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Diabetes and
Nutrition
Lesson 2
Expand Your Options, Improve Your Choices
Objectives
• Meal Plans for Diabetes
– Diabetes Pyramid/My Pyramid
– Exchange list
– Plate Method
– Carbohydrate Counting
• General Nutrition Recommendations
• Reading the Food Label
Managing Diabetes Successfully
Involves three things:
• Food
• Exercise
• Medication
Did You Know??
• Food raises blood glucose
• Exercise and medication lowers it
• Balance these three to keep blood glucose
level close to normal.
Diabetes Facts
Food choices can make a difference in blood
Glucose control.
• You don’t need special
foods
• The foods that are good
for you are good for
everyone
• Eat a variety of foods
that contain the right
amount of nutrients
The Diabetes Pyramid
Healthy Food Choices
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A healthy daily meal plan includes at least…
2 to 3 servings of nonstarchy vegetables
2 servings of fruit
6 servings of grains, beans, and starchy
vegetables
2 servings of low-fat or fat-free milk
About 6 ounces of meat or meat substitutes
Small amounts of fat and sugar
The Plate Method
Which Plate is Better??
A 10 inch dinner plate-a typical
dinner plate
A 8 inch dinner platethis is the recommended
plate to use
The Plate Method
Fruit = Milk = Starch
• Sometimes, if you want an extra starch during
a meal, you just need to omit a fruit or milk
from that meal.
Visualize Portion Sizes
• 1 cup pasta/rice is about the size of a fist.
• 1 oz of cheese is about the size of your thumb.
• 1 or 2 oz of crackers, nuts, or snack crackers
equals a handful.
• 1 fruit is about the size of a tennis ball.
Exchange List for Meal Planning
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Oldest method for meal planning.
Based on Dietary Guidelines and My Pyramid.
Includes a variety of foods.
Emphasizes label reading and most exchanges
are listed under the food label.
Carbohydrate Counting
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Newest method of meal planning.
Type 1 or Type 2 can use.
Requires reading the food label.
Requires constant blood sugar monitoring.
When reading the food label, look at total
carbohydrate grams only.
• Carbohydrates are found in milk,
breads/starches, fruit and starchy vegetables
only!
Know Your Carbohydrates
Food
Grams of
Carbs/Serving
Starch/Bread
15 grams
Fruit
15 grams
Milk
12 grams
Vegetables
5 grams
Meat
0 grams
Fat
0 grams
More on Total Carbs…
• Helpful for carb
counters.
• Look at the total
carbohydrates not the
grams of sugar.
• Total carbohydrates
include: sugar, complex
carbohydrates, and
fiber content.
• When a food has 5 g or
more of fiber per serving:
– subtract half the fiber
grams from the total
grams of carbohydrate
for a more accurate
estimate of the
carbohydrate content.
Sample 1800 calorie Carbohydrate
Counting Meal Plan
• Breakfast:  2 servings of starch, 1 fruit serving, 1 milk
serving, 1 meat serving, 1 fat serving.
• Lunch:  2 starch servings, 1 fruit servings, ½ milk serving, 2
vegetable servings, 2 meat servings, 2 fats.
• Dinner:  2 starch servings, 1 fruit serving, 2 vegetable
servings, 3 meat servings, 2 fats.
• Snack:  1 starch serving, 1 fruit serving, ½ milk serving.
• This meal plan is approximately 60 g of
carbohydrates per meal and 30 g of carbohydrates
per snack.
Examples of One Carbohydrate Choice
Snacks
• 1 ounce granola bar
• 3 graham crackers with 1
tbsp. peanut butter
• 3 cups popped non-fat
popcorn
• 6 animal crackers
• 1 small muffin
• A 3 inch cookie
• 1 medium apple, orange,
pear
• 12-15 cherries or grapes
• ¼ cup dried fruit
• 1 cup soy milk
• ¾ to 1 cup yogurt
• ½ cup sugar free pudding
Portion Control Is The Key To
Managing Your Diabetes
• Which will have the greater effect on your
blood sugar, 1 tsp of sugar or ½ cup
potatoes??
– Potatoes have 15 g of Carbohydrate, while 1 tsp.
of sugar has only 4 g of carbohydrate. Therefore,
potatoes have 3 times the effect on blood sugar
than table sugar would.
2008 ADA Recommendations for General
Meal Planning for Persons with Diabetes
• Meal plan should include fruits, vegetables, legumes,
low-fat dairy products, lean meats, and whole grains.
