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Diabetes Symposium 2015

Power of the Plate: Nutrition and Diabetes

http://www.vinafengshui.com/wp-content/uploads/2014Presentation PurposeTo increase knowledge about identifying carbohydrates, carbohydrate counting, and portion sizes of carbohydrates

To understand the important role of the diet in diabetes

There are no conflicts of interest to disclose.Presentation Objectives Identify major food groups with carbohydrates Understand the importance of portion sizes, and identify portion sizes of carbohydrates Recognize the benefits and impact of good nutrition on diabetes

What is Diabetes?Diabetes mellitus is a disorder in which the body either does not produce enough insulin, or is unable to use the insulin it makesType 2 diabetes does not produce enough insulinType 1 diabetes is unable to use the insulin it makes

Diabetes is all about BalanceControlling diabetes is a balance of what you eat, how much you move, and what medicine you takeSome people with type 2 diabetes can control their blood sugar with diet only. Some people take medicine by mouth and watch their diet. Others may take insulin, medicine, and watch their dietIt is most important to keep your blood sugar levels under controlDiabetes and DietThe food we eat is fuel for our bodiesThe body breaks down food into glucose, or sugarThe body uses insulin to move the glucose into our cells to give us energyIf glucose cannot enter our cells, it builds up, causing high blood sugar (hyperglycemia)Diabetes and Diet (cont.)Food raises blood glucoseWhen you eat, how much you eat, and what you eat affects how much your blood sugar increases.All foods are made up of protein, fat, carbohydrates, vitamins, and mineralsCarbohydrates impact and increase blood sugar levels the mostWhat are Carbohydrates?Carbohydrates are foods that break down into sugar, or glucose, in the bodyThere are several groups of foods that contain carbohydrates, including sweets, fruit, starches, and milk/yogurt

https://www.google.com/search?hl=en&site=imghp&tbm=isch&source=hp&biw=1229&bihSweetsCakes, cookies, candy, chocolate, regular pop

http://andreakihlstedt.com/wpsys/wp-content/cropped-chocolate-chip-cookies-stacked.jpg

http://www.kusi.com/story/28995262/soda-tax-legislationFruitAll fruit has a naturally-occurring sugar called fructose.

http://www.teluguone.com/vanitha/content/health-benefits-of-fruits-75-24004.htmlStarchesIncludes bread, cereals, grains, pasta, rice, beans, and starchy vegetables (potatoes, corn, peas)

https://thedentalessentials.wordpress.com/2010/11/28/

http://jj-tropicalfood.com/product/corn/

http://www.ronchalker.co.uk/products/potatoes/Milk and YogurtMilk and yogurt products have naturally occurring sugar called lactose.

http://smariorganics.com/our-yogurt/Foods Without CarbohydratesProtein and fat groups contain ZERO carbohydratesProtein: meat, poultry, fish, cheese, eggs, peanut butter, cottage cheeseFat: butter, oils, margarine, mayonnaise, cream cheese, sour cream, nuts, seeds, avocado, salad dressing

https://thathealthygirlau.wordpress.com/2014/02/15

http://www.practitionerselect.com/You-Need-Nutrients-s/1885.htmA Word on Artificial SweetenersThe scientific community, along with the US FDA, has conducted hundreds of studies on the safety of approved low-calorie sweeteners: Consumption of these sweeteners is well within designated acceptable daily intake (ADI) levels, or levels that can be consumed safely every day over a lifetime.FDA Approved Low-Calorie Sweeteners:Splenda (sucralose), Equal(aspartame), Sweet N Low (saccharin), Truvia (stevia), and othersArtificial Sweeteners (cont.)Scientific Positions:Academy of Nutrition and Dietetics: Non-nutritive sweeteners, when substituted for nutritive sweeteners, may help limit carbohydrate and energy intake as a strategy to manage blood glucose or weight.Non nutritive sweeteners added to the diet have been shown to promote modest loss of weight and, within a multidisciplinary weight-control program, may facilitate long-term maintenance of reduction in body weight.

imgarcade.com550273Artificial Sweeteners (cont.)American Heart Association and American Diabetes Association: Substituting non-nutritive sweeteners for sugars added to foods and beverages may help people reach and maintain a healthy body weight, as long as the substitution does not lead to eating additional calories later as a compensation.

