NUTRITION AND YOU NUTRIENTS IN FOODS

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1 NUTRITION AND YOU It has been said that nutrition is the cornerstone to diabetes management. There are some basic ideas about meal planning that you need to know to prevent diabetes-related complications. In this session you will have the keys to help you open up the doors to manage your diabetes through good nutrition. In this section you will be able to: Name one nutrient that raises blood glucose levels Understand carbohydrate serving sizes Choose foods from a restaurant menu that would be low in fat and / or sugar NUTRIENTS IN FOODS Food is made up of carbohydrates, protein, fat, vitamins, minerals, fiber and water. Of these nutrients, the ones that affect your blood glucose are carbohydrates, protein and fat. These supply energy to your body. You need insulin to get this energy into the cells where it can be used. CARBOHYDRATES/GRAINS Carbohydrates are our bodies main source of energy or fuel. When we eat carbohydrates they are completely converted to glucose (sugar). They provide 4 calories per gram. Grains are divided into 3 subgroups, sugars, starches and fiber. Starches can be whole grain or refined grain. Whole grains contain the entire kernel -- the bran, germ, and endosperm. Examples include: whole-wheat flour and whole cornmeal bulgur (cracked wheat) and brown rice oatmeal Refined grains have been milled, a process that removes the bran and germ. This is done to give grains a finer texture and improve their shelf life, but is 9-1

2 also removes dietary fiber, iron, and many B vitamins. Some examples of refined grain products are: white flour degermed cornmeal white bread white rice Most refined grains are enriched. This means certain B vitamins (thiamin, riboflavin, niacin, folic acid) and iron are added back after processing. Fiber is not added back to enriched grains. Check the ingredient list on refined grain products to make sure that the word enriched is included in the grain name. Some food products are made from mixtures of whole grains and refined grains. The total amount of carbohydrate is more important than the carbohydrate source or type. It is the total amount of carbohydrate you eat that raises blood sugar levels, not whether the carbohydrate is from bread, potato, or gum drops. However, foods high in sugar also tend to have more carbohydrate than starches. Sugar Research has shown us that when foods containing sugar are eaten in combination with other foods that the blood glucose levels do not rise higher than when similar amounts are eaten alone. For this reason, the belief to avoid sugar in the diet has been relaxed. The amount you can eat is going to be smaller because of its concentration of carbohydrate in sugar compared to starches. The rule of thumb when including these foods is that your blood glucose levels should be under good control, and it needs to be substituted for other carbohydrates in your meal plan (usually fruit or starch/breads). Fiber Whole-grain carbohydrates contain more fiber. Fiber is an indigestible complex carbohydrate found in plants. Fiber in itself has no calories because the body cannot absorb it. Therefore, high fiber foods low in fat are low in calories such as fruits and vegetables. A food with 5 grams of fiber or more is considered a high fiber food. Fiber can be divided into two categories according to their physical characteristics and effects on the body: Water insoluble and water soluble. 9-2

3 Each form functions differently and provides different health benefits. Insoluble fibers, such as cellulose, hemicellulose and lingnin, do not dissolve in water. Soluble fibers, such as gum and pectin, do dissolve in water. Many health experts are advising people of all ages to consume more dietary fiber. Much research suggest that fiber may prevent cancer, diabetes, heart disease and obesity. Recommended fiber intake is grams every day. PROTEIN Protein is used for building tissue. A little more than half of protein is converted to glucose. It provides about 4 calories per gram. Recent research is showing that protein does not seem to increase or lower blood glucose levels. Protein is converted to glucose at a much slower pace than carbohydrates. Protein is found in: Animal sources: meats, fish, poultry, dairy products, and eggs. Vegetable sources: legumes, beans, nuts, and seeds, grains. FATS Fats are a concentrated source of energy. Per gram they contribute about 9 calories. Our bodies need some fat. There are 4 types of fats found in foods. They are saturated, trans polyunsaturated, and monounsaturated. Regardless of the type of fat eaten, very small amounts, if any, are converted into glucose. 1. Saturated: Bacon, Butter, Cream, Cream Cheese, Sour Cream, Shortening 2. Trans Fat: hydrogenated oils 3. Polyunsaturated: Margarine, Mayonnaise, Nuts, Oils, Salad Dressings, Seeds 4. Monounsaturated: (Heart healthy fat source): Avocado, Oils (Canola, Olive, Peanut), Olives, Nuts, Peanut Butter Eating foods that have too much fat or the wrong kind of fat may cause the blood fats (cholesterol / triglycerides) to increase. Monounsaturated fat is believed to lower cholesterol and may assist in reducing heart disease. Like 9-3

