Erickson Tribune

Health Secrets

UPDATED: Tuesday, January 17, 2006

More Flexible Diets, More Food Choices-Exciting Changes in Diabetes Nutrition

Posted on Tuesday, November 01, 2005
 

By Wendy J. Meyeroff
THE ERICKSON TRIBUNE

“I’ve stopped smoking. I’ve stopped drinking. Now I can’t eat either?!”

That’s the reaction many people seem to have when they’re first diagnosed with diabetes.

It’s a major misconception. “You can have carbohydrates and some sweets. The key is how you do it,” says Dee Cary, R.D., C.D.E, a dietitian at Charlestown, a community in Maryland built and managed by Erickson. That means planning plus adapting, to new ways to eat.

The Importance of Carbohydrates

Many older people are not aware of a change that occurred in dietary recommendations in 1993. “Instead of focusing on sugar intake, the American Diabetes Association told dietitians to help patients focus more on carbohydrates. It’s recommended that carbohydrates should be about 50 percent of diets for people with diabetes,” says Cary.

Simple carbs are sugars that absorb quickly into your system, including table sugar, fruit juices, and honey. Complex carbs, which are preferred in diabetic diets, are starches. The latter break down into sugars slowly, so they don’t spike blood glucose as quickly as simple sugars. Whole wheat bread, wild rice, and oatmeal are good complex carbohydrates.

“The latest classifications are to break foods down into sugars (such as table and milk sugars), starches (e.g., potatoes, beans, and various grains), and fibers, like oat bran,” says Patti Geil, M.S., R.D., C.D.E., a diabetes educator based in Lexington, Ky.

Beware of Carb Confusion

There are several methods for planning your carb intake. One is through servings, also called “exchanges.” “On a 1,500-calorie diet you may have five or six starch servings each day and each serving is equal to 15 gms of carbohydrates (90 gms total),” says Cary.

You can opt for “carb counting,” in which you aim to consume a pre-determined number of carb grams throughout the day. “Generally it’s 275 grams for men daily and about 225 grams for women,” says Geil.


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The newest method is the Glycemic Index, in which foods are rated by how quickly they raise your blood sugar after you’ve eaten them. Obviously people with diabetes should seek out foods that raise their sugar level slowly.

Unfortunately these options can become very confusing. “Six servings of starch sounds like a lot, until you see one serving of rice is only 1/3 cup. How many people eat 1/3 cup of rice at a meal?” asks Cary.

Similarly Geil emphasizes the carb recommendations she cited are generic figures. “You have to take into account activity level and other factors. You also have to distribute those carbs properly throughout the day; you can’t ‘save’ carbs to use later.”

Experts warn that low-carb diets are not a good idea for people with diabetes. “With their emphasis on protein and fat, low-carb diets create a significant risk for cardiovascular disease, a major concern for people with diabetes,” says Cary.

Beyond Carbohydrates Michael Franklin, R.D., a dietitian at the Cedar Crest community in New Jersey built and managed by Erickson, suggests checking out the government’s new U.S. Food Pyramid (www.MyPyramid.gov). “It’s more specific now. It tells you to have six ounces of grains daily, instead of a certain number of servings.”

If you’ve been living with diabetes for a while it might be time to do a review with your health care team. Find out if any new medicines require further modifications to your diet. Is your activity level still what it should be to allow you to eat as you like?

Don’t forget: exercise is critical. “It helps you lose weight, control blood pressure, utilize calories more effectively,” says Cary. “Get a pedometer and opt for walking 10,000 steps a day —but not all at once. The first week, record how many steps you walk daily. What was the highest number? Make that the number you try to walk every day next week,” adds Geil.

Other options: Classes featuring chair or water exercises, like those residents have in communities built and managed by Erickson.

Think Teamwork

Franklin, Geil, and Cary agree that people with diabetes should seek individualized, expert help. “Medicare includes a consultation with a certified diabetes educator or a dietitian who specializes in diabetes,” says Cary. To find help, check your insurer, the ADA, or the American Academy of Diabetes Educators.

Your nutritional consultant can examine some of your favorite recipes and teach you, family and friends ingredient modifications and realistic portion sizes. Another option: join or start a cooking club and adapt your favorite recipes.

“Precut vegetables are easier for tracking servings, but they’re expensive to buy and many people can’t make them themselves. So start a shopping club, buying in bulk from warehouse outlets,” suggests Franklin.

“Diabetes doesn’t go away, you just get it under control. That’s why ‘dieting’ won’t work. This has to be a total lifestyle change,” says Cary.

Geil adds, “Don’t get discouraged. It took a lifetime to learn to eat a certain way. You’re not going to change overnight.” She encourages people by telling of her neighbor who says, “Diabetes made me change my lifestyle for the better.”



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