This week I received the following question from http://foodpicker.org :

I have been diagnosed with pre-diabetes and a friend told me I should eat low carb and no sugar.  What is considered to be low carb and low sugar in specific numbers?

Good question. The FDA (Food and Drug Administration) is responsible for defining nutritive claims that food companies use. For instance, a product must contain 0.5 grams or less of sugar to be labeled as “sugar-free.” Low-fat items must be 3 grams or less. As of present however, the FDA has not legally defined “low carb” or “low sugar.” You may see “reduced sugar” on items, which is defined of having 25% less sugar than the original product.

So, what to do when you are diabetic? Being diabetic does not necessarily mean you can’t have carbs or sugar. It just means you have to monitor your carbohydrates (which includes sugar) to the appropriate amount for you. For women, that is 2-3 servings per meal, or men, 3-4 servings per meal.  Remember that 1 serving = 15 grams of carbohydrates, so when reading labels on food items that claim “low carbohydrate,” keep this in mind for blood sugar control.

Reading labels will keep you aware of its calories and fat too. Often products advertised as “low carb” are higher in fat, thus are higher in calories. When you compare labels, you may find that the product that has a little more carbs is actually lower calorie as well. This is fine, because its all about the portions of that product you eat.

Until next time!

Diabetes and Weight Loss

This week I received the following question from http://foodpicker.org :

I am very new to the diabetes lifestyle.  I have started working out and so far have dropped 8 pounds (I have about 100 pounds still to lose).  I am excited about the weight loss so far, but I am scared that I won’t drop the weight and that I will slip somehow.  Can you offer any advice in regards to cravings (I have a big sweet tooth and enjoy greasy foods such as burgers and fries)?

Great job! You should give yourself a big pat on the back for what you have accomplished so far. Losing excess weight will tremendously benefit your health in the short and long term.

Cravings can be annoying when trying to lose or maintain your weight, but consider several factors first before turning to the fatty foods and sweets. Are you getting 3 balanced meals daily, with the right amount of carbohydrates, fat, and protein? Skipping meals, or not eating enough at meals can understandably set you up for the munchies later.  If you eat smaller meals, do you make time to prepare healthy snacks?  Check out this link: http://www.rd.com/living-healthy/15-diabeticfriendly-snacks-tips/article98255.html for a few snack ideas. When you get enough to eat of the good stuff, you’re less likely to want to reach for the bad stuff.

Sometimes you may still just really want something sweet. Fruit is a great way to fulfill a sugar craving– see my last post for more details on fruit and diabetes. Again, avoid eating fruit by itself to prevent a drastic spike in blood sugar, and pair it with a protein, such as peanut butter or cheese. I also believe that it is alright to treat yourself occasionally, just make room for your dessert in your daily carbohydrate allowance, and enjoy it with a meal.

It is important to remember that we are all human, and sometimes we “slip up” or “fall off the wagon” with our new diet and lifestyle. It’s okay, don’t beat yourself up! You can always get back on track. Just recognize what triggered the habit change ( such as maybe stress or having a hectic schedule) and think how you could handle the situation better the next time around. We have all experienced this at one point or another, noone is perfect.

Keep up the great work, and keep in mind that your choice to take control of your health through proper nutrition and an active lifestyle sets a great example for others, including friends or members of your family.  This is the way we should all be eating and living, diabetes or not!

Sugar content of fruit

This week I received the following question from http://foodpicker.org :

I have pre-diabetes and am trying to learn about carbohydrate and sugar.  Does the sugar in fruit count as sugar?

Yes. Although the sugars in fruit are natural sugars as opposed to processed sugar we add to desserts or beverages, they are still sugar, which is a form of carbohydrate. The source of sugar does not matter. However, choosing fruits as opposed to other sugary snacks is a great way to go, as it is typically low in calories, and is rich in fiber, vitamins, minerals, and antioxidants. These qualities are essential for our health, so if you have diabetes you definietly do not want to skip out on fruit!!

