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ОглавлениеDirector, Book Publishing, Abe Ogden; Managing Editor, Greg Guthrie; Acquisitions Editor, Victor Van Beuren; Editor, Lauren Wilson; Production Manager, Melissa Sprott; Composition, ADA; Cover Design, Jody Billert; Printer, Versa Press.
©2014 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
DOI: 10.2337/9781580405140
Library of Congress Cataloging-in-Publication Data Dunbar, Stephanie. 21 things you need to know about diabetes and nutrition / by Stephanie Dunbar and Cassandra Verdi. pages cm Summary: “By using these healthy tips, this book will help the reader make the connection between healthy eating and managing diabetes”-- Provided by publisher. Includes bibliographical references and index. ISBN 978-1-58040-514-0 (pbk.) 1. Diabetes--Diet therapy. 2. Diabetics--Nutrition. 3. Diabetics--Health and hygiene. I. Verdi, Cassandra. II. Title. III. Title: Twenty-one things you need to know about diabetes and nutrition. RC662.D86 2013 616.4’620654--dc23 2013010805 eISBN: 978-1-58040-590-4
For my parents—thank you for your love and support and for always being there for me.
—Stephanie
To my mom and dad—for their support, gentle guidance, and encouragement all of these years.
—Cassie
Table of Contents
6 Meal-Planning Strategies
7 Carbohydrate Counting
8 Glycemic Index
9 Sweets
10 Artificial Sweeteners
11 Beverages
12 Alcohol
13 Sodium
14 Special Occasions
15 Breakfast
16 Snacks
17 Eating Out and Quick Meals
18 Reading Nutrition Labels
19 Weight Loss
20 Dietary Supplements
21 Exercise
Resources
There are many people we’d like to thank for their contributions to this book. First, we’d like to recognize Abe Ogden for giving us this unique opportunity to answer the most commonly asked questions about nutrition and diabetes.
A special thanks to Greg Guthrie. We greatly appreciate your patience, kindness, and guidance throughout the writing process. To Victor Van Beuren, for answering many questions along the way and for all of your moral support. To Kelly Rawlings—thank you for sharing your way with words during the writing process. Thanks to Lauren Wilson for doing a wonderful job with copyediting the book—you’ve been a joy to work with. We’d also like to thank Melissa Sprott for her hard work on the design and layout of this book.
Many thanks to Sue Kirkman, Jane Chiang, and Bob Ratner for the opportunities you have provided and your encouragement and support to expand our work at the Association, including writing this book.
We’d also like to recognize Alison Evert and Sue McLaughlin for their thorough review of this book. We are very grateful for your willingness to share your expert insight into the world of diabetes. A big thank you to Lyn Wheeler for your analysis of our recipes and, more importantly, for being a mentor and lending your time and expertise to advise on many of our projects.
There are many dedicated Association volunteers and colleagues who have contributed to our work at the Association. In doing so you have touched our lives, made our work enjoyable, served as mentors, and become friends. Thanks to all of you.
—Stephanie and Cassie
It’s impossible not to mention and thank my husband, Jimmy Verdi.
You bring so much joy to my life every day, and I am incredibly grateful for your constant encouragement to pursue my dreams.
—Cassie
Matthew, thank you for your enthusiasm and your help keeping the book a surprise for a really long time!
—Mom
There are many aspects to managing diabetes. For many people, making food choices is the most challenging. What you eat and how much you eat has a direct effect on your blood glucose level, your risk of developing complications, and many other health factors.
Food is made up of a mix of carbohydrate, protein, and fat. You can think of these as the building blocks for your body. Healthy foods not only provide those building blocks, they provide the extra bonus of vitamins, minerals, and fiber. Choosing healthy foods is the best way to give your body the energy it needs to do daily activities and the things that you love!
Following a healthy, balanced meal plan can help you:
• Lower your A1C (average blood glucose over the past 2–3 months)
• Lower your blood pressure
• Improve your cholesterol levels
• Lose weight or maintain your current weight
• Increase your energy level
• Prevent or delay diabetes complications
What Is a Diabetes Diet?
