Transcript Nutrition Therapy for Diabetes - New Hanover Regional Medical

Part 2: Nutrition Therapy for
Diabetes Management
How Do You Control Blood
Sugar With Food?
Meal Planning
• Consistent meal times
• Consistent carbohydrates
• Combine protein foods with
carbohydrates
How Nutrients Affect Blood Sugar
CARBOHYDRATE
PROTEIN
FAT
Total Carbohydrates Count
Carbohydrates give energy
ENERGY
But too much carbohydrate can raise blood sugar
above your target range
Total Carbohydrates Count
Men
45-60 grams per meal
15-30 grams per snack
Women
30-45 grams per meal
15-30 grams per snack
Carbohydrates (CHO) in
Each Food Group
Breads, Cereals, Grains & Starchy
Vegetables Have CHO
Each serving has about 15 grams carbohydrates
One serving is:
• 1 slice of bread
• ¼ bagel
• 1/3 cup cooked rice, pasta or oatmeal
• ½ cup starchy vegetables
– potatoes, beans, peas, corn
Fruits Have CHO
Each serving has about 15 grams carbohydrates
One serving is:
• 1 small fruit (size of tennis ball)
• ½ cup fruit
• ½ large banana
• 17 small grapes
• 2 Tbsp raisins or dried fruit
Non-starchy Vegetables Have
Very Few CHO
Each serving has about 5 grams carbohydrates
One serving is:
• 1 cup raw vegetables
• ½ cup cooked vegetables
Dairy Products Have CHO
Each serving has about 15 grams carbohydrates
One serving is:
• 8 oz cow’s milk
• 6 – 8 oz plain yogurt
– Flavored yogurt = 18 – 45 g! Check the label!
Meats & Protein Alternatives
Have No CHO
• Meats, eggs and cheeses have very little CHO but
can be high in fat and cholesterol
• Beware of breading and sugary sauces
• Protein alternatives have very little CHO:
– Nuts, nut butters, seeds, soy & tofu
– Veggie burgers DO have CHO – check the label!
Sweets & Sugars Have CHO
• Count towards total carbohydrates
• ‘Sweets’ have little nutritional value but can
be high in fat and calories, which can cause an
increase in weight and triglycerides
• Sugar free products still have CHO
• Limit ‘sweets’ to 1-2 servings each week
Portion Sizes
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3 oz of meat = size of deck of cards
1 cup = size of baseball
½ cup = ice cream scoop
1 serving of fruit = size of baseball
1 Tbsp of fat = thumb tip
1 serving of bread = size of CD
Use the Plate Method
½ Plate Veggies
¼ Plate Protein
¼ Plate Starches, Grains, Fruit or Milk
Reduce Saturated Fat
Roasting
Baking
Broiling
Grilling
• Remove skin from poultry & choose white meat
• Choose lean proteins
– chicken, turkey, fish, tofu or pork tenderloin
• Eat fewer high-fat foods
– cold cuts, hot dogs, sausage, bacon & fried food
• Use less fat in cooking or use cooking sprays
Meal Planning: Timing
• Eat every 3-5 hours
• Do NOT skip meals
• Try to eat at the same time
every day
• Eat a snack if meal is
delayed
Reading a Label
Always check
the serving size!
Look for total
CALORIES
Check the FAT
Nutrition Facts
Serving Size 1 cup (236 g)
Servings Per Container 2
Amount Per Serving
Calories 230
Calories from fat 120
% Daily Value*
Total Fat 14g
22%
Saturated Fat 7g
35%
Trans Fat 1g
Cholesterol 40mg
13%
Sodium 950mg
40%
Total Carbohydrate 16g
5%
Dietary Fiber 2g
8%
Sugars 3g
Protein 11 g
Vitamin A 20%
Calcium 2%
Vitamin C 0%
Iron 6%
Check for
CARBS
*Check the first
3 items on the
ingredients list
for hidden fats
and sugars
Water & Non-Calorie Liquids =
8 cups per day
Sugar-free drinks do count, but water is best!
SF Tang
Diet Soda
Herbal Tea
Crystal Light
Flavored Water
Coffee or Tea
Your Meal Plan:
Deciding What to Eat
Lunch Sample
2 slices whole wheat bread
2 oz of turkey
1 slice of 2% cheese
1 Tbsp lite mayo
Lettuce/tomato
1 small piece of fruit
Noncalorie beverage
Total Carbohydrates
30 grams
0 grams
0 grams
0 grams
0-2 grams
15 grams
0 grams
= 45 grams
Exercise Therapy for
Diabetes Management
Carbohydrates
Count
GoodTotal
News
About Physical
Activity
Lose weight
Gain energy
Lower risk of
heart disease
Increase
well-being
Possibly reduce
the need
for some
medications
Improve overall
health
Keep It Fun!
Add Variety
to Your Daily
Routine
Choose
Enjoyable
Activities
Enjoy
Activities
with Friends
Blood Sugar & Exercise
Blood Glucose Level
Guidelines
Lower than 100 mg/dL
(5.6 mmol/L)
Your blood sugar may be too low to
safely exercise. Eat a carbohydrate
containing snack.
You're good to go!
This is a safe pre-exercise zone.
100 to 250 mg/dL
(5.6 to 13.9 mmol/L)
> 250 mg/dL
(13.9 mmol/L) or higher
Your blood sugar may be too high
to exercise safely. Postpone your
workout until your blood sugar
drops to a safe pre-exercise range.
Diabetes & Exercise
•Exercise only when feeling well
• Become familiar with blood
glucose patterns
•Know the symptoms of highs and
lows
Diabetes & Exercise
• 30 – 45 minutes of exercise is safe when
diabetes is under good control
• Eat a meal 1 – 3 hours before exercise
• Insulin
– Administer insulin more than 1 hour before exercise
– Administer insulin in abdomen
– Avoid extremity injection
Diabetes & Exercise
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During exercise, drink plenty of fluids
Remember: sports drinks contain sugar
After exercise, monitor your blood glucose
Wear shoes and socks at all times
Always wear properly fitted footwear
Check your feet after every session
Consult your physician if any symptoms develop
during or after exercise
Where Can You Find
Shoes & Socks for Exercise?
• Pharmacies
• Podiatrists
– Wilmington Foot & Ankle
• Omega Sports (Oleander Dr)
• Diabetic socks can be purchased
at the EFC, most pharmacies and
large retail stores
– Dr. Scholl’s brand
What is Exercise?
•Exercise is anything you want it to be
– walking the dog, cleaning, taking the stairs,
working out at the Employee Fitness Center
•Focus on duration over intensity
– three 10 min sessions or one 30 min session; every
minute counts!!
•Adding to your normal, daily activity is important
– if you walk all day at work, you still need planned
exercise or additional physical activity in your routine
Time to Get Started
Want to get started now?
Your safety is very important to us. Follow the guidelines we have provided, and remember that you can
always contact a trainer at the EFC for more specific advice on physical activity and exercise. Always seek
help with each new exercise.
Can’t start the 12toLife just yet?
Try a group exercise class offered at the EFC, take a walk with some friends or coworkers during lunch,
take the stairs, or even contact a trainer for an appointment.
Not sure if you can participate in any of the NHRMC EFC programs?
Remember our guidelines, and seek help when needed. Your team is here to help you. For more
information on outdoor resources for exercise and physical activity in your area, contact a member of
the Diabetes Health Plan Team or an EFC staff member! Even if you live farther away, always remember
that you are not alone.