Diabetes and Meal Planning

Introduction Your health care provider may have told you that you have diabetes or that you are at risk of developing diabetes. A healthy diet may help you control or prevent diabetes. This reference summary will help you understand healthy eating habits, especially related to diabetes. Diabetes The body is made of millions of cells that need energy to function. Some of the food we eat turns into sugar, called glucose. Glucose is one of the most important substances the cells need to make energy. The bloodstream carries glucose to the cells. For glucose to enter a cell, 2 conditions must be present. 1. The cell must have enough “doors,” called receptors. 2. A substance called insulin must be available to “unlock” the receptors. With enough receptors and insulin to “unlock” them, glucose enters the cell and turns into energy. Without energy, all cells die. Insulin is a hormone, or chemical, that the pancreas makes. Insulin levels in the blood change depending on how much glucose is in the blood. Diabetes is a disease that makes it hard for cells to get the glucose they need to make energy.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 1

Type 1 diabetes happens when the cells in the pancreas that make insulin are destroyed. People who have type 1 diabetes do not make any insulin. This causes high blood sugar. Type 2 diabetes happens when a person's body does not make enough insulin, or the insulin that the body makes does not work well. There may not be enough receptors on the cells to allow glucose to enter. This results in high blood sugar. Diet & Diabetes A healthy and balanced diet is important for everyone, but eating well is especially important for people with diabetes. You can help control your blood sugar by: • Keeping track of when, what and how much you eat. • Exercising regularly. • Eating regularly. • Trying to reach and maintain a healthy weight. Eating regularly plays a role in controlling your blood sugar. When you eat regularly, carbohydrates are spread throughout your day. Skipping or delaying meals or snacks can cause hypoglycemia, or low blood sugar, and overeating. For some people who have type 2 diabetes, diet and lifestyle changes may control blood sugar so well that medication may not be needed. For others, diet and exercise can work alongside diabetes medication to help control your blood sugar. Reaching a healthier weight also improves your body’s use of insulin. Even a 10 to 20 pound weight loss makes a big difference for many people with type 2 diabetes. Exercise also helps insulin work well and can help control blood sugar levels. Healthy eating habits are the cornerstone of diabetes management. You can help control your blood sugar level by paying attention to when, what and how much you eat.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 2

Carbohydrates, Protein and Fat Carbohydrates, protein and fat provide our bodies with energy, or calories. Carbohydrates, protein and fat are nutrients that have important functions in the body. They also affect blood glucose differently. Carbohydrates turn into glucose in the body, which gives the body energy. Glucose enters the bloodstream in the hours after a meal. Insulin turns glucose into energy. If not enough insulin is sent to the blood, or if the body’s insulin does not work well, blood glucose can remain high after eating. Carbohydrates are found in many different foods. Some of those foods include: • Grains like bread, rice and pasta. • Starchy vegetables like potatoes and corn. • Dried beans. • Fruit and fruit juice. • Dairy products. • Sweets like candy, cake, soda and cookies. In order to help control your blood sugar, choose healthy, high fiber carbohydrate foods. Plant foods can be good sources. A high fiber diet can help you manage your blood sugar, lose weight and improve heart and intestinal health. Fiber is found in: • Beans. • Fruits and vegetables. • Nuts. • Seeds. • Whole grains. Fiber is also known as “roughage.” It can add bulk to the contents of your intestines, which can prevent constipation. Fiber can also improve blood sugar and cholesterol levels. Healthy carbohydrate choices include: • Fortified plant-based products, like almond milk. • Low fat or nonfat milk. • Nonfat plain or light yogurt.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 3

Try to avoid or limit processed carbohydrates and products with added sugars. These include: • Breaded or fried foods. • Candy. • Potato chips. • Desserts and baked goods. • Soda. Try to include a few different carbohydrate choices at each meal. Keep portions small. For example, include half a cup of fruit or a small fresh fruit at your meals, and fill only a quarter of your plate with starchy vegetables, grains or beans. Add a cup of low fat or nonfat milk or light yogurt. Choosing the right amount of carbohydrates can help control blood sugar levels. Eating too many carbohydrates at once can make blood sugar go too high. If you are taking certain diabetes medications, such as insulin, eating too little can cause blood sugar to drop too low. People with diabetes also need to eat foods that contain protein to stay healthy. Good sources of protein include: • Cheese. • Eggs. • Meat, fish and poultry. • Nuts, seeds and peanut butter. Choose lean cuts of meat and poultry. Plant sources of protein are often the healthiest option. Examples of plant sources of protein include peanut butter, nuts, dried beans and lentils. A Healthy Diet A healthy diet is a way of eating that provides the amount of nutrition your body needs. Different people need different amounts of calories and nutrients. Here are 6 general guidelines.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 4

