Diabetic Diet Tips

Benefits of a Bedtime Snack

Introduction
Diabetics are told to watch what they eat, keep their blood sugar under control and maintain a healthy weight. So, it would seem that a bedtime snack goes against all these instructions. Given the nature of diabetes and how it affects those diagnosed, the right bedtime snack can actually help them.

Why Diabetics Need Bedtimes Snacks
Depending on the diabetes prescriptions a diabetic takes, either injected insulin or an oral medication, he could experience a nighttime dip in his blood sugar levels. If the level goes low enough, this can be potentially deadly, so a small, healthy nighttime snack can help prevent this problem

Oral medications that have been implicated in nighttime hypoglycemia include glipizide, glyburide and glimepiride. If he skips meals, exercises at night or drinks alcohol, he is also at higher risk of developing symptoms of nighttime hypoglycemia.

Choose the Right Snacks
The diabetic patient who deals with nighttime hypoglycemia should choose about 1 ounce of protein and 15 to 30 grams of healthy complex carbohydrates. Low-fat cheese, skim milk, graham crackers, sugar-free pudding or low-fat yogurt with no sugar are all excellent choices.

Other good bedtime snacks include 1/2 cup of canned fruit in light syrup or a small piece of fruit. Combined with about 1/2 cup of low-fat cottage cheese, this gives him the protein and carbohydrates his body needs to avoid an episode of nighttime hypoglycemia.

Nighttime Hypoglycemia
Nighttime hypoglycemia develops when the amount of blood sugar and the amount of medication or insulin in the diabetics body are out of balance. He will wake up feeling bad; he may have a nightmare caused by his low blood sugar; soaking night sweats; confusion when he wakes up or a headache and he may feel extremely tired in the morning. If he does not discuss his symptoms with his doctor, he could slip into a coma, develop seizures or die. While that nighttime snack sounds like a frivolous allowance, it can save the life of a diabetic.

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Choosing Snack Foods

If you are a snacker and a diabetic, it can be hard to resist the quick pick-me-ups that you pass on the way to the check-out counter, or that my be lurking on your own kitchen shelves.

The average household has chips, crackers, candy, juices, soda and other fat and sugar-laden products around the house. For the diabetic, these foods can spell fluctuating blood sugars, signs and symptoms of high and low blood sugar, and increased risk for complications.

So, how do you choose the right snack foods? If you follow the guidelines of the American Diabetes Association (ADA), you can group your snacks by their category: carb, fat or protein. Knowing that it is recommended that you eat 50% of your calories in the form of complex carbohydrates, let's start here.

Some good carb snacks include:

* fresh fruit - apples, coconut or
fresh pears make a great snack and
are low in carbs
* vegies - eat all the carrots you
want, and toss in some fresh spinach,
radishes, green beans and salads, too
* whole grain breads - keep it to the
suggested serving size and you will
be fine
* 1 ounce chunks of low-fat cheese, or
yogurt or low-fat cottage cheese,
string cheese is great, too

ADA suggests 30% fats:

* cheese to the rescue, again
* 1 ounce of nuts
* olives are good too, just stick with
the serving size

They also suggest 20% proteins:

* lean slices of ham or turkey rolled
up for a quick grab
* nuts have protein, too, as does
cheese and yogurt

Keep pre-made servings of your favorite snacks in your fridge, for easy grabbing on the run. This way you don't have to think about how much to take, and this reduces your risk of overeating.

Clean out your cupboards and ditch the high fat, high calorie junk foods that tend to populate many peoples' shelves.

Add low-calorie juices, bottled water, and sparkling water to your snack shelves to encourage hydration while you snack.

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Six Smalls Meals

Though there is not a specific "diabetic diet," the American Diabetes Association has guidelines that they recommend for persons with diabetes.

These guidelines include 50% carbs, 30% fats and 20% proteins. Additionally, the concept of 6 small meals has been supported. There are several reasons for this:

* maintains more consistent blood sugar
levels
* reduces the urge to binge
* promotes hydration
* decreases hunger sensations,
especially in those who are reducing
calories or intake to promote weight
loss

1. When you eat at regular 2-3 intervals
throughout the day, your blood sugar
does not have time to drop to any
significant degree. This pattern of
eating decreases the roller-coaster
effect seen with 3 meals a day.

2. Frequent meals decreases the risk that
you will binge, as you consistently have
food on board, providing feelings of
satiety.

