httpwwwvinafengshuicomwpcontentuploads2014 Presentation Purpose To increase knowledge about identifying carbohydrates carbohydrate counting and portion sizes of carbohydrates To understand the important role of the diet in diabetes ID: 669951
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Slide1
Diabetes Symposium 2015
Power of the Plate: Nutrition and Diabetes
http://www.vinafengshui.com/wp-content/uploads/2014Slide2
Presentation Purpose
To increase knowledge about identifying carbohydrates, carbohydrate counting, and portion sizes of carbohydrates
To understand the important role of the diet in diabetesThere are no conflicts of interest to disclose.Slide3
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 diabetesSlide4
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 makes
Type 2 diabetes does not produce enough insulinType 1 diabetes is unable to use the insulin it makesSlide5
Diabetes is all about Balance
Controlling diabetes is a balance of what you eat, how much you move, and what medicine you take
Some 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 diet
It is most important to keep your blood sugar levels under controlSlide6
Diabetes and Diet
The food we eat is fuel for our bodies
The 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)Slide7
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 mostSlide8
What are Carbohydrates?
Carbohydrates are foods that break down into sugar, or glucose, in the body
There 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&bihSlide9
Sweets
Cakes, 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-legislationSlide10
Fruit
All fruit has a naturally-occurring sugar called fructose.
http://www.teluguone.com/vanitha/content/health-benefits-of-fruits-75-24004.htmlSlide11
Starches
Includes 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/Slide12
Milk and Yogurt
Milk and yogurt products have naturally occurring sugar called lactose.
http://smariorganics.com/our-yogurt/Slide13
Foods Without Carbohydrates
Protein and fat groups contain ZERO carbohydrates
Protein: 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.htmSlide14
A Word on Artificial Sweeteners
The 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 othersSlide15
Artificial 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.com550 × 273Slide16
Artificial 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-RawSlide17
Carbohydrate Counting: A Meal Planning Approach for Diabetes
Based 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 carbohydratesSlide18
How to Count Carbohydrates
One serving of carbohydrates is about 15 grams
There is about 1 serving of carbohydrate (15 grams) in 1 slice of bread, ½ cup fruit juice, ½ 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 daySlide19
Timing of Carbohydrates with Meals
If you eat a lot of carbohydrates at one time, it increases the need for insulin
It 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 youSlide20
Timing of Carbohydrates with Meals
To 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-fromSlide21
Benefits of Carbohydrate Counting
It is more flexible than other meal planning methods
Sugar is not forbiddenFocuses attention on the foods most likely to make blood sugar levels go upSlide22
Tools to Count Carbohydrates
Nutrition Labels
Measuring toolsPortion GuidesSlide23
Nutrition Labels
Total 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 eatenSlide24
Measuring Tools
Measuring Cups
Measuring SpoonsFood Scale
Ebay.com.au
http://pixhder.com/dry+measuring+cups+clipart
Overstock.comSlide25
Carbohydrate Counting Hand Guide
http://www.diabeticlivingonline.com/food-to-eat/count-carbs/easy-practical-tips-counting-carbs-accuratelySlide26
Carbohydrate Counting in Action!
Please refer to handout on carbohydrate foods, so we can practice carbohydrate counting.Slide27
Carbohydrate Counting in Action
Pour your breakfast cereal into a bowl!
It should equal ¾ 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.jpngSlide28
Carbohydrate Counting in Action
Portion Distortion: Beware!Larger sizes of plates and bowls can make us add more food to the plate or bowl
This 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/Slide29
Carbohydrate Counting in Action
Pour 1 serving of 100% fruit juice!It should equal ½ cup, which is about 15 grams.
http://www.mairlynsmith.com/?p=2332
The glass on the right is the correct serving size, or ½ cup juice. Slide30
Carbohydrate Counting in Action
Measure 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.jpgSlide31
Carbohydrate Counting in Action
Measure 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=21153507Slide32
So what about the rest of my plate?Slide33
The MyPlate Method
https://www.eatsmart.org/client_assets/Images/myplate_white.jpgSlide34
The MyPlate Method and Diabetes
The MyPlate method has 3 choices of carbohydrates per “plate” (45 grams), and fits in with carbohydrate counting
This method can also make eating healthier and keeping track of carbohydrates more approachable
http://www.choosemyplate.gov/aboutSlide35
Keep Your Plate Balanced
Your plates should include:
1 cup of nonstarchy vegetables 1 cup or 1 medium piece of fruit3 ounces of lean meat/protein½ cup of carbohydrate8 oz. or 1 cup low fat dairy
http://www.melaniealbertfitness.com/styled-5/MEALPLANS.htmlSlide36
Remember…
All of the carbohydrates in your meal include all of the starches, fruit, and dairy you eat
This total should equal around 45-60 grams per meal
Wholeheartedmen.comSlide37
Why 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 management
Prevent or delay long term diabetes complications, including neuropathy, kidney failure, retinopathy, etc.
Improve your overall health!Slide38
Exercise
Exercise works like a medicine
It 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/Slide39
Summary
Controlling diabetes is a balance of food, exercise, and medicine
Make small changes in your eating habits to positively affect your weight, blood sugar, and the overall management of diabetesSlide40
Diabetes Resources
The Calorie King: “Calorie, Fat, and Carbohydrate Counter”
www.calorieking.comAvailable at WalmartDiabetic Living
www.diabeticlivingonline.com
Available at Walmart or Kroger
Diabetes Self Management: magazine published bimonthly
$18.00 per year
www.diabetesselfmanagement.comSlide41
Diabetes Resources (cont.)
Diabetes Forecast: healthy living magazine of American Diabetes Association
www.diabetes.org/diabetesforecastDiabetes Health: monthly magazinewww.diabeteshealth.comSlide42
References
Caso
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
. 2
nd
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.Slide43
Questions?