Eat Your Peas and Carrorts Too

Below is the newest question from www.FOODPICKER.org:

Is it ok to eat peas & carrots if you have diabetes?  I heard to avoid those two veggies.

Vegetables are high in many valuable nutrients including vitamins, minerals, phytochemicals, fiber and water.  They are highly beneficial to our diet and should consume approximately half of our plate at dinner or lunch.  So why would someone say “beware”?  There are 2 types of vegetables, starchy and non-starchy.  Starchy vegetables have 80 calories per serving and contain 15 grams of carbohydrate.  However, non-starchy vegetables have ONLY 25 calories per serving and 5 grams of carb.  Due to the difference in calories and carbs, portions should be considered when chosing a starchy vegetable, especially if you are diabetic.  Feel free to eat non-starchy vegetables more liberally. 

Starchy vegetables: potatoes (sweet and plain), corn, peas, beans/legumes, pumpkin and squash.

Non-starchy vegetables: zucchini, summer squash, green beans, cucumber, greens, tomatoes, peppers, and okra (to name a few).

Carrots fall into the non-starchy vegetables, but the reason for the comment(s) you have heard is because they are considered a high glycemic food.  This means that the high concentration of sugars in carrots that make them sweet also raise blood glucose.  I would not recommend overeating carrots in one sitting, but I would highly recommend you NOT remove them from your diet.  Carrots are an excellent source of vitamin A and a good source of vitamins C and K, potassium and fiber. 

A serving of cooked vegetables is 1/2 cup and a 1 cup for raw.  Vary your veggies and watch your portions and you will reap all of the nutritional benefits.  It is wise to not leave any out.

Reversing Type 2 Diabetes

Below is a question from www.FOODPICKER.org:

My 45 year-old husband was diagnosed with type 2 diabetes a few months ago.  Is it true that you can reverse diabetes?

Diagnosis of any disease can be scary.  It is natural for our first response to be a search for a cure.  My advice would be to begin by seeking advice from your physician and obtaining dietary and lifestyle training from a dietitian or a Certified Diabetes Educator.  There are some thoughts that diabetes can be reversed and a holistic or integrative health care physician may be able to assist you in a protocol that may lead to reversal. 

In Type 2 Diabetes, either the body does not produce enough insulin or the cells do not recognize it (insulin resistance).  Weight loss can significantly affect the body’s ability to sense the insulin and respond to it.  Therefore getting to and maintaining a healthy weight is not only beneficial but crucial to living a healthy life and reducing complications of the disease.  Monitoring blood glucose and carbohydrate counting are also important. 

Begin by taking these steps and let your doctor know that you are wanting to take an aggressive lifestyle approach to treating the diabetes.

Does sugar free candy sound too good to be true?  Foods advertising the words “sugar free” can masquerade as healthy foods for diabetics, but do not be deceived.  In order to determine how we incorporate it into a diabetic diet, we need to take a closer look at the nutrition label.  The gentleman below wrote in to www.FOODPICKER.org questioning sugar free candy.  If you are curious too, check out my response.

Q: My doctor recently diagnosed me with type 2 diabetes.  I know it is important to watch my sugar intake.  Is sugarless candy really sugarless?

A: Sugar Free candy is made with 1 or more of two types of sweeteners: 1) sugar alcohols, like sorbitol, maltitol, xylitol, mannitol, erythritol, and 2) artificial sweeteners, like sucralose (Splenda), acesulfame K, aspartame, saccharin, and neotame.  You will notice that the sugar alcohols end in suffix “ol” identifying it as such. 

Sugar alcohols do not raise blood sugar as much as pure sugar or starch, however, the effects can vary depending on what type of alcohol.  According to the American Diabetes Association, if a product has more than 5 grams of sugar alcohols (as seen on the food label),

subtract ½ the grams of sugar alcohol from the amount of total carbohydrate

Count the remaining grams of carbohydrate in your meal plan

Sugar alcohols occur naturally in plant foods.  Artificial sweeteners are simply that…artificial OR man-made. 