3. When most people eat, they also drink a
beverage. More frequent eating will
then also promote better hydration, just
make sure that you are drinking water,
low calorie fruit juice or other non-
caffeinate or alcoholic beverages, as
these will dehydrate you.

4. If you are "dieting" trying to lose
weight, the 6 small meals decreases
feelings of hunger. Even if the calorie
or quantity is decreased, the act of
eating every 2-3 hours reduces hunger
pangs, and will help you be more
successful in your weight loss efforts.

Whether you opt to eat 3 meals a day and a bedtime snack, or to go with 6 small meals, each day, remember these key things:

* 50% carbs, 30% fats, 20% proteins
* hydrate with non-alcoholic and non-
caffeinated beverages to a total of
at least 1 ounce for each 2.5 pounds
of your body weight
* test your sugar at regular intervals
* keep your Food Diary
* notify your doctor for repeated high
or low values, so that you can work
together to adjust your meal plan
and/or medications.

Talk to your doctor, Nutritionist or Registered Dietitian about your meal plan; they can provide you with more information about the risks and benefits of the meal plans and the best way to help you manage your diet and your blood sugars.

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The Role of Protein in the Diabetic Diet

There is no such thing as a diabetic diet, however the American Diabetes Association does recommend that you have 50% carbs, 30% fats, and 20% proteins in your daily diet.

The roles of protein include:

* to help stabilize blood sugars
throughout the day
* to provide amino acids to use as
skeletal muscle fuel
* provide a feeling of satiety at meal
times

Protein is required to help the body rebuild, and also provides needed nutrients not found in carbs and fats.

Protein comes from many sources, including:

* meats (also contains fat)
* cheeses (also contains fat)
* nuts (also contains fat)
* soy
* beans and lentils

The type of protein you choose is less important than making sure that you eat some, each day, to support healing and nutrition.

Talk to your doctor, Nutritionist or Registered Dietitian for more information about protein, and how to incorporate adequate supplies of protein into your diet.

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Balancing Carbohydrates, Fats and Proteins

According to the American Diabetes Association, carbohydrates should comprise no more than 50% of your diet, with the remaining 50% made up of 20% proteins and 30% fats. This formula is based on the way the body processes different types of food fuels.

Carbohydrates burn quickest and include grains, legumes (peas and beans) and vegetables. These foods tend to give you the quicker pick-me-up that lasts for a short time.

Proteins take longer to process and the energy level lasts longer than with carbohydrates, though less than with fats. Proteins generally include eggs and meats. This is what carries you through from meal to meal, when combined with fats.

Fats are the longest acting fuel source and provide baseline stability for your blood sugar over the course of 24 hours.

Together, these 3 types of fuel, in the right balance, provide for consistent blood sugars throughout the day, which promotes better health and reduces the risk of complications.

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Different Kinds of Carbohydrates

Carbohydrates come in many different forms from potatos, vegetables and legumes, to breads, rice and pasta.

Vegetables, unless packaged with sauces are included within many pre-packaged, pre-seasoned foods are a good source of carbohydrates. Vegetables contain water and fiber, which promotes bowel health and hydration, and they tend to be low in calories. Lacking high quantities of simple sugars, you will not get the rapid rise and subsequent rapid fall as you do with other types of carbohydrates.

Potatoes, breads, rice and pasta are also carbohydrates, however they are high in starches, break down rapidly into simple sugars and tend to be higher in calories. This can result in significant fluctuations in blood sugar levels, causing symptoms of high or low blood sugar. This does not mean that these foods are bad for a diabetic, however understanding how the body processes these types of carbohydrates is important to avoid they symptoms of blood sugar fluctuation.

Choosing whole grains and brown rice over white bread and rice reduces simple sugars and offers more fiber and higher nutrition. Additional, many whole grain breads contain nuts or seeds - members of the fats family - which provide for longer lasting stability in blood sugars.

For best results when considering carbohydrates, choose lower fat, whole grains, fiber and texture over simple sugars, processed breads and rice, to better sustain your blood sugars, obtain more nutritive value and promote optimum blood sugar control without the side effects of blood sugar fluctuations.

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Cooking With Low-Calorie Sweeteners

With the increased focus on reducing carbs and calories in our diets, low-calorie sweeteners are at the forefront. This is especially the case for persons with diabetes.

