GUIDE TO HEALTHY SHOPPING WITH DIABETES FOR MORE INFORMATION, VISIT CDIABETES.COM: THE COSTCO DIABETES WEBSITE

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1 GUIDE TO HEALTHY SHOPPING WITH DIABETES

2 Please note: Product selection may vary between Costco Wholesale locations DIVIDE YOUR CART. MAKE HEALTHIER FOOD CHOICES. Apply MyPlate principles to your cart. Imagine a line that divides your cart into sections for vegetables, fruits, whole grains, lean proteins, and low-fat dairy products. As you fill your cart, choose foods that fall into each category.

3 FILL YOUR CART WITH BLOOD GLUCOSE FRIENDLY OPTIONS AT COSTCO. Read the Nutrition Facts on the food label. Serving Size Calories Saturated and Trans Fats Fiber Sugar Keep track of how many grams of carbs you are eating. Keep snacks to calories, and meals to calories. Select foods with zero grams of trans fats and as few grams of saturated fat as possible. Choose foods with at least three grams of fiber, and eat a total of grams of fiber a day. Select foods with as little added sugar as possible. Try to eat foods with 10 grams of sugar or less per serving. And remember, proteins make you feel full and satisfied and they have little or no carbohydrates.

4 Costco has a large selection of fruits and vegetables, so buy enough for all of your meals and snacks. When you eat, fill half of your plate with fruit or vegetables. Eating fruits and vegetables makes you feel full for very few calories. The antioxidants in fruits and vegetables help to cool inflammation and reduce body fat. Costco Kirkland Signature OPTIFIBER Quckly dissolves in hot or cold beverages & soft food

5 Experts recommend eating 5-9 servings of fruits and vegetables each day. This is what one serving of fruit and vegetables really means. Food Raw Vegetables or Salad Greens 1 Serving Equals: 1 cup Cooked Vegetables Raw Fruit Fruit Juice ½ cup 1 medium- sized fruit or ½ cup ½ cup

6 Key Points: Fresh produce in season tastes better and costs less Fresh is best, but frozen or canned is a great substitute when fresh is not available Look for low-sodium canned products Look for frozen products without sauce or seasoning

7 DIABETES-FRIENDLY PRODUCTS AT COSTCO Costco Pharmacy has a variety of vitamins, minerals, and other supplements that can help you stay well nourished and healthy. Be sure to speak with your doctor or primary care provider prior to taking any supplements other than a daily multivitamin. Supplements and vitamins can help support your healthy lifestyle while helping you control your diabetes. Products include supplements for healthy joints, low-sugar nutrition drinks for healthy, diabetes-friendly snacks or meals on the go, and treatments to help you stop smoking so you can lower your risk of diabetes-related health problems such as nerve damage and high blood pressure.

8 DIABETES-FRIENDLY PRODUCTS AT COSTCO: SUPPLEMENTS

9 Nutrient Vitamin C Vitamin D Magnesium Multivitamins Fish oil Fiber Lactase Probiotics Benefit Important for your heart, skin, and blood glucose level Keeps your bones and teeth strong and your immune system healthy so you re less likely to develop infections The amount you need can increase if your diabetes isn t well controlled To stay healthy To reduce inflammation and lower triglycerides. Can also cause your blood to become thinner, so check with your healthcare provider to make sure it doesn t interfere with other medicines that have the same effect Slows down the absorption of glucose into your bloodstream Can help you digest dairy Are healthy bacteria that live in your digestive tract. Taking probiotic supplements can help restore the proper balance

10 Cinnamon Both whole and extracted cinnamon have been shown to lower blood glucose levels. Cinnamon can help reduce unhealthy LDL cholesterol levels and blood pressure, both of which can increase your risk of heart disease. Cinnamon contains water soluble and fat soluble compounds. We can easily process water soluble compounds, but fat soluble compounds are harder to digest. Look for cinnamon concentrate without the fat soluble compounds. Read labels and look for water extracted. Water extracted cinnamon can maximize health benefits, and it s more concentrated so you take fewer capsules. Water-extracted cinnamon is backed by six human clinical studies which found that water extracted cinnamon lowered fasting blood glucose an average of 10%. If you are considering taking cinnamon, make sure to discuss this with your diabetes educator or healthcare provider. If you use cinnamon with other medicines or supplements that also lower glucose levels, you might increase your risk of hypoglycemia. Your healthcare provider can work with you to incorporate cinnamon into your diabetes treatment plan in a way that works best for you.

