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December 09
Culinar y Nutrition News:
Diabetic Menu Makeover
Presented by ACF Chef & Child Foundation and Clemson University
E
because it is most often diagnosed before
and infant are getting the nutrients they
are diagnosed with diabetes and 200
the age of 30. However, type 1 diabetes
need. Most cases resolve once the baby is
die from the disease. Of the nearly 23.6
can develop at any age, even in the elderly.
born; however, many women who have had
million Americans who have diabetes, 5.7
People with type 1 diabetes are unable to
gestational diabetes develop type 2 diabetes.
million of them are unaware that they
produce their own insulin, so they must
do. In other words, diabetes awareness
take insulin daily, through either injections
Pre-diabetes
and prevention is crucial, especially
or an insulin pump. Insulin doses are
Fifty-four million Americans have pre-
considering the environment that we live
timed to correspond with food intake, so
diabetes, a condition that occurs when a
in plays a part. While diabetes onset can
eating the right food in the right amounts
person's blood-glucose levels are higher
be linked to a number of risk factors,
is essential to treatment.
than normal but not high enough to be
very 24 hours, more than 4,000 adults
diagnosed with type 2 diabetes. Without
genetics and environment are two that
play major roles. Experts convey that
Type 2
drastic changes in diet and exercise, these
environment, specifically one where poor
Accounting for nine out of ten diabetics,
people will eventually develop diabetes.
eating habits are encouraged, make it
this type is by far the most common.
much easier to become overweight and,
Once considered an adult disease, type 2
Meal planning
thus, develop diabetes. Here is where you,
diabetes has drastically increased in both
Regardless of the type, or even if you
as chefs, come into the picture. In our
adults and children across the nation over
do not suffer from diabetes, eating a
environment, eating out and convenience
the last 30 years. This type can slowly
consistently healthy diet helps keep
foods are mainstays in meal practices. You
develop over time and is influenced by
glucose levels in check. The general
are in the rare position to begin reshaping
poor eating behaviors. It results from
recommendations for people with
our health and transforming growing
insulin resistance, a condition in which
diabetes are surprisingly similar to the
diabetes’ statistics into a precedent of the
the body fails to properly use insulin,
dietary advice for any adult:
past. Let the menu makeover begin.
which may eventually lead to insulin
deficiency. Unfortunately, the longer a
sWatch your carbohydrate intake.
Typecasts
person has diabetes, the more likely it
s Eat more vegetables, fruits, fiber, low-
Diabetes is a disease in which the body
is that insufficient insulin is the cause
fat dairy foods, whole grains, fish,
does not produce sufficient amounts
of high blood-glucose levels, which is
poultry and nuts.
of, or properly use, insulin. Insulin is a
referred to as hyperglycemia.
s Eat less saturated and trans fats.
and other food into energy needed for
Gestational Diabetes
Not everyone with diabetes has the same
daily functions. There are several types of
This form of diabetes affects about four
meal plan or the same nutrition goals.
diabetes, and these types may affect what
percent of all pregnant women in the
For some, reducing caloric intake is most
your customers will be able to eat.
U.S. It usually develops during the last
important. Others may need to limit fat
stage of a pregnancy when hormonal
and salt and eat more foods high in fiber.
Type 1
changes can increase the body’s demand
Therefore, meal planning is essential for
Five to ten percent of Americans with
for insulin. It is generally treated with
any type of diabetic, which makes menu
diabetes fall into this category, which
an eating plan and careful blood-glucose
planning as a chef imperative for adhering
used to be called “juvenile diabetes”
monitoring to make sure both mother
to diabetics’ needs. Here are a few ways
hormone used to convert sugar, starches
that diabetics plan their meals.
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Carb counting
Carbohydrate is the general term for
starches and sugar found in foods.
Carbohydrates (carbs) are the body’s
main source of energy. Since the
body digests carbohydrates into sugar
(glucose) that enters the bloodstream,
carbs have a direct affect on bloodglucose levels. Many diabetics manage
their blood-glucose levels through a
meal planning technique known as “carb
counting.” While carb counting depends
Apples are considered low on the glycemic index, with 38 points for one.
One tablespoon of honey is 55 points and is considered medium.
on the activity level and medications
taken by individuals, the general range
of carbs for diabetics is around 45 to
60 grams per meal. Carbs are found in
Exchange system
exchange, you could substitute one for
a variety of foods and not just sugary
In the past, most diabetics used the
the other.
foods. They are also found in grains,
exchange system for meal planning, while
dairy products, beans, starchy vegetables
nowadays many rely on carb counting.
No matter what meal planning strategy
and fruits, and juices.
