In The American Dietetic Association's (ADA) recent study, meal planning provided by a registered dietitian together with other diabetes treatment proved to be very helpful in controlling the disease.

Three forms of diabetes

Type I diabetes is the most serious but least common form and usually develops before age 30. People with this type of diabetes cannot make the hormone insulin in their pancreas to help energy (glucose) get into the body's cells. They need to take insulin and balance their food intake and physical activity with their insulin.

Type II diabetes is the most common and usually develops after age 40. Type II diabetes is more likely to develop if you are overweight and have high blood pressure, high levels of fat in your blood, or a history of diabetes in your family. The treatment is weight loss and increased physical activity, sometimes along with medication (pills or insulin injections).

Gestational diabetes develops in some women during pregnancy and often results in unusually large babies if not treated. Women who are overweight and older are more likely to have gestational diabetes. All pregnant women should be tested for diabetes between 24 and 28 weeks of pregnancy so that gestational diabetes, if found, can be treated.

Old beliefs don't stand up to new research

For a long time, nutrition experts thought that "sugars," such as candy and regular soda and "sweets," such as cakes and cookies, were off limits for people with diabetes. That was because they thought such foods raised blood glucose (sugar) too quickly.

Though it's hard to believe, research shows that sugars and sweets, or "simple sugars," don't raise blood glucose any quicker than starches, or "complex carbohydrates." So sugars and sweets aren't off limits. Simply follow healthy nutrition advice--eat sugars and sweets in moderation.

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No one "diabetes diet"

There's no one diet for diabetes. General guidelines exist, such as "eat less fat and saturated fat" and "eat more whole grains, fruits, and vegetables." Your diabetes meal plan must be based on your individual needs and developed with expert assistance from a registered dietitian. Also, use the Nutrition Facts information on food labels to help you choose healthful foods.

What's to eat?

Eat more whole grain and high fiber starches, such as bread, cereal, and starchy vegetables--6 servings a day or more.
Start the day with cold high fiber (dry) cereal with nonfat/skim milk or a bagel with one teaspoon of jelly/jam.
Put starch center stage--whole grain pasta with tomato sauce, baked potato with the skin with chili, wild rice and stir-fried beef and vegetables.Add cooked black beans, corn, or garbanzo beans (chickpeas) to salads or casseroles.

Eat more fruits and vegetables--try 5 a day.
Grab a piece of fruit or two as a snack.
Pack raw vegetables for lunch--broccoli, carrots, cauliflower, or peppers.
Add vegetables to chili, stir-fried dishes, or stews.

Eat sugars and sweets in moderation.
Pick your favorite sweets and include them in your meal plan once a week at the most.
Split a dessert to satisfy your sweet tooth while lowering the sugar, fat, and calories.

Eat less total fat.
Use low-fat or fat-free cream cheese, salad dressing, mayonnaise, or sour cream.
Just use less--butter/margarine, mayonnaise, cream cheese, salad dressing, or oil.
Use fat-free toppers--jam/jelly, mustard, salsa, fat-free yogurt, or sauces.
"Sauté" with flavored vinegars or lemon/lime juice.
When using oil, choose olive, canola, soybean, corn, sunflower, or safflower.

Eat less saturated fat.
Choose lean cuts of meats (beef, lamb, pork, or veal) and think of meat as the side dish, not the main course.
 Eat more skinless poultry and seafood prepared by grilling, broiling, or poaching.
Use low-fat dairy products--nonfat/skim milk, low-fat cheeses, low-fat yogurt, and low-fat dairy desserts.
Moderate your intake of foods that use hydrogenated fat as an ingredient.

Help is close by

Just as no one diabetes diet exists, no one meal plan or approach to meal planning exists. You must have an individualized meal plan designed for you, based on your diabetes treatment goals, eating habits, and lifestyle. Registered dietitians can help you develop a plan to fit your own needs.

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Remember you need your teeth to effectively chew the foods that your dietitian needs you to have in order to maintain proper glycemic control.

For more information

Your Guidelines to Diet and Diabetes

The above research has lead the ADA nutrition task force to conclude that monitoring total grams of carbohydrate, whether by carbohydrate counting, exchanges, or experience is a key strategy in achieving glycemic control. For some individuals, the use of the GI/GL may provide an additional benefit. It is suggested that individuals test pre- and postmeal glucose to determine their own response to foods rather than making assumptions based on published GI values or categories.

I would suggest that the concept of differing glycemic responses to meals is helpful after individuals have mastered meal planning basics. But we need to avoid the concept of "good foods" versus "bad foods" based on their GI values. This didn't work very well when sugars were "bad" and starches were "good." However, other health care professionals like this concept because it is easy to advise pts to avoid certain foods, such as "white foods." It also means they don't need to refer to dietitians because all pts need to do is avoid high GI foods.

Marion J Franz, MS, RD, CDE Nutrition Concepts by Franz, Inc. 2/06

The American Dietetic Association/National Center for Nutrition and Dietetics Consumer Nutrition Hot Line.
For food and nutrition information or for a referral to a registered dietitian in your area, call 800/366-1655. For customized answers to your food and nutrition questions by a registered dietitian, call 900/CALL-AN-RD (900/225-5267). The cost of the call will be $1.95 for the first minute and $.95 for each additional minute.

Month of Meals: Menus and Meal Planning Tips.
The American Diabetes Association. 800/232-3472.
Quick and Easy Diabetes Menus by Betty Wedman. Contemporary Books, 1993.
Diabetes Meal Planning Made Easy by Hope Warshaw.
The American Diabetes Association, 1996.

Nutrition Fact Sheet provided by American Dietetic Association

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