Sugar free foods can be a better option for diabetics, but the absence of sugar does not mean the absence of carbohydrate.  For example, a sugar free cookie might not contain carbohydrates from sugar, but will contain carbohydrates from other ingredients like flour.  Before munching on a sugar free food, a diabetic should consider the total carbohydrates in the food per serving and work that into their overall meal plan.  Also to consider…calories, saturated fat, trans fats (hydrogenated oils), and sodium.  Does the food have any nutritional value?  Does it provide any vitamins, minerals, fiber or protein?  

Lastly, sugar alcohols can have a laxative effect and cause GI distress.  If eaten in moderation (small amounts), there should be no or minimal symptoms, but overindulgence of foods containing sugar alcohols may cause some uncomfortable problems.

An occasional sweet treat or indulgence is perfectly fine and normal.  And for diabetics, a sugar free option may be a better choice than the regular counterpart.  But when choosing foods to incorporate into a diabetic diet, look to include foods that will provide nutrients and benefit your health.

Blood Sugar Numbers- The Good, Bad and Ugly

Trying to understand what your blood sugar numbers mean?  Asking questions is a great start.  The question below came from www.FOODPICKER.org.  I hope my answer will bring some clarity…

Q: My fasting glucose number was 127.  Does this sound like pre-diabetes or diabetes?  What should I do to control by blood sugar?

A: There are multiple tests that can be used to determine blood glucose levels: 1) Fasting Blood Glucose Test,  2) Hemoglobin A1C Test, 3) Oral Glucose Tolerance Test, and 4) Random (or Casual) Plasma Glucose.  In order to diagnose diabetes, a physician needs 2 of the above tests to show glucose levels in the diabetes range along with common symptoms of diabetes.  See the table below for tests and ranges:

Blood Glucose Tests	Optimal Ranges	Pre-Diabetes	Diabetes
Fasting Blood Glucose Test	70-99 mg/dL	100-125 mg/dL	≥126 mg/dL
Hemoglobin A1C (Hb A1C)	<6.0%	6.0-6.5%	≥6.5%
Random Plasma Glucose Test	—–	—–	≥200 mg/dL
Oral Glucose Tolerance Test	<140 mg/dL	140-199 mg/dL	≥200 mg/dL

As you will notice, a fasting blood glucose level of 127 mg/dL does indicate Diabetes, however, I encourage you to speak to your physician as only he can diagnose you.  He should also be able to give you information about a local diabetes education class for training and information on self-management and diet. 

Below are some of the common Diabetes symptoms.  If you have noticed any of these, you will want to mention them to your physician so that he can diagnose and treat you properly.

• Increased thirst
• Frequent urination
• Excessive hunger
• Fatigue
• Blurred vision
• Slow healing sores
• Frequent infections- skin, vaginal, bladder

There are many ways to manage your blood glucose (sugar) levels.  Diet is a primary method of control and a Dietitian or Certified Diabetes Educator can provide detailed information about carbohydrate counting.  You physician may choose to use a medication or insulin to manage your glucose levels.  Exercise and weight loss, if overweight, have been shown to improve insulin sensitivity and aid in diabetes management. 

Kudos to you! (well, not the chocolate candy bar) for asking questions to take control of your health.  Speaking with your physician about your numbers and symptoms is the next step.  Keep asking questions and stay proactive for optimal health!

Take Action, Prevent Diabetes

Looking to prevent diabetes before it starts?  You can!  While age, gender, race and family history can increase your risk, the disease can be completely prevented through a healthy lifestyle and diet.  You have control so don’t assume that if “Aunt B” or “Papa G” had diabetes you will too.  When considering how to pursue a healthy lifestyle, begin by incorporating more “whole” foods and removing those that are processed.  This is exactly what the writer of the question below is trying to do.   

Q: I have pre-diabetes and am trying to lose weight.  How many servings of fruit and veggies should I have each day?

Incorporating more fruits and vegetables into your diet is a great way to boost fiber intake, reduce calorie consumption and prevent disease.  Fruits and vegetables are packed with phytochemicals (aka phytonutrients) that research has shown to lower the risk of many types of disease and cancer.  Because they are full of fiber, they fill you up and improve GI and heart health.  By munching on fruits and veggies at a meal or snack, you are less likely to reach for snack with minimal nutrient value like chips, cookies, candy and processed snack foods. 

