Nutrblog's Blog

“I have type 2 diabetes and just found out I have gluten intolerance.  I haven’t been able to figure out what I can eat.  I have been leaving grains out of my diet.  What should I do?”

Answer to this weeks question: Gluten is a complex protein found in wheat, rye, barley and oats, and people who have gluten intolerance cannot consume these foods, as they sensitive to gluten. In addition to wheat and wheat products, some food other food products that can contain wheat are: salad dressing, instant mix, frozen dinners, gravies and sauce, egg substitute, cold cut meats, herbal teas and even potato chips.  Therefore, it is important to read the food label of products and checking for products used in your meal while dinning out.

However, some grains that you can consume if you have gluten intolerance are corn, quinoa, rice, tapioca, amaranth, sago, flax, and millet.  Consider these grain as carbohydrate exchange like wheat, pasta or bread exchange.

For example, Quinoa a gluten free grain, is high in fiber; in-soluble, has complete protein, and low glycemic index.  Quinoa takes about 15 minutes to cook, and can used for pilaf, stew, casserole and even salad.

Some restaurants that offers gluten free items: http://www.glutenfreerestaurants.org/

Key in making sure if the product is gluten free is to read the food label for ingredients used by the food manufacturers.

Response to this weeks query “Is it ok to eat peas & carrots if you have diabetes?  I heard to avoid those two veggies.”.

My dear friend, you can have peas and carrots;  starchy and non-starch veggies in moderation. Peas and carrots in combined, or in combination with other veggies like corn, lima bean, and beans are a good source of vitamin A ,C, K, fiber, and minerlas like magnesium which are needed for good skin and bone health, and make you fillup fast.

You can have fresh, frozen or canned.  Frozen and canned once have the same nutritional benefits like fresh once. However, if it is canned, make sure that it is of low sodium or without added salt.  It is good to have 3-5 servings of non-starchy veggies, and 1-2 servings of starchy veggies.

Starch veggies contribute approximately 15 gms of carbohydrate, and 2 gms of protein. On the other hand, non-starchy veggies contribute approximately 5 gms of carbohydrate and 2 gms of protein.

What ever veggies you have; starchy or non-starchy veggies, it is good to have them in moderation.

This is the answer to this weeks question “Since I live alone, I rarely cook (if ever).  I have type 2 diabetes and I’m wondering which is better… eating frozen dinners or restaurant food?  Thank you for your help.”

This question is very good and every now and then we come across this puzzle and we are not able to find the right choice to eat.

No matter what we eat- frozen dinner or restaurant foods, we have to make wise choices on the portion, fat content and carbohydrate content of the food.

When buying frozen foods avoid foods which contains cream sauces, gravy, and fried foods. Choose entrees which contains vegetables, whole grains, and grilled or roasted meat in them. Key for choosing frozen foods is reading labels, as many of the frozen entrees are low sodium, whole grains, and contains grilled, or roasted meat.

There are many brands that offers healthier versions; i.e low sodium, low in saturated fat, low sodium, low in fat and cholesterol. And it might be cheaper than restaurant foods.

While dinning out ( go for restaurant foods in place of fast foods), look out for portion size. Have half of your order and save the rest for your next meal. Fast foods are high in calories, fat, sodium, and may not contain any vegetables.

Some tips in eating out:

• Average fast-food meal can run as high as 1000 calories or more, and raise your blood sugar above your target range.
• Know the nutritional value of your food before you order, they can be high in fat and calories.
• Learn how your food is cooked- baked, broiled, fried or breaded.
• When ordering breakfast go for whole wheat bagel, toast of English muffin, low fat milk with cereals, or fresh fruit in place of muffins, biscuits, or hash browns.
• Beware of words like ‘JUMBO, LARGE, GIANT,  DELUXE OR SUPER SIZED. They can add more calories, fat, sodium and cholesterol.
• While choosing salad dressing, go for fat free once, and order it to the side.
• While ordering condiments and relish for your sandwiches, avoid mayo, and go for fresh, sliced tomato and veggies with mustard and ketchup.
• Go for thin crush pizza with veggies and limit to 1-2 slice.

Key in eating out or choosing your frozen dinner items are: reading the food labels, and learning about your meal before your order and your portion size.

Response to this weeks post: “My 45 year-old husband was diagnosed with type 2 diabetes a few months ago.  Is it true that you can reverse diabetes?”

