Update March, 2012
In the beginning, when diabetes is first diagnosed in a person, the establishment of a suitable diabetic diet and the diabetic menu is usually the responsibility of the supervising doctor and health care team, often with the assistance of a qualified dietician.
But diabetes is a life long condition, there is no cure, and over time, specific diabetic menu items can become less favored and replaced by others. This means that the diabetic person should be familiar with the basic guidelines of what constitutes an acceptable diabetic menu that meets the dietary objectives of keeping blood sugar levels to as close as possible to normal.
Note: the meal plan at the end of this piece is just one example of a suitable approach to diabetic meal planning. But the comments preceding it are relevant to all diabetic situations.
The primary objectives in devising a diabetic menu are, firstly, to choose and list nutritious food items that aid and support the management and control of diabetes and help achieve acceptable levels of blood sugars. And secondly, but just as important, is the selection of foods that meet the personal preferences and tastes of the diabetic individual who will have to eat them.
No one diet plan or menu is appropriate for everyone. Among other things, the calorie requirements will vary for individuals, partially due to the demands of daily activities and lifestyles, and their weight and body mass.
While we can set out in general terms a range of foods that should be acceptable and meet the requirements of most individuals, sometimes there are other factors that are specific to an individual or a group of individuals who have additional needs and objectives, including such things as a need to lose weight, levels of activity, ethnic guidelines, food allergies, and so on.
For the diabetic, in keeping with the recommendations of the American Diabetes Association and national diabetic authorities in other countries, the approach to meal planning outlined here is built around the suggested percentages of complex carbohydrates in the diet, preferably those of low Glycemic Index and Glycemic Load values, topics that I will discuss elsewhere on this site at a later date. Published recommendations suggest that carbohydrates should provide about 55 to 60 percent of total calories. But there is not complete agreement within the medical community on this.
The foods we eat are comprised mainly of proteins, fats, or carbohydrates, in varying proportions. It is the carbohydrate content of foods that provide the body with glucose, its essential energy source. And for those people who are diabetic, it is their body’s inability to regulate the amount of glucose in their blood that causes the problems.
For the diabetic, the usual recommendation is that there should not be long intervals of time between the main meals, perhaps three or four hours at the most, and there should be a small snack taken in between those meals. Meals should be of approximately equal carbohydrate content to help regulate and keep blood sugars at a more or less even level, so that the inevitable spikes in blood glucose last for as short a time as possible.
An easy approach is to focus on, and suggest limits for, the carbohydrate foods that provide the glucose that diabetics are most concerned about. The foods that do not affect blood glucose include eggs, cheese, meats, fish, poultry, tea, coffee, and many others. So with no limits on those, nobody need go hungry on a diabetic diet — – unless you have to watch your weight, and for that it might mean an increase in daily exercise, not a bad thing for good health anyway.
To illustrate the steps to be followed, let us consider an example, starting with an average plan for an individual, a male weighing about 160 pounds and height 5 feet 8 inches – and not involved in a particularly strenuous job or lifestyle. That places such an individual just at the acceptable value of 25 on the Body Mass Index. The Body Mass Index is used by physicians to define a patient’s weight within a range of body weights of human beings.
For the meal plan of our example person requiring a daily calorie intake of about 2150 calories, let’s allocate the inclusion of about 75 grams of carbs (carbohydrates) for breakfast, and about 60 grams of carbs for each of lunch and 75 for dinner with the in between meal snacks at about 15 grams each. That’s about 45 to 50% of total daily calories. Remember the carbs will be accompanied by non-carb foods such as those listed above.
Experience shows that it is convenient to think of carbs in amounts of 15 grams, so if we know the amounts of the actual carb foods that comprise 15 carbs, it will be simple to work out how much of any and all of them can be eaten to meet the meal limit we have established. The labels of Nutrition Facts on foods list their carbohydrate content, so it is useful to learn how to read them. It will then be easier to become familiar with, and perhaps remember, what amounts of the items you like to eat that constitute 15 grams, or multiples thereof, that way there would be less need to always check to see their contents.
For example, there are approximately 15 grams of carbohydrates in each of the following:
Typical breakfast items:
1 slice of whole grain bread, 1 waffle, ½ bagel, ½ English muffin, ¾ cup of cold (ready-to-eat) cereal, 1/3 cup of oatmeal, a glass of milk.
Typical lunch and supper items:
One cup soup, each slice of bread in a sandwich (making 30grams for a usual 2 slice sandwich), ½ cup of potato, peas, cooked beans, yams, or corn, ½ cup of fruit juice, 1/3 cup canned brown beans, 1/3 cup pasta, 1/3 cup rice, 6” tortilla, 1 large tomato.
Fruits: ½ medium banana, ½ grapefruit, ½ cantaloupe, medium sized fresh fruit, apple, orange, peach, etc., 2 tablespoons of raisins, 3 prunes, ½ cup of fruit juice
For other Vegetables: assume about 5 carbohydrate grams in a “regular” serving of any of the vegetables not mentioned above, for example, ½ cup of broccoli, cauliflower, spinach, brussel sprouts, cooked carrots, green beans, salad greens.
Snack items: 3 plain arrowroot type cookies, 4-6 crackers, 25 pretzel sticks, 3 cups of popcorn, ½ cup light ice cream, frozen yogurt, or pudding.
With a little effort and working with the above and other information it should not be difficult to choose a combination of food items that meet the target carb amounts for meals. Variations can be made in meal totals but the daily target should remain the same.
It depends on knowing, or being able to find out, the number of carbohydrate grams in any quantity of a preferred food item, then doing the simple arithmetic to identify the amounts that in total equal the approximate carb limit established for that meal.
Diabetics measure the glucose in their blood by testing daily and should be able to adjust their carbohydrate allowances if the test readings indicate something must be done to achieve better control. But diet is only one factor in the management of diabetes, exercise and medications also play a significant part.
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