11 DIABETES-FRIENDLY PRODUCTS AT COSTCO: SUPPLEMENTS Great prices on Weider Red Yeast Rice Helps lower cholesterol

12 If you are having a hard Cme keeping a healthy lifestyle, meal replacements might help you get back on track. Here are some ways you can add meal replacements to your day. Keep a meal replacement on hand to prevent overeating Keep a protein bar in your bag Try a protein-based shake or fruit drink for a quick and refreshing breakfast Having a filling meal replacement when you are invited on a last minute outing with friends, or when you are craving sweets, can help you avoid giving in to temptation. Whether you re running late, stuck in traffic, or have errands to run and not enough time, a protein bar is a great way to keep your blood glucose balanced. Glucerna makes chocolate chip and peanut chocolate chip meal replacement bars, as well as 80-calorie snack bars in oatmeal raisin, chocolate caramel, and chocolate peanut flavors. The best part? They only have about 11 carbohydrates per serving.. Meal replacement shakes and drinks are great breakfast options for those who usually skip breakfast. Glucerna meal replacement shakes are for people with diabetes, and come in delicious flavors like vanilla, chocolate, strawberry, and butter pecan. Glucerna shakes are 8 ounces each, and have 190 calories, 23 grams of carbs, 3 grams of fiber, and 10 grams of protein. Glucerna also makes Hunger Smart brand shakes in vanilla and chocolate, which are higher in protein and only 140 calories.

13 DIABETES-FRIENDLY PRODUCTS AT COSTCO: EVERYDAY PRODUCTS Great prices on Weider Red Yeast Rice Helps lower cholesterol

14 Between healthy food, exercise programs, prescription medicine and testing supplies, the costs of diabetes care can really add up. That s why the Costco Member Prescription Program (CMPP) is so valuable for people with diabetes. CMPP allows Costco members who have no prescription drug insurance, or whose insurance does not cover all of their prescription medicines, to save money at the pharmacy. This program is not insurance, but a value added benefit of Costco membership. Here is some sample pricing on Costco s popular 50 Count blood glucose test strips: BAYER BREEZE 2 Regular: $62.27 CMPP: $40.63 BAYER CONTOUR Regular: $62.27 CMPP: $38.08 BAYER CONTOUR NEXT Regular: $41.34 CMPP: $33.73 With Costco s proven commitment to member service, value, quality and product confidence, you can be assured that you ll be getting the best supplies at the best prices.

15 DIABETES-FRIENDLY PRODUCTS AT COSTCO: DIABETES CARE PRODUCTS Great prices on Weider Red Yeast Rice Helps lower cholesterol

16 CHOOSING MEAT AT COSTCO Processed meats, such as bacon, hot dogs, bologna and other cold cuts, contain more sodium and fat than fresh meats. Processed meats also contain preservatives, such as nitrites. So, eat less processed meat and look for fresh options when available.

17 MEAT FACTS Meat is a good source of high-quality protein. Red meats (beef, lamb, pork) contain iron, vitamin B12 and zinc. Lean cuts of meat are best.the leanest cuts of meat include: round, sirloin, tenderloin, and chuck. Trim visible fat from meat before cooking.