Diabetes is a metabolic disorder, meaning there is some underlining medical condition with the metabolism; and here it is with regards to glucose metabolism.  It is not possible at this time to reverse this disorder, but you and your husband as a family can work together to take control of the issues associated with.

If you husband is overweight or obese he can reduce weight, which will help in uptake of glucose in the cell level. Eating meals consistently (carbohydrate), and choosing whole grains in place of wheat flour, and eating variety if fruits and veggies.

Unlike other medical conditions, diabetes is something which can be managed and through lifestyle change, diet and medication.

Management of diabetes using diet, physical activity and medication along with monitoring of blood glucose levels are key for this metabolic disorder. For more help with for managing your husband’s diabetes please see a registered dietitian or a diabetes educator.

Below is the answer for this weeks question ” My doctor recently diagnosed me with type 2 diabetes.  I know it is important to watch my sugar intake.  Is sugarless candy really sugarless?”.

Sugarless candies are made of sugar alcohols like erythritol, hydrogenated starch hydrolysates, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol or made of artificial sweeteners like aspartame, saccharin and sucralose.

The effect of sugarless candies and desserts made from sugarless once has same effect on the blood glucose levels as regular/table sugar. However, caution should be taken as many of the sugarless food products could be loaded with fat, which could add calories.

The focus should be on whole grains, fruits, and vegetables rather than on processed foods which will add vitamins, fiber and other nutrients.  Moderation is key, even if it is for regular candy or sugarless once.

Response to this weeks question “My fasting glucose number was 127.  Does this sound like pre-diabetes or diabetes?  What should I do to control by blood sugar?”.

According to American Diabetes Association if your blood glucose level is > 126 mg/dl you are at risk for pre-diabetes. 

http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/how-to-tell-if-you-have.html.

There are test that can be done by your doctor to determine if you are predisposed to pre-diabetes; the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT). If the FPG is > 126 mg/dl and if OGTT is >200 mg/dl you are pre-diabetes.

The website also has a link for testing if you are at risk for pre-diabetes: http://www.diabetes.org/diabetes-basics/prevention/diabetes-risk-test/

However, you can take control of your blood glucose level and prevent complication associated with diabetes, and prevent predisposing yourself to type 1 or 2 diabetes by making healthy food choices like eating a varieties of fruits and veggies, choosing non starchy vegetables, go for whole grains, including different varieties of dried beans in your daily meals, if you are drinking regular or whole milk choosing low fat or skim milk and dairy products, choosing your cooking oil wisely by opting for canola, olive or sunflower oil in place of butter or high fat cooking oil, and choosing lean protein in place of red meat.

Other means to take control of your pre-diabetes is to be more physically fit, by increasing the time that your sit down and just being on the feet. Even if you are not going to gym or working out, take more steps in a day, by walking in place of sitting and watching that TV shows, and taking stairs in place of elevator. Forming a walking group.

If you are over weight try to loose weight or at least not gaining any more weight. This will help in controlling your blood glucose levels and predisposing yourself to type 1 or 2 diabetes.

Remember: color your plate, go for whole grain, cut your fat, and BE MORE PHYSICALLY ACTIVE.

For more information check out the website: http://www.diabetes.org/

Today, March 23 2010 is Diabetes Alert day.  On this day I want to share some information that I came across.

To know what is happening in your area check out his link (many of the health fairs are free, and there was some post a few weeks ago about getting some help for once in need, and this link will help them) : http://main.diabetes.org/site/PageServer?pagename=SD_alertdayeventlisting

If you are interested in joining the movement or in volunteering your time check this link: http://stopdiabetes.diabetes.org/site/PageServer?pagename=SD_homepage

To learn more about diabetes and to take control check out American diabetes association website: http://www.diabetes.org/food-and-fitness/

Your Nutritional Editor & friend,

Sree Raji.

This response is for the question “I have pre-diabetes and am trying to lose weight.  How many servings of fruit and veggies should I have each day?”. It is great that you are trying to loose weight, and research has shown that, people who loose weight will help with glucose uptake at the cell level, and in turn in controlling your blood glucose levels.

