how diet affects blood glucose levels july 30, 2007 liz weinandy, mph, rd the ohio state university...

How Diet Affects Blood Glucose Levels

July 30, 2007Liz Weinandy, MPH, RDThe Ohio State University Medical CenterLiz.Weinandy@osumc.edu

Objectives

At the end of the presentation you will be able to:Describe how different food components

affect your blood glucose (BG) levels and your energy level

Read a food labelCount grams of carbohydrate

Diabetes in the US

20.8 million children and adults -- 7.0% of the population -- have diabetes.

Diagnosed: 14.6 million peopleUndiagnosed: 6.2 million peoplePre-diabetes: 54 million people1.5 million new cases of diabetes were

diagnosed in people aged 20 years or older in 2005.

Source: American Diabetes Association

Diabetes in the US

People with diabetes have increased health risksHeart diseaseStrokeHigh cholesterolKidney diseaseEyesight problemsVascular disease

Food and Blood Glucose Levels

Factors that impact BG levelsFood

Eating a healthy diet can help control BG levelsHealthy weight Physical activity

Food and Blood Glucose Levels

Food is made up of three basic components:Carbohydrates ProteinFat

What component(s) affects the BG the most?

Carbohydrates!

Food and Blood Glucose Levels

Carbs affect BG the mostProteins affect BG very littleFats keep BG elevated if eaten with a

large carb load, but do not raise BG

Food and Blood Glucose Levels

American Diabetes Association recd’sCarbohydrates: 50- 60%

Low carb diets are NOT recommendedProtein: 15- 20%

Most from low fat sourcesFat: ~30%

Most from mono- and poly- unsaturated fats

Food and Blood Glucose Levels

What foods have carbohydrates in them?Starches

Bread, cereal, tortillas, pasta, rice, corn, peas, potatoes, crackers, pretzels, popcorn, muffins

FruitsDairy Desserts & SweetsNon- Starchy Vegetables

Food and Blood Glucose Levels

Different Types of CarbsSimple and processed

Sugars, refined flourComplex

High fiber, whole grainsFiber

Not digested

Food and Blood Glucose Levels

Goal is to eat moderate carbs at all meals and avoid large carb intake at any one mealEat three meals dailySnacks optional but good idea

Can help prevent getting too hungryConcentrate on eating better carbs

Complex carbs, those high in fiber

Food and Blood Glucose Levels

Source: http://www.urbanext.uiuc.edu/diabetes2/subsection.cfm?SubSectionID=26

How Much Carbohydrate?

Individualized approachGenerally, for weight loss:

45 grams per meal for women60 grams per meal for men15- 30 grams for 1-2 snacks a day130 grams total minimum per day

Amount of carb depends on many factorsGender, age, activity level, BG levels

How Much Carbohydrate

Example1800 calorie diet

250 grams of carb total (55% carb)60 grams carb each meal35 grams carb for 2 snacks

225 grams of carb total (50% carb)60 grams carb each meal20-25 grams carb for 2 snacks

How Much Carbohydrate?

Remember, if you are trying to lose weight, it is NOT just about the carbsTotal calories matterLow to moderate fat (<30% of total calories)

Moderate fat diets result in same or more weight loss as very low fat diets

By limiting (not eliminating!) carbs, most people lose weight

Label Reading

Reading labels is important in managing BG levels and overall health

Carbohydrate counting Look at Total Carbohydrate grams

Can subtract Dietary Fiber grams if 5g or moreSugars are included in total carb grams

Simple carbohydrates raise BG levels faster

Label Reading

Label Reading

Carbohydrate Content

What if a food item doesn’t have a label?ProduceSpecialty cheesesMeats, Poultry, SeafoodAunt Martha’s potato casseroleRestaurant FoodsAlcohol

Carbohydrate Content

Easiest to buy calorie/ carb counter book or look up onlineAmerican Diabetes Assoc.

www.diabetes.orgAmerican Dietetic Assoc.

www.eatright.orgCalorie King book ($8 Barnes & Noble)Calorieking.comFitday.com

Carbohydrate Content

Produce Fruit

Serving is generally small piece fruit (4 oz), ½ cup fruit, ¼ cup dried fruit, or ½ cup (4 oz.) juice

15 g carb, 60 calories

Vegetables Starchy- ½ cup of peas, corn, or potatoes

15 g carb, 80 calories Nonstarchy vegetables- 3 cups raw or 1 ½ cups cooked

broccoli, carrots, cucumbers, peppers, etc. 15 g carb or less, 75 calories or less

Carbohydrate Content

Meat and Meat SubstitutesChicken, fish, beef, eggs, cheese, peanut

butterGenerally contain little or no carb, mostly protein

and variable amounts of fat Choose lower fat options except for fish and pb

Moderate portions 3-4 oz or deck of cards

Calorie difference is great! Ex: 4 oz of skinless chicken breast vs 4 oz pork spareribs

Calorie difference is 260 (140 vs 400 calories) Extra calories all from fat!

Carbohydrate Content

Combination FoodsCasseroles, lasagna, spaghetti w/

meatballs, mac & cheese, chili w/ beans, etc.

In GENERAL, 1 cup = 30 g carbPizza, thin crust

¼ of 12 inch (about 5 oz) = 30 g carbMost of carb is in crust so avoid thick ones or

limit portion size greatly

Carbohydrate Content

Restaurant Food If a chain, look up info If not a chain, will have to estimateCaution with portions!

Number one way to eat large amount of carbsAsk waiter to bring to go container with meal and

eat half or split with someone elseBe moderate with bread basket, corn chips, etc.Decide where you want to “spend” carb grams

Alcohol

Moderate consumption ok if physician approves 1 drink for women a day, 2 for men

Always with food Not on empty stomach

Not with high Triglycerides May cause hypoglycemia, or low blood sugar Stimulates appetite

Summary

Carbohydrates affect BG the most50- 60% of calories from carbCarb counting is an effective way to

monitor carb intakeLabel reading importantLose weight if needed or maintain

currentPhysical activity important

Questions?