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University of Georgia Cooperative Extension Why Change Eating Habits? • To prevent complications of diabetes – by keeping control of: • Blood glucose • Cholesterol • Blood pressure Why Change Eating Habits? • To improve your health – by making healthy food choices – and being physically active Carbohydrate and Diabetes • Include foods containing carbohydrate from whole grains, fruits, vegetables and low-fat milk in your diet Carbohydrate and Diabetes • The amount of carbohydrate at a meal affects your blood glucose more than the type – Sugar and starch have similar effects on blood glucose = Carbohydrate and Diabetes • Consistency in carbohydrate intake is important from day to day – For people not taking diabetes medication – For people taking a fixed dose of insulin • Insulin should be adjusted based on amount of carbohydrate at meals – For people on varying doses at meal times Carbohydrate and Diabetes • Several things affect how much your blood glucose increases after you eat: – amount of carbohydrate – type of sugar or starch – cooking and food processing – food form – other foods in the meal that slow digestion Carbohydrate and Diabetes • Limited amounts of sugar or foods containing sugar can be used without affecting blood glucose – when substituted for other carbohydrates at the meal • Large amounts of sugar-containing foods are not recommended Substituting Sweets Usual diet: 45 grams carbohydrate (or 3 Carbohydrates Choices) 1 slice bread 1/3 cup rice 1/2 cup fruit 3 ounces chicken Vegetable salad Substitute ice-cream for 15 grams of carbohydrate (or 1 Carbohydrate Choice) 1/2 cup ice-cream 1/3 cup rice 1/2 cup fruit 3 ounces chicken Vegetable salad Carbohydrate and Diabetes To observe effect of new food on blood glucose: • check blood glucose 2 hours after meal for several days • substitute food containing sugar for other carbohydrate in meal • check blood glucose 2 hours after meal and compare Sweeteners and Diabetes Sugar alcohols (polyols): sorbitol, mannitol, xylitol • Used as sweeteners and bulking agents • Safe to use • May cause diarrhea, especially in children Fructose: • Not recommended as a sweetener Sweeteners and Diabetes Low calorie sweeteners: are safe for people with diabetes when consumed within recommended levels Cans of soda Acesulfame K Aspartame Saccharin Sucralose Packets (maximum/day) (maximum/day) 25 15 2 4.5 18 86 7.5 60 Carbohydrate and Diabetes Fiber: • Fiber is encouraged for everyone: 20-35 grams/day • Good sources of fiber: – Whole grain cereals – Fruits – Vegetables – Beans and peas Carbohydrate and Diabetes Fiber: • Only large amounts (50 grams/day) have shown improvement in blood glucose and cholesterol – Primarily soluble fiber (barley, oatmeal, beans, apples, broccoli) – Side effects make this difficult for many people Protein and Diabetes • Protein has very little effect on blood glucose • Avoid large amounts of protein – may promote kidney disease • Restrict protein only if you have early kidney disease Protein and Diabetes • Protein does not slow the absorption of carbohydrate – Adding protein to snacks does not help prevent hypoglycemia – Fruit or crackers are good snack foods Protein and Diabetes • Safety of high protein, low carbohydrate weight loss diets are unknown – do not promote long-term weight loss – may increase LDL cholesterol Dietary Fat and Diabetes • Primary goal - Lower LDL cholesterol by: –Eating less saturated fat and cholesterol –Eating less trans fats Dietary Fat and Diabetes Foods That Contain Saturated Fats: • Meat and meat fats (bacon, lard) • Dairy products (whole milk, butter, cheese, cream, ice-cream) • Palm and coconut oil • Baked goods made from these fats Dietary Fat and Diabetes Foods That Contain Trans Fats: • Formed when a liquid oil is made more solid • Found in many types of stick margarine, fast foods, and baked goods like cookies, crackers, snack foods, pastries and croissants Dietary Fat and Diabetes Foods That Contain Cholesterol: • All animal foods • Organ meats like liver • Egg yolks Dietary Fat and Diabetes • Choose monounsaturated fat in place of saturated: – olive oil, canola oil, peanut oil, olives, avocados, nuts Dietary Fat and Diabetes • Eat less total fat • Low-fat diets can help: – with weight loss – improve cholesterol and other fats Dietary Fat and Diabetes • Eat 2-3 servings fish per week – contain a type of fat protective against heart disease – fatty fish especially beneficial Weight Loss and Diabetes A small amount of weight loss can: • improve insulin resistance • lower blood glucose • improve blood cholesterol • reduce blood pressure Weight Loss and Diabetes Successful weight loss usually requires: • a structured weight loss program • education • reduced fat and calories • regular physical activity • frequent follow-up Vitamins and Minerals and Diabetes • Vitamins and minerals from foods important • High doses of vitamin and mineral supplements can be toxic Vitamins and Minerals and Diabetes People who may benefit from a multivitamin supplement: • persons deficient in a vitamin or mineral • elderly • pregnant or nursing mothers • strict vegetarians • persons on calorie-restricted diet Vitamins and Minerals and Diabetes • No clear benefit from vitamin and mineral supplements except – calcium for prevention of bone disease – folate for prevention of birth defects • Use of antioxidants is not advised – vitamin C, E, selenium, beta carotene – long-term safety and effectiveness unknown Alcohol and Diabetes • If you choose to drink, limit to: – 1 drink/day for women – 2 drinks/day for men • To reduce risk of hypoglycemia, consume alcohol with food High Blood Pressure and Diabetes You can lower blood pressure by: • Eating less salt • Losing a modest amount of weight Preventing Diabetes Family members of people with Type 2 diabetes can prevent diabetes by: • Weight loss if overweight – using a structured weight loss program • Regular physical activity The Bottom Line Your lifestyle affects your health Eat healthy foods Daily Physical Activity