There are many reduced-calorie or low-calorie sweeteners currently available on the market. If you choose to cook with these sweeteners, keep these key things in mind:

* some low-calorie sweeteners lose
their sweetness when cooked at high
temperatures, or for long period of
time
* the sweetness equivalency to sugar
varies between low-cal sweeteners
* foods made with low-cal sweeteners
don't brown like those made with sugar
* low-cal sweeteners work best in
recipes where they only provide a
sweet taste, rather than bulk or
texture
* results can vary from sweetener to
sweetener, to check out the
individual product prior to including
it in your baking

When replacing sugar with a low-cal sweetener, the exchange is as follows:

Sweet One – 12 packets = 1 cup sugar
Equal – 24 packets = 1 cup sugar
Splenda – 1 cup = 1 cup sugar
Sweet N Low – 12 packets = 1 cup
sugar
Brown Sweet N Low – 4 tsps = 1 cup
brown sugar

Remember that this exchange is for the level of sweetness, not to replace bulk or add texture that you would normally get with sugar.

Talk to your nutritionist or registered dietitian about using low-calorie sweeteners for cooking.

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Recipes for the Diabetic

Here is a delicious recipe for a grilled chicken kabob.
Ingredients:
1 lb. chicken breasts/thighs cut into 1 inch pieces
4 green peppers, sliced into 1 inch wedges
1 zucchini cut into 1/2 inch slices
2 onions, cut into wedges
12 mushrooms (whole)
3 tomatoes cut into small wedges

marinade: 1/2 cup seasoned vinegar
3 Tablespoons oil
1/2 garlic clove, crushed
3 tsp. oregano leaves
2 tsp. basil leaves

marinate chicken wedges in marinade sauce for one hour before cooking

Take chicken and vegetables, and alternate them on metal skewers. Grill them on a covered grill over medium hot coals until chicken is well cooked (no longer pink), turning the kabobs as they cook.
Oven: grill in oven in grilling pan for 10 to 15 minutes, until chicken is cooked through, turning halfway through cooking time.

Serving suggestion:
You can serve this with 1/2 cup cooked pasta or rice on the side.

Two kabobs alone =1 starch, 3 lean meat, 3 vegetable exchanges; total fat 5 g; carbohydrate 32 grams.

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The Role of the Nutritionist

A nutritionist is a person who has education and training on diets and nutrition, and who can advise you on healthy eating and nutritional topics.

A nutritionist is not a Registered Dietitian or licensed as a healthcare practitioner. They may have a degree in nutrition, but this is not required, in order to be a nutritionist.

When you have diabetes, there are many questions, including:

* What should I eat?
* What can't I eat?
* Is there a special diet I should
follow?
* Why do I need to eat a bedtime snack?

A nutritionist can help to answer these questions, while also providing:

* information on eating properly
* nutritional information regarding
different types of foods
* weight loss suggestions/ideas
* support during your diet challenges
* coaching for meal problem-solving

When you have diabetes, you don't have to tread the diet and nutrition waters alone. Talk to your doctor about a referral to a nutritionist or registered dietitian to help you develop appropriate meal plans, and to problem-solve your nutritional needs and concerns.

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Low-Calorie Sweeteners

Recent studies have shown that sugar can be included in the diabetic diet, however that does not mean that you should give up on low-calorie sweeteners.

Sugar must be figured into your carbohydrate count, however low-calorie sweeteners generally do not have any calories or carbohydrates. This makes them free foods!

Low-calorie sweeteners have a place in your diet plan:

* they make food taste sweet
* they do not count as a carbohydrate
* they are not a fat
* they can be added to your meal plan
instead of substituted
* they are FDA approved
* the American Diabetes Associates
accepts these sweeteners as safe and
part of a healthy diet

There are different types of low-calorie sweeteners, but the 4 primary types are:

1. Saccharin - Sweet N Low, Sugar Twin
2. Aspartame - NutraSweet, Equal
3. Acesulfame Potassium - Sweet One, Sunett
4. Sucralose - Splenda

These low-calorie additives will not add calories, fats or carbs to your diet, and can be enjoyed without worrying about effects on your blood sugars or your waistline.

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Risks and Benefits of Low-Calorie Sweeteners

There is alot of information out there about sugar and reduced-calorie or low-calorie sweeteners. It can be hard to get the facts that you need, to make the best decisions regarding your diet plan.

If you are considering adding reduced or low calorie sweeteners to your diet, you may want to consider the following risks and benefits:

Risks:

1. Sugar-alcohols - one type of reduced-
calorie sweetener - are neither sugars
nor alcohols. They are used to sweeten
sugar-free gum and candy and can cause
diarrhea and other stomach upset,
elevate your cholesterol and blood sugar.
2. Nutrasweet in large quantities may
actually increase your appetite.
3. Saccharine, though not widely used
anymore, is believed to cause cancer
in rats.
4. Low-calorie sweeteners have no nutritive
value.
5. They may alter the taste of beverages
and food products, and some can leave an
aftertaste.