18 CHOOSE LEAN PROTEINS Whether you eat red meat, pork, poultry, fish or seafood, choose lean proteins for weight loss and weight maintenance. Protein helps you: Build (and keep) lean muscle tissue Increase the number of calories you burn every day Boost your metabolism Promote weight loss Fight off hunger

19 POULTRY & FISH AT COSTCO

20 POULTRY CHOICES Ground poultry (turkey or chicken) is a perfect substitute for ground beef in your recipes. Purchase lean ground poultry made from the white meat breast portion. If not labeled lean, ground turkey can have fat and skin added, which increases the fat content.

21 BUDGET-FRIENDLY FISH PRODUCTS AT COSTCO Tuna in pouches or cans makes an easy, portable lunch. Canned salmon is rich in omega 3 fatty acids, calcium, Vitamin D and magnesium. Omega-3s help reduce stress hormones and reduce belly fat.

22 For a healthy, low cost alternative to meat, consider Tofu: Low in fat High in protein and calcium Can be grilled, baked or diced as an add-in to soups and salads

23 SHOPPING FOR MILK AT COSTCO For most people, low-fat milk, such as 1% or nonfat skim, is the best choice. Children under the age of 2 should drink whole milk. If you are lactose intolerant try a lactose-free milk or dairy-free milk option, such as soy or almond milk.

24 YOGURT

25 Yogurt can be eaten as a healthy part of breakfast, snacks, or even dessert. Yogurt is a great source of calcium, probiotics and protein. Be sure to choose yogurts low in sugar Many types of yogurt, such as the fruit at the bottom or packaged with add-ins like chocolate candies, can contain a lot of added sugar. Add your own flavors to plain yogurt for the healthiest choice Add a tablespoon or two of protein-rich granola, chia seeds, or berries for a naturally crunchy and sweet flavor.

26 GREEK YOGURT IS A GREAT CHOICE. Plain Greek yogurt has only 110 calories per serving, and only a fraction of the carbohydrates and sugar in other types of yogurt. Try adding cut fresh fruit or a tablespoon of nuts, seeds or granola to plain yogurt for added protein, fiber and flavor. Greek yogurt has more than twice the amount of protein of regular yogurt.

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28 SHOPPING FOR EGGS AT COSTCO Eggs have around 60 calories and 6 grams of protein for a large egg, and they are packed full of vitamins and minerals. Eggs can be used for delicious and healthy breakfast omelets, in baking, or boiled for a portable, protein-rich snack. Fresh is best, but egg substitutes can be used to provide a quick, lower calorie, and lower fat replacement for fresh eggs.

29 SHOPPING FOR CHEESE AT COSTCO

30 CHEESE Do you avoid cheese because of the fat and calories? Cheese can be a great source of calcium, protein and Vitamin D, and can be eaten alone or as a flavorful addition to soups, salads, or other recipes. Get the right kind of cheese for your healthy lifestyle, and eat the right size portions. Dairy in your diet help you burn more calories. Dairy keeps you feeling full for longer. Eating dairy can help you flatten your belly faster than just cutting calories alone.

31 CHEESE Light cheeses are lower calorie and have less fat. Cream cheese, however, may be lower in calories or fat than other cheeses, but it also has very little protein. Serving size is what matters. The Pepper Jack 100 Calorie Pack is great because each packet is portion-controlled. You can also save money and pre-package your own 100 calorie cheese packs.

32 SHOPPING FOR BUTTER AT COSTCO

33 The type of butter product you buy could mean the difference of calories a week, based on using just one tablespoon a day. Natural is best, but margarine products provide buttery flavor and texture with fewer calories and less fat.

34 SHOPPING FOR BREAD AT COSTCO

35 BREAD TIPS Make sure the first ingredient is whole wheat flour. Wheat flour, unbleached, multigrain, enriched, or stone-ground wheat flours are sneaky ways of saying refined white flour, which you want to avoid. Check for high fiber content. Most refined, white flour-based breads will contain almost no fiber, while a true whole grain bread will contain at least 3 grams of fiber per slice. Calories matter. Diet or light breads have about 45 calories per slice, while most others have about 100 calories per slice.