According MyPyramid, most adults should eat about 2.5-3 cups of vegetables per day and 2 cups of fruit per day.  You can find out more about servings for different fruits and veggies at www.mypyramid.gov.  It is important for diabetics and pre-diabetics to plan to eat fruit with a source of protein and/or fat to prevent an immediate sharp rise in blood sugar.  The protein and fat slow the digestion of the food allowing your body to appropriately handle the blood sugar.  Starchy vegetables like corn, peas and potatoes will increase your blood sugar quickly as well, so apply the principle above when eating these. 

There are no rules for non-starchy vegetables.  Eat as many as you want throughout the day!  While we should always consider moderation, this is the one food category containing foods with minimal calories and carbohydrates and loaded with nutrients.  Some foods in this group include, greens, lettuce, tomato, cucumber, squash, broccoli, cauliflower and peppers.  The more colorful your diet the better because many of the nutrients are concentrated in the deep colors. 

By simply focussing on eating more fruits and veggies and eliminating some of the processed foods in your diet, you should begin to see changes in weight and blood glucose levels.  Wave goodbye to diabetes because it cannot keep up with you in the race towards health.  Run strong! 

Want more insight about diabetes prevention/management, check out http://foodpicker.org/

Unveiling the Mystery of Carbs and Sugar

Trying to make smart carbohydrate choices, but overwhelmed with information on the food labels?  Below is a question from the www.FOODPICKER.org website that covers this particular issue.  Read below for some useful info.

Question: I was diagnosed with type 2 diabetes last month.  I’m having difficulty understanding how many carbs and sugar I can have each day.  I’m finding that nearly everything contains carbs and sugar!  Can you help me with this?

Response: The daily recommended carbohydrate intake is different for each person depending on activity level, prescription diabetes medications, and recommended caloric consumption.  Most women need approximately 30-45 grams of carbohydrate at each meal and about 15 grams at a snack.  An important point to emphasize is spreading carbohydrates throughout the day and avoiding eating an excessive amount in one sitting. 

When looking on food labels, you will look for the TOTAL Carbohydrate to determine how much you are consuming in that food.  Realize that foods with whole grains will have fiber in them and not raise your blood sugar levels as quickly (this is good!). 

The following foods have carbohydrates:

*grains          *starchy vegetables           *dairy           *fruit           *beans/legumes

Another important tip is to always eat your carbohydrates with protein and/or good fat (plant based fats OR omega-3 fats in salmon, walnuts and ground flax seed).  By doing this, you will be able reduce a dramatic rise in your blood sugar.  If you were to eat carbohydrate alone, (example: crackers), your blood sugar would rise quickly- this is not healthy for diabetes maintenance. 

All carbohydrates are broken down into sugars.  However, many foods also have added sugar, as you may have noticed on the Ingredient List of the Food Label.  Considering the TOTAL carbohydrate is the easiest way for you to determine the appropriateness of that food with your meal.

Your doctor may be able to refer you to a Diabetes Education Center or a Registered Dietitian who can provide you with more detailed information about carbohydrate counting and diabetes maintenance.  They can help you develop a meal plan that will identify the recommended servings of carbohydrate at each meal.  Please remember that carbohydrates are not bad, as they provide your body with energy.  But you benefit the most when you consume high quality carbohydrates- whole grains and whole foods- because these foods will supply you with vitamins, minerals, and fiber as well as maintain more stable levels of blood sugar in your body.   

As a last suggestion, do not be fooled by packaging that says “low sugar.”  Just because it is identified as low sugar does not indicate that it is low carb.  Look at the carbohydrates per serving  before tossing it into your grocery cart.

Type 1 Diabetes

Below is a question I recently received from www.foodpicker.org:

I am trying to find a class for our grandson.  He is 19 and has a part-time job but no insurance.  He just found out last week that he is a type 1 diabetes after losing a lot of weight and his blood sugar was 523.  He is on insulin but needs to go to a class to manage is diabetes without going hungry.  Where do we start?  Any suggestions would help us a lot.