Benefits:

1. Low-calorie sweeteners, with the
exception of sugar-alcohols such as
mannitol and sorbitol, are "free foods" -
they add no calories or carbohydrates to
foods and beverages.
2. Many now have a similar taste as sugar.
3. You can cook with low-calorie sweeteners
by following special recipes.
4. They contain no fats, carbs or proteins
5. They can be added to your diet instead
of being substituted
6. The ADA accepts them as part of a
healthy diet.

Making the decision about whether to use reduced or low-calorie sweeteners requires some research.

Talk to your doctor, Nutritionist or Registered Dietitian about which reduced-calorie or low-calorie sweetener would be right for you.

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Carbohydrates in Fruits and Vegetables

Different foods have different carbohydrate values and it's important to be aware of which fruits and vegetables are high in carbs, so that diabetics can effectively balance their diets.

If you like fruit, go with raw apples and pears, coconut, apricots and all kinds of berries, including currants. Vegetables that are low or moderate in carbs include green beans, beets, cauliflower, broccoli, lettuce and other greens.

Fruits and veggies that are higher in carbs are grapes, most citrus fruits (because of the membranes), breadfruit, pineapple, peas, corn and hominy.

Fresh, steamed, baked and raw are generally better than other methods for preparing fruits and vegetables, as important nutrients can be lost with cooking, and heating some foods can alter not only their consistency but also their carb count.

As with all things, moderation is the key to a balanced and healthy diet, for persons with or without diabetes,

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The "Sugar-Free" Dilemma

May products are now touting "sugar-free," "low fat," "low carbs," and more. Does something being sugar-free or low in fat make it safe for a diabetic to eat? Actually, a simple carbohydrate is a simple carbohydrate, in terms of your disease, however sometimes the difference is in how the body processes the carb.

In foods that contain simple sugars, the body processes the sugar-fuel very rapidly, causing a spike in your blood sugar. Often you then have a boomerang effect of a sudden drop in blood sugar, leaving you feeling dizzy, nauseated and weak.

In "sugar-free" foods, frequently the sugar-substitute is actually another naturally-occurring "sugar" like fructose or lactose. In foods containing lactose, maltose, fructose or honey, the only thing that makes them "sugar-free" is the lack of cane sugar. They DO contain another natural form of sugar, and you can anticipate a similar rise and fall of blood sugars, though due to the increased complexity of the molecule, the effect is generally less dramatic.

Today's most popular artificial sweetener -- Aspartame -- is actually sugar-based, but it's molecules have been modified to remove the sugar-base structure that is problematic in simple sugars, with those who have diabetes. However, sugar-free does not mean that you can eat all you want.

Be smart about your diet plan. Get a referral to a Registered Dietitician or Nutritionist to help you take the "fat" out of nutrition labels. Being smart about your diet will help you better control your disease and reduce the risks of complications

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Low-Sugar Jams and Jellies

There is a wide variety of low-sugar and sugar-free jams, jellies and preserves on the market. Many people also like to can their own, but diabetics must be cautious of their sugar and carb intake. If you are a home-canner and wish to try your hand at low-sugar or sugar-free recipes, here are some things to keep in mind:

* In addition to adding sweetness, sugar
also helps in gel formation, and
reducing the risk for spoilage.
Lowering your sugar content can impact
gelling and preservation.
* Low-calorie sweeteners have different
stability when heated, with some losing
some of their sweetness with cooking.
* Jellies and jams that are made without
heat processing will need to be
refrigerated to prevent spoilage.

Making your own low sugar jams and jellies can be fun, and you can have more variety in your flavors if you mix and match your favorite fruits.

Contact the company that makes your canning jars for recipes.

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Water and Diabetes

Have you ever seen a recipe where it calls for "reducing" something by 50%? What this refers to is cooking the water out of the food until it is 1/2 the volume that it was when you started. This process concentrates the food.

When your body gets low on water, everything becomes concentrated. This includes your blood sugar. When you are dehydrated, your urine gets darker, you become constipated and your blood sugars go up.

Ideally, each person should drink 1 ounce of water each day, for every 2.5 pounds of body weight. When you do not reach this goal, everything is more concentrated in your blood stream - this includes your blood sugar.

When you see a high blood sugar, you then treat it by changing the dose of your medication. However, f the blood sugar elevation is false, because you do not have enough fluids on board, you may be giving yourself unnecessary additional insulin.