Eatdrinkbetter.com

http://www.walmart.com/ip/Monk-Fruit-In-The-RawCarbohydrate Counting: A Meal Planning Approach for DiabetesBased on the following ideas:Carbohydrates are the main nutrients affecting blood sugar levels after mealsTotal amount of carbohydrates consumed is more important than the source of carbohydratesHow to Count CarbohydratesOne serving of carbohydrates is about 15 grams There is about 1 serving of carbohydrate (15 grams) in 1 slice of bread, cup fruit juice, cup of ice cream, and 8 ounces of milkThe number of carbohydrates you should have at a meal depends on your weight, blood sugars, and lifestyleA good rule of thumb is to have about 45-60 grams of carbohydrates per meal, per dayTiming of Carbohydrates with MealsIf you eat a lot of carbohydrates at one time, it increases the need for insulinIt takes more insulin to bring down a high blood sugar level than to keep your blood sugar level in a normal rangeTo help keep your blood sugar in a normal range, eating 3 meals/day and a snack, or 6 small meals/day, can help do this, depending on your lifestyle and medicineYou can work with a diabetes nurse or dietitian to help youTiming of Carbohydrates with MealsTo help keep your blood sugars in a normal range, it is important to:Eat the same amount of carbohydrates for each meal or snackDo not skip mealsEat breakfast every day

http://blog.prepscholar.com/how-to-get-36-on-act-english-9-strategies-fromBenefits of Carbohydrate CountingIt is more flexible than other meal planning methodsSugar is not forbiddenFocuses attention on the foods most likely to make blood sugar levels go upTools to Count CarbohydratesNutrition LabelsMeasuring toolsPortion GuidesNutrition LabelsTotal Carbohydrate: includes grams of sugar, sugar alcohol, starch, and dietary fiberTotal Grams of Carbohydrate: to determine amount of carbohydrates eaten, multiply grams of total carbohydrates on the label by the number of servings eaten

Measuring ToolsMeasuring CupsMeasuring SpoonsFood Scale

Ebay.com.auhttp://pixhder.com/dry+measuring+cups+clipart

Overstock.comCarbohydrate Counting Hand Guide

http://www.diabeticlivingonline.com/food-to-eat/count-carbs/easy-practical-tips-counting-carbs-accuratelyCarbohydrate Counting in Action!Please refer to handout on carbohydrate foods, so we can practice carbohydrate counting.Carbohydrate Counting in ActionPour your breakfast cereal into a bowl! It should equal cup, which equals about 15 gramsWith milk, cereal and milk typically equal about 30 grams of carbohydrates for breakfast

http://www.consumerreports.org/content/dam/cro/news_articles/health/CRO_Health.jpngCarbohydrate Counting in ActionPortion Distortion: Beware!Larger sizes of plates and bowls can make us add more food to the plate or bowlThis is why it is so important to measure carbohydrates, and consider eating from smaller plates or bowls

http://thedietitianspantry.com/2014/02/28/portion-perfection-or-portion-distortion/Carbohydrate Counting in ActionPour 1 serving of 100% fruit juice!It should equal cup, which is about 15 grams.

http://www.mairlynsmith.com/?p=2332The glass on the right is the correct serving size, or cup juice. Carbohydrate Counting in ActionMeasure 1 serving of pasta!It should equal 1/3 cup, which is about 15 grams.

