Dept of Clinical Nutrition 2056389107 Objectives 1 State the rationale for managing carbohydrate intake in diabetes 2 Identify foods containing carbs 3 Demonstrate how to count carbs ID: 810742
Download The PPT/PDF document "Nutrition for Diabetes Rainie Carter Rob..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Nutrition for Diabetes
Rainie Carter Robinson, MS, RD, LD, CDEDept. of Clinical Nutrition(205)638-9107
Slide2Objectives1) State the rationale for managing carbohydrate intake in diabetes
2) Identify foods containing carbs 3) Demonstrate how to count carbs using a sample menu 4) Verbalize how to read a nutrition facts label
Slide3Objectives, continued5) Discuss why it is important to be heart healthy as a patient with diabetes
6)Recognize and determine proper nutritional choices based on patient needs
Slide4My Plate
Slide5Identify Carbohydrate
Food Sources Breads, Starches, and Starchy VegetablesFruitMilk and Milk ProductsSweets and other desserts
Carb
counting has been shown to improve HbA1c levels in patients with type 1 diabetes
Gosken
D, et al.
Effects of carbohydrate counting method on metabolic control in children with type 1 diabetes mellitus.
Clinical Research in Pediatric Endocrinology
. 2014;6(2):74-8.
doi
: 10.4274/Jcrpe.1191.
Slide6Reading the Nutrition
Facts Label-Look at Serving Size first-Then total carbohydrate
*Look at servings per container.
Slide7Educated Guesses
1 carbohydrate/exchange/choice/serving = ___ grams of carbohydrate Milk= 12g of carbohydrate
Slide8The Fruit Group
Fresh fruitCanned fruit packed in 100% fruit juice100% fruit juiceDried fruit
Fresh fruit
1 cup, 1/2 banana, 15 grapes, 1/8 cantaloupe, tennis-ball size piece
Canned fruit
1/2 cup, water or juice packed
100% fruit juice
4 ounces
Dried fruit
2 Tablespoons
Slide9The Bread and Starch Group
Starches Bread, pasta, rice, crackers, cereals, snack foodsStarchy Vegetables Corn, potatoes, dried beans and peas
Starches
1 slice bread, 1/3 cup rice or pasta
cooked
, 1/2 cup hot cereal, 1 small roll, 1/2 bun, 15 chips, 3 cups popcorn
Starchy Vegetables
1/2 cup corn, potatoes, dried beans, English/ sweet peas
Slide10The Milk Group
Milk Whole, 2%, 1%, or skim Check labels for Chocolate, Soy, Almond, etc.Yogurt
Pudding
Ice Cream
Milk
8 ounces
Yogurt – Fat Free
6oz
Pudding & ice cream (no sugar added)
1/3 -
1/2 cup
Slide11The FREE Foods
A “FREE” food is one that contains less than 20 calories. Is less than 5 grams of total carbohydrates per serving Examples: 1 Tablespoon ketchup = 5g carb
1 Tablespoon fat-free dressing = 4g
carb
2 Tablespoons salsa= 3g
carb
1 Tablespoon peanut butter =4g
carb
Slide12Examples of FREE Foods
Sugar-free and Diet drinks Unsweetened Tea and Coffee Sugar-free Gelatin Sugar-free popsicles
Mustard
Dill Pickles
Sweet Pickles (made with
Splenda
®)
Non-Starchy Vegetables
Artificial sweeteners
Equal®, Sweet & Low®,
Splenda
®,
Truvia
/
Stevia
®
Slide13More Free Foods:
Non-Starchy VegetablesArtichokeAsparagusGreen, wax and Italian beansBean sprouts
Beets
Broccoli
Brussels sprouts
Cabbage
Cauliflower
Celery
Cucumber
Eggplant
Green Onions or scallions Greens (collard, kale, mustard, turnip)
Kohlrabi
Leeks
Mushrooms
Okra
Onions
Peppers (all varieties)
Radishes
Sauerkraut
Salad Greens
Snow Peas
Spinach
Summer Squash (Yellow)
Tomato
Turnips
Water Chestnuts
Watercress
Zucchini
Slide14Cheerios® VS. Froot
Loops®
Slide15Heart Healthy
Why is it important to be Heart healthy as a diabetic?Diabetes increases a person's risk for heart disease.Homma TK1, et al. Dyslipidemia in young patients with type 1 diabetes mellitus. Archives of Endocrinology and Metabolism. 2015 Jun;59(3):215-9. doi: 10.1590/2359-3997000000040
Soliman
EZ
1
,
Backlund
JY
2
,
Bebu
I
2
,
Li Y
3
,
Zhang ZM
3
,
Cleary PA
2
,
Lachin
JM
2
. Progression of Electrocardiographic Abnormalities in Type 1 Diabetes During 16 Years of Follow-up: The Epidemiology of Diabetes Interventions and Complications (EDIC) Study.