The best way to avoid dehydration and the possible complications is to:

1. drink 1 ounce of water for every 2.5
pounds of your body weight
2. avoid beverages that dehydrate you, such
as coffee, sodas with caffeine, sugary
beverages and anything alcoholic
3. if you are exercising, add more water to
compensate for sweating and rapid
breathing - you lose water when you
breathe fast
4. if you are doing urine dipsticks, check
your specific gravity (the concentration
of your urine). If the value is higher
than 1.030, than you need to get more
water on board.

Keep up on your Food Diary to help you track trends on your blood sugars, and your hydration status.

Talk to your doctor or Dietitian about more ways to keep hydrated.

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Reduced Calorie Sweeteners - Sugar Alcohols

Sugar-alcohols do not actually contain alcohol, and are not true sugars. They are one type of lower calorie sweetener commonly used in sugar-free gums, candies and desserts, which is converted to both fats and carbohydrates in the liver.

Large quantities of sugar-alcohols can contribute to elevated cholesterol, and high blood sugars, especially if the blood sugar is already out of control.

Some examples of sugar-alcohols include:

* mannitol - a seaweed extract
* sorbitol - made from fruit sugars
* xylitol - birch wood extract

There are some identified health benefits to using sugar-substitutes, including: 1) decreased risk for ear and urinary infections, 2) decreased incidence of tooth decay, and 3) no impairment of immune function, which is seen with high levels of sugar consumption.

However, using sugar-alcohols also pose risk for some persons, including:

* worsening of Irritable Bowel Sundrome
* diarrhea
* nausea
* increased risk for disease of the
retina (specifically fructose)
* elevated triglycerides (bad
cholesterol)
* blood sugar spike if your blood
glucose is already high

For the diabetic, the risk for eye disease is a considerations that should not be taken lightly, and the concerns regarding blood sugar spikes and elevated triglycerides can make a strong case against the consumptions of sugar-alcohols.

Read the nutrition labels of gums and sugar-free candies for the type of sugar-free sweetener used, and consult your physician, Dietitian, Nutritionist or other healthcare provider for information about sugar-substitutes and their impact on your diabetes.

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Keeping Your Carbohydrates in Check

When you think of carbohydrates, what comes to mind? Bread, pasta or rice? Jelly, honey or sugar? Fruits and vegetables? Well, ALL of these are carbohydrates!

All of these foods must be figured into your diabetic meal plan, in conjunction with fats and proteins, to stabilize your blood sugar and reduce the risk for complications associated with high or low blood sugar.

One key to keeping your blood glucose on target is to balance your carbs throughout the day. It's a good rule of thumb to average between 45-60 grams at each main meal, though this can vary depending on your weight and whether you are trying to lose weight.

Serving sizes are another important part of managing your carbs. Check the container for the recommended serving size, i.e. one small apple is one serving, or 1/2 cup of applesauce, or 1 slice of bread. Keeping within the recommended portions gives you more room to add variety to your daily carb selections, while keeping your numbers in line.

Be creative and think outside the box. If you want to sweeten up your snack or meal, check the carbs and make a "trade." If you want cookies at lunch, try adding chicken to a green salad, instead of having a chicken salad sandwich. With this, you are trading the bread portion for the cookies, and still staying within your meal plan.

In the diet recommended by the American Diabetes Association, carbohydrates should make up approximately 50% of your daily dietary intake. By setting a carb goal for your meals and snacks, keeping to the suggested serving sizing and being creative, your can keep your carbohydrates in check.

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Sugar and Other Sweeteners with Calories

Experts used to believe that sugar would cause rapid blood sugar increases in the diabetic. Studies have shown, however, that sugar has about the same effect on blood glucose as any other carbohydrate, raising the blood sugar at about the same rate.

Diabetics need to work sugar into a diet plan, applying them as you would any other carbohydrate. Remember that most sweets and desserts that contain sugar do not provide the nutritive value you can find in healthier foods, and many of them are higher in fat and calories.

Though sweeteners such as honey, brown sugar and molasses may sound healthier, they are sugars, too, and must also be figured into your meal plan as carbohydrates.

Satisfying your sweet tooth CAN be accomplished while still keeping within your meal plan. Try these:

* dried or fresh fruit
* downsize your favorite sweet treat
* reduce the fat and sugars in your
favorite recipes
* choose lower calorie, lower fat
versions of your favorite sweets
* use a low calorie sweetener instead
of sugar

Keeping within your meal plan can be a challenge when you have a sweet tooth, however keeping in mind that all sugars add up the same, can help you make smart choices about your sweet treats!

