“Nutrition Insight for Managing Diabetes”
By: Alan Lee, RD, CDE, CDN, CFT
Diabetes is a chronic condition that is a great concern for all folks in America. An alarming rate of prevalence of diabetes is seen in all age groups. We all can move the needle higher and adopt self-management habits that move us towards a healthier lifestyle.
What can you do to prevent diabetes? What can you do to take control and eat well if you are currently living with diabetes? No longer is diabetes a problem for those with “bad genes” or the rich, but rather a problem caused by sedentary lifestyles, too much “screen time”, perception that healthy foods costs too much, and crazy large food portions. Approximately 29 million or 9% of the United States (US) population has diabetes in 2012. Over 11 million seniors (1 in 4) have diabetes or pre-diabetes. Diabetes is currently the seventh leading cause of death.
Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include obesity and being overweight, family history, impaired glucose tolerance, physical inactivity, history of gestational diabetes and race/ethnicity. African Americans, Latino Americans, Asian Americans & Pacific Islanders, and American Indians are particularly at high risk for developing type 2 diabetes.
The good news is that diabetes is a PREVENTABLE disease. We can sharply lower the chances of getting diabetes with proper nutrition and exercise. The Diabetes Prevention Program (DPP) was the first major clinical trial conducted in the US to show that proper nutrition and exercise can effectively delay the onset of diabetes in a diverse American population of overweight people with impaired glucose tolerance (IGT). IGT is a condition that often precedes diabetes and indicates blood glucose levels are higher than normal but not yet to diabetic levels. The DPP involved over 3,200 people comprised of 45% minority groups that included African Americans, Latino Americans, Asian Americans & Pacific Islanders, and American Indians. Participants who made lifestyle changes reduced their risk of getting type II diabetes by 58%! That is a remarkable finding considering all it took was following a healthy low-fat diet and doing moderate physical activity of 30 minutes a day 5 days a week! Most people chose walking as their form of physical activity. Talk to your doctor before you engage in any physical activity program.
For people already living with diabetes, there are self-management behaviors you can adopt to prevent complications associated with diabetes. Complications may include: heart disease, stroke, high blood pressure, blindness, kidney disease, neuropathy and complications with a pregnancy. Here are some of my recommendations to help you manage your weight and keep your blood sugar levels under control:
- Consume no more than 50% of calories as carbohydrates and choose high fiber carbohydrates, whole-grains, and plenty of non-starchy vegetables. When you are living with diabetes, it is especially important to be mindful of the amount of total carbohydrates you eat. In general, women want to aim for 3-4 carbohydrate choices per meal (1 cup of rice=3 carbohydrate choices) and men want to aim for 4-5 carbohydrate choices per meal (1⅓ cup of rice=4 carbohydrate choices). One choice (or serving) of carbohydrate has 15 grams in it. For a customized carbohydrate-controlled eating plan, visit a health-care professional that specializes in nutrition & diabetes care like a Certified Diabetes Educator (CDE) or Registered Dietitian (RD).
- Keep saturated fat (whole milk, sour cream, butter, lard, cream cheese, beef tallow, coconut and palm oil) intake low.
- Use olive, corn, peanut, sesame, or canola oil in your cooking instead of animal-derived oils.
- Choose foods rich in omega-3 polyunsaturated fatty acids (fatty fish, walnuts, flaxseed) and monounsaturated fat acids (avocados, nuts, seeds).
- Consider eating small frequent meals every 3-4 hours. Eating 4-6 times/day is important to keep your blood sugar stable.
- Men should aim for 25-38 grams of fiber per day and women should aim for 20-25 grams of fiber per day.
- Choose whole fruit as a dessert with a meal and avoid excessive fruit juice intake. Avoid intake of sweets and excess carbohydrates (soda, sweet tea, Kool-Aid, candy).
- Ok to use high intensity non-nutritive sweeteners [aspartame (Equal), sucralose (Splenda), stevia (Truvia)] to satisfy your desire for sweets. Unless for YOU, consuming sugary tastes leads you to want more….then JUST SAY NO.
- What about my java? According to the 2015 Dietary Guidelines For Americans, good evidence suggests that 3-5 cups of regular coffee (200-400 mg of caffeine) is safe to consume daily. Have your last cup well before you are going to need to fall asleep so it does not affect your sleep quality.
- Get 6 to 8 hours of sleep each night as a sleep deficit may lead to decreased glucose tolerance.
In conclusion, you can live well with diabetes, eat healthfully on a budget, and be smart in the supermarket. A little planning goes a long way.
About The Author:
Alan Lee, RD, CDE, CDN, CFT is available for nutrition counseling and education to members of The Eating Well Nutrition Program at TOUCH for people living with chronic illness. He has been the Registered Dietitian/Nutritionist at TOUCH since 2001. He is a well-respected nutrition expert and has given presentations around the globe from London to Vancouver and the Caribbean. He did his dietetic internship at New York Presbyterian Hospital and graduated from New York University. You can also stay in touch with Alan via email anytime at AlanLeeRD@yahoo.com or by leaving at voicemail at (212) 229-2298.