http://img2.timeinc.net/health/images/gallery/eating/carbs-wheat-pasta-400x400.jpgCarbohydrate Counting in ActionMeasure one serving of a baked potato!It should equal 3 ounces, which can be measured with a food scale

http://abcnews.go.com/Health/10-filling-foods-weight-loss/story?id=21153507So what about the rest of my plate?The MyPlate Method

https://www.eatsmart.org/client_assets/Images/myplate_white.jpgThe MyPlate Method and DiabetesThe MyPlate method has 3 choices of carbohydrates per plate (45 grams), and fits in with carbohydrate countingThis method can also make eating healthier and keeping track of carbohydrates more approachable

http://www.choosemyplate.gov/aboutKeep Your Plate BalancedYour plates should include:1 cup of nonstarchy vegetables 1 cup or 1 medium piece of fruit3 ounces of lean meat/protein cup of carbohydrate8 oz. or 1 cup low fat dairy

http://www.melaniealbertfitness.com/styled-5/MEALPLANS.htmlRememberAll of the carbohydrates in your meal include all of the starches, fruit, and dairy you eatThis total should equal around 45-60 grams per meal

Wholeheartedmen.comWhy Balance My Plate?Good nutrition can greatly benefit diabetics:Help keep blood sugar ranges as normal as possibleHelp maintain cholesterol ranges as normal as possibleProvide appropriate calories that can help with weight managementPrevent or delay long term diabetes complications, including neuropathy, kidney failure, retinopathy, etc. Improve your overall health!ExerciseExercise works like a medicineIt helps with insulin resistance: physical activity burns more calories (and glucose), and helps the insulin you make work betterAlways check with your doctor before starting an exercise regimen to see what will work best for youStart slowly when beginning a new exercise routine

http://vivesse.net/blog/study-shows-exercise-can-keep-skin-healthy/SummaryControlling diabetes is a balance of food, exercise, and medicineMake small changes in your eating habits to positively affect your weight, blood sugar, and the overall management of diabetesDiabetes ResourcesThe Calorie King: Calorie, Fat, and Carbohydrate Counterwww.calorieking.comAvailable at WalmartDiabetic Livingwww.diabeticlivingonline.comAvailable at Walmart or KrogerDiabetes Self Management: magazine published bimonthly$18.00 per yearwww.diabetesselfmanagement.com

Diabetes Resources (cont.)Diabetes Forecast: healthy living magazine of American Diabetes Associationwww.diabetes.org/diabetesforecastDiabetes Health: monthly magazinewww.diabeteshealth.com

ReferencesCaso EK. Calculation of diabetic diets. J Am Diet Assoc. 1950; 26:575-583.Evert AB, Boucher JL, Cypress M et al. Nutrition Therapy Recommendations for the Management of Adults with Diabetes (a position statement of the American Diabetes Association). Diabetes Care. 2013; 36: 3821-3842. Wheeler ML, Dunbar SA, Jaacks LM, et al. Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of literature, 2010. Diabetes Care. 2012; 35: 434-445.Thomas E. Surgery reveals shortfall in pediatric nurses knowledge of diabetes. J Diabetes Nurs. 2004; 8:217-231.American Dietetic Association, American Diabetes Association. Exchange lists for Meal Planning. 2nd ed. Alexandria, VA. American Diabetes Association, 2003.American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care. 2007; 30:54-541.Warshaw H, Bolderman K. Practical Carbohydrate Counting, A How to Teach Guide for Health Professionals. Alexandria, VA: American Diabetes Association, 2001.Position of the Academy of Nutrition and Dietetics: Use of Nutritive and Nonnutritive Sweetener. Journal of the Academy of Nutrition and Dietetics May 2012 Volume 11 Number 5.Gardner, C et al. Nonnutritive Sweeteners: Current Use and Health Perspectives: A Scientific Statement from the AHA and the ADA. Circulation, 2012; 126:509-519.IFIC Foundation. Facts About Low-Calorie Sweeteners, 9/2014. www.foodinsight.org.

Questions?