However, there are many who still follow
is used, the goal is to strike a proper
the exchange system. The exchange
balance of carbohydrates, proteins
system groups foods into six categories:
and fats throughout the day. To put
starch/bread, meat, vegetables, fruits,
this in perspective, calories should be
milk and fat. Foods can be substituted
distributed as follows:
or exchanged for each other within a
sCarbohydrates: 55-58 percent of total
Glycemic index (GI)
Another way diabetics manage their
blood-glucose level through meal planning
is by using the glycemic index (GI). This
system groups foods that contain equal
amounts of carbohydrates by their ability
category if they contain similar nutrient
to raise blood glucose. Foods are grouped
makeup, such as calorie, carbohydrate,
s Protein: 20-23 percent of total calories
as being high GI (* 70), medium GI (55-
protein and fat content. However,
s Total fat: 24-26 percent of total calories
70) or low GI () 55). The lower the GI
no exchanges can be made between
number given to a food, the less likely
categories, even if they have the same
the food will elevate blood sugar, and
number of calories. For example, since a
Diabetes superfoods
the more diabetic-friendly it is. While all
slice of bread, half an English muffin and
This may seem like an information
of this may seem confusing—and it has
a half cup of oats all count for one starch
overload on diabetes, however, it is
calories
(less than 10 percent is saturated fat)
caused some controversy—menu planning
does highlight healthier foods. For
FOOD
SERVING SIZE
GLYCEMIC
INDEX
CARBS (G)
example, vegetables, whole grains and
beans tend to fall lower on the glycemic
PEANUT
4 OUNCES
14
15
scale, while processed and refined foods
BEAN SPROUTS
1 CUP
25
4
are higher up. However, considerations
GRAPEFRUIT
½ LARGE
25
11
such as whether a food is eaten alone
SKIM MILK
1 CUP
32
13
or with a combination of foods, how a
LOW-FAT YOGURT
1 CUP
33
47
food is prepared, ripeness of fruits and
APPLES
1 MEDIUM
38
16
vegetables, and individual metabolism are
CARROTS
1 LARGE
47
5
a few factors that may affect the GI. Since
ORANGES
1 MEDIUM
48
12
GI meal planning is still a controversial
WHOLE GRAIN BREAD
1 SLICE
51
12
topic among health researchers, it is
BANANAS
1 LARGE
52
27
prudent to stay up-to-date on the latest
CORN TORTILLA
2 MEDIUM
52
21
findings involving this system.
BROWN RICE
1 CUP
55
42
HONEY
1 TABLESPOON
55
17
OATMEAL
1 CUP
58
21
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important to know exactly what your
customers may be dealing with and how
they are coping in terms of food choices.
Then, you can ask yourself how you, as a
chef, can make changes to your menu to
help alleviate the anxiety diabetics may
1. Beans (kidney, pinto, navy and black
beans)
2. Dark green leafy vegetables (spinach,
collards and kale)
3. Citrus fruits (grapefruit, oranges,
lemons and limes)
face when dining out. As always, let us
4. Sweet potatoes
first start with individual ingredients. The
5. Berries (blueberries, strawberries,
American Diabetes Association (ADA)
raspberries and blackberries)
has compiled a top ten list of superfoods
6. Tomatoes
for diabetes, which merely lists foods that
7. Salmon and other fish high in omega-3
have a low glycemic index and provide
key nutrients that are lacking in the
typical diet, such as calcium, potassium,
s Offer vegetables that have been
prepared stewed, steamed or boiled.
s Offer fish or meat that has been broiled
using flavoring ingredients, such as spices
and herbs, rather than extra butter.
s Offer fresh fruit for desserts and appetizers.
s Offer whole-grain rolls, crackers,
biscuits, tortillas or breads.
s Offer salads without added cheeses and
croutons, served with low-calorie dressing.
s Serve sauces and gravies on the side.
fatty acids
8. Whole grains (pearled barley and
oatmeal)
Cooking for kids
There is no hiding the fact that the
fiber, magnesium, and vitamins A, C and
9. Nuts and seeds (walnuts and flax seeds)
number of children with diabetes has
E. By making an effort to incorporate
10. Fat-free milk and yogurt
drastically increased over the years.
some of these foods into your menu for
When it comes to childhood diabetes,
diabetic-friendly offerings, you will not
Guide to dining out
there are two types of kids that you may
only be helping those with diabetes, but
The ADA also offers a guide to dining
be catering for:
everyone. The fact is that these foods are
out for those with diabetes. Diabetics
a good addition to any dish or diet.
are looking for foods that have been
s Type 2 diabetes: According to
prepared with vegetable oil or low-fat
health professionals, approximately 80
margarine, little salt, no extra sauce or
percent of these kids are overweight,
butter, and broiled instead of fried. This
so their diets are more geared to
SUGAR IN THE RAW
may seem a little uninspiring for you as
weight loss and low-fat/reduced-calorie
Regardless of whether or not you or your
a chef, however, what appears boring
meals. Offering alternatives that are
customers have diabetes, watching the
in text can actually be made into an
substantially lower in fat and calories
According to the United States Department
exceptional dish that not only diabetics
than the average kid’s meal at your
of Agriculture (USDA), people following a
will enjoy. If you have been keeping up
restaurant would benefit any child.
amount of sugar in your dishes is crucial.