People often ask which diet is best for managing diabetes. But there is no ideal diet or meal plan that works best for everyone with diabetes. In fact, research has shown that many different ways of eating can work for people with diabetes. The types of meal plans that can be used to manage diabetes include Mediterranean style, low fat, lower carbohydrate, vegetarian, and the DASH (Dietary Approaches to Stop Hypertension) eating pattern.
For people who are overweight, cutting calorie intake is important regardless of the type of meal plan they follow, because it helps with weight loss. Losing a moderate amount of weight can make it easier to control A1C, blood pressure, and cholesterol levels. A moderate amount of weight is about 7% of your body weight. For a person who weighs 200 pounds, for example, that is about 14 pounds.
What Is a Meal Plan?
A meal plan is a guide that tells you how much and what kinds of food to choose at meals and snack times. Some people may refer to a meal plan as an eating plan, food plan, or diet. All of these essentially mean the same thing. Your plan should fit your schedule, culture, and eating habits. The right plan for you should help you keep your blood glucose, blood pressure, cholesterol, and weight on track. For more information on how to create a healthful meal plan, see Chapters 6 and 7.
Can My Meal Plan Change Over Time?
Yes. Some people with type 2 diabetes are able to control their disease with just diet and physical activity. But over time, many people need to add medications, and sometimes insulin, in order to control their blood glucose. Though people with type 1 diabetes have to take insulin from the start, their needs will change as well. Having to add new medications, change your insulin dose, or adjust your meal plan does not mean that you have failed at managing your diabetes. Most people can expect their health-care provider to make changes to their treatment plan over time.
Tracking your blood glucose level can help you fine-tune your plan. A blood glucose monitor allows you to check your blood glucose level at any point in time. Some providers may have you check your blood glucose at certain times to get an idea of how well your meal plan, exercise routine, and medications are working together. Talk to your health-care provider about whether you should be checking your blood glucose. Those on insulin can especially benefit from this.
Can Healthy Eating Still Taste Good?
Many people assume that eating healthy means giving up all of your favorite treats and restricting yourself to bland meals. This is not true. There are a lot of tasty, flavorful foods and recipes out there that are also good for you. You don’t have to eat the same thing every day or give up your favorite foods. It’s all about controlling portions and making the best choices most of the time.
Who Can Help with Diabetes Meal Planning?
This book will answer some of the most commonly asked questions about nutrition and diabetes. You’ll find the information you need to make good food choices and plan diabetes-friendly meals and snacks. We’ve also included some recipes and practical tips to get you started.
Working one-on-one with a registered dietitian (RD or RDN) is also recommended. Ask your health-care provider if he or she can refer you to an RD who has experience in diabetes or is a certified diabetes educator (CDE). An RD can help you figure out your food needs based on your desired weight, lifestyle, medications, and health goals. Even if you’ve had diabetes for many years, a visit with an RD can help. Appointments with an RD are covered by many insurance plans.
Diabetes education classes are another option. If you haven’t attended a diabetes education class, ask your health-care provider for a referral to a local program. These programs include information on meal planning as well as other components of diabetes care. For now, it’s important to learn the basics. Let’s get started with what you need to know about including carbohydrate in your meal plan.
You’ve probably heard about carbohydrate if you have diabetes. Many things affect your blood glucose, and one of them is the amount of carbohydrate you eat. Foods with carbohydrate, such as fruits, starchy foods, and dairy products, don’t have to be off limits, but knowing how much to eat is important.
How Many Grams of Carbohydrate Can I Eat Each Day?
There is no one amount of carbohydrate that is best for everyone with diabetes. We are all different shapes and sizes, so each person has different needs when it comes to nutrition. The type of diabetes you have, the medications you are on, and many other factors will determine the amount that is best for you.
