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The Basics of a Healthy Diabetes Diet

From: http://diabetes.webmd.com/diabetes-diet-healthy-diet-basics?ecd=wnl_dia_021109

Contrary to what you may have heard, there is no " diabetes diet,"
per se -- and that's good news! The foods recommended for a diabetes
diet to control blood glucose (or sugar) are good for those with
diabetes -- and everyone else. This means that you and your family
can eat the same healthy foods at mealtime. However, for people with
diabetes, the total amounts of carbohydrates consumed each day must
be monitored carefully. Of the different components of nutrition -- carbohydrates, fats, and proteins -- carbohydrates have the greatest
influence on blood sugar levels. Most people with diabetes also have
to monitor total fat consumption and protein intake, too.

To keep your blood sugar levels in check, you need to make healthy
food choices, exercise regularly, and take the medicines your health
care provider prescribes. A dietitian can provide in-depth nutrition
education to help you develop a personalized meal plan that fits your
lifestyle and activity level, and meets your medical needs.

Learn the ABCs of a Diabetes Diet

The goal of nutrition for people with diabetes is to attain the ABCs
of diabetes. The A stands for the A1c or hemoglobin A1c test, which
measures average blood sugar over the previous 3 months. B is for
blood pressure, and C is for cholesterol. People with diabetes should
attain as near as normal blood glucose control (HbA1c), blood pressure,
and healthy cholesterol level.

Alcohol and Diabetes

Use discretion when drinking alcohol on a diabetes diet. Alcohol is
processed in the body very similarly to the way fat is processed, and
alcohol provides almost as many calories as fat. If you choose to
drink alcohol, only drink it occasionally and when your blood sugar
level is well-controlled. It's a good idea to check with your doctor
to be sure drinking alcohol is acceptable.

Diabetes and Glycemic Index

For years, researchers have tried to determine what causes blood sugar
levels after meals to soar too high in those with diabetes. Potential
culprits have included sugar, carbohydrates, and starches, among other
foods. The glycemic index is a ranking that attempts to measure the
influence that each particular food has on blood sugar levels. It takes
into account the type of carbohydrate in a meal and its effect on blood
sugars.

Foods that are low on the glycemic index appear to have less of an impact
on blood sugar levels after meals. People who eat a lot of low glycemic
index foods tend to have lower total body fat levels. High glycemic index
foods generally make blood sugar levels higher. People who eat a lot of
high glycemic index foods often have higher levels of body fat, as
measured by the body mass index (BMI).

Talk to your doctor, a registered dietitian, or a diabetes educator and
ask if the glycemic index might work to help gain better control of your
blood sugar levels.

The glycemic load takes into account the effect of the amount of
carbohydrates in a meal. Both the type of carbohydrate and the amount
have an effect on blood sugars.

Eating Right on a Diabetes Diet

If you have diabetes, it's important to eat right every day to keep
your blood sugar levels even and stay healthy.

Here's some easy tips:
* Be sure to eat a wide variety of foods. Having a colorful plate is
the best way to ensure that you are eating plenty of fruits, vegetables,
meats, and other forms of protein such as nuts, dairy products, and grains/cereals.
* Eat the right amount of calories to maintain a healthy weight.
* Choose foods high in fiber such as whole grain breads, fruit, and
cereal. They contain important vitamins and minerals. You need 25 to
35 grams of fiber per day. Studies suggest that people with type
2 diabetes who eat a high fiber diet can improve their blood sugar
and cholesterol levels. Similar results have been suggested in some
studies in people with type 1 diabetes.

Serving Sizes and Diabetes

Be sure to eat only the amount of food in your diabetes meal plan.
Excess calories result in excess fat and excess weight. In people with
type 2 diabetes, excess body fat means less sensitivity to insulin.
Weight loss in overweight and obese people with type 2 diabetes helps
improve blood sugars and reduces those risk factors which lead to heart
disease. Your dietitian can help you determine the appropriate serving
sizes you need, depending on if you need to maintain your weight, gain
weight, or lose weight, and if you have high or low blood sugar levels.

* In women with gestational diabetes, it's important to eat multiple
meals and snacks per day as recommended.
* Do not skip meals.
* Eat meals and snacks at regular times every day. If you are taking a
diabetes medicine, eat your meals and take your medicine at the same
times each day.

Note:
If you are taking some of the newer diabetes medicines, some of these
tips may not apply to you; ask your health care provider the tips you
should follow.

The Sweet Truth about Food and Diabetes

You might have heard that, as a person with diabetes, you shouldn't have
any table sugar. While some health care providers continue to promote
this, many -- realizing that the average person lives in the real world
and will probably indulge in a bit of sugar every now and then -- have
adopted a more forgiving view. Most experts now say that small amounts
of sugar are fine, as long as they are part of an overall healthy meal
plan. Table sugars do not raise your blood sugar any more than similar
amounts of calories from starches, which is found in many foods that
we consume. It is important to remember that sugar is just one type of carbohydrate.