36 NUTS & SEEDS Looking for a great snack? Include a small amount of nuts every day. Dry roasted or unsalted types are best. Nuts contain healthy mono-unsaturated fats, vitamins and minerals. Mono-unsaturated fats fight inflammation and help decrease belly fat. Watch your portions. One ounce, or two tablespoons, of nuts contains about 180 to 200 calories. Walnuts, Chia Seeds and Flax seeds are a good source of Omega-3 fatty acids.

37 BEANS & LENTILS Add more beans or lentils to your daily meals. Beans and Lentils contain no cholesterol and are naturally low in fat. Can be eaten alone, or in soups, salads, as part of tacos or wraps, or as a base for dips. High in protein, fiber, vitamins and minerals.

38 BAKED CHIPS ARE BEST Baked snack chips are lower in fat, but portion size is still important. So be careful of how much you eat.

39 POPCORN IS HEALTHY! All popcorn has fiber, but it is important to look for brands that have lower fat and sodium content. Look for brands with no trans fats and with a blend of poly and mono-unsaturated fat that will support heart health.

40 THE CEREAL AISLE

41 HEALTHY CHOICES: CEREAL Choose cereals with a fiber content of 4 grams or more. Fiber helps reduce cholesterol levels and keeps blood sugar steady. One serving of All Bran has about 51% of the daily recommended serving of fiber, with about 13 g of fiber per 1/3 cup serving. All-Bran gets most of its fiber from wheat bran. Mini-Wheats, or shredded wheat, provides 20 % of the daily recommended serving of fiber, with 6 g of fiber per 24 mini biscuits. Mini-Wheats gets its fiber from 100% whole wheat.

42 HEALTHY CHOICES: OATMEAL Oats are a great source of soluble fiber, vitamins & minerals. Oat products all contain similar nutrition, but differ in texture and cooking time. Instant oats are finely chopped and just need hot water to prepare. Rolled oats take 5 minutes to cook. Steel-cut oats have the least amount of processing and require a longer cooking time.

43 WHOLE GRAINS Promote belly fat loss by helping to control your appetite. Whole grain foods get digested slower than refined versions so they keep you feeling full for longer. Insulin response is limited and you have fewer cravings.

44 BROWN RICE IS THE HEALTHIEST CHOICE Whole grain brown rice has more vitamins and minerals than white rice. Brown rice has four times the amount of fiber as white. The extra fiber helps you stay full longer. Adding whole grains or brown rice to your daily meal plan is a budgetfriendly way to get more fiber, essential vitamins and minerals.

45 OTHER WHOLE GRAINS Barley, quinoa and buckwheat are nutrient-dense foods rich in essential vitamins and minerals. These grains are a low-fat source of complex carbohydrates, fiber, and protein. They can be used like other side dish grains, or even as breakfast cereal.

46 SEASONINGS Adding certain seasonings to your foods can help improve your blood glucose control. Seasonings may help to raise metabolism and lower blood pressure. Cinnamon helps reduce insulin resistance. Turmeric contains the compound curcumin, which improves blood glucose levels by preventing insulin resistance. Cloves reduce blood glucose when eaten regularly for 30 days. The capsaicin in cayenne pepper boosts metabolism, lowers blood pressure, and promotes better blood glucose control.

47 BEVERAGES Vitamin water is fortified with vitamins and other nutrients, but may still be adding calories to your diet. Check the labels carefully. Diet soda and sugar free drink mixes offer calorie-free options that are made with artificial sweeteners. Drink mixes and juice drinks are usually sweetened with sugar.

48 Please note: Product selection may vary between Costco Wholesale locations BEVERAGES Plain water is best Milk and 100% juice are most nutritious. Too much juice adds extra calories and sugar. Caffeine: coffee and tea in moderation are OK. Flavored seltzer or sparkling water with lemon or lime is a refreshing and naturally low fat and low calorie option.