Blood glucose levels are affected by many factors, including what you eat, when and how much you exercise, available insulin in your body, medicines, hormones, and stress. Of all the foods you eat, those with carbohydrate affect your blood glucose the most. The key to keeping blood glucose levels in your goal range is to balance the food you eat with your physical activity and any pills or insulin you take. If you check your blood glucose, you can use those results to help you fine-tune your meal plan. Finding a way to balance all of these factors is important so you can feel your best, do the things you enjoy, and lower your risk of diabetes complications.
Your health-care team can help you find that balance. Work with them to develop an individualized meal plan that will help you meet your diabetes goals. Your provider can help you set these goals, which might include:
• Losing a certain amount of weight
• Lowering your A1C (average blood glucose over past 2–3 months)
• Lowering your blood pressure
• Improving cholesterol levels
Looking for a Place to Start?
If you haven’t set up an individualized plan yet, you can start with a goal of about 45–60 grams of carbohydrate per meal. However, some people may need more and some people may need less. Want more information about carbohydrate counting? Turn to Chapter 7.
Work with your health-care team to create the best meal plan for you. Discuss how many grams of carbohydrate to include at each meal and whether or not to include snacks. Over time, you’ll learn what works for you and what doesn’t.
What Are the Different Types of Carbohydrate?
Did you know there are three main types of carbohydrate in food? They are:
• Starches
• Sugars
• Fibers
You’ll also hear terms such as “naturally occurring sugar,” “added sugar,” “low-calorie sweeteners,” “sugar alcohols,” “reduced-calorie sweeteners,” “processed grains,” “enriched grains,” “complex carbohydrate,” “refined grains,” and “whole grains” used to discuss carbohydrate.
No wonder knowing what kind and how much carbohydrate to eat can be confusing!
On the Nutrition Facts label, the term “Total Carbohydrate” includes all three types of carbohydrate. This is the number that you should pay attention to if you are carbohydrate counting.
Starch
You may hear some foods referred to as “starchy.” Foods high in starch include:
• Starchy vegetables, such as peas, corn, lima beans, and potatoes.
• Beans, lentils, and peas, such as pinto beans, kidney beans, black-eyed peas, and split peas.
• Grains, such as oats, barley, and rice.
• Bread, pasta, and crackers. (The majority of processed grain products in the U.S. are made from wheat flour but the variety is expanding.) Read more about whole grains in Chapter 3.
Sugar
Sugar is another type of carbohydrate. You may also hear sugar referred to as a simple or fast-acting carbohydrate. There are two main types of sugar: naturally occurring sugars, such as those in milk or fruit, and sugars that are added during processing (added sugars). Examples of added sugars include the heavy syrup that fruit is often canned in and the sugar used to make a cookie. On the Nutrition Facts label, the number of sugar grams includes both added and natural sugars.
You may also see table sugar listed by its chemical name: sucrose. The natural sugar in fruit is known as fructose and the sugar in milk is called lactose. You can recognize other sugars on labels because their chemical names also end in “-ose.” For example: glucose (also called dextrose), fructose (also called levulose), lactose, and maltose are sugars that you may find listed in the ingredients on a package. For more information on sugar and how it fits into a diabetes meal plan, see Chapter 9.
Fiber
Fiber is the indigestible part of plant foods. Fiber-rich foods include fruits, vegetables, whole grains, nuts, and legumes. There is no naturally occurring fiber in animal products, such as milk, eggs, meat, poultry, and fish. When you consume dietary fiber, some types are partially digested, but most of it passes through the intestines and is not digested.
Fiber contributes to digestive health, helps to keep your bowels moving regularly, and makes you feel full and satisfied after eating. Research suggests that there are additional health benefits of a diet high in fiber, such as a reduction in cholesterol levels.
Daily Fiber Recommendations
For good health, adult women should aim for about 25 grams of fiber per day and adult men should aim for about 38 grams per day. Most Americans do not consume nearly enough fiber in their diet, so while it is wise to aim for this goal, any increase in fiber in your diet can be beneficial. Most of us only get about half of the recommended daily amount of fiber.