4 polyunsaturated fat, monounsaturated fat provides essential fatty acids for healthy skin and the development of body cells. Even healthy types of fat like monounsaturated fat are high in calories and can lead to weight gain. AFFECT ON BLOOD GLUCOSE LEVELS: Carbohydrates: 100% Protein: 58% Fats: 10% RATE OF EFFECT: Carbohydrate: 15 min to 1 ½ hrs Protein: 2 4 hours Fat: 6 hours CALORIES PER GRAM: Carbohydrates: 4 calories Protein: 4 calories Fat: 9 calories 9-4

5 S E R V I N G S I Z E S S ta r c h e s : 1 s lic e b r e a d ½ c u p c o o k e d c e r e a l ¼ s m a ll b a g e l 1 /3 c u p p a s ta, b u lg u r, o r r ic e ½ E n g lis h m u f f in, p ita b r e a d, h a m b u r g e r o r h o t d o g b u n ½ c u p c o o k e d b e a n s, le n tils, in c h to r tilla p e a s, o r c o r n 4 to 6 c r a c k e r s ½ s m a ll p o ta to ¾ c u p d r y c e r e a l 1 c u p w in te r s q u a s h V e g e ta b le s : F r u its : 1 c u p f r e s h v e g e ta b le s 1 s m a ll f r e s h f r u it ½ c u p c o o k e d v e g e ta b le s ½ c a n n e d f r u it ½ c u p to m a to o r v e g e ta b le ju ic e ¼ c u p d r ie d f r u it M ilk : M e a t & o th e r s : 1 c u p o f m ilk 2 to 3 o z. c o o k e d le a n m e a t, 1 c u p y o g u r t p o u ltr y, o r f is h ¼ c u p tu n a, c o tta g e c h e e s e 1 e g g 2 ta b le s p o o n s p e a n u t b u tte r F a ts : 1 ts p. m a r g a r in e, o il, o r m a y o n n a is e 1 tb s p. s a la d d r e s s in g, d ie t m a r g a r in e 1 tb s p. s e e d s 1 0 p e a n u ts 1 /8 a v o c a d o 9-5

6 SWEETNERS There are sweeteners and sugar substitutes that you may have heard about. Some contain calories and need to be counted in your meal plan. These include: Fructose Fruit juice Sugar Honey Glucose Sweeteners that have little or no calories in the amounts that are usually eaten are called non-caloric, or free. These can be used without having to calculate them in to the meal plan. Examples of these would include: Saccharin: Sweet N Low, Sweet 10 Acesulfame K : Sunette, Sweet One, Swiss Sweet Aspartamate : NutraSweet, Equal, Sweet Mate Sucralose: Splenda (made from sugar but not recognized by the body as carbohydrate) Sugar alcohols:. These are common sugar alcohols that do not raise your blood glucose as much. They are used as sweeteners in foods. The only disadvantage to using them is their laxative effect such as: abdominal gas, discomfort, and diarrhea. Sorbitol Mannitol Xylitol 9-6

7 DINING OUT Dining out serves as favorite form of entertainment. Learn how to make healthy choices when eating out. If you know what questions to ask and how to order, and which foods to choose, then you can stay in control of your diabetes. Select healthy food choices from restaurants that fit your meal plan. There are five areas that need to pay attention to when eating out: planning ahead, asking questions, timing, and portion control. 1. Plan ahead Choose places to eat that you know offer some healthy choices. Decide what you will eat before you arrive. Think ahead about how you will balance what you eat at the restaurant with your other meals during the rest of the day. 2. Ask questions, make requests Can food be prepared a different way? Or served in a different combination? Can substitutions be made? Can sauces, gravies, or dressings be served separately? Are there low fat dressings available? 3. Timing is important Try to eat your meals on time if you take diabetes pills or insulin. If you need to eat late, eat a snack when you would normally eat your meal. When you eat your meals at unusual times, check your blood glucose more often and carry foods to prevent or treat low blood glucose. If you take pills or insulin, take them after you have placed your food order. If you take insulin, talk to your educator about how to vary the dose and timing of your injections for restaurant meal times if different from your usual meal time. 9-7

8 4. Control portions Order an appetizer or two as a main meal or split a main dish with a friend. Plan to take home leftovers. Ask for a carryout container before your meal is served. Then, portion out the extra food when it arrives so that you will not be tempted to over eat. Share two complementary dishes that can create a balanced meal, like grilled chicken and a pasta dish. 5. Monitor Keep track of how often you are going out to eat especially if you are having difficulty meeting your diabetes goals. Check blood glucose levels after eating out. Limit your frequency of eating out to four times per week. You may have to limit this further if you are not meeting your diabetes goals. 9-8