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The Glycemic Index and Diabetes

When a person eats a food which contains carbohydrates, like bread or vegetables, their blood sugar rises. Interestingly enough, however, is that not all carbohydrates raise blood sugar at the same rate.

How high the blood sugar rises three hours after eating a carbohydrate is known as its "glycemic index."

Armed with this information, you can make better choices about they types of foods -- especially carbohydrates -- that you are eating, to help avoid blood sugar spikes.

Food for thought: the simpler the carbohydrate, the more rapid the spike, since the body does not have to expend much time or energy to break it down.

So, if given the choice between eating a chocolate kiss and a piece of fruit, the fruit will take longer to process and therefore cause less of a spike than the chocolate., and will therefore have a lower glycemic index!

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Alcohol and Diabetes

Alcohol is considered a carbohydrate, and it breaks down very easily into simple sugars. Due to this fact, it can have a dramatic effect on your blood sugars.

Just as you would see if eating chocolate, the blood sugar rises sharply, and then subsequently drops just as quickly, which can result in symptoms of hypoglycemia - low blood sugar - including dizziness, weakness, sweating and nausea.

Alcohol also acts as a diuretic, pulling fluid from the body and contributing to dehydration. Dehydration results in concentration of sugars in the bloodstream, which significantly impacts the effectiveness of insulin, requiring adjustments in your insulin dosages.

Talk to your doctor about the effects of alcohol on your diabetes, to reduce the risk for negative outcomes. When in doubt, leave it out!

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Carbohydrate Choices on the Diabetic Meal Plan

According to the American Diabetes Association, there is no such thing as a "diabetic diet." Instead, they promote a healthy diet with a combination of 50% carbohydrates, 20% proteins and 30% fats.

In terms of carbohydrates, one fruit exchange is equal to one carbohydrate, such as one small apple, or 1/2 cup of orange juice.

One starch exchange is one carbohydrate, such as one slice of bread, 1/2 cup cooked cereal, or 1/2 of a medium baked potato.

Vegetables are lower in carbohydrates, and 1/2 cup of most non-starchy vegetables will be about 5 grams of carbohydrate, so 1 1/2 cups of broccoli would equal one carbohydrate choice, for example.

Eight ounces of low fat milk or sugar free yogurt is also one carbohydrate choice.

Learning to use "exchanges" allows to you go into any dining setting and make good choices regarding your carbohydrate. Ask your physician for a referral to a Nutritionist or Registered Dietitian, or contact your local chapter of the American Diabetes Association for more information about food exchanges and your diabetic meal plan.

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Keeping a Food Diary

For the diabetic person, diet is one of the primary tools used to control the disease, reduce adverse symptoms and promote health and well-being. The American Diabetes Association recommends a diet consisting of 50% carbohydrates, 30% fats and 20% proteins. This diet "blend" provides for stable metabolism and decreases the roller-coaster effect in your blood sugars.

How do you know if you are doing well with these dietary guidelines? By writing it down, of course!

It doesn't have to be complex - a small spiral notebook in your purse or pocket, and a pen, are all you need to start your diary. Put the date at the top of the page and jot down what you eat for meals, snacks and beverages. At the end of the day, look over your list and make little notes about how you felt after each meal or snack, what your mood was, and how you responded.

Many people find that when they are feeling blue or frustrated, they tend to eat more simple carbs - they provide a quick pick-me- up, but also a quicker drop in sugars, as well. This can leave you feeling even bluer or low on energy - making you want to get a quick boost, again.

In recognizing your own eating patterns, you can put a plan in place to cope with your blue moods and life frustrations, without sabotaging your diet and your health.

Then you can jot down your successes, too!

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Why Should I See a Registered Dietitian?

A Registered Dietitian has a degree in Nutrition/Dietetics and clinical training, has passed a National Exam and is considered a diet and nutrition expert. They are professionally licensed in each state and have a professional association.

They can provide you with important information on your dietary needs, in terms of your diabetes, and can help you:

* learn about foods and their risks and
benefits on your diet plan
* design healthy menus that are tasty
and work within your diabetes plan
* understand how the body processes
food nutrients and the impact on body
systems
* map out a weight loss plan
* monitor your nutritional markers
(albumin, hemoglobin, A1C)
* make recommendations to your
physician for dietary changes, labs
or supplements

These professionals specialize in diet and nutrition and, like any other specialist, they have the most current knowledge in their specialty, and possess the tools necessary to help you manage your diet, lose weight and eat healthier.