Good sources of dietary fiber include:
• Beans and legumes, such as black beans, kidney beans, pinto beans, chickpeas (garbanzo beans), white beans, and lentils.
• Fruits and vegetables, especially those with edible skin (for example, apples and corn) and those with edible seeds (for example, berries).
• Whole grains, including:
—Whole-wheat pasta, brown rice, whole-grain barley, and quinoa.
—Whole-grain cereals (Look for those with 3 grams of dietary fiber or more per serving, including those made from whole wheat and oats. Bran cereals are not whole grain but are very high in fiber and a good choice.)
—Whole-grain breads (To be a good source of fiber, one slice of bread should have at least 3 grams of fiber. Another good indication: look for breads where the first ingredient is a whole grain. For example, whole wheat or oats.) Many grain products now have “double fiber” (extra fiber added).
• Nuts and seeds are not high-carbohydrate foods, but are a great source of fiber and healthy fat. Try different kinds such as peanuts, walnuts, almonds, cashews, sunflower seeds, pumpkin seeds, or chia seeds. Just be sure to watch portion sizes because nuts and seeds also contain a lot of calories in a small amount.
In general, an excellent source of fiber contains 5 grams or more per serving. A good source of fiber contains 2.5–4.9 grams per serving.
It is best to get your fiber from food rather than taking a supplement. In addition to the fiber content, fiber-rich foods have a wealth of nutrition and contain many important vitamins and minerals. In fact, they may contain nutrients that haven’t even been discovered yet!
If you are not used to eating foods that are high in fiber, gradually increase your fiber intake to prevent stomach irritation. Also, drink more water as you increase your fiber intake, to prevent constipation.
What Is Inulin?
Inulin (not insulin) is a type of fiber that cannot be digested or absorbed. It is added to many food products in the form of chicory root to boost the fiber content. You’ll find fiber added to many products, including bread, granola bars, and even yogurt.
Many people assume that carbohydrate-containing foods are off limits if you have diabetes because they raise blood glucose. However, many carbohydrate-containing foods are also packed with important nutrients that our bodies need to stay healthy. You can still include many carbohydrate foods in your meal plan when you control portions.
What Are the Best Carbohydrate Choices?
When you choose to include carbohydrate-containing foods, make them count! Choose those that are nutrient dense, which means they are rich in fiber, vitamins, and minerals, while also being low in added sugars and unhealthy fats.
Here are the best choices for carbohydrate foods:
• Nonstarchy vegetables, such as leafy greens, tomatoes, carrots, cucumbers, and asparagus
• Fresh, frozen, or canned fruit without added sugars
• Whole grains, such as 100% whole-wheat bread, brown rice, oatmeal, quinoa, and whole-grain barley
• Starchy vegetables, such as sweet potatoes, winter squash, pumpkin, green peas, corn, parsnips, and plantains
• Beans, legumes, and peas
• Low-fat dairy, such as 1% milk, skim milk, and nonfat yogurt
Focus on the foods listed above and limit highly processed carbohydrate foods that provide few nutrients, such as:
• Soda and other sugary drinks
• Refined-grain foods, such as white bread, white rice, many crackers, pastries, and sugary cereals
• Chips, pretzels, and other similar salty snacks
• Sweets and desserts
What Are Nonstarchy Vegetables?
Nonstarchy vegetables are any vegetable with the exception of potatoes, corn, green peas, parsnips, plantains, and most types of winter squash. The best nonstarchy vegetable choices are fresh, frozen, or canned vegetables without added salt, fat, or sugar.
These veggies are packed with important vitamins, minerals, and fiber. They have fewer calories and less carbohydrate than other types of food, so you can actually enjoy them in larger portions. In fact, a good goal to shoot for is to fill at least half of your plate with nonstarchy vegetables at lunch and dinner. Here are just a few ways you could do that:
• Try the recipe for a refreshing Cucumber, Tomato, and Red Onion Salad.
