Food For Thought
Nutrition help for diabetics.
By Robyn Webb, M.S., L.N.
TWEENS & TEENS News November
2007
Meal Planning
Your most valuable friend in managing your diabetes
is a registered dietitian, preferably someone
who is a certified diabetes educator or CDE.
If you have not seen a registered dietitian,
ask for a referral from your doctor. The dietitian
should be able to design a food program to suit
you and your needs.
Whatever the dietitian designs, it is up to
you to follow the food plan. The first step
in understanding the role that a good diet plays
is to know there are many approaches to meal
planning. You may have to try a few different
approaches to see what works best for you.
The Diabetes Food Pyramid
The diabetes food pyramid has six sections
or food groups: grains, beans and starchy
vegetables; vegetables; fruit; milk; meat
and meat substitutes; and fats and sweets.
The pyramid approach uses the number of servings
from each group as a basis to develop a food
plan. Foods from the large bottom portion
of the pyramid are the healthiest, and as
you get to the top of the pyramid, sweets
and fats should be eaten less often.
The bottom line for diabetics: Eat foods that
help to keep your blood sugar under control.
In addition to taking your insulin, exercising
and getting a good night’s rest, having
a good food plan can go a long way to grant
you blood sugar control.
Exchanges
The exchange program was one of the first
ways people with diabetes managed their food
intake. Exchange lists organize food into
eight different exchange groups— breads/starches,
fruits, milk, vegetables, meat/protein, fats,
other carbohydrates and free food. Because
each serving or exchange within a group has
the same nutritional value, foods in each
exchange list can be substituted with other
food from the same list. For example, you
can substitute one slice of bread for ¾
of a cup of dry cereal. Again, a dietitian
can prescribe the number and type of exchanges
to be eaten at every meal.
Carbohydrate Counting
What do an apple, a bagel and string beans
have in common? They are all carbohydrates!
More than half of the food we consume turns
out to be carbohydrates. Carbohydrates have
taken a bad rap over the years, supposedly
causing weight gain. However, you need carbohydrates—
they comprise the food group providing the
energy to get through your busy day.
Carbohydrates have the most direct effect
on your blood sugar readings. Therefore, it
makes sense to count the number of carbohydrates
in your food program. If you figure out how
many grams of carbohydrates you eat in a meal,
you can match it with the right amount of
insulin to bring your blood sugar back to
normal. This method offers a huge amount of
freedom and flexibility in your daily life.
A dietitian can help you with carbohydrate
counting. He or she will determine the number
of carbohydrates you should have each day,
and then will divide that number among your
meals and snacks. No two people with diabetes
eat the exact number of carbohydrates each
day. The number is based on your age, activity
level and schedule.
A dietitian can also teach the difference
between carbohydrates you should have on a
limited basis versus better carbohydrates.
Carbohydrate counting works well because it
keeps you from giving up your favorite sweets
altogether; you just have to recognize how
much you consume. However, a good healthy
food program recognizes that fruits, vegetables
and whole grain foods should be eaten more
often than desserts and sweets. In addition,
a good carbohydrate counting program prompts
a diabetic person to calculate the amount
of protein and fat that should be eaten each
day.
Managing Your Diabetes
Conflicts generally prevent diabetics from
always having perfect blood sugar readings.
Read on for ways to avoid low blood sugars
and, should they occur, how to promptly treat
lows.
Symptoms of low blood sugar include dizziness,
trembling, sweating, sudden fatigue, irritability,
headaches, stomachaches and mood changes.
But the most drastic effect of low blood sugar
would be having a seizure or falling into
a coma.
To help prevent low blood sugar, run through
this checklist when considering your food
intake: Have you had too much insulin? Then,
monitor the amount of insulin you need if
you continue with a lot of lows. Have you
eaten too little? Try not to skip meals or
eat less than you are supposed to. Have you
exercised too much? Test your blood sugar
before any activity. If there is a chance
your blood sugar may fall lower, eat something
before exercising.