Journal of the American Heart Association
. 2016 Mar 14;4(3):e002882.
doi
: 10.1161/JAHA.115.002882
Slide16Heart Healthy Eating
What to look for:<5g Total Fat per servingNo Trans fatLittle to no Saturated fatLow cholesterol foods“Healthier” fats:Polyunsaturated fatty acidsMonounsaturated fatty acidsThink plants + fish
Slide17Heart Disease
Slide18HDL vs. LDL Cholesterol2 main types of cholesterol
HDL (good), Think “heaven, happy”LDL (bad), Think “loser, lame”HDL helps pull LDL away from artery walls. Ways to increase HDL: Eat unsaturated fats (almonds, olive oil, fish)Exercise (1 hour each day)
Slide19Saturated Fats and trans fatsCan increased “bad” cholesterol (LDL)
Saturated fats are found in:Animal products (red meats, butter, milk)Fried foodsTrans fats are found in:Prepackaged baking mixes, baked goods, and many other placesAre seen as “hydrogenated oil” or “partially hydrogenated oil” on ingredients list
Slide20Fats Recap
Unsaturated fats:Can help raise “good” cholesterol levels (HDL)Can help lower “bad” cholesterol levels (LDL)Known as the “heart” healthy fatsLiquid at room temperatureExamples: vegetable oils, fish, safflower oil, sunflower oil, corn oils, olive oil, canola oil, fish oil, nuts, nut butters
REMEMBER: The softer the fat is at room temperature, the healthier it is!
Slide21Trans Fatty Acids
Slide22Poly and mono-unsaturated fats
Olive oil
Slide23WAYS TO REDUCE FAT AND CHOLESTEROL IN YOUR DIET
Limit amount of red meat to 4-6 ounces/weekChoose non-fat dairy productsAvoid organ meats- Choose Lean cuts of meatChoose olive or canola oil instead of butterUse plant fats more often (oils, nuts)Limit fried food to 1x/wkCook HEART HEALTHY!!!
Slide24Drink plenty of water with high fiber!
Insoluble FiberKeeps you regular!Sources: Whole grain, whole wheat foods; Nuts & seeds; Fruits, VegetablesSoluble FiberHeart Healthy, Lowers CholesterolSources: Oats, oat bran, oatmeal, Dried beans & peas, Fruits, Vegetables
High fiber food =
>
5 grams dietary fiber
FIBER
Slide25How Much Fiber Do You Need Per Day?
Fiber is not digested and causes carbs to break down slower in the stomachRecommended Intake: Age + 5 = total grams per dayExample Serving Sizes:1 cup Vegetables = 3 g fiber
1 small apple = 2 g fiber
Remember to look for “whole-grain” or “whole wheat” products
Slide26Fiber Trick
If a serving size of a carbohydrate product has 5 grams or more of FIBER, half the fiber grams can be subtracted from total carb grams = Net carb
per serving of product
IE:
FiberPlus
® bars have 9gFiber and 24gCarb = new total
carbs
20g!
http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/carbohydrates.html
Slide27Spaghetti-Whole Wheat (cooked)
Fiber= 6gCarb= 37gCarb (37)- ½ fiber (3)=
34g
carb
adjusted
Slide28Sugar Alcohol & Sweetener Tips
Sweeteners are safe for consumption per The Food and Drug Administration (FDA)Sugar alcohols do not contain alcohol (liquor)Examples: erythritol, isomalt, lactitol, maltitol, mannitol
,
sorbitol
,
xylitol
The Academy of Nutrition and Dietetics “advises that intakes greater than 50 grams/day of
sorbitol
or greater than 20 grams/day of
mannitol
may cause diarrhea.”
