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    Nutrition

    Eating well 

    To find out that you now have to live with an illness such as diabetes is a shock. That is hard to swallow. Even more difficult when you have to evaluate and relook your eating habits, making it a lot to look into all at the same time. With the help of health professionals, the necessary changes can be identified and gradually made.

    Eating is one of life’s pleasures. Eating well and getting a good level of blood glucose can be a challenge. Nutritional habits have been molded in us for years and can be hard to change. One way of treating diabetes is nutrition.

    Wanting to change habits too fast, may cause failure. By doing it gradually and having precise goals, your chance of succeeding increases. When the first goal is obtained, you set your mind on the next goal.

    Nutritional goals

    Having a well balanced diet:

    A diabetic’s nutrition is based on the Canadian Food Guide. A well-balanced diet and a variety of foods is the best way to reach your goal.

    Getting and maintaining a healthy weight:

    An obese diabetic will generally struggle with controlling his blood glucose. He will need bigger doses of medication or insulin to lower the blood sugar level. By losing weight, generally diabetics will have a better control and less medication or insulin.

    Controlling blood glucose:

    Here are a few pointers to get a better control on your blood glucose. Make sure you have 3 well balanced meals per day and choosing products with no sugar added (honey, syrup, jelly, sugar, etc) also keep a regular schedule for meals and snacks.

    Preventing strokes:

    By reducing the quantity of fats, especially animal fat, will help reduce your chances of having a stroke. Saturated fats also trans fats must also be reduced or eliminated as much as possible.

    Food composition

    The energy components found in food are carbohydrates (sugar), proteins and lipids (fats). Those components give the cells the energy they need to work. We also find non-energetic components such as vitamins, minerals, fibers and water.

    The carbohydrates

    Carbohydrates are the combined sugars present in food. There are 2 categories of carbohydrates:

    Simple carbohydrates:
    the most common ones are glucose, dextrose, fructose, lactose and sucrose.We find those in fruits and their juices, certain vegetables and their juices, such as carrots, turnips and green peas, milk, yogurt and also in pastries, chocolate, jams and syrups.

    Complex carbohydrates: 
    those carbohydrates are also known as starch. We find them in food made from a starch base, bread and other bakery products, crackers, cereals, rice, pasta, legumes and potatoes.

    Proteins

    Proteins are necessary to construct, to repair and renew the cells of the human body organs. They take about 2 hours to digest.

    There are two types of proteins:


    Animal proteins:
    meat, chicken, fish, giblets, eggs and milk products

    Vegetable proteins:
    legumes, nuts, seeds, peanut butter and tofu.

    Fats

    Those are the fats found in food. They help carry certain vitamins and supply the organism with essential fatty acids. But excessive amounts of fat can be related to high cholesterol and obesity. They take about 4 hours to digest and they give you the feeling of being full long after a meal.

    Warning:
    Some fats are hidden in foods such as: chicken skin, meat and cold cuts, fried foods, certain cheeses, nuts and seeds, gravy, vinaigrettes, mayonnaise, pastries and chocolate.

    Vitamins and minerals

    The daily required quantities of vitamins and minerals are small, but essential. Most foods contain a variety of vitamins and minerals, but no food contains all of the essential elements in sufficient quantities to answer the organism’s needs.The daily needs in vitamins and minerals should be obtained by eating well balanced meals and without adding a supplement, unless for special needs or in case of inadequate nourishment.

    Fibers

    Fibers are plant components that are not digested by the organism. They help regulate your bowel function. Some fibers help slow the sugar absorption and control the cholesterol level.Fibers can be found in whole grains, some vegetables (corn, cabbage, broccoli, etc), wheat bran, oats, leguminous, fruits rich in pectin such as apples, strawberries and citrus fruits.

    In conclusion

    A diabetic person must be sure to have well balanced meals, including at least one choice from every 4 food groups as shown in the Canadian Food Guide (milk product, fruits and vegetables, meat and substitutes and cereal product).Respect regular meal hours as much as possible, and the portions should be adapted to your needs. Rich meals increase your blood glucose quite considerably. If needed, complete by a nutritive snack between meals and in the evening.

    There are 3 main goals when talking about nutrition for a diabetic person:

    - Regulating the blood glucose
    - Maintaining or getting to a healthy weight
    - Obtaining an optimal level in cholesterol and triglycerides

    A well balanced diet includes a variety of foods. You need to eat foods in each of the following groups:

    - Milk products
    - Meat, fish and eggs
    - Vegetables
    - Fruits
    - Bread, cereals and other grain products
    - Fats

    In these six groups, some will bring you carbohydrates and others not. It is important to know the sugar content in each of them. You can evaluate the quantity of food you eat. You have to eat enough to keep your energy level stable and not too much so that you do not get a high blood glucose level and gain weight.

    Here are the food groups that will give you carbohydrates:

    - Milk products
    - Certain vegetables
    - Fruits
    - Bread and other grain products

    There is no need calculating the carbohydrates in cheese, meat, fish, eggs and fats, because they contain low quantities or none.