The recommendation for fruits and vegetables  for children are 1 1/2 cups, and for adults are 2 cups daily. (Mypyramid.gov)

It is important to chose whole fruits like: citrus, berries, or melons, in place of fruit juice.  Fruit juice will increase the blood glucose levels fast, where as whole fruits has added fiber and vitamins like C, A and minerals like magnesium, iron and phosphorus which works as antioxidants and helps built immunity and add bulk to your diet.

While choosing vegetables it is good to choose non starchy vegetables like green leafy vegetables, broccoli, cauliflower, or squash which will not spike your blood glucose levels and will add fiber, vitamins and minerals to your diet.

It is also important that you also be physically active; at least 30 minutes a day, for added benefit in losing weight and for controlling your blood glucose levels.

For more information of what and how much fruits and veggies to add into your diet, please visit the website: http://www.diabetes.org/food-and-fitness/

Key for losing weight is slow, and gradual reduction in weight; and eating every thing in moderation.

This response for the question “I was diagnosed with type 2 diabetes last month.  I’m having difficulty understanding how many carbs and sugar I can have each day.  I’m finding that nearly everything contains carbs and sugar!  Can you help me with this?”.

I understand that when you are diagnosed with diabetes, you will be bombarded with lot of information and advise that you will be lost as to which one to follow and where to get started.

No matter what kind of carbohydrate count you are put on, you need to be consistent in eating the carb through out your meal, you need to have some amount of carbs to prevent hypoglycemia (low blood glucose level).

Simple rule to start with is to have at least 4-5 carbs per meal, and 1-2 snacks. As you may know grains, fruits, vegetables and milk are counted as carbohydrate. One serving of grain is counted as 15 g, fruits as 15, vegetables as 5, and milk 12 g. Therefore, when you eat a bread (look for serving size as some breads are counted as 1.5-2 serving), multiply the serving with 15 to get the carbs in them. Do the same for fruits, vegetables and milk. For fruits try to eat a citrus fruit rather than banana or other, as it has some added fiber in them. And for milk, go for low fat, or fat free once.

Say for e.g if you are on a 1800 ADA diet, you will be eating 5 carbs per meal, and one snack.

When reading food label look for the amount of sugar it has, this will help you to over doing some of the foods like desserts, and fruits juices, as they are going to increase the blood glucose levels sharply.

When choosing grains, go for whole grains, the first ingredient in the label should say ‘whole’. Fiber will control from increasing the blood glucose levels sharply and also will full you up, so you will not feel hungry fast. There are some breads which looks and taste like white bread, but will say whole bread. They are a good starting point if you are used to eating white bread. The outer layer of wheat is removed from these breads for the color, but they still contains fiber.

Always reading books, and checking with your nutritional educator about any questions are the best stepping stone to start with.

If you are in the Midwest, Jewel Osco has free diabetes education classes ( a group of 6-8 at a time), offered few times a month is give in collaboration with the RD and the pharmacist. Check out their website, under pharmacy.

Links:

http://www.jeweloscopharmacies.com/ishp/ishp_diabetesCare.action

(Check with your local jewel osco for the time and date for the class).

http://www.diabetes.org/

Here is the response for the question ” I am trying to find a class for our grandson. He is 19 and has a part-time job but no insurance. He just found out last week that he is a type 1 diabetes after losing a lot of weight and his blood sugar was 523. He is on insulin but needs to go to a class to manage is diabetes without going hungry. Where do we start? Any suggestions would help us a lot.”

First and foremost, check with your doctor for any support group or any other programs for people who have just diagnosed with Diabetes. Check your local community clinic or community college, or University where there might be student dietitian who might help with managing diabetes and also with educating about carbohydrate education( any many for them might be free of service). Being a student myself, I have conducted community educational fairs at our school, local church, and even at schools, which are free and usually will have free samples, and coupons for many of the products.

Few things to keep an eye are:  constant carbohydrate consumption through out the day (3 meals and 1-2 snacks), and check his blood sugar levels at least few times a day. Initially, it is good to keep a record of blood glucose levels, and this will help in adjusting his insulin levels and also with his meal exchange. Currently, it is better to check the blood sugar levels at different times of the day.

During summer months there might be diabetes camps, but check for rules and procedure for joining them.

Your local church or other cultural place of worship might have some free, monthly camp for help with free health screening, and education about different health conditions.

Some useful websites: http://www.diabetes.org/ and http://www.eatright.org/ are useful links to get started with preliminary, self educating, informative sites.

If you need any help you can contact me, and will be more than happy to help your grandson.