Jan 20 2010

My Diabetic Food Plan – Part 2

Category: Content — JimR @ 4:00 am

My Food Plan, continued from Part 1 :

My Diabetic Food Plan is based on the inclusion of specified amounts of carbohydrates in each meal and snack throughout the day, as listed below.

There are no specified amounts for the other nutrients, the proteins and fats, that, although essential to maintain the body in good health, play only a minor role as a source of glucose –  except in the absence of carbohydrates.

The diabetic food plan has been devised for me by the dietitons at the Diabetes Education Center of my local hospital. It is simple and easy to follow and is printed conveniently on one side of a sheet of paper. It merely lists the suggested number of grams of carbohydrate for three main meals eaten about four hours apart and interspersed with a snack about two hours after each meal. And I have added an extra snack at or before bedtime.

The rest of the Food Plan page is taken up with lists of half a dozen foods in 15 gram quantities under the headings Vegetables, Fruits, Dairy, Breads etc., and Snacks. The 15 gram quantities make it easy to calculate how many portions of any category need be selected to make up the required meal amount for carbohydrates, providing a sort of mini diabetic food list.

The details, the amounts of carbohydrates recommended
Breakfast, at 8 0’clock, is 60 grams, Lunch about mid-day is 45 grams, and Supper (called dinner by some) at about 6 pm is also 45 grams. The snacks are each 15 grams, that’s a total of 60+15+45+15+45+15+15 = 210 grams. Those are carbohydrate grams @ 4 calories per gram which equals 840 calories of carbohydrate each day. That is a little less than the amount suggested by the Calorie Calculator referred to in Part 1 of this article, which was 900 calories, but close enough.

There is no limit to the amounts of protein or fat on this dietary plan but common sense tells me that if I eat too much I will gain weight and that is something I don’t wish to do.  The Calorie Calculator suggested that my total calorie intake should be about 2000 calories, with 840 taken up by the carbohydrates, it means 1160 calories for the proteins and fats allowance for the day.

Referring to the Calorie Calculator again, it suggests 25% fats in a 2000 calorie daily food intake, that’s 500 calories @ 9grams of fat per calorie = 56 grams of fat approximately, leaving about 660 grams of protein to provide the 2000 calories.

My plan provide 210 grams of carbohydrates daily
To summarize the rather lengthy description above, my diabetic food plan provides 2000 daily calories from 840 g, carbohydrates, 660 g, of protein, and 56 g. of fat. s

COUNTING CARBOHYDRATES IN A DIABETIC FOOD PLAN

Carbohydrates are the main nutrient source of glucose and will have the biggest effect on  blood sugars. The foods supplying the protein and fat, while providing a minor amount of glucose, will not affect blood sugar levels. Those foods include meat, fish, poultry, eggs, cheese, margarine, and oils — but they can, of course, increase weight and cholesterol if eaten in too large a quantity.

For the carbohydrate portion of a meal, I can choose from the following food list, each item  contains 15 grams of carbohydrate. For more choices, I can add 15 gram amounts of whatever carbohydrate foods I wish to the lists.

Grains Breads, Cereals

  • 1 slice whole wheat bread
  • ¼ large bagel
  • 6” tortilla
  • 1/3 cup pasta or rice
  • ¾ cup cold cereal
  • 1 pkg plain oatmeal
  • 1/3 cup dry plain oatmeal
  • 1 cup soup

Milk and Yogurt

  • 1 cup Milk
  • ¾ cup unsweetened or
  • artificially sweetened yogurt

Sweets and Snack Foods

  • 4-6 crackers
  • 3 cups popcorn
  • 2 to 3 plain cookies
  • (arrowroot or ginger)
  • 1 tbsn sugar or honey
  • ½ cup light ice-cream
  • or pudding or frozen yogurt
  • 25 pretzel sticks

Fruits

  • 1 small fresh fruit
  • ½ medium banana
  • ¾ cup mixed fresh fruit
  • ½ cup fruit canned in juice
  • ½ cup fruit juice
  • 3 prunes
  • 2 tablespoons raisins

Vegetables, Dried Beans

  • ½ cup potato, peas, or corn
  • ½ cup cooked dried beans, lentils
  • 1/3 cup canned brown beans
  • 1 cup squash

“Free” Foods (Less than 5 grams of Carbs)

  • Water, decaffeinated or regular coffee and tea, sugar free soft drinks and mineral water, all vegetables not listed above, sugar free gelatin desserts, light jams and jellies, calorie-wise salad dressings.

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Or continue to Part 3, the last page of My Diabetic Food Plan

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Jan 06 2010

Establishing Food Plans – Considerations

Category: Explanation — JimR @ 9:12 pm
Different approaches to establishing food plans

The objective of a dietary plan or diabetic food list for the diabetic person is primarily to aid in the control the amounts of glucose in the bloodstream and to keep the glucose levels within as narrow a range as possible so that they do not exceed acceptable levels by too great an amount.