    If you also have to watch your cholesterol, you have to choose foods reduced in fats. If you have to lose weight, eat less fat, reduce the portion size in all food groups, even those who do not have carbohydrates and exercise.

    Evaluating the portion sizes

    The expressions “reasonable portion” and “moderate portion”, may have different meanings from one person to another. 

    Evaluating the portion size is very important. That is why a diabetic person must follow the personalized meal plan, established by a nutritionist or dietician.

    A little extra?...Yes it counts!

    It’s important to be aware that:

    - Yes, more than 125ml (1/2 cup) of pasta, does count (75ml or 1/3 cup = 15g)
    - Yes, another teaspoon of margarine, makes a difference
    - Yes, a bigger fruit than usual will add calories and more carbohydrates.

    Yes, all little extras will influence your blood glucose. “Why? After all it’s only a little bit!” True, but we must keep in mind that all of those little extras, here and there, add up. And the chain reaction begins:

    Superfluous calories = more weight = blood sugar control difficulties

    How not to fall in this trap? Here are a few tips to help you:

    Evaluating without measuring

    Measure 250ml (1 cup) of liquid and pour it in your favorite glass or cup. With the help of a marker, indicate on the outside of the glass where the liquid stops. Also, if you have a design on your glass, that could be a good reminder of the measurement. So the next time you have a glass of milk, etc., you will know where to stop for a cup.

    Do the same thing with hot cereals (oatmeal, cream of wheat). Pour 125ml (1/2 cup) in a cereal bowl. Again, take note of the level. Use the same type of bowl every time. You will not have to measure anymore.

    For dry cereals, you must measure before adding the milk or fruits. Don’t forget that 125ml (1/2 cup) of different cereals may vary in the same bowl, because of their form and size (ex: Corn Flakes vs Rice Krispies).

    Evaluating the weight or size of fruits and vegetables is different. At the market or grocery store, feel the weight of a small, medium and big banana. Do the same for apples and oranges.

    - Try to guess the weight of each fruit
    - Look at the size in your hand
    - Put them in the store scale and weigh each fruit or vegetable and take note of the ounces or grams.

    Is the estimation right? Repeat the same process at home on a food scale. You will be able to practice more often, and at the same time verify if your home scale is adjusted with the store scale.

    With time, evaluating the weight and the size of fruits and vegetables will get easier. Eventually, just by weighing it in your hand, by the size in your hand or even just by looking at it, you will assess what portion you have and your food plan will be respected.

    Meat and cheese

    It is a little more difficult to evaluate foods rich in proteins such as meat, poultry and cheese. We must keep a close eye on those foods. In fact, 30g (1 ounce) more does not make a big difference in weight or size, but can give you 35 to 100 more calories.

    If we take a look at cheese sold by weight, look at the indicated weight on the package. For example, if the portion is 180g, try to imagine what would be 90g in terms of dimension and weight in your hand.

    Boneless fresh meats weighing 360g (3/4 pounds), a third of that (120g or 4 ounces) would represent a medium size portion, raw.

    While cooking, meat looses weight:

    120g (4 ounces) of raw meat, boneless, will equal 90g (3 ounces), cooked.
    150g (5 ounces) of raw meat, with bone, will equal 90g (3 ounces), cooked.

    Prepared foods

    Prepared foods and salads can rapidly be evaluated if you have practiced the following tricks:

    - Taking your usual plate, put in the recommended portion of spaghetti with sauce. Look at the portion size in your plate. Keep in mind the room it holds in your plate, so that next time you will know what portion should be on your plate.
    - Repeat the procedure with mashed potatoes, cooked spinach, coleslaw or any other vegetables or side dish.
    - Look for a kitchen utensil that can easily hold a measurable portion (ex.: 1 cup or 250ml) of liquid or an ice cream scoop that can contain ½ cup (125ml) of solid foods. You can then use those utensils fast and easily for any kind of food.
    - Take note of the portion size of salad or soup in your usual bowl. By visualizing the salad or soup, you will not have to measure your portions every time.

    Labels are a precious source of information

    Most food sold in grocery stores have the nutritional information on their packages. The information is given by portion (ex.:  for 1 slice of bread or for 2 cookies).

    Read it carefully and if you have any questions, ask your nutritionist or dietician. Be careful, because the indicated portion may not be what is recommended in your meal plan.

    Essential tools

    To get familiarized with portion sizes, some tools may be essential:

    - Measuring spoons: use real measuring spoons to get the right amount. Do not use your regular silverware as a measuring tool. They are not precise.
    - Measuring cups: use transparent and well indicated measurements on the cup.
    - Food scales: Buy a scale that can weigh ounces and grams, so you can weigh meat, poultry, fish and cheese. Always measure these foods raw.

    Occasional checking

    With time, visualizing and evaluating portion sizes will become child’s play at home or at the restaurant.

    But even when you are confident in your skills, it is important to verify your portions or evaluations every now and then. In fact, it is not unusual to see the portion sizes grow with time. It is suggested to measure or weigh your portions every 3 months to make sure you are still doing it right.