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Nutrition for Diabetes Mellitus

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I wish I had a quarter for every time I hear - My so & so (fill in the blank) said I can't eat bread or anything white because it turns to sugar!" Well guess what?

**Everything you eat contributes to sugar (AKA glucose).**

It's supposed to. The purpose of food is to give you energy & nutrients so your body can function. Glucose or "sugar" is your body's energy. Without it, you wouldn't survive. Giving up bread & pasta won't do anything magical except make you feel depressed & deprived. The trick to planning meals for diabetes is balance & portion control.

I might as well tell you right from the beginning - I don't believe in "forbidden" foods. Being told you can't have something just makes you want it more. It's human nature. I saw this when my son was a child. If I put 100 toys in the room & pointed to one & said "You can play with any of them except that one." Guess which one he wanted? Yep - the one that's "forbidden". Well, you're no different. No one wants to be told they can't have something - food or otherwise.

What exactly is a well-balanced meal plan for someone with diabetes?

With all the different opinions out there, you're probably confused. I can't say I blame you. There are so many contradictions to muddle through. One says a high protein is best. Another says high carbohydrate. Another one says you can't mix foodstuffs because they won't digest! Oh boy! It's no wonder you're confused.

Believe it or not, eating well for diabetes is not very different than eating for a healthy lifestyle. I truly believe (OR I have always told my clients) that the diagnosis of diabetes is really just a kick in the pants encouraging you to live a healthful lifestyle. Diabetes or not, everyone should eat a well-balanced, nutritious menu, participate in exercise on a regular basis & manage their stress. Having diabetes is nothing but a strong motivator to get you on the road to wellness.

Fact: everything you eat contributes to sugar or glucose because food has calories & calories provide energy. Remember this simple equation:

Food = calories = energy = glucose = "sugar"

Looking at this in more logical terms:

"The more calories you eat at a meal, the higher your blood sugar will usually be after the meal.

How Quickly Foods Turn to Blood Sugar

When you have diabetes, it's a good idea to realize that different foods turn to sugar at different rates. This is based on "the glycemic index" - a technique that compares how quickly different foods effect blood glucose. The higher the glycemic index, the faster the food increases your blood sugar.

For example, table sugar & jelly beans have a much higher glycemic index than brown rice or quinoa. Your blood sugar would increase much more quickly after eating a handful of jelly beans than it would after eating a cup of brown rice or quinoa.

The key to planning meals is to choose foods which turn to glucose more slowly & to eat a small amount of food from each food group at each meal. The foods which are absorbed more slowly will help slow the digestion of foods which would normally be absorbed more quickly.

However, it is also a good idea to avoid as much simple sugar as possible, since these foods (ie: gum drops, pancake syrup & fruit juice) are absorbed very quickly & cause a very big rise in your blood sugar.

This doesn't mean you can never have candy again. It's all a matter of give & take. If you really want a piece of candy & your overall goal is to have the best blood sugar control possible, you must be willing to give up something from another meal to compensate.

Rates of Food Absorption

1. Simple carbohydrates: Pure sugar foods (ie: table sugar, honey, agave, pancake syrup & jelly beans), fruit juice & fat free dairy products (ie: skim milk & fat free yogurt). Mind you, skim milk is still healthier for you than whole milk but because skim milk has a minimal amount of fat to help slow the breakdown, it is absorbed more quickly than whole milk.

2. Complex carbohydrates: Whole grain bread, potatoes, pasta, rice, legumes & vegetables.

3. Protein: Poultry, seafood, pork & beef. Low fat, lean proteins, such as turkey breast, seafood & egg whites are absorbed more quickly than higher fat choices, such as filet mignon & prime rib. However, the lean proteins are healthier for you, since they have less saturated fat.

Rule of thumb: "The higher the fat content of the food, the slower the absorption."

4. Fat: Butter, margarine, mayonnaise, ghee, & salad dressings. Condiments which are basically fat contain 100 calories per tablespoon! That means you consume 100 extra calories per tablespoon when you add these items to your meals. (A tablespoon is as big as a coffee creamer; not the large spoon in the silverware drawer.)

Now not all fat is bad. In fact, adding some healthy fats to your meals will help to slow the breakdown of the carbohydrates in your meal leading to less of a spike in your blood sugar after eating. The healthy fats are nuts/nut butters, avocado, olives & the oils from these. Now these are still calorie dense but they don't seem to increase cholesterol in the same way as the saturated fats do.

One personal suggestion to help you manage your blood sugar: do not drink fruit juice - unless you're having a low blood sugar reaction! That's right! I suggest that you avoid ALL fruit juice.

Why? Because drinking juice is the same as drinking a regular soda. Both are absorbed very quickly & cause a big spike in your blood sugar. It's much better to eat the fruit. At least then you'll acknowledge you're eating something & the fiber in fruit will help slow the breakdown. If you have been drinking juice with your morning medication, switch to water, unsweetened ice tea or a sugar-free drink like Crystal Light.

Not only will you prevent a sudden spike in your blood sugar - you'll save excess calories, too. :-)

Bottom Line on Absorption of Foods for Controlling Blood Sugars

For some reason, when people drink something, they often ignore the calories in the drink. A small 4 oz. glass of juice has the same calories as a serving of fruit but whole fruit will be digested more slowly. This is because it takes longer to eat it & has more fiber than juice - fiber helps slow digestion. So go ahead & enjoy 2 to 3 pieces of fruit throughout the day.

Fat free dairy products, such as skim milk & fat free yogurt, are also absorbed fairly quickly but their protein content helps lessen the spike. It is fine to have at 2 servings from this group every day. Dairy foods are the best source of calcium & vitamin D, which will help you maintain bone health & prevent osteoporosis.

A good rule of thumb for absorption rates is: "The lower the fat content, the faster the foods is absorbed." This does not in any way, shape or form mean that I am suggesting you go on a high fat kick. I am merely trying to explain food absorption in the easiest way I know how.

The trick to planning a meal is to make it "well-balanced." This means having foods from the different food groups at the same time. When you do this, the combination of foods will give a slower rise to your blood sugar.

Think of the colors blue & red. When you use each color separately, you get 2 distinct colors. When you combine them, the overall effect is purple. The same is true with food.

If you eat an orange & a chicken breast separately, they will effect your blood sugar differently - the orange will cause your glucose level to rise much faster than the chicken breast. Then eaten together, the protein & fat in the chicken slows the absorption of the sugar in the orange.

The result: a slower, smaller rise in blood sugar.

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