Diabetes Meal Planning Made Easy. Hope S. Warshaw

a high-fat meal may cause a slower rise in blood glucose than a high-carbohydrate meal. This doesn’t mean you should eat a lot of fat, especially saturated fat, as a way to manage your blood glucose. Keep your total fat intake moderate and choose the healthiest fats. You’ll learn how to reach these goals in the pages ahead.

      Sodium

      Research showing the benefits of a lower sodium count on blood pressure is mounting. Control of blood pressure is an important topic because nearly three-quarters of people with diabetes have high blood pressure. A lower sodium intake can impact blood pressure even more in people with diabetes or high blood pressure, along with African Americans and adults who are middle-aged and older. Keep in mind that we now eat around 4,000-6,000 milligrams of sodium a day. More than half of this is from processed foods. Research shows you can further lower your blood pressure by eating sufficient fruits, vegetables, whole grains, and low-fat dairy foods that provide much needed potassium (among other essential nutrients). Learn more about how to reduce your sodium intake and raise your potassium count in chapter 8.

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      Research shows that getting your sodium intake down to below 2,500 milligrams per day can help lower and control blood pressure.

      Alcohol

      The recommendation for alcohol is consistent with general dietary guidelines. Women should have no more than 1 drink a day, and men should have no more than 2 drinks a day. Research shows there are some benefits of various types of alcohol on the heart.

      Vitamins and Minerals

      If you eat at least 1,200 calories a day from a wide variety of healthy foods and your blood glucose levels are within the target ranges at this point, the ADA does not believe you need to take vitamin, mineral, or dietary supplements. People with diabetes have not been shown to have any greater need for various vitamins and minerals than anyone else.

      You may be at risk for or have difficulty getting sufficient amounts of some critical vitamins and minerals. Studies show that many people are deficient in vitamins A, C, D, and E along with essential minerals like choline, folic acid, magnesium, and potassium. Your first step to ensure that you do get enough of these important nutrients is to eat a wide variety of foods. Choose nutrient-rich as well as minimally processed foods. Next, talk to your health care provider about a multivitamin and mineral supplement that offers you optimal amounts of missing vitamins and minerals as extra “insurance.” This is especially true if your daily calorie intake is at or below 1,200, or you know you don’t get enough of certain vitamins or minerals. (See chapter 7 for more information on vitamins, minerals, and supplements.)

       Vegetarianism and Diabetes

      Vegetarianism has exploded across the country in the last several years. There are more restaurants that cater to the vegetarian and vegan lifestyle. If you’re a vegetarian or thinking about becoming a vegetarian and you’re worried that it won’t mesh with your diabetes healthy eating lifestyle, think again. There is no reason a person with diabetes can’t adopt a vegetarian lifestyle.

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      The nutrients vegetarians need to be concerned about are those provided by meats, poultry, and seafood as well as dairy products and eggs (if these are omitted). Consider your intake of calcium, iron, zinc, vitamin B-1 2, vitamin D, riboflavin, and omega-3 fats. Discuss the use of vitamin and mineral supplementation with your care providers.

      Being a vegetarian represents a broad range of eating styles. Some vegetarians do not eat any meat products but will still consume milk and eggs, while vegans restrict all animal products from their diet. Others do not eat red meat, but will occasionally eat seafood or poultry. The Vegetarian Resource Group (www.vrg.org) defines four categories of vegetarianism.

      Research shows that vegetarians tend to receive a multitude of health benefits because of their higher consumption of foods from healthier food groups, along with fiber and other nutrients; however, just because someone is a vegetarian doesn’t mean they automatically eat more healthfully. Vegetarians need to work just as hard (if not harder) to choose healthy foods and eat them in healthful ways. It will be important to choose and prepare your foods with limited fats and salt (as suggested for everyone) and to monitor your ABCs to make sure you are hitting your targets. If your blood glucose is difficult to control, you may be ready for blood glucose-lowering medication.

      Health Benefits of Vegetarianism

      Proven health benefits for those people who practice a vegetarian lifestyle are:

      • Lower LDL cholesterol

      • Lower blood pressure

      • Lower rates of type 2 diabetes (over non-vegetarians)

      • Lower body weight

Chapter 5

       Secrets of Successful Weight Loss and Control

       What You’ll Learn:

      • realistic weight loss goals

      • how weight loss can improve your ABCs

      • an optimal eating plan for weight control

      • secrets of successful long-term weight control

      • whether weight loss medications or gastric surgery can be effective

      During the last decade, much has been learned about the impact of weight loss on health and preventing or managing type 2 diabetes. Research studies have also revealed how people can succeed at losing weight and keeping that weight off over time. Bottom line: It takes a lot more doing than knowing when it comes to short- and long-term weight control.

       Be Realistic about Weight Loss

      For most people, it’s neither realistic nor necessary to get back down to the weight you were when you were a teen or young adult. This is especially true if you’ve become overweight or obese. Losing weight and keeping it off is tough for everyone for several reasons. People who lose weight seem to require fewer calories to maintain their lighter weight. There are also adaptations of hormones related to hunger and appetite control. Lastly, it appears that the presence of insulin resistance (a problem most people with pre-diabetes and type 2 have) makes weight loss and control even tougher.

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      Keep in mind any weight you lose is a move in the right direction. It’s worth noting that on average, an adult puts on two pounds a year, so, just preventing further weight gain is an accomplishment!

      Research shows that you’ll be more successful if you lose a small amount of weight (10 to 20 pounds) and work hard to maintain this healthier weight. Numerous studies show that your weight loss will be greatest at six months. If you want to lose a few more pounds, try it several months later; however, remember that maintaining the initial weight loss is what’s most important for your long-term diabetes control.

       Weight Loss and Blood Glucose Control

      For many years, it was believed that many people with diabetes could control their blood glucose with a healthy eating plan, weight loss, and by increasing physical activity. This notion no longer stands up to research for many people. Some people can control their blood glucose for a time if their type 2 diabetes is detected early (or if pre-diabetes is diagnosed), and they are diligent about implementing a healthy eating plan, etc.

      Weight loss accomplished by healthy eating and physical activity can decrease insulin resistance, improve insulin sensitivity, and result in lower blood glucose, lower blood pressure, and improved blood lipids for a time.

      You and your provider will be able to determine if healthier lifestyle habits and