Treat low blood sugars immediately by keeping
a stash of one or several of these items in
your backpack:
•2 to 3 glucose tablets •3 to
4 ounces of orange juice •4 to 6 ounces
of regular soda •5 lifesavers •a
small tube of cake frosting •any high
carbohydrate and low-fat food that you like.
Check your blood sugar within 15 minutes
after consuming any of the above items. If
your blood sugar has risen to a normal state,
then you will be fine. If your next meal is
more than one hour away, then follow a low
blood sugar episode with a small snack that
has a little fat in it. A more substantial,
slowly digested snack like cheese and crackers
or a quarter of a peanut butter sandwich should
help prevent the recurrence of low blood sugar.
Diabetics should consider wearing a medical
alert identification bracelet or necklace
in the event of severe low blood sugar, also
known as hypoglycemia. Also, let your friends
know the signs of low blood sugar, so they
can quickly react by calling for medical help.
Let’s Eat!
Likely the most important aspect of managing
your diabetes is having food that tastes good
to you. Following are two diabetes-friendly
recipes that many kids favor.
Lazy Lasagne Roll-Ups
Serves: 6
Ingredients
For the filling:
•1 cup part-skim ricotta cheese •3
lb. firm tofu, mashed •3 Tbs. grated
Parmesan cheese •1 tsp. each of dried
oregano, basil and thyme •salt and pepper
to taste
•2 cups marinara sauce
•6 lasagne noodles, cooked according
to package directions, drained and rinsed
under cold water
•2 cups shredded part-skim mozzarella
cheese
Directions
Preheat the oven to 400 degrees. In a medium-size
mixing bowl, combine all the filling ingredients.
Spread 1 cup of the sauce in the bottom of
an 8-inch square baking dish. Place the lasagna
noodles on a clean surface or cutting board,
and spread some of the filling on top of each.
Roll up the lasagna jelly-roll style and place
each roll seam-side down in the baking dish.
Spoon over the remaining sauce and top with
the mozzarella cheese. Cover with foil and
bake for 20 minutes. Remove the foil and continue
to bake until the sauce is bubbly and the
cheese has melted, about 15 minutes. Serve
immediately.
Spicy Finger-Lickin Fried Chicken
Strips with Blue Cheese Dip
Serves: 6
Ingredients
For the dip:
•2 cups non-fat mayonnaise •1
Tbs. wine vinegar •1 small garlic clove,
peeled and minced •3 cups crumbled blue
cheese •3 tsp. salt •freshly ground
black pepper
For the chicken:
•1 pound chicken tenderloins, trimmed
•2 cups low-fat buttermilk •dash
of Tabasco sauce •2 cups all-purpose
flour •2 tsp. salt •2 tsp. paprika
•3 tsp. freshly ground black pepper
•dash of ground red pepper •2
Tbs. canola oil
Directions
In a small mixing bowl, stir together the
dip ingredients, cover and set in the refrigerator
until ready to serve. In a shallow bowl, combine
the buttermilk and Tabasco. In another shallow
bowl, combine the flour, salt, paprika, black
pepper and ground red pepper. Moisten the
tenderloins in the buttermilk mixture, then
dredge each one in the flour mixture, shaking
off any excess. Set aside on a clean plate.
Heat the oil in a heavy non-stick skillet
over medium-high heat. Add the tenders and
cook, until crispy and golden, about three
minutes per side. Remove and drain on paper
towels. To serve, transfer the dip to a small
bowl and place in the center of a platter,
arranging the chicken around.
Robyn Webb, MS, LN, is an award-winning
nutritionist, cookbook author and owner of
Pinch of Thyme Nutrition and Culinary Services
in Alexandria, Virginia. Her ten cookbooks
include the much anticipated, You Can Eat
That!: Awesome Food for Kids with Diabetes
(Cleveland Press). She is also the associate
editor of Diabetes Forecast Magazine, the
award-winning magazine of the American Diabetes
Association.