There will be spikes in blood glucose levels after eating a meal or snack that will vary based on the type of food eaten and its carbohydrate content and the speed in which the resulting glucose is produced when digestion of the food takes place. That is why it is good to know, when compiling a diabetes food list, which foods are the source of the highest carbohydrate content and are the speediest broken down to glucose,  so that they can be eliminated or at least limited in quantity. Those can be identified by reference to the Glycemic Index and Glycemic Load index avail able elsewhere on this site.

To maintain glucose levels as evenly as possible throughout the day it is often suggested that meals should be of about the same size and interspersed with snacks, rather than any one meal being much larger than the others.

The essential nutrients needed by the body for its energy and maintenance are obtained from the carbohydrates, proteins, and fats in the foods consumed each day. Those foods are broken down to their nutritional chemical components in the digestion process and released through the walls of the intestine to be carried in the bloodstream to the many organs of the body where they are then selectively taken up as required into the body’s millions of cells.

When present, the carbohydrate fraction of the foods is the main source of glucose in the bloodstream and so it is the carbohydrate content of foods that is the major factor around which diabetic food plans are constructed. The more carbohydrates there are, the more glucose will end up in the blood stream. After a meal or snack, when glucose is produced, the impaired body mechanisms of the diabetic person in the production of insulin, needed to conduct the glucose into the cells that require it, and the desensitized sensors on the outer membranes of those cells, results in the unhealthy levels of the glucose remaining in the blood.

From that statement the question could be asked:
“Then why not reduce the amounts of carbohydrate to a minimum so that less glucose is produced to overload the bloodstream?”

That is a good question that would seem to require an answer in the affirmative. But the diabetic associations of most countries do not seem to concur.

The High Carbohydrate approach
The ADA (American Diabetes Association) and others recommend what can be considered a high carbohydrate diet of 50 to 60 percent Carbohydrates, 15 to 20 percent proteins, and 25 to 30 percent fats based on total calories consumed. A calorie is the unit applied to the measurement of energy provided by components of food.

The Low Carbohydrate approach
Although in the minority, many physicians advocate an “Anti-ADA” approach that, conversely, recommends a low carbohydrate content in meals to minimize the amount of glucose that can enter the bloodstream.

A number of books have been published by doctors providing details on diets that have successfully brought their patients to a reversal or near reversal of their diabetic condition or at least a very good control of their glucose levels. The carbohydrate content of those diets is low, from about 20 to 35 percent. There are many different versions, you’ve probably heard of the Dr.Atkins and South Beach Diets, but there are others, some less extreme than those.

The American Academy of Family Physicians defines low carbohydrate diets as:
“Low-carbohydrate diets restrict caloric intake by reducing the consumption of carbohydrates to 20 to 60 g per day (typically less than 20 percent of the daily caloric intake). The consumption of protein and fat is increased to compensate for part of the calories that formerly came from carbohydrates.”

It should also be noted that the American Diabetes Association, after carrying out their own clinical studies with patients on a low carbohydrate diet, agreed that the low carbohydrate was successful in achieving lower blood glucose levels. However, their stated opinion was that such a diet was not likely to be adhered to for a sufficiently long period of time and they therefore keep to their current recommendations regarding carbohydrates. For additional information on lower carbohydrate foods, see our companion site: Diabetic Menu Guide and the reference to low carbohydrate effectiveness can be found in our post :  Low Carbohydrate Approach.

There are other health concerns voiced by members of the medical and health care profession in which reservations are expressed regarding the adoption of a low calorie diet.

Caution:
All matters of diet, exercise, weight-loss, and especially any changes being contemplated, should be discussed with your doctor who will provide guidance on your treatment and should refer you to other health care professionals for more complete answers if necessary.

One other factor regarding carbohydrates is that they exist in several different forms that are usually classified as either “simple” or “complex”. The difference being in their chemical structure that results in a speedier breakdown to glucose for the simple form and a longer time for the complex forms. This makes the complex forms generally more favorable to include in a diabetic menu plan and a special index, known as the Glycemic Index, has been devised to rate the varying speeds of conversion of carbohydrates to glucose.

Vegetarian, Vegan, and Others
There are other dietary approaches that are effective in the management and control of blood glucose and that do not so much emphasize the carbohydrate content of foods. Among these are the Vegetarian and Vegan life styles that have many virtues from a viewpoint of nutrition. They concentrate on vegetables and fruits that are automatically low on the Glycemic Index, the speed in which their carbohydrate content is converted to glucose.

However, in North America, only a small percentage of the population follow a vegetarian or vegan regime, we are a meat-eating and fat-rich food consuming nation.

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