutrient content of foods may benefit your blood glucose control.
BASIC NUTRITION LABEL
Your best source of information is the nutrition facts panel, where manufacturers provide serving size information, quantities of specific nutrients, and percent Daily Values (%DV). Nutrient information required on all food labels includes total calories, calories from fat, total fat, saturated fat, trans fat, cholesterol, sodium, total carbohydrate, dietary fiber, sugars, protein, vitamin A, vitamin C, calcium, and iron.
Check the serving size
All of the information on the nutrition facts panel reflects the serving size listed in the print.
Calories
The calorie information tells you the number of calories in the serving size (serving size listed on the nutrition facts panel). If the serving size increased, then the calorie amount is increased; likewise, if the serving size is cut in half, then the calorie amount is 50% less.
Limit the fat
The American Diabetes Association recommends that people limit their saturated fat intake to less than 7% of total calories, along with minimal intake of trans fat, on a daily basis. Saturated fat is a fat or oil—from either animal or vegetable sources—that is typically solid room temperature. Eating foods high in saturated fat is thought to contribute to higher levels of cholesterol in the blood. Trans fats are partially saturated and may increase your risk of heart disease. Your dietary cholesterol intake should be < 200 mg on a daily basis and your overall daily fat intake should be determined based on your individual need. Expert counseling with an RD is important to learn more about the various types of fat, as well as a recommended total daily intake of that is right for you.
Check the total carbohydrate
Focus on total carbohydrate (sugar is only part of the total carbohydrates) to determine the amount of carbohydrates in a serving. The total carbohydrates listed on the nutrition facts label are 31 grams each 1 cup serving that you eat. If the serving size is changed, you should calculate the total carbohydrate to match the change. For example, if you eat 1/2 cup, then the total carbohydrate is 15 1/2 grams; likewise, for 2 cups, the total carbohydrate is 62 grams.
Note your protein
The amount of protein you need is based on your size, calorie needs, and stage of life. The ADA recommends that most adults get between 15 to 20% of their daily calorie requirement from protein. In general, men need about 60 grams of protein per day and women need about 45–50 grams of protein.
What about sodium?
Keep in mind that the ADA recommends that adults get about 2,400 mg of sodium on a daily basis. Use this as a guide when keeping track of daily sodium intake. In some cases, a restriction of sodium recommended by your physician or RD. Adjust accordingly as you track the amount of sodium you eat.
While this information can help you get started, keep in mind that visits with an RD can help you further analyze the nutrition information on the foods you are eating and help you make healthy food choices to keep your blood glucose control optimal.
WEEK 4
Portion Size Matters
Whether it was in your early childhood years, any previous experience monitoring your eating habits, or any consults you have had in the past with a nutrition expert, somewhere down the line you have probably been exposed to portion sizes. These days, portion sizes are often blurred in a food service industry where smalls have become talls, mediums have become grandes, and larges are now super supremes. True, you may justify this by thinking you get more for your money, but in reality, increased portion sizes mean higher calories and more carbohydrates and fat, which can subsequently affect your blood glucose control and weight. Since weight is a concern of many with type 2 diabetes, sizing up your servings makes sense.
While portion sizes in the marketplace have increased, standard serving sizes found on food labels and used by RDs when designing diabetes meal plans have not. When working toward keeping your portions in check, the following tips may be helpful.
Measure your foods
If you want to be sure of how much you are eating, use measuring tools—such as measuring cups, spoons, or a food scale that measures food in grams. Start by putting your usual serving on a plate, in a bowl, or in a cup, and then measure it. Next, measure out the standard serving or the portion specific to your meal plan and compare. What the difference? Are these changes you are willing to make? Keep in mind that YOU have to make the effort to scale down portion sizes.
Estimate food portions
While measuring food is by far the most accurate, there will be times when carting around measuring cups and spoons is not practical. In those instances, it may be helpful to use a measuring tool always available to you in any situation—your hands. Another way to help you estimate your portions is by using common, standard size items, when keeping your portions in check when measuring tools aren’t option. Examples include:
• 2 Tbsp peanut butter (ping-pong ball)
• 3 oz meat or poultry (deck of cards)
• 1 medium fruit (a tennis ball)
• 1/2 cup of fresh fruit (1/2 baseball)
• 1 1/2 oz of low-fat or fat-free cheese (4 stacked dice)
WONDERING HOW MUCH TO EAT? DO THE “HAND JIVE”!