When eating sugar, keep these tips in mind:

* Read food labels. Learn how to determine how much sugar or carbohydrates
are in the foods that you eat.
* Substitute, don't add. When you eat a sugary food, such as cookies,
cakes, or candies, substitute them for another carbohydrate or starch
(for example, potatoes) that you would have eaten that day. Make sure
that you account for this in your carbohydrate budget for the day. If
it is added to your meal for the day, then remember to adjust your
insulin dose for the added carbohydrates so you can continue to maintain
glucose control as much as possible. In other words, readjust your
medications if you do add sugars to you meals.
* Sugary foods can be fattening. Many foods that have a lot of table
sugar are very high in calories and fat. If you are watching your
weight (and many people with diabetes must), you need to eat these
foods in moderation!
* Check your blood sugar after eating sugary foods and talk to your
health care provider about how to adjust your insulin if needed when
eating sugars.
* Ultimately, the total grams of carbohydrates -- rather than what
the source of the sugar is -- is what needs to be accounted for in
the nutritional management of the person with diabetes.

Diabetes Diet Myths

Before you start a diabetes diet, get the facts. So many people believe
that having diabetes means you must avoid sugar and carbohydrates at all
cost, load up on protein, and prepare "special" diabetic meals apart
from the family's meals. Wrong! Most individuals with diabetes can
continue to enjoy their favorite foods, including desserts, as long
as they monitor the calories, carbs, and other key dietary components
and keep a regular check on their blood glucose levels.

Diabetes Diet Q&A
What Is the TLC Diet for Diabetes?

People with diabetes who have abnormal cholesterol levels will likely
be placed on a diet known as a "TLC" diet. The TLC diet will help reduce
the intake of cholesterol-raising nutrients. As part of this diet you
may be asked to lose weight and increase physical activity levels -- all
of these are components that will help lower bad LDL cholesterol. Looking
at food labels will help you become more knowledgeable about your intake
of fats and cholesterol.

Specifically, the TLC diet calls for the following:

* Total fat consumption should be 25%-35% or less of total calories eaten
per day.
* Saturated fats should be less than 7% of total calories eaten in a day.
* Polyunsaturated fats (from liquid vegetable oils and margarines low in
trans fats) should be up to 10% of the total calories per day consumed.
* Monounsaturated fats (derived from vegetable sources like plant oils
and nuts) should be up to 20% of total calories per day eaten.
* Carbohydrates should be 50%-60% of total calories per day eaten
* We should eat 20-30 grams of fiber per day. These can be derived from
oats, barley, psyllium, and beans.
* The amounts of protein in the diet should equal about 15%-20% of total calories eaten per day.
* Cholesterol content of the diet should be less than 200 milligrams per
day.

How Much Fat Is Acceptable on a Diabetes Diet?

People with diabetes have higher than normal risk for heart disease,
stroke, and disease of the small blood vessels in the body. Controlling
blood pressure and limiting the amount of fats in the diet will help
reduce the risk of these complications.

Limiting the amounts of saturated fats, increasing the amount of regular
exercise, and receiving medical treatment can lower bad LDL cholesterol.
This has been repeatedly shown in medical studies to help people with
diabetes reduce their risk of heart disease and reduce the risk of death
if a heart attack does occurs in a diabetic person.

Can I Use Artificial Sweeteners on a Diabetes Diet?

Artificial sweeteners can be added to a variety of foods and beverages
without adding more carbohydrates to your diabetes diet. Using non-caloric
artificial sweeteners instead of sugar also greatly reduces calories in
your favorite foods.

Keep in mind that foods with artificial sweeteners are not necessarily
'no' carbohydrates foods. Many have carbohydrates; therefore, you must
read the food labels to determine the gram amounts per serving that
these have in order to take into account the effect that these
carbohydrates have on your glycemic control. Foods labeled with
artificial sweeteners can affect your blood sugars.

As long as you are aware of the content of carbohydrates you can adjust
your meal or medication to maintain blood glucose control. Sugar free
means no sugar has been added, but you must remember these foods still
contain carbohydrates which does affect your blood sugars.

Examples of artificial sweeteners you can use include:
* Aspartame
* Acesulfame-k
* Saccharine
* Sucralose
* Other non-nutritive sweeteners

Pregnant or breastfeeding women should avoid saccharine, and people who
suffer from phenylketonuria should not use aspartame. People with
phenylketonuria are unable to metabolize phenylalanine, an amino acid
that's a common part of many proteins.

Some artificial sweeteners -- such as xylitol, mannitol, and sorbitol
-- have some calories and do slightly increase blood sugar levels.

The American Diabetes Association cautions that eating too much of any
artificial sweetener can cause gas and diarrhea.