• Make a salad with spinach, tomatoes, red peppers, radishes, and mushrooms, all drizzled with light dressing.
• Steam broccoli and enjoy it with a squeeze of lemon juice.
• Roast Brussels sprouts that have been lightly tossed in olive oil and seasoned with minced garlic and freshly ground pepper. You could also try roasting other vegetables that you like, such as cauliflower, asparagus, or carrots.
• Steam green beans and top them with a few toasted sliced almonds and trans-fat-free margarine.
• Lightly stir-fry a medley of frozen vegetables.
• Grill sliced eggplant or summer squash that has been lightly brushed with olive oil.
• Lightly sauté your favorite greens with onions and garlic in a little oil. Choose from spinach, kale, or Swiss chard.
• Keep it simple and dip baby carrots and celery sticks in nonfat ranch dressing.
Can I Eat Fruit?
Yes, people with diabetes can still enjoy fruit as part of their daily meal plan. Many people with diabetes are under the impression that they need to avoid fruit because it contains natural sugars. While it does have some carbohydrate from natural sugars, fruit is also high in fiber, vitamins, and minerals, making it a good food choice.
When buying fruit at the store, the best choices are fresh, frozen, or canned fruit without added sugars. Dried fruit and 100% fruit juice are also options, but the portion sizes for these options are very small and they are not nearly as filling as fresh, canned, or frozen fruit.
A piece of fruit makes a great snack or side at mealtime. If you are looking for a sweet bite, you could also have fruit to satisfy your craving. It’s a much more nutritious dessert choice than cookies or ice cream!
Budget-Friendly Tips
For a budget-friendly alternative to fresh fruits and vegetables, try frozen and canned varieties. They can be just as nutritious!
For frozen fruits and vegetables—Choose those without added salt, sugar, or sauces.
For canned vegetables—Opt for reduced-sodium varieties when available and be sure to drain and rinse them. This will remove about 40% of the sodium added in the canning process.
For canned fruit—Buy fruit canned in juice if possible. If fruit canned in juice is not available or doesn’t fit your budget, buy fruit canned in syrup and drain and rinse it to remove some of the syrup.
Can I Eat Starchy Foods?
Starchy foods have a place on your plate in small amounts—about 1/4 of your plate. The best starchy food choices are whole grains, beans, and starchy vegetables without added salt, sugar, or fat. Whole grains, beans, and starchy vegetables all contain carbohydrate, but they are great sources of fiber, vitamins, and minerals.
Starchy vegetables are higher in carbohydrate and calories than nonstarchy vegetables, but they can still fit into your meal plan. These include: sweet potatoes, winter squash (with the exception of spaghetti squash), corn, green peas, lima beans, pumpkin, parsnips, and plantains.
Foods such as dried or canned beans, lentils, split peas, black-eyed peas, nonfat refried beans, hummus, and other bean spreads are also good carbohydrate choices. In addition to all the fiber and other nutrients they contain, these foods are also a lean source of protein.
What Counts as a Whole Grain?
The grain group can be split into whole grains and refined grains. Both have about the same amount of calories and grams of carbohydrate in a serving. However, whole grains are a much more nutritious choice than refined grains. Wondering what the difference is?
All grains contain three parts:
• The Bran is the outer hard shell of the grain. It is the part of the grain that provides the most fiber and most of the B vitamins and minerals.
• The Endosperm is the soft part in the center of the grain. It contains the starch.
• The Germ is technically the seed for a new plant within the grain and is packed with nutrients, including healthy fats and vitamin E.
“Whole grain” means that all three parts of the grain kernel are in the food, so you get all of the nutrients that the grain has to offer. Most refined grains, such as white bread and white rice, have had the most nutritious parts of the kernel (the bran and germ) removed during processing. So you only get the endosperm or the starchy part of the grain, causing you to miss out on a lot of vitamins, minerals, and fiber.
