Nutrition in Type 2 Diabetes

1. Nutrition in Type 2 Diabetes Gilda Bastasi, P.dt.,CDE Telehealth Presentation March 27, 2007 Montreal , Quebec

2. What is most important • Eat well • Control your weight • Exercise • If you take medication for diabetes, take it as prescribed • Check your blood sugar daily if possible

3. How do we EAT WELL? • Respect QUANTITY • Choose the right QUALITY • Limit sugars and sweets, not avoid • Limit high fat foods • Fried foods, chips and pastries • Eat more fibre • Brown breads, dried beans, brown rice • Eat at REGULAR times • Three meals per day • Correct spacing of 4 to 6 hours

4. Control your weight • Do you need to lose weight?? • If you are overweight, losing 10 to 20 pounds will help you get better control of your diabetes • Fat, especially animal fat, intake should be limited • Fat has the most calories • helps to keep weight down • Keeps a healthy heart! • GET MOVING!! • Exercise at least 150 minutes per week • Exercise when blood sugars are higher

5. Quantity : What is a portion? • You must watch HOW MUCH you eat especially foods that contain sugar or carbohydrate • Using the “sugar cube method” will help you decide if you are eating well or not

6. Using sugar cubes to help with quantity • Generally, most food contains some kind of sugar • Especially breads, rice, fruit, pastas • 1 teaspoon of sugar= 1 sugar cube • General recommendations • 9 to 12 cubes per meal • 3 cubes per snack

7. How many in these foods? • Grains and starches: • 1 slice bread = 3 cubes • ½ cup pasta or rice= 3 cubes • ½ potato or ½ cup corn = 3 cubes • Fruit and vegetables: 1 small fresh fruit = 3 cubes ½ -3/4 cup juice = 3 cubes ½ cup carrots, peas, turnip or beets = 3

8. How many in these foods? • Milk Products • 1 cup milk = 3 cubes • 1 cup plain yogurt = 3 cubes • ½ cup fruit flavoured yogurt = 2 -3 cubes • Other foods • 1can regular Coke = 9 cubes • 1 small piece of pie = 9 cubes • 1 tablespoon of regular jam= 3 cubes

9. Quantity : the perfect plate National nutrition committee Canadian diabetes association

10. Let’s calculate together.... 1apple= 3 cubes 1 potato = 3 cubes ½ cup carrots = 3 cubes 1 piece of meat = 0 cubes Broccoli = 0 cubes TOTAL = 12 cubes 1 Cup milk= 3 cubes

11. Quantity: Use your hands to measure Palm of hands: approximate size of meat one should eat The fist portion applies to starches and fruit Both hands cupped together and overflowing represent a portion of vegetables or salad High fat foods such as chips and nuts are limited to a portion that fits in one cupped hand

12. Quality : Healthy eating • Grains and Starches • whole grain bread, grains, pastas, rice, potatoes or corn AT EVERY MEAL! • Limit use of cakes, pies, desserts • Fruits and vegetables • Eat more vegetables • Include at least 5 fruits and vegetables per day • Have fruit as your dessert at every meal • Protein foods • Lean meat, poultry, fish, low fat cheese ,eggs or nuts • Milk • Have a glass of milk or yogurt to finish your meal

13. Grains and Starches • RECOMMENDED SERVINGS • 2 to 3 servings per meal • Here are some examples of one serving • 1 slice whole grain bread • ¾ cup bran cereal • ½ cup pasta • 1/3 cup brown rice • 1 small potato • ½ cup corn

14. Fruits and Vegetables • Recommended servings • Eat 3 to 7 servings a day • At least 3 should be fruit • Aim for 1 fruit and 1-2 vegetables at each meal • You can use fresh, frozen or canned • Fresh has more fibre than juice • Most vegetables contain little calories and sugar • What is a serving? • Generally ½ cup of fruit or vegetable

15. Don’t forget Milk Products !! • Recommended servings • Have at least 2 low fat servings of milk or milk products per day • 1 serving = 1 cup • Choose milk and yogurt with 1% fat or less • Use sugar free or plain yogurt • Plain soya milk • You can eat ice cream, frozen yogurt or pudding occasionally • Choose cheese with 20 % milk fat or less

16. No sugar in meat..but watch out for fat !! • Have a source of protein like fish, chicken, tofu, meat, eggs, low fat cheese, nuts or peanut butter at every meal • Do not fry • Remove visible fat • Eat portion like the palm of your hand

17. Fats • Choose heart healthy fats • Canola oil, olive oil • Non- hydrogenated margarine • Small portions of nuts • No more than 20 nuts per day • Choose food labelled “no trans fats”

18. What about sweeteners? • Sweeteners that INCREASE blood sugar: • Sugar alcohols: Lactilol, maltilol, Mannitol, Sorbitol, Xylitol • Polydextrose • Sweeteners that DO NOT increase blood sugar: • Aspartame (Equal, Nutrasweet • Cyclamate (Sucaryl, Sugar Twin, Sweet n Low) • Saccarin (Hermesetas) • Sucralose (Splenda)

19. Is alcohol allowed? • Do not take more than two drinks per day • Two for men, one for women • 1 drink = 1 bottle of beer • 3.5 ounces of wine • 1.5 ounces of hard liquor • Be careful! • Never drink on an empty stomach especially if you take medication

20. A little bit of everything.... • A small serving of lean meat • A good quantity of colourful vegetables • Always have some starch like whole grain bread, rice or corn • Finish the meal with some low fat plain yogurt with fresh fruit • Respect your quantities • Never skip a meal!

21. Let’s build a “good” breakfast.... • 2 servings grains and starches 2 slices brown bread • 1 lean protein 1 ounce low fat cheese • 1 fruit 1 small banana • 1 milk product ¾ cup plain yogurt • 1 fat 1 tsp of margarine • Other foods sugar free jam