A good goal for anyone is to get at least two to three servings of fruit in a day. Remember, 1 serving of fruit = 15 grams carbohydrate. Eating fruit with meals as a way to satisfy your sweet tooth is an excellent practice.
The following are 15 gram servings of fruit:

Apple, small (2 inches across)	1 (4 ounces)
Apricots	4 (5 1/2 ounces)
Banana, extra-small	1 (4 ounces)
Blackberries, blueberries	3/4 cup
Cantaloupe, honeydew, papaya, cubed	1 cup (11 ounces)
Cherries	12 (3 ounces)
Dates	3
Grapefruit, large	1/2 (11 ounces)
Grapes, small	17 (3 ounces)
Kiwi	1 (3 1/2 ounces)
Mango, cubed	1/2 cup
Nectarine, small	1 (5 ounces)
Orange, small	1 (6 1/2 ounces)
Peach, medium	1 (6 ounces)
Pear, large	1/2 (4 ounces)
Pineapple, cubed	3/4 cup
Plums, small	2 (5 ounces)
Raspberries	1 cup
Strawberries	1 1/4 cup
Tangerines, small	2 (8 ounces)
Watermelon, cubed	1 1/4 cup (13 1/2 ounces)
Dried fruit
	Apples	4 rings
	Apricots	8 halves
	Blueberries, cherries, cranberries, mixed fruit	2 tablespoons
	Figs	1 1/2
	Prunes	3
	Raisins	2 tablespoons
Canned fruit, unsweetened
	Applesauce, apricots, cherries, peaches, pears, pineapple, plums	1/2 cup
	Grapefruit, mandarin oranges	3/4 cup

Source: MayoClinic.com

If you have diabetes, its a good idea to avoid eating fruit by itself. Have it with a protein or healthy fat to slow sugar absorption and prevent a spike in blood sugar.  If you are still worried about sugar in general, I tend to tell patients to focus on the total carbohydrate amount instead. Sugar is listed underneath this category on nutrition labels and is included in this total amount.  This is just a way to look at the whole picture to determine how it will effect you, rather than just one component.

Diabetic Meal Replacements

This week’s question from http://foodpicker.org !!

I was diagnosed with diabetes a few months ago.  I’m wondering about those bars and shakes I see advertised for people with diabetes.  Are they good to use?  Sometimes I’m out and need a snack or quick lunch.

Absolutely. When you are on the go and are short on time, snack bars and shakes can be a good option. They can prevent your blood sugar from dropping too low when you have to skip a meal, and can even provide extra nutrition to those who are in need of it. These bars and shakes are typically referred to as “meal replacements,” and can also include puddings, soups, and frozen meals. When you go shopping you will find that there are a TON of them out there.  Meal replacement sales are as high as $1 billion each year.

Do be careful though. Ones that are directed towards diabetes are generally alright, such as Glucerna products, however always be conscientious of those carbohydrates and check labels. Everyone responds to food differently, so be sure that when you start using them you are monitoring your blood sugar regularly. This can give you an idea what works best for you.  You want to aim for a meal replacement that has a little fat and protein  in it to keep you full, and that will slow its absorption to prevent a dramatic spike in your blood sugar. Also look for ones that have 3 grams of fiber or more.

There are other issues to consider as well. If cost is a factor, this may not be the best route to go. Meal replacements can be pricey, and in the long term it can become very expensive. Taking some time to plan healthy snacks from home  occasionally can help alleviate this, such as a smoothie with low-fat or skim milk, or some cheese and crackers.

Use meal replacements sparingly, or only when they are needed. They are wonderful for a quick snack  if you are having a busy day, but if you have time to eat a real meal instead, please do. Research has found that excessive use of meal replacements can cause you to be deficient in vitamins and minerals in the long run. You may find your blood sugar becomes hard to control as well.

Everything in moderation!