Judy Dodd, MS RD, LDN, Giant Eagle^® Corporate Nutritionist

Diabetes, a metabolic disorder affecting how the human body processes glucose from food, affects nearly three in 100 people worldwide. Diabetes manifests in one of two ways: Type I (or insulin-dependent) diabetes and Type II (or insulin-resistant) diabetes.

Type I diabetics, who are often diagnosed with the condition in childhood or adolescence, produce no insulin, so they must obtain it artificially. They must also tightly control their carbohydrate intake to match their insulin intake. Type II diabetics usually do not require daily insulin injections like Type I diabetics because their bodies produce some insulin. Their condition can usually be controlled by lifestyle changes and medication.

Another difference between Type I and Type II diabetes is cause. Type I diabetes, like celiac disease and rheumatoid arthritis, is considered to be an autoimmune condition with undefined environmental and genetic triggers. However, Type II diabetes can be caused by related lifestyle risks and choices. According to the Centers for Disease Control, specific risk factors include being older, having a family history of diabetes, having had diabetes while pregnant (gestational diabetes), having impaired glucose tolerance, being obese, and not exercising. With proper diet and exercise, as well as the correct medication regimen if needed, Type II diabetes – which accounts for 90 to 95 percent of diabetes in the United States – can be controlled.

The diabetes dietary guidelines recommended by The American Diabetes Association and The American Heart Association mirror those of the dietary guidelines for most Americans. Proper eating begins with reasonable portions to fit calorie needs. Adequate physical activity is also important to keeping the disease in check. For a person reliant on medications or insulin, special considerations, including meal timing and specific meal content, must be taken into account when planning to eat. Always discuss changes in diet with your physician, Giant Eagle® registered dietitian and pharmacist to bring meal planning into focus. This month's meal book focuses on some diabetes-friendly food ideas for you, your family and your guests.

• Think “balance” at every meal. Try the “whole-plate method” of meal planning to help you achieve portion control and balance your recommended daily intake of various food groups. Fill half of your plate with veggies and fruit – with an emphasis on leafy greens, broccoli, tomatoes, zucchini, cauliflower, and eggplant. Fill up one quarter of your plate with lower-fat protein sources (lean meat and fish are great choices) and fill the remaining quarter with grains (preferably whole grains), pasta or starchy vegetables like potatoes or corn.
• Visualize your plate or use sample suggested meals to plan each day. Here's an example of a balanced meal: one serving of lean beef, one serving of pasta with grated cheese, one serving of green beans, and one serving of salad. Notice that one-quarter of the plate contains protein, one-quarter contains carbohydrates, and one-half contains produce.
• Put fiber on the menu by adding vegetables, fruit and grain. Black beans, navy beans, chickpeas, kidney beans, and lentils provide great sources of fiber and fit into the part of your plate reserved for proteins.
• Focus on keeping protein sources low in fat and within portion guidelines. A serving the size of a deck of cards fits your protein requirement at each meal. Fiber-rich beans, nuts and tofu are vegetable-based sources of protein. On the meat side, turkey, chicken, fish and other seafood, lean pork, and even beef fit this slot.
• Check the sodium content of prepared and processed foods if high blood pressure is an issue for you, and choose salt substitutes instead of added salt when possible.
• Keep comfort foods, casseroles and soups on the menu, but substitute a few ingredients. Use lowfat dairy foods, limit the amount of salt or sodium-containing ingredients and use cooking oil spray for browning.
• Change your cooking method to broiling, roasting, grilling, or steaming rather than frying.
• If you're watching your weight, keep an eye out for extras. Gravy, dressing, mayonnaise, and butter all add calories to meals – so make these savvy substitutions to keep calories in check.
1. Gravy made from broth or pan liquids is okay as long as you take the time to skim the fat. Try bringing liquids to a boil and dropping in ice cubes to help remove fat. The fat should solidify on the cube so you can remove it quickly.
2. Choose low-fat dressings for salads, or try using balsamic vinegar with a touch of olive oil spray and your favorite seasonings.
3. Keep your mashed potatoes lower in fat and saturated fat using low-fat milk and a light touch with added butter or margarine. Another trick is to cook mashed potatoes in chicken broth to add flavor without increasing fat content. Adding a touch of cinnamon to your sweet potatoes brings out flavor just as well as butter or sugar.
4. Look for lower calorie “maple flavored” syrup and brown sugar replacements.
5. Choose a heart-healthy margarine, light butter or butter-canola blend spread.
• Watching your total carbohydrate intake is key to healthy eating with diabetes – and desserts are prime sources of empty carbs (and empty calories). You can still enjoy dessert on occasion – just follow these tips for working them into your diet in a diabetes-friendly way:
1. Keep dessert portions small or have just a taste.
2. Include a lower fat or lower sugar dessert topping. Some “creamy” types of desserts taste great with yogurt rather than whipped topping.
3. A touch of vanilla helps bring out the flavor of fresh berries.
4. Try eating fruit as your dessert or use fruit as a key dessert ingredient as in one-crust pies or fruit crisps.
5. Look for low-fat, low-sugar options like “lite” frozen desserts, biscotti, small cookies, or angel food cake.
6. For most diabetics, sugar is not forbidden, but needs to be controlled. Since sugar adds calories to your diet without adding nutrition, look for sugar-free versions of your favorite sweet treats and drinks whenever possible. Products made with aspartame, sucralose, stevia, or saccharine taste sweet – without the added sugar. (Editor's note: Some people experience allergic reactions or intestinal discomfort after consuming artificial sweeteners, so always check with your physician before trying new foods.)
• Strive to make most of your daily carbohydrates complex carbohydrates like pasta, wild rice and whole-wheat bread.
• Remember that naturally occurring sugars, such as the lactose in milk products and fructose found in fruits count toward your daily carbohydrate intake.
• Read labels and check ingredient lists to limit added sugars.

For more information on eating with diabetes, contact Nutrition@gianteagle.com.

Important Physician Advice Disclaimer: The content provided by Giant Eagle^® , including but not limited to, web site, recipe and health information is for educational purposes only. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Consult your physician for professional guidance before changing or undertaking a new diet program. Advance consultation with your physician is particularly important if you are under the age of 18, pregnant, nursing, or have health problems.

November 2010