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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. w w w. a c f c h e f s. o rg | p a g e 1 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 w w w. a c f c h e f s. o rg | p a g e 2 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 w w w. a c f c h e f s. o rg | p a g e 3 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 w w w. a c f c h e f s. o rg | p a g e 4