Response: Type 1 Diabetes must be carefully managed with insulin and diet.  It is this complementary relationship between diet and insulin that will provide him with sustained energy and manage his blood sugar levels.  The American Diabetes Association (www.diabetes.org) has a website that will provide you with information about diabetes, testing, diabetic-friendly recipes, research and support groups.  Other resource you may find helpful include the National Diabetes Education Program (http://ndep.nih.gov/) and American Dietetic Association (www.eatright.org). 

Your healthcare provide will likely be able to recommend a Registered Dietitian or a Certified Diabetes Educator to provide professional counseling and education for Type 1 Diabetes.  A session will likely cover the following:

*discuss diabetes, what is occurring in the body and negative consequences of poor management

*what types of food to eat and food combinations

*when to eat

*how to monitor blood glucose (sugar) and how to use insulin

It may be helpful for a family member to attend the class or session with your grandson to learn, ask questions and determine how to best help him adapt to a new lifestyle.  Ask your health care provider about local diabetes support groups or camps that may be targeted at the teen/young adult population.  Members of these groups can provide camaraderie, practical tips and lead you to additional resources.  Encourage your grandson to ask questions, not fear or avoid the topic.  Knowledge is power!

Diabetes and Snacking

Below is a question from www.FOODPICKER.org:

I have been diagnosed with type 2 diabetes.  During the day at work I eat very little, but in the evenings and weekends, I can’t seem to stay out of the kitchen.  Do you have any suggestions to control my snacking in the evenings and weekends?

Snacking has pros and cons, however, for a diabetic, it can be very helpful in maintaining blood sugar levels.  The purpose of a snack should be to help tie you over until the next meal, especially if the meal is more than 5-6 hours away.  One reason you may have a voracious appetite in the evenings is because you have not consumed enough calories (energy) throughout the day.  If your body feels starved and energy stores depleted, it will crave food- usually foods that will help raise blood sugar levels quickly like sweets and carbohydrates.  Here are a few suggestions to better manage these cravings and provide your body with what it needs to function at your best throughout the day:

1. Eat a well balanced breakfast, including protein and complex carbohydrates (whole grains).  The protein and fiber will keep you full longer, balance your blood sugar levels and provide you with sustained energy until your next meal.

2. Take time to eat throughout the day and while at work so that you are not starving when you get home.   This may include a small mid-morning and/or afternoon snack in addition to a healthy breakfast and lunch.  Keep raw fruits, vegetables, dips like humus or yogurt, whole grain bread, p-nut butter or raw nuts, and low-fat cheese in an office refrigerator or lunch sack with a cold pack to have  healthy snack options available if you begin feeling hungry.

3. Clean out your pantry and refrigerator of processed and unhealthy foods.  When you consider buying a food, look for a nutritionally dense foods- those that provide fiber, vitamins, minerals, protein and complex carbs.  Usually these types of foods are “whole” foods, meaning that they are very close or exactly identical to their form when picked or harvested.  Looking at the number of ingredients on nutrition label will also give you an idea of the amount of processing.

4. If you find yourself excessively snacking over the weekend, stop and consider your last meal.  Did it contain fiber and protein?  Did you consume a lot of sugar through food or a beverage?  How much did you eat?  This will provide you with direction as to how you may need to change your meals to sustain you.

5. Physical activity is a natural appetite suppressant.  If you are feeling hungry or munchy try going for a walk outside first.

Type 2 Diabetes requires some extra planning and awareness, however, I believe these tips may help you assess your eating habits and lifestyle.  After making some changes I believe you will begin to notice increased energy and mental clarity throughout the day, as well as better control over blood sugar.

Hello world!

My name is Jennifer.   I am a Registered and Licensed Dietitian and a Nutrition Editor at http://FOODPICKER.org/.  This website is aimed at sharing practical nutrition and diabetes information that can help you make smart choices for your health.  Do you need to find a breakfast cereal that does not exceed your carbohydrate limit or want to determine how long it will take to burn off the sweet treat you just devoured?  Check out the website and interactive tools.

My passion is helping people identify and incorporate practical, creative strategies to achieve their health goals.  I know from experience that “change” is tough.  It requires us to think differently and mix-up our routines to transform behaviors.  Change is often uncomfortable.  But, “If we don’t change, we don’t grow.  If we don’t grow, we aren’t really living (Gail Sheehy).”  I propose we live and LIVE WELL!