• You can eat sugar containing foods, but your meal
plan will be adjusted.
• Monitor carbohydrate intake.
• Consume 25-35 grams of fiber.
• Avoid Skipping meals.
More Recommendations
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Sugar alcohols and artificial sweeteners are safe.
Limit saturated fat intake.
Limit trans fat intake.
Eat fish at least 2x’s per week.
Moderate alcohol intake.
Consume a meal plan that if low in fat,
cholesterol, sodium, and calories
Increase physical activity or exercise.
Continuously monitor blood sugar levels.
Check with physician for vitamins.
Lose weight if you are told to.
Alcohol
• Limit/control your intake of alcohol.
• Ask yourself the three questions to determine
if you can drink.
– Is my diabetes under control?
– Does my doctor agree that I do not have any
other problems that alcohol can affect?
– Do I know how alcohol can affect my diabetes
and me?
A Drink Is Defined As:
Avoid Low Blood Sugar When Drinking
• Never drink on an empty
stomach.
• Limit yourself to 1 or 2
drinks.
• Test your blood sugar
before you drink and once
while drinking.
• Make sure to test before
going to bed and eat a
snack!
• Serving Size
• Servings Per Container
• Calories and Calories
from Fat
• Nutrients with % Daily
Value
• Footnote (Only found on
larger packages)
Stated in Household
and Metric Measures
Servings Per Container tells you how many servings are
in a package.
There are 2 servings in this package.
The label shows that 1 cup is a serving.
If you consume 2 cups you are having two servings.
Labels include the total calories as well as the
calories from fat
General Guide to Calories per serving:
– 40 calories is low
– 100 calories is moderate
– 400 calories or more is high
Based on Daily Value recommendations
Only for a 2,000 calorie diet
Trans Fats
Sugars
Protein
Limit these nutrients
Get enough of these
Based on 2,000 and 2,500 calorie diets
Only found on larger packages
Nutrient
*DV
%DV
Goal
Total Fat
65g
100% DV
Less Than
**Sat. Fat
20g
100% DV
Less Than
Cholesterol
300mg
100% DV
Less Than
Sodium
2400mg 100% DV
Less Than
Total ***CHO
300g
100% DV
At Least
Dietary Fiber
25g
100% DV
At Least
*DV = Daily Value; **Sat. Fat = Saturated Fat; ***CHO (carbohydrate)
List of ingredients
found in the food
product
Listed in
descending order
by weight, from
the most to the
least
Be informed.
Determine the best choices.
Eat a variety of foods.
Points To Remember About
Diabetes Meal Planning
• Actual amounts of each depend on the
number of calories you need.
• Calorie needs depend on your gender, size,
age, and activity level.
• Meal planning with diabetes is very
individualized.
• Get a personalized meal plan from a
Registered Dietitian or Certified Diabetes
Educator.
References
• American Diabetes Association, www.diabetes.org
• American Dietetic Association, www.eatright.org
• Mahan,L.K. and Escott-Stump, S. Krause’s Food, Nutrition, and Diet
Therapy. 10thed. 2000.
• Diabetes Medical Nutrition Therapy. American Dietetic and Diabetes
Association. 2002.
• LSU AgCenter’s Diabetes Education and Awareness Program.
• University of Illinois Extension Service.
• American Dietetic Association & American Diabetes Association Guide to
Diabetes Medical Nutrition Therapy, CD-ROM 2008.
• Amercian Diabetes and Dietetic Association’s “Choose Your Foods:
Exchange Lists for Diabetes.” 2008.
• University of Idaho Extension Service. “The Idaho Plate Method.”
References
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University of Georgia Extension Service.
http://www.fcs.uga.edu/ext/food/diabetes.php
U.S. Food and Drug Administration, Center for Food Safety
and Applied Nutrition - www.cfsan.fda.gov
Keeping Up with the Changing Food Label: International
Food Information Council (IFIC) – www.ific.org
Understanding Food Labels, American Dietetic Association
Food Label Presentation Developed By: Cathy Agan,
Extension Agent (FNP), Ouachita Parish and Adapated by
Bertina McGhee, MPH, RD, LDN; Extension Agent, Orleans
Parish.
Diabetes and Nutrition
Prepared By:
Mandy G. Armentor, MS, RD, LDN
Assoc. Extension Agent-FCS (Nutrition)
Vermilion Parish