TRICK: If a product contains >5g sugar alcohol, you can subtract
one half of the sugar alcohol grams
from the
total carbohydrate grams
Slide29“Sugar-Free” DOES NOT mean “Carbohydrate- Free”
Slide30Sugar free Oreos®
Sugar Alcohols= 7gHalf of 7= 3.5gTotal Carb= 16g
Carb
(16) - half sugar alcohol (3.5) = 12g* carbohydrate adjusted
*rounded down for easy math
Slide31MOST IMPORTANT NUTRIENT!
Drink 6-8 cups (8-ounces) per daySources: Water, Crystal Light®, Sugar-free Kool-Aid®Drink MORE than recommended with illness and when ketones present
WATER
Slide32Points to Remember
1 serving Carb = 15 gramsALWAYS read the label- serving size and total carb
Choose foods with
5 g fat/serving
Avoid Trans Fats
Choose low fat/low cholesterol foods
Choose high fiber foods
Water is the most important nutrient, so drink at least 6-8 cups per day
Slide33Some Helpful Websites
www.choosemyplate.govwww.calorieking.comwww.diabetes.org
http://diabetes.niddk.nih.gov/dm/a-z.aspx
www.dlife.com
www.heart.org
www.jdrf.org
http://kidshealth.org/
http://ndep.nih.gov/
http://nutritiondata.self.com
Nutritional data and images courtesy of www.NutritionData.com."
Slide34Apps for Phones
Diabetes App ReviewsMarisa Moore, MBA, RD, LD, reviews the 10 top-rated free iPhone apps for managing diabetes. http://www.eatright.org/Media/content.aspx?id=6442467022 BantDesigned to easily capture blood glucose readings and supply trend data for up to 90 days. RD rating: 4 stars Blood Sugar Tracker
Allows user to easily log blood sugar levels, set target blood glucose ranges, and view history and simple graphs to quickly identify numbers that are out of range. RD Rating: 5 stars
Carb
Master Free
Tracks carbohydrate intake plus total calories, fat, sugar, protein and fiber for the day. This app targets people with diabetes or those on a low-
carb
diet. RD Rating: 2 stars
Slide35Apps cont.
Diabetes Buddy LiteTracks factors that influence blood glucose levels: daily carb intake, glucose measures, medication, food and water intake. RD Rating: 2 stars Diabetes CompanionIncludes complete nutrition facts for common foods, tons of recipes, informative videos, Q&A for common diabetes related issues and blood glucose tracking tools. RD Rating: 4 stars
Diabetes Log
Allows user to easily track glucose readings, carbohydrate intake and insulin dosage by date. RD Rating: 2 stars
GluCoMo
Allows user to track blood sugar levels, insulin intake and other health components like blood pressure and weight, activity and pulse. RD Rating: 4 stars
Slide36Apps cont.
Glucose BuddyUsers can manually enter blood glucose numbers, carbohydrate intake, insulin dosage and activities. RD Rating: 4 stars Vree for DiabetesIncludes blood glucose tracking, nutrition tracking, activity tracking, medication tracking, progress charts and blood pressure tracking. RD Rating: 5 stars WaveSense Diabetes Manager
Tracks blood glucose results,
carb
intake and insulin doses. Features include a logbook, trend chart, email reports, color-coded results, video content and customizable target ranges for hypo-/hyperglycemia limits and mealtime schedules. RD Rating: 4 stars
Calorie King or Go meals
- 2 different, free apps for smart phones. Searchable database for food items. Great for fast food and dining out.
Slide37Questions