Planning Your Diet - Diet The Foundation Of Treatment: Diabetes A Plan For Living

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Planning your diet

No matter which type of diabetes you have, the foods emphasized in your eating plan are good for everyone in your family. A diet low in saturated fats, cholesterol, and sweets, but high in fiber, fruits, vegetables, and whole grains can help you sidestep many common ailments, such as heart disease and high blood pressure, and can go a long way in helping you live a longer, healthier life.

Your dietitian: A valuable ally

A dietitian or nutritionist can provide invaluable help as you develop a personalized eating plan. After all, you're not making temporary adjustments; this is a lifelong commitment. Using food to prevent hypoglycemia, or to treat it if it occurs, is also a critical safety issue.

People who've been recently diagnosed are usually asked to keep a food diary to track their calories, carbohydrates, and fats. A dietitian can instruct you on how to meet your caloric and blood glucose needs by counting fat and carbohydrate grams, measuring portions, and adjusting your food intake to the amount of exercise you get. If you prefer, more structured menus have been developed specifically for people with diabetes. Check your library or bookstore, or contact the American Diabetes Association (see "Resources").

Even once you've learned to manage your diabetes, you may find that a change in schedule, a trip, or a move to another part of the country necessitates some adjustments in your meal plan. On such occasions, consult your dietitian.

Monitoring carbohydrates

People with diabetes should try to get about 45%–55% of their daily calories from complex carbohydrates — that is, from vegetables, whole-grain breads and cereals, and simple sugars that exist naturally in fruit and low-fat milk.

Watching your carbohydrate intake is particularly important because most of the glucose flooding your bloodstream after you eat comes from the breakdown of carbohydrates. But not all carbohydrates are equal. The amount of glucose and the speed with which it's released into your bloodstream varies, depending on the food's manner of preparation, its fiber content, and other foods it's combined with. For example, raw vegetables are digested more slowly than cooked ones; eating fats with carbohydrates retards digestion; and drinking a glass of apple juice raises blood sugar more rapidly than eating an apple.

Targeting fats

Recently there has been a keen interest in high-fat, high-protein, low-carbohydrate diets as a means to lose weight. Although short-term studies have shown that these eating plans can be an effective way to drop pounds, no long-term studies have verified that they are more effective than other low-calorie diets. In addition, some of these diets fail to distinguish between unhealthy saturated and trans fats (which increase the risk of heart attacks, strokes, and other forms of cardiovascular disease) and healthier unsaturated fats (which may lower cardiovascular risk when consumed in moderation). As a result, experts question the safety of the high-fat, low-carbohydrate diets in the long run, especially in regard to cardiovascular risk. That's why no more than 20%–35% of your total daily calories should come from fat, and less than 7% from saturated fat.

Saturated fat is notorious for raising unhealthy LDL cholesterol levels. And it speeds the artery-clogging process called atherosclerosis, raising your risk for heart disease. It's found in meat, dairy products, and certain vegetable oils, such as palm oil and coconut oil, and it's generally solid at room temperature.

Trans fats, partially saturated vegetable oils produced through a chemical process called hydrogenation, also pose health dangers. These fats — commonly found in margarine, deep-fried foods, commercial baked goods, and many other products — are identified on the label as "hydrogenated" or "partially hydrogenated." They raise the harmful blood lipids LDL cholesterol, triglycerides, and lipoprotein(a), all of which have been linked to heart disease. And they depress the healthy HDL cholesterol.

Instead, opt for polyunsaturated or monounsaturated fats. Polyunsaturated fats (such as corn, safflower, and soybean oils) and monounsaturated fats (such as olive, peanut, and canola oils) don't raise cholesterol levels. Indeed, research indicates that monounsaturated oils reduce LDL cholesterol and increase HDL cholesterol.

The best way to reduce the saturated fat in your diet is by limiting your consumption of red meat, fatty dairy foods, and poultry skin. Choose skim or 1% milk, and buy light or low-fat cheeses and yogurt. To keep trans fats to a minimum, avoid margarine, shortening, and commercial baked goods. When eating dessert, stick with ice milk, low-fat or nonfat frozen yogurt, or fat-free ice cream.

Limiting sugar

Although sugar and so-called concentrated sweets that contain a lot of sugar were once considered dangerous for people with diabetes, small amounts won't necessarily thwart your effort to control your blood glucose. Most people with type 1 and type 2 diabetes can consume some sugar as long as they count it as a carbohydrate and don't add it to their diet indiscriminately. Of course, they must adjust their insulin dosage accordingly. Nevertheless, experts still advise limiting simple sugars because they raise blood glucose levels quickly. Artificial sweeteners, such as saccharin or aspartame (NutraSweet), don't raise blood glucose levels.

Alcohol

You can drink alcohol in moderation if you account for the calories in your daily meal plan. Research has shown that drinking moderate amounts of alcohol can lower heart disease risk. Moderate drinking is defined as one standard drink a day for women and up to two a day for men (see "What is a standard drink?" below).

You must be cautious, however. Alcohol can cause low blood sugar or further exacerbate a low blood sugar reaction. And because some effects of alcohol (such as drowsiness or slurred speech) resemble those of hypoglycemia, it can be hard to recognize a true diabetic emergency (see "Symptoms of hypoglycemia"). Finally, while moderate drinking may have benefits, there is always the risk of developing alcohol dependence. Certainly no one should drink and drive, and drinking during a pregnancy can hurt your baby.

What is a standard drink?
12 ounces of beer	5 ounces of wine	1.5 ounces of 80-proof distilled liquor

Last updated:	January 23, 2007