Some common whole grains are:
• Bulgur (cracked wheat)
• Whole-wheat flour
• Whole oats/oatmeal
• Whole-grain corn/corn meal/popcorn
• Quinoa
• Brown rice and wild rice
• Whole rye
• Whole-grain barley
• Whole farro
• Buckwheat and buckwheat flour
How do you tell if your bread, pasta, cereal, and crackers are a good source of whole grains? Some of these foods will say that they are “made with whole grain” on the front of the package, when they actually only contain a small amount. For all cereals and grain products, check the ingredient list and make sure one of the grains above is listed first. Many starchy products in the U.S. are wheat based, so most of the time you’ll be looking for whole-wheat flour.
Let’s Compare
When you choose healthy sources of carbohydrate, you get more nutrients for fewer calories. The portions are often larger and higher in fiber, so you feel full for longer when you choose these foods. Think about it:
| Instead of this… | Try this… |
| 1 small blueberry muffin (250 calories, 35 g carbohydrate, 0.7 g fiber) | 2/3 cup cooked oatmeal + 2 tablespoons raisins + a sprinkle of cinnamon (170 calories, 35 g carbohydrate, 3.7 g fiber) |
| 15 jellybeans (65 calories, 15 g carbohydrate, 0 g fiber) | 1 cup raspberries (65 calories, 15 g carbohydrate, 8 g fiber) OR 1 orange (65 calories, 16 g carbohydrate, 3.6 g fiber) |
| 12-ounce can of soda (150 calories, 40 g carbohydrate, 0 g fiber) | 1 peach + 1/2 cup nonfat vanilla Greek yogurt (145 calories, 24 g carbohydrate, 2.3 g fiber) |
| 1.5-ounce bag potato chips (230 calories, 20 g carbohydrate, 1.9 g fiber) | 1 cup sugar snap peas + 1/4 cup hummus (165 calories, 17 g carbohydrate, 4 g fiber) |
Cucumber, Tomato, and Red Onion Salad
This simple salad makes a great side at dinner and can be a nice change from the traditional salad made with leafy greens.
Serves: 3 / Serving Size: 1 cup
1 medium cucumber, peeled and sliced
2 small tomatoes, sliced
1/3 cup sliced red onion
1 tablespoon olive oil
1 tablespoon red wine vinegar
Ground black pepper, to taste
1. In a medium bowl, toss together the cucumber, tomatoes, and red onion.
2. In another small bowl, whisk together the olive oil, red wine vinegar, and ground black pepper.
3. Pour the dressing over the vegetables and toss to coat.
4. Chill the salad in the refrigerator for at least 30 minutes and serve cold.
Nutrition Facts
Calories 65 Total Fat 4.5 g Saturated Fat 0.7 g Trans Fat 0.0 g Cholesterol 0 mg Sodium 5 mg Potassium 255 mg Total Carbohydrate 5 g Dietary Fiber 1 g Sugars 3 g Protein 1 g Phosphorus 30 mg Exchanges/Food Choices: 1 Vegetable, 1 Fat
Black Bean Quinoa Salad
This whole-grain salad is packed with fiber and is also a good source of protein from the quinoa and beans. Serve it over a bed of leafy greens for a light lunch or as a dinner side with chicken or fish.
Serves: 9 / Serving Size: 1/2 cup
3 cups cooked quinoa
1 (15-ounce) can reduced-sodium black beans, drained and rinsed
2 tablespoons finely diced red onion
1/4 cup chopped cilantro
Juice of 1 lime
1/2 teaspoon fresh ground pepper
1. Combine the quinoa, black beans, red onion, and cilantro in a medium bowl.
2. Pour the lime juice and freshly ground pepper over the other ingredients and toss the salad to mix the ingredients.
3. Serve warm or refrigerate for 30 minutes and serve cold.
TIP: To get 3 cups of cooked quinoa, rinse 1 cup dry quinoa thoroughly with cold water. Combine the rinsed quinoa with 2 cups water in a medium saucepan and bring to a boil. Lower the heat, cover, and simmer for about 12 minutes or until the quinoa has absorbed all the water.