Hand Jive is based on a method used in Zimbabwe where teaching without any written materials is a common approach. The hand teaching method is very useful for anyone when estimating portion sizes.
Adapted from Wondering How Much to Eat? Do the Hand Jive! American Diabetes Association, Diabetes Spectrum, Volume 12, Number 3, 1999.
Pre-portioned foods
Taking time in advance to package your foods in single portion sizes may be helpful. For example, measuring snack type foods and putting them in snack-size bags in 15 gram (carbohydrate) serving portions may be helpful in preventing the tendency to overeat, as well as keeping serving sizes in check. On pre-packaged foods, take time to review the nutrition facts label or ask your RD to help you figure out how to pre-portioned foods, such as frozen meals, into your meal plan.
Share a meal
Scale down the super size by requesting smaller portions when eating out. Appetizer portions may be smaller, so don’t be shy about ordering from the appetizer menu. Adding a green salad or side of vegetables can be healthful. Share a meal with yourself by requesting the doggy bag at the start of the meal and saving some food for later. Take appropriate portion sizes from the plate and then store the rest to take home (even if you don’t want to take it home, it helps to remove the excess food and avoid the temptation to overeat). Taking the steps to reverse the trend of ever-increasing portion sizes can help you tune up your eating habits and your health.
WEEK 5
Analyze Healthy Choices
As you embark on your carbohydrate journey, think about the healthiest choices possible. For example, if you drink a serving (8 oz) of milk three times a day, you can save 180 calories a day by simply choosing skim milk over whole milk. That translates into 1,260 calories a week. An 8-oz serving of fat-free milk is approximately 90 calories, while an 8-oz serving of whole milk is about 150 calories. Do the math. Making low-fat choices in the appropriate serving sizes can mean fewer calories and help you meet your weight goals. What other choices can you make to keep calories in check?
TAKING THE FIRST STEP: HOW MANY CARBOHYDRATES DO I NEED?
Nutrition experts recommend that about half the calories you eat come from carbohydrates. One gram of carbohydrate contains about 4 calories, if your daily meal plan contains 1,200 calories, that’s about 600 calories or 150 grams of carbohydrate per day. (See week 2 to help balance total carbohydrate amounts through the day with meals and snacks.)
WEEK 6
Minimize Sugar and Fat
You may be concerned about the amount of sugar you are eating and rightfully so. When you check a food label, the amount of sugar can give you important clues on how healthy a food is. Foods that contain a great deal of sugar are not typically the best nutritional choice because they don’t usually contain a lot of fiber, vitamins, and minerals. In some cases, foods high in sugar are also high in fat content. While knowing the content of sugar is an important fact to note, you will still want to focus on the total carbohydrate content of foods with regard to blood glucose control.
Fat free doesn’t necessarily mean calorie free. In many cases, fat-free foods are just as high in calories as the regular kind. When manufacturers remove the fat from an item, it is usually replaced with sugar, which translates to carbohydrates and adds to your total carbohydrate intake. Take fat-free salad dressings, for example. A common brand of fat-free ranch dressing is 30 calories, 0 fat grams, and 6 grams of total carbohydrate for a 2 Tbsp serving. The regular same brand) ranch dressing has 140 calories per serving, 14 grams fat (no trans or saturated fat), and 2 grams of total carbohydrate. The one with the lowest calorie content is the fat free; however, you may prefer the regular ranch dressing in regard to taste. The carbohydrate content is three times greater in the fat-free version because the soybean oil (a thickening agent that is primarily fat) is replaced with corn syrup (primarily sugar). Neither is a wrong choice, but it important to know how it will affect your overall meal plan.