Their knowledge aids you in reducing risks for complications related to diabetes, including:

* high cholesterol
* high blood pressure
* obesity
* stroke
* anemia
* ketoacidosis

A Registered Dietitian is an important part of your healthcare team, to better manage your diabetes and reduce the risk for serious complications.

Talk to your doctor or Diabetes Educator for a referral to a Registered Dietitian in your area.

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Reading Nutrition Labels

The Nutrition Information provided on food labels can help you make good dietary choices, and avoid some nutritional pitfalls, that can impact your diabetic meal plan.

When looking at a nutrition label:

1. Make note of the calories - this value
includes carbohydrates, fats and
proteins. It isn't just about the
calories, but about the percentage of
calories that are fats, carbs and
proteins.
2. Look at the number of calories made
up of the fat portion of the product.
If the fat content is higher then 25% of
the total food value, you may want to
skip this food.
3. For the fat calories, look at saturated
and unsaturated fats. Unsaturated fats
are easier for the body to breakdown and
are, therefore, healthier.
4. Is the food product sugar-free or low-
calorie? Remember that many low-calorie
or sugar-free foods still have carbs.
Look for the carb content, and then for
the sugar content. Fruit may be
naturally sweet, but that sweetness
comes from a type of sugar, and that
counts in your carbs.
5. Pectin used to thicken foods is a carb,
and may add calories to your foods, such
as jams, jellies and fruit spreads.
Even low-sugar jams may contain pectin,
and therefore have carbs, though may
have less nutritive value.
6. Check out the fiber. Fiber is important
to combat constipation - a complication
of diabetes. Foods should contain at
least 3 grams of fiber per serving to
have an impact.
7. Sodium is also a concern, especially in
managing blood pressure. A low sodium
diet has 2000 mg of sodium. Shoot for
values between 2000 and 3000 mg to
reduce the impact on blood pressure and
fluid retention, unless your physician
directs otherwise.

Learning to get the most out of nutrition labels will help you get the most out of your foods.

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Fad Diets and Diabetes

Every time you open a newspaper, there is another diet being touted as the best new breakthrough in losing weight.

Quick and easy schemes for losing weight may seem appealing, especially if the doctor has told you to drop pounds in order to better control your diabetes, and losing weight has not been easy for you, in the past. But what impact do these fad diets have on your body and your disease?

Some popular "new" or fad diets are:

* Atkins Diet
* Southbeach Diet
* Blood Type Diet
* Mediterranean Diet

In looking at each diet, there are both risk and benefits for the diabetic person that need to be considered, and discussed with your physician, before beginning the diet.

1. The Atkins Diet - this diet is based on the belief that our bodies do not manage carbs effectively, and we must retrain them. The diet is high protein and fat, and gradually adds carbs.

Risks: 1) High fat diets can increase cholesterol - a risk factor for developing diabetes and complications of diabetes,
2) High protein levels have been implicated in diabetes in young people, are difficult for the kidneys to process and can cause ketoacidosis - a serious complication of diabetes associated with the body using protein and fat for fuel, instead of carbs

Benefits: 1) rapid weight loss

2. Southbeach Diet - a three-phase plan that is also low-carb, high in proteins, but low in fats, in which you gradually add your carbs back in, using a list of "Foods to Enjoy" and "Foods to Avoid."

Risks: 1) Low carbs and high proteins can cause ketoacidosis - a serious complication of diabetes

Benefits: 1) Three meals + six snacks each day decreases cravings and roller-coaster blood sugars, 2) Uses Glycemic Index (the rate at which a food raises the blood sugar) to help make food choices - leans toward whole grains, fresh fruits and veggies.

3. The Blood Type Diet - touts that different blood types need different types of nutrients, and that eating the "wrong" food their their blood type would cause serious injury to the body.

Risks: 1) Not based on scientific fact, the information in the diet may frighten or mislead the readers, into unnecessarily limiting intake, 2) Limits foods for certain blood types, that have known health benefits, which may result in high cholesterol, ketoacidosis, anemia, and malnutrition.

Benefits: 1) None identified.

4) The Mediterranean Diet - based on intake of a wide variety of grains, fruits and vegetables, moderate protein, unsaturate fats and seafood.

Risks: 1) Suggests wine in moderation - causes blood sugar fluctuations and can contribute to mood swings.