1. Eat a variety of foods. No single category of food can give you all of the nutrients you need. A healthy diet includes food from each of the different food groups. 2. Eat the amount of food your body needs. When you eat more food than your body needs, the extra calories are stored as fat. Striving to reach a healthy weight and activity level can help you control your blood sugar. 3. Eat a plant-based diet. A diet that contains mostly plants and fewer animal proteins is linked to a lower risk of heart disease and cancer. This type of high fiber diet is more filling and can help with weight loss. Eating more of a plant-based diet does not mean you have to be a vegetarian. Simply eating more vegetables and plant proteins like beans, while cutting back on meat and high fat dairy products, will make your diet healthier. You can choose not to eat meat a few times a week. A few meal ideas that do not contain meat include: • Bean soup. • A peanut butter sandwich. • Vegetarian or black bean burgers. • A bean burrito. • Vegetable chili. • Vegetable fajitas. 4. Eat a diet that is low in cholesterol. Cut back on fried foods, snack chips and added fats like butter, mayonnaise and salad dressings. Choose low fat or nonfat dairy products. 5. Consume certain foods and drinks in moderation. Unhealthy carbohydrates, specifically candy, desserts and sweetened drinks, as well as salt and alcohol, should be consumed in moderation or avoided. 6. Quitting smoking if you are a smoker can help improve your overall health. My Plate My Plate is a guide for healthy eating. It suggests eating a variety of food while eating the appropriate amount from each group of food.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 5

My Plate was created by the US Department of Agriculture. It has 5 colors. Each color represents a food group. The larger the area of the color category, the more servings you need from this food group. Orange represents grains. Slightly more than a quarter of your plate should be for grains. Any food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a grain product. Examples are bread, cereal, crackers, rice and pasta. Grains are divided into 2 subgroups: whole grains and refined grains. Whole grains contain the entire grain kernel, which includes the bran, the germ and the endosperm. When choosing grains, eat mostly whole grains. Look for “whole” before the grain name on the list of ingredients. Examples of whole grain foods include: • Brown rice. • Bulgur, or cracked wheat. • Oatmeal. • Whole cornmeal. • Whole-wheat flour. Because starchy vegetables like corn, potatoes, winter squash, dried beans and peas are high in carbohydrates, they are often considered part of the orange plate portion. Some people should not eat grain products, such as those who are sensitive to gluten. Gluten is found in many grain products. If you have celiac disease or if your body is sensitive to gluten, avoid products that contain it. Green represents vegetables. Vegetables are organized into 5 subgroups, based on their nutrient content. These groups include: • Dark green vegetables. • Orange vegetables. • Beans and peas. • Starchy vegetables. • Other vegetables. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 6

Try to eat vegetables at most of your meals. Eat a lot of dark green and orange veggies. Starchy vegetables, beans and peas are considered part of the orange group. Eating a variety of vegetables will give your body many different vitamins and nutrients. Red represents fruits. Eat a variety of fruit. Choose fresh, frozen, canned or small amounts of dried fruit. Eat fruit in moderation, since it raises your blood sugar. Limit or avoid fruit juices, which contain a lot of sugar and little fiber. Blue represents dairy. Aim for 8 ounces or 1 cup of dairy at each meal. If you are lactose intolerant or do not want to drink cow's milk, you can replace it with plant-based milk and dairy products, such as almond milk. Purple is the last category, and it represents protein. About a quarter of your plate should be for protein. Include plant-based protein options regularly. These include beans, nuts and seeds. Dried beans and peas are part of the protein group, as well as the grain group. These foods contain both protein and carbohydrates. If you are a vegetarian, many of your protein choices also contain carbohydrates. Ask your dietitian or diabetes educator for advice on staying within your carbohydrate targets. Fish and shellfish are also good sources of protein. Try to include fatty fish like salmon in your diet a couple times a week. Pregnant women and young children should limit seafood. Choose lean meat and poultry. Bake it, boil it or grill it. The divided areas on My Plate are to remind you to balance your portions. Half of your plate should be fruits and vegetables. The amount of food eaten is measured in a unit called a serving. Depending on the food group, the serving size may be measured in cups, grams, slices or whole items.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 7

The servings defined by nutritional guides are much smaller than a restaurant portion. For example, if you go to a restaurant and order a large steak, it may contain 3 to 5 servings of protein. The number of servings you need from each food group depends on the amount of calories you need each day. Your health care provider can help you figure out how many calories you need based on your age, sex, height and level of physical activity. Blood Sugar Levels It is important to check your blood sugar levels regularly as directed by your health care provider. Have them checked more often when you change your diet or activity level and if you are sick. Depending on your blood sugar levels, you may need to increase or decrease your medication. Talk to your health care provider or diabetic care team if you have any questions about your blood sugar level. Summary A healthy diet may help you control or prevent diabetes. Diabetes is a disease that makes it hard for cells to get the glucose they need to make energy. Type 1 diabetes happens when the cells in the pancreas that make insulin are destroyed. People who have type 1 diabetes do not make any insulin, which causes them to have high blood sugar. Type 2 diabetes happens when a person's body does not make enough insulin, or the insulin that the body makes does not work well. There may not be enough receptors on the cells to allow glucose to enter. This results in high blood sugar as well. You can help control your blood sugar by: • Keeping track of when, what and how much you eat. • Exercising regularly. • Trying to reach and maintain a healthy weight.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 8

A healthy diet is a way of eating that provides the amount of nutrition your body needs. Different people need different amounts of calories and nutrients. Eat a variety of foods in the amounts your body needs. Eat a plant-based diet. Quit smoking if you are a smoker and check your blood sugar levels regularly. Your health care providers have additional information about diabetes and nutrition. Ask them to recommend resources and websites so you can learn more about how to prevent or control diabetes.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2015, The Patient Education Institute, Inc. www.X-Plain.com Last Reviewed: 11/06/2015

db050107 9