WEEK 7
Dealing with Healthy Eating Challenges
It is no small task to try and eat healthy meal after meal, day after day. Add a challenge like eating out, whether it’s at a restaurant or someone’s home, and it gets very tough. In fact, the average American eats four or more meals away from home each week. You will need to be creative at times to make sure you are making the healthiest choices a majority of the time. Start with these tips to help you stay on the healthy side of eating when dining away from home.
Keep an open mind when menu gazing
Take a look at what the menu has to offer and compare the food items. Which might be a healthier choice? Don’t be shy about asking the host or food server about a particular food, such as how it is prepared, and what sauces and spices are included. You are the customer so speak up; you have the right to know!
What is your pattern for eating out?
Start by taking a look at how often you eat out and why. Review the places that you tend to eat out and decide what control you have over the preparation of food.
Is nutrition information available?
Many restaurants have nutrition information for the food choices they provide. More often than not, the information is not posted at the place of dining, but may be available when requested or posted on the restaurant’s website. The American Diabetes Association has books and other publications that address issues concerning dining out. Do your homework to figure out what foods are healthiest for you before you get to the restaurant!
Focus on your meal plan
Think about the recommendations that your RD has made and stay focused on trying to meet those goals. Learn to order items that can jeopardize your healthy eating—creamy sauces, heavy salad dressings, and condiments like sour cream and butter—on the side. Be careful and limit these types of foods or, if you are willing, just leave them out!
Stay within your limits
Review the portion size information and stay within your limits. This will go a long way to keeping your calories to the minimum. Many us grew up thinking we couldn’t leave the table until every morsel food was eaten. It is best to always stay aware of the portion sizes when you order and keep overdoing it to a minimum.
Plan for events with never-ending food
Parties, restaurants, get-togethers, and picnics often have unlimited food available for extended periods of time. Don’t let the buffet wear down your healthy outlook and your blood glucose control.
BUFFET TABLE TIPS
• Look for the high-fiber, low-fat options such as beans, peas, lentils, and dark green vegetables like broccoli, cabbage, spinach, and kale. Go for the bean salads and pasta salads that are primarily fresh vegetables. Make whole-grain choices like brown rice, couscous, whole-wheat bread, and pasta.
• Watch out for dishes loaded with fat—those with mayonnaise, sour cream, and butter. Choose veggies that are light on salad dressings and heavy sauces. Bring your own healthy version of salad dressing.
• Choose grilled or roasted meats over fried versions. Try and make lean choices (removing the skin if present).
• Choose fresh fruit and lighter options over cakes and pastries. Desserts are usually plentiful, make the healthiest choice.
• Drink plenty of water. Iced tea with no added sugar and sugar-free soda are reasonable choices. If you choose to drink alcohol, stay in control. Generally, moderation is considered one alcoholic beverage for a woman and two for a man.
• Stay in carbohydrate control. Many healthy foods contain carbohydrates, so be sure and keep your targets in mind.
Adapted from Buffet Table Tips for People with Diabetes. Control Your Diabetes for Life (November 2005). http://www.ndep.nih.gov or http://www.cdc.gov/diabetes. Accessed February 2007.
WEEK 8
How Are You Doing?
You are human and are not perfect. With that in mind, take the time to recognize every positive change that you have made—maybe even make a list of those positive changes to recognize your accomplishments. Are you recognizing portion sizes by paying attention to them? Are you making healthier carbohydrate choices? How are you doing with eating out? Each small change that you make adds up, and everything you do to establish healthful eating is important.
How will you know if your healthy eating changes have made a difference in your diabetes control? Ask yourself the following: Do you feel better? How do you feel about yourself? Are you at a comfortable weight for you? What is your A1C?
Your diabetes team can request an A1C test, which gives a snapshot of blood glucose control over the previous 2 to 3 months. The lower your A1C, the better your chances are of avoiding serious diabetes complications. According to the American Diabetes Association, the recommended A1C goal for adults with diabetes is less than 7%, while an A1C level as close to normal (less than 6%) as possible is encouraged.
Healthful eating, along with physical activity and diabetes medicines, needed, can help keep your blood glucose in target range. Take what you have learned and put it to good use. Your diabetes health outcome can only benefit from healthful eating.