Benefits: 1) Low in red meats and animal fats, touting fish and unsaturated fats can decrease cholesterol, 2) Balanced diet including all food types, to provide core nutrients, 3) High in essential fatty acids and antioxidants - touted as cancer preventatives

Each diet listed above has both risks and benefits, with some demonstrating greater potential risks for complications for persons with diabetes, due to the complex needs of your body.

Obtain information about the diet you are considering, and then meet with your physician, Nutritionist or Diabetes Educator to discuss the risks and benefits of the diet, and it's potential impact on you.

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Dietary Fat and Diabetes

Everyone knows the word "cholesterol" and we also know that it is supposed to be "bad" for us, but not enough people know why.

For the non-diabetic person, cholesterol contributes to fatty plaques that can form inside the blood vessels. This causes narrowing of the blood vessels, resulting in poor circulation and high blood pressure. Also, parts of these plaques can break off and travel to the lungs, heart and brain, causing heart attack, stroke and pulmonary embolus. Any one of these can be fatal.

For the diabetic person, the risks increase further, since simply having the disease already contributes to circulatory problems, heart disease, kidney disease (impacts blood pressure) and increases your risk for stroke.

Many dietitians now recommend that dietary fat be 30% or less of the diet, with less than 10% of the diet as saturated fats. Saturated fats do not break down as easily within the body as unsaturaged fats, and are therefore mor apt to cause health problems.

Keeping your saturated fats low, your total fat intake not more than 30% of your diet and embracing a healthy lifestyle that includes proper diet, exercise, fluids and blood sugar monitoring, can help to decrease your risk of developing heart, kidney and neurologic disease.

Here's to your health!

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Being a Diabetic Vegetarian

Yes, you can be diabetic and a vegetarian.

As with most vegetarian diets, ensuring complete sources of protein and adequate sources of fats are key to stabilization of blood sugars, since both are vital for the diabetic.

For vegetarians who eat eggs and cheese, getting adequate protein and fat can be less challenging than with more restrictive vegetarian diets. However, beans and rice, soy foods and beverages, nuts and nut-based products can provide the necessary protein and fat resources the body requires to sustain blood sugar levels and prevent hypoglycemia.

As with any diabetic diet, three primary meals combined with snacks (or six small meals) offers the most satisfactory results in terms of blood glucose management.

A nutritionist or registered dietitian can assist you in mapping out a diet plan for your diabetes that honors your dietary choices, and provides you with the important nutrients in the necessary quantities to support blood sugar stability and reduce the risk for diabetes-related complications.

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Portion Control: Everything in Moderation

You have the heard the phrase, “everything in moderation.” This also holds true when you have diabetes.

Portion control is an important part of managing your blood sugars, stabilizing your metabolism and ensuring adequate nutrition.

How do you determine a portion? That depends on what you are eating. For example:
* ice cream comes in a ½ cup portion
* most vegetables also come in ½ cup
servings
* cereals are generally ¾ cups to a
serving
* meat is 2-4 ounces, depending on the
meat or fish product
* one egg is a serving, as is 1 ounce
of cheese, 8 ounces of milk, and 4
ounces of fruit juice
* yogurt comes in an 8 ounce serving
* cottage cheese comes in ½ cup

If you are not used to eating according to the recommended serving sizes, the amount may seem small, at first.

Drink extra water at each meal, to provide a feeling of fullness, eat slower, take smaller bites and put your fork or spoon down between bites. These tips will help you feel more full, and make the portions seem more reasonable.

As always, talk to your Nutritionist or Dietitian to get more serving size information and suggestions for taking control of your portions and your diet.

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Eating Out Without Blowing Your Diet

Eating out does not have to mean trouble for those with diabetes, but here a few guidelines to help you navigate the eating-out dilemma:

1) When eating out, ask for a nutrition
guide. Almost all restaurants and
fast food places have nutrition
guides, with the calories, fat
content, and carbohydrate amounts
for different foods to help you make
good food choices.
2) Choose traditional restaurants over
fast food, whenever possible. They
serve a wider selection of foods,
which can be prepared to order, with
lower fat and sugar content
3) Look for the low fat or "Heart
Healthy" menu choices, and then
choose the smaller of the available
portions, i.e. 6oz versus a 10oz
steak.
4) Avoid alcoholic beverages and the
dessert tray. Go for fruit juices,
water or milk, and simple desserts
such as ice cream or a fruit cup.

For additional tips on eating out with diabetes, contact your local chapter of the American Diabetes Association.

Eating out is an enjoyable experience, and having diabetes should not take the fun out of it. Bon Apetit!

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