2,000-calorie diet should get no more than
40 grams of added sugars daily, which is the
with these articles, you have the basic
equivalent of eight to 10 teaspoons of sugar.
tools and fundamental concepts needed
s Type 1 diabetes: Many of these
Eight teaspoons of sugar may seem like a lot,
to create delicious and nutritious meals
children use insulin pumps and often
for your customers. Start putting these
use carbohydrate counting as a means
an average of three to four times more than
ideas into practice so that diabetics
of regulating blood-glucose levels.
the suggested amount.
and those looking to indulge in healthy
Portions, or serving sizes, are key
dishes don’t have to order bland
for these kids because a small baked
(the sugar found in fruit and honey), lactose
alternatives of your creations. Here
potato can have considerably different
(the sugar in milk), and sucrose (table sugar,
are some ways to adhere to a diabetic’s
carbohydrate content than a large
vegetables)—break down into simple sugar or
needs, but remember, these are only
one. Having the carbohydrate content
glucose, which provides energy to the body's
concepts. To conceptualize a dish that is
available and making sure serving sizes
a tasty and satisfying meal fit for anyone
are accurate would be an exceptional
the most common being high-fructose
is the real challenge. So fire up the oven
practice to exercise in your restaurant.
corn syrup. Your body makes no distinction
and get cooking.
but one 12-ounce soda contains that much
sugar. Unfortunately, most people consume
During digestion, complex sugars—fructose
which also occurs naturally in fruits and
cells. Added sugars, on the other hand, may
take the form of any number of sweeteners,
between natural and refined sugars.
When kids are offered chicken fingers,
Consequently, they are all broken down into
glucose. That means natural sugars are not
necessarily better for you than table sugar. In
other words, the focus should not be on the
type of sugar, but on whether it is replacing
other nutrients in your diet.
s Make sure you and your wait staff know
pizza and french fries, of course they are
exactly what is in every dish and the
going to eat it. In fact, they have grown
serving size.
accustomed to such staples of awayfrom-home foods and, thus, associate it
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with the dining-out experience. Yet, this
premier professional organization for
should not be the case. We need to begin
culinarians in North America. With
molding childrens' concepts of dining
more than 22,000 members spanning
out to encourage healthy eating behaviors.
230 chapters nationwide, ACF is the
Downsizing adult entrées to kid-friendly
culinary leader in offering educational
portions of lean meats or fish will not only
resources, training, apprenticeship and
expose their young, influential palates to
accreditation In addition, ACF operates
healthier cuisine, but also get them on the
the most comprehensive certification
right track to a healthy lifestyle. Think of it
program for chefs in the United States.
this way—by offering kids healthy portions
ACF is home to ACF Culinary Team
of foods, such as salmon, steamed vegetables
USA, the official representative for the
and couscous today, you will be increasing
United States in major international
your customer clientele for tomorrow.
culinary competitions, and to the Chef
KID’S MENU MAKEOVER
& Child Foundation, founded in 1989 to
BEFORE
4 fried chicken strips
promote proper nutrition in children and
to combat childhood obesity. For more
Walnuts are one of the American Diabetes
Association's top ten superfoods for diabetes.
information, visit www.acfchefs.org.
1 cup french fries
50 carbs
About Clemson University
schools, churches, restaurants. Clemson
AFTER
University, located in Clemson, S.C.,
3-ounce salmon
is ranked 22 among the nation's top
½ cup mixed vegetables
public institutions. Since 2001, Clemson
½ cup couscous
has doubled external research funding,
raised the academic profile of the
30 carbs
®
Dr. Margaret D. Condrasky, R.D.,
C.C.E., is an associate professor of
Food Science and Human Nutrition
at Clemson University. She leads the
CU CHEFS® program for improving
culinary nutrition skills.
CU CHEFS (Clemson University’s
student body, increased retention and
Cooking and Healthy Eating Food
graduation rates, launched high-profile
Specialists) instructional program,
economic development and has earned
led by Dr. Marge Condrasky, Associate
national accolades, including being
Professor in Food Science and Human
named TIME magazine's Public College
Nutrition, is a registered trademark
of the Year.
of Clemson University designed to
promote changes in menu planning,
Marie Hegler is a graduate of the
food purchasing, food preparation and
Food Science and Human Nutrition
food consumption behaviors with a
department with a culinary science
goal of fostering good health through
emphasis at Clemson University, which
healthy nutrition. ‘Culinary nutrition’ is
operates the CU CHEFS® program for
the application of nutrition principles
improving culinary nutrition skills.
combined with food science knowledge
displayed through a mastery of
About the American Culinary Federation
and the Chef & Child Foundation
culinary skills. The results are healthy
confidence and nutrition alertness.
CU CHEFS ® promotes an awareness
of the latest trends in foods and
nutrition through the demonstration
of proficient culinary skills to produce
The American Culinary Federation,
FOR MORE INFORMATION
eating behaviors grounded in culinary
flavorful, health-inspired menus for
The American Diabetes
Association’s Web site provides
all sorts of tools and resources to
prevent and cure diabetes while
improving the lives of all people
affected with the disease.
Visit: www.diabetes.org
Inc., established in 1929, is the
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