dsmt nutrition 2012- debi edited

Life with Pre-

diabetesLearn to eat with

Pre-diabetes

Did You Know?

Total prevalence of diabetes:

Total: 29.1 million children and adults in the United States

Diagnosed: 21.0 million people

Undiagnosed: 8.1 million people

Prediabetes: 86 million people

ObjectivesParticipants will be able to:

Stage 3 actions to prevent diabetes

Describe treatment plan for pre-diabetes

Describe one day’s menu for diet prescription

Prediabetes

Associated Associated ConditionsConditions

What is Prediabetes?

o People with prediabetes have blood sugar levels that are higher than normal, but not high enough for a diagnosis of diabetes.

o Without lifestyle changes to improve their health, 15% to 30% of people with prediabetes will develop type 2 diabetes within 5 years.

How can Type 2 diabetes be prevented?

Modest weight loss

5-7% of body weight (which is 10-14 lbs for a 200 lb person)

Regular physical activity!

150 minutes each week of physical activity (ex: brisk walking)

Both can help delay type 2 diabetes by 58% in people with prediabetes.

How the Body Gets Energy?

Food is composed of protein, fat, carbohydrate, vitamins, minerals and water

Digestive system breaks down food into more simple nutrients, one of which is glucose-needed by cells for energy

Some of the glucose is stored in the liver but the majority enters the bloodstream.

Glucose needs the help of insulin to enter most cells.

Think of insulin as a

Role of Diet Food Raises blood glucose

What, when and how much food is eaten affects how much the blood glucose goes

Reasons for Meal Planning

Maintain blood glucose as close to target range as possible.

Maintain cholesterol (blood fats) and blood pressure as close to target as possible.

Prevent, delay, or treat diabetes-related complications.

Improve health through food choices.

Meet individual nutritional needs

Healthy Food Choices

3 Things Directly Affecting Blood Glucose

Timing of Food Intake

-- Small amounts throughout the day help keep glucose levels more even.

Portion Sizes -- Too much food at one time raises

blood glucose Food Composition

-- Some foods make your blood glucose go up higher and faster.

The Glycemic Index

A ranking system that shows how a carbohydrate-containing food raises blood glucose.

Foods are ranked based on how they compare to a reference food

Glucose

White bread

The Glycemic Index

A high GI food raises blood glucose more than a medium or low GI.

A low GI food will cause a small rise, while a high GI food will trigger a dramatic spike.

A GI value tells you only how rapidly a particular carbohydrate turns into sugar.

It doesn’t tell you how much of that carbohydrate is in a serving of a particular food.

Fiber Type of Carbohydrate

Contributes no calories

Food Label

Insoluble vs. Soluble fiber

Makes you feel full!

25 to 30 grams of fiber each day

Tips to get more fiber!

Eat more whole fruit instead of fruit juice

Read labels

Look for the word “whole”

Start your day with a bowl of high fiber cereal

Snack on raw veggies

Replace white bread, pasta, and rice with whole grain products

Grouping foods can make it easier to think about how different foods affect your blood glucose

Currently foods are divided into 6 different groups: Starch Fruit Milk Vegetable Meat Fat

Sugar Alcohols Do not contain alcohol

“Sugar free” or “No sugar added”

Fewer calories than sugar

Weight management

Not always considered a free food!

• Products labeled as “sugar free”

• Carbohydrates are still available for body to use, so they still need to be counted in your meal plan

• ADA recommends half of these carbohydrates to be counted towards your meal total

How many carbohydrates is in this 1 candy bar?

Sugar Alcohols

Good Fats vs. Bad Fats

An individual with diabetes is at a higher risk of heart disease

Lower good cholesterol

Increase bad cholesterol

Insulin resistance

Meal Planning Approaches:

Healthy Food Choices

Preplanned Menus

The Plate Method

Basic Carbohydrate Counting

The Exchange System

Healthy Food Choices

2 Main Parts:

Healthy Food Choices Food Servings

Food Servings

Starch

Fruits

Milk

Nonstarchy Vegetables

Meat and Meat Substitutes

Fats

Preplanned Meals

Month of Meals series (books available from the American Diabetes Association.

Includes menus with 28 breakfasts, 28

lunches and 28 dinners.

The Plate Method

Breakfast

½ plate is for starches

¼ for meat/meat substitute

Can also add a piece of fruit and/or glass of milk

The Plate Method

Lunch and Dinner

¼ of plate is for starches

¼ of plate for meat/meat substitute

½ for vegetables

Then add a piece of fruit and/or glass of milk

Carbohydrate Counting

Foods that contain carbohydrate are: starchy foods like bread, cereal, rice, and crackers fruit and juice milk and yogurt dried beans like pinto beans and soy products like veggie

burgers starchy vegetables like potatoes and corn sweets and snack foods like sodas, juice drinks, cake,

cookies, candy, and chips

Non-starchy vegetables have a little bit of carbohydrate but in general are very low (Examples include green beans, carrots, tomato, broccoli, onions).

One carbohydrate serving has approximately 15 grams of carbohydrate

= 15

How Much Carbohydrate???

The amount of carbohydrate that is desired at meals/each day is determined by factors such as calorie needs, food preferences, blood glucose readings and triglyceride levels.

The average number of carbohydrate servings per meal is between 3-5

Examples of Carbohydrate Servings:

Fruits

Small piece of fruit

1/3-1/2 cup of juice

2 tbsp of dried fruits

Milk

8 ounces of milk

6-8 ounces of yogurt

Sweets, Desserts and Other Carbs

1 1/4” square brownie, unfrosted

3 tbsp BBQ sauce or sweet & sour

sauce

Starches

1/2 cup cooked cereal, grain,

or starchy vegetable

1/3 cup rice or pasta

1 oz of bread

¾-1 oz of most snack foods

Non-starchy Vegetables

Green beansCabbageBroccoliTomatoes

5 grams of carbohydrate per ½ cup cooked or 1 cup raw.

Meat and Fat

Do not count as carbohydrate choices as they do not tend to be high in carbohydrate.

Exchange System

Food/Exchange Groups:

Starch

Fruit

Milk

Vegetable

Meat

Fat

Additional Resources

Let’sPractice!