Nutrition Facts
Calories 115 Total Fat 1.5 g Saturated Fat 0.2 g Trans Fat 0.0 g Cholesterol 0 mg Sodium 55 mg Potassium 220 mg Total Carbohydrate 21 g Dietary Fiber 4 g Sugars 2 g Protein 5 g Phosphorus 135 mg Exchanges/ Food Choices: 1 1/2 Starch
Carbohydrate gets a lot of the attention with diabetes, but it is also important to choose protein foods wisely. The amount of calories and unhealthy saturated fat in protein foods can vary quite a bit. So it’s important to choose lean sources of protein and those with healthier fats while also keeping an eye on portion sizes. Including a source of protein can help round out your meal and some people find that it helps them feel full for longer.
Why Is Protein Important?
Protein is found in every cell in your body. It helps us build and repair tissues such as muscles, organs, bones, and skin. You also need protein to make enzymes and hormones, which are essential for many body processes.
What Are the Best Protein Choices?
Many people think that eating meat, poultry, or fish is the only way to get protein in your diet. But there are also many plant-based foods with plenty of protein, such as beans, lentils, and tofu. One benefit of plant-based protein foods is that they are usually lower in unhealthy fats, and may even contain some healthy fats. They also provide fiber, which is not found in animal protein sources. You can find a list of the best animal- and plant-based protein foods below.
Shopping Tip
When shopping for groceries, focus on filling your cart with mostly vegetables (nonstarchy and starchy), fruits, and whole grains. Then pick out some plant-based sources of protein and some fish, poultry, or lean meats (if you eat meat).
Plant-based protein options are a great choice! Choose from:
• Beans and legumes (pinto beans, black beans, lentils, black-eyed peas, and garbanzo beans are just a few examples). Try cooking dried beans or using canned beans that have been thoroughly drained and rinsed.
• Tofu, tempeh, veggie burgers, soy crumbles, and other soy or gluten-based meat substitutes. Soy milk is a dairy alternative that also provides protein.
• Nuts, nut butters, and seeds. These are good sources of protein, and they also provide a good amount of healthy fats. Be sure to watch portion sizes since they are also high in calories.
Good options for animal sources of protein include:
• Fish or shellfish.
• Low-fat dairy, including 1%, 1/2%, and skim milk, low-fat and nonfat plain or artificially sweetened yogurt. Greek yogurt is even higher in protein than regular yogurt.
• Eggs, egg whites, and egg substitutes.
• Reduced-fat cheese or cottage cheese.
• Poultry, such as chicken, turkey, and Cornish hen without the skin.
• Lean types of pork, such as pork loin and center loin chops.
• Select or Choice grades of beef that have been trimmed of fat, such as chuck, rib, round, rump roast, sirloin, cubed, flank, porterhouse, T-bone steak, tenderloin, or beef jerky.
• Veal lean chop or roast.
• Lamb chop, leg, or roast.
Limit Processed Meats
Studies have linked processed meats to certain types of cancer, heart disease, and even early death. Processed meats include anything that has been more than cut or ground. Examples are hot dogs, sausage, kielbasa, bacon, and many deli meats, such as bologna, pepperoni, salami, and pastrami. The takeaway? When choosing animal sources of protein, go with fresh instead of processed sources.
A lot of us have been raised to plan our meals around the meat on our plate with small sides of vegetables. But over the years, more and more research has supported the value of eating more plant-based foods and less red and processed meats in the diet to control weight and reduce disease risk.
The Diabetes Plate Method described in Chapter 6 can serve as a guide to help you control your meat portions. It’s an easy way to see if you are getting enough vegetables too.
Portion Control Tip
A serving of fish, poultry, or meat is 3–4 ounces, which is about the size of a woman’s palm or a deck of cards.
