Diabetes Meal Planning Made Easy. Hope S. Warshaw

even known) that may protect against chronic health problems.

      If you are keeping your calorie level low (1,500 calories and below) to meet your diabetes and nutrition goals, you’ll have towork even harder to eat all the nutrients you need. If you need to eat less than 1,500 calories a day or you cannot eat a particular category of food, ask your health care provider whether you should take a multivitamin and mineral supplement or a supplement that contains the nutrients you are lacking. For example, many people need to take a supplement to get enough calcium and vitamin D. Luckily, these nutrients are often paired in one supplement.

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      Keep nutrition-packed fruits, such as berries, bananas, oranges, apples, grapefruit, and mangos in your refrigerator and rotate your fruit choices.

       Vitamin and Mineral Needs: Who Sets the Targets?

      Vitamin and mineral deficiencies, which can result in diseases, were much more common several hundred years ago. Today, people don’t often get scurvy from having insufficient vitamin C, beriberi from a deficiency of thiamin, or rickets from not getting enough vitamin D. For the past few decades, government agencies and government-appointed experts have worked to establish which vitamins and minerals are necessary for health and how much of these vitamins and minerals people need at various ages and stages of life.

      The recommendations for many vitamins and minerals are based on the Dietary Reference Intakes (DRIs), which are developed through the Institute of Medicine at the National Academy of Sciences. Over time, the DRIs are reviewed and revised based on the evolving nutrition science.

       Daily Values on the Nutrition Facts Label

      The Nutrition Facts label uses the single term Daily Value (DV) to provide nutrient levels, which will cover the needs of most people. The Daily Values provide food manufacturers with guidelines to follow for food labeling and nutrition claims. Keep in mind that Daily Values are based on a calorie intake of 2,000 calories a day.

      The table on page 65 lists current Daily Values and the amount of the vitamin or mineral that a food must have per serving to use an “excellent source of” or “good source of” nutrition claim.

      • The terms “excellent source of,” “rich in,” and “high” mean that a serving (noted on the food label) of the food provides 20% or more of the Daily Value.

      • The terms “good source of,” “contains,” and “provides” mean that a serving of the food must provide 10-19% of the Daily Value.

      Learn more about food labeling and use of the Nutrition Facts label in chapter 22.

       Getting Enough Vitamins and Minerals

      While the vitamin and mineral needs of people with diabetes are no different from those of other Americans, research shows that many adults don’t get enough of the essential vitamins and minerals. These tips can help you:

      • Eat more fruits and vegetables and eat a wide variety of them. Go for the high-color ones because they often provide more vitamins and minerals—orange, dark green, blue, and red.

      • Eat more fruits and vegetables raw, unprocessed or minimally processed.

      • Make many of your starch choices whole-wheat or whole grains—cereals and breads, brown rice, whole-wheat pasta, bulgur, and barley.

      • Use legumes (beans, peas, and lentils) frequently. Make soups or bean salads or sprinkle beans or peas on tossed salad. These foods are packed with vitamins and minerals.

      • Eat or drink 2 to 3 servings a day of low-fat milk, yogurt, or cheese. Many children and young adults don’t get enough calcium and vitamin D. Dairy foods naturally contain calcium and are nearly always fortified with vitamin D.

      See the individual chapters in section 2 for more tips on how to eat your vitamins and minerals.

       Top 10 for 10 Vitamins and Minerals

      Each of the 10 tables on the following pages provides a list of the top 10 food sources (based on one serving of food) of the nutrients you are most likely to be lacking. At the top of each table, you’ll find the daily value for each nutrient and the amount needed for a food to be considered an “excellent source” or a “good source” of the nutrient. Use these tables to see how the foods you eat stack up and to find new nutrition-packed foods to add to your eating plan. Nutrient data was obtained from the USDA nutrient database. This is a searchable database which is an excellent resource for nutrition information on about 8,000 foods at: www.ars.usda.gov/ba/bhnrc/ndl.

       Dietary Supplements and Diabetes

      Research shows that people with diabetes are more likely to take dietary supplements than the general public. Good quality research, however, is still very limited on dietary supplements and whether some people with diabetes would benefit from certain vitamins, minerals, and nutrients.

      According to the Diabetes Supplement Health and Education Act (DSHEA), dietary supplements don’t require FDA approval prior to marketing. This lack of approval leads to the marketing of many ineffective products and many unfounded product claims. A number of dietary supplements are marketed to people with diabetes. If you choose to use dietary supplements, make sure you have good scientific reason to use them and make sure you buy high-quality supplements. Read Before You Buy (below).

      Below are a few of the dietary supplements that show some promise for people with diabetes in animal and human studies. Keep in mind that most of these still require more research to verify those claims. At this time, the ADA does not recommend the use of dietary supplements for most people.

      Antioxidants

      Nutrition experts used to believe that people with diabetes might need more antioxidants—that is, vitamins E, C, and A (as beta carotene) and other carotenoids and selenium—because diabetes is a state of oxidative stress. Oxidative stress is known to create free-radicals that may damage various tissues in the body. Some large research trials have demonstrated that the use of antioxidants didn’t show a benefit. In fact, there was concern that high doses, particularly of vitamin E, might cause health problems. ’

      This doesn’t mean that you shouldn’t get the amount of these nutrients suggested by the Dietary References Intakes for your age and gender. It does mean that taking these in greater volume was not found to be beneficial.

      Alpha-Lipoic Acid (ALA)

      ALA, an antioxidant normally made in the liver, circulates in the body in small amounts. Foods also contain only small amounts of ALA. Some studies have shown that, in people with type 2 diabetes, ALA may help the muscles use glucose more efficiently and may make tissues more sensitive to the insulin made by the body. Some studies have also found ALA to lessen the pain of diabetes nerve disease (neuropathy).

      Chromium

      Chromium is an essential trace mineral that the body needs to maintain normal blood glucose levels. Chromium is found in small amounts in foods like egg yolks, whole grains, and green vegetables. Chromium, in the form of chromium picolinate, may help lower blood glucose levels and improve blood