Plant-Based Protein
Plant-based or vegetarian eating plans are becoming increasingly popular. It’s easy to make a delicious, well-rounded meal with vegetarian protein. Plant-based protein foods, such as tofu and beans, are naturally lower in unhealthy saturated and trans fats than animal-based protein.
Don’t be afraid to give meatless meals a chance! Choose a vegetarian entrée when you go out to eat. Or, start by cooking at least one meatless meal each week. Some ideas are stir-fry with tofu, veggie burgers, or 3-bean veggie chili topped with a dollop of plain Greek yogurt.
Tips for Selecting and Preparing Protein Foods
• For chicken or turkey, the white breast meat is leaner than the dark meat of the bird. If you’re looking for a less expensive cut, opt for chicken or turkey legs or thighs. Always remove the skin from all cuts to reduce the amount of unhealthy fat and calories.
• Cut away all visible fat on meats and choose the cut with the least amount of visible fat/marbling.
• When selecting ground beef or ground turkey, choose those marked as 90% lean or more. For the leanest option, try 99% lean ground turkey breast.
• If you are on a budget you can still buy the less expensive, higher-fat ground beef. Just drain the fat after cooking and rinse the cooked beef with hot water.
• Buying lean meats, poultry, or fish in bulk can be a money saver. They freeze well, so you can use what you need and freeze the extras for another day. Most uncooked meat or poultry can be stored in the freezer for 3 months or more.
Fish and Omega-3 Fatty Acids
You’ve probably heard about fish and heart-healthy omega-3 fatty acids. Omega-3s are a type of healthy fat that helps lower cholesterol levels. Fish are a good source of omega-3s, especially those that are considered “fatty fish.” Healthy fatty fish that are high in omega-3 fatty acids include: salmon, herring, trout, sardines, mackerel, and albacore tuna. Try to include fish, particularly fatty fish, in your meal plan at least two times per week.
Get your omega-3s from fish and natural food sources rather than supplements, which have not been shown to reduce your risk of heart disease. For more information, see Chapter 20 on supplement use. Want to learn more about healthy fats? Turn to Chapter 5.
Shopping Tip
For convenience, try buying frozen fish, which may also be a less expensive option than buying fresh fish.
Simple Oven-Roasted Salmon
Here is a quick and simple fish recipe that’s high in protein and healthy fats. Serve it with a side of brown rice and steamed green beans.
Serves: 4 / Serving Size: 1/4 recipe
Cooking spray
4 fresh salmon fillets (about 4 ounces each or 1 pound total)
1 tablespoon olive oil
1 teaspoon dried dill
1/4 teaspoon freshly ground pepper
2 teaspoons lemon juice
1. Preheat the oven to 425°F and coat a glass baking dish with cooking spray.
2. Lay the salmon fillets in the baking dish and brush the top of each fillet with olive oil.
3. Sprinkle dill and ground pepper evenly over each fillet and roast in the oven for 10–12 minutes, or until the fish is opaque and flakes when touched with a fork.
4. After removing the fish from the oven, pour lemon juice evenly over each fillet and serve immediately.
Nutrition Facts
Calories 230 Total Fat 13.0 g Saturated Fat 2.2 g Trans Fat 0.0 g Cholesterol 80 mg Sodium 60 mg Potassium 360 mg Total Carbohydrate 0 g Dietary Fiber 0 g Sugars 0 g Protein 25 g Phosphorus 255 mg Exchanges/Food Choices: 4 Lean Protein, 1 1/2 Fat
For a long time, we thought that a low-fat diet was the answer to reducing heart disease risk and losing weight. Many people still think that it is best to limit how much fat we eat. It is true that fat is high in calories, but more recent research shows that certain types of fat, when eaten in moderate amounts, may actually promote health. Because people with diabetes are at increased risk for cardiovascular disease, it’s a good idea to limit the unhealthy fats you eat and replace some of them with healthier fats. At the same time, you should keep your portions of healthy fats small to avoid excess calories, especially if you are trying to lose weight.
