Saturday, May 8, 2010

What Can I Eat When I Have Diabetes?

I'm going to discuss two diets here: the diet proposed by the American Diabetes Association (ADA) and the diet I have found works best for the diabetic patients that come to my office.

The ADA recommends the following:

•Grains and starches 6-11 servings a day
•Vegetables 3-5 servings a day
•Fruit 2-4 servings a day
•Milk and dairy 2-3 servings a day
•Meat and meat substitutes 4-6 oz. divided between meals
•Fats, sweets and alcohol keep small servings for a special treat

A serving of grains or starches includes 1 slice of bread, ¼ bagel, 1/3 cup rice, ½ cup potatoes, yams, peas, corn, beans.

A serving of vegetables is 1 cup raw or ½ cup cooked.

A serving of fruit is ½ cup canned fruit, 1 small fresh fruit, or 1 cup melon or berries.

A serving of mild and dairy is 1 cup non-fat or low-fat milk or 1 cup of yogurt.

Four ounces of meat is a quarter pound. 1 oz. of meat is equal to ¼ cup cottage cheese, 1 egg, 1 tablespoon peanut butter, and ½ cup tofu.

A typical serving of sweets includes ½ cup ice cream, 1 small cupcake or muffin, or 2 small cookies.

The problem I see in my patients on this diet, even though basically healthy, is that their blood glucose and insulin levels are still not controlled. And I believe the greatest source of that problem is in the grains and the starches, which are given the highest priority in this diet.

Sugar Stabilization Program

The following is the program I put my patients on which has very positive effects in balancing their blood glucose and insulin levels. This can be used for both type 1 and type 2 diabetics, and often both the amount of insulin and/or oral medication can be reduced (under the direction of a physician) when the diet is used in combination with the supplements.

1. Avoid refined sugar: sucrose, fructose, maltodextrose, etc. No honey, syrup, turbinado sugar, etc. Avoid artificial sweeteners: aspartame (Nutrasweet, Equal), saccharin (Sweet'N Low, SugarTwin), acesulfame K (Sunett, Sweet One), Sucralose (Splenda). Limited amounts of xylitol, stevia and agave nectar are acceptable.

2. Eat a palm size piece of protein (meat, fish, egg, tofu) at each of the three major meals a day.

3. Eat as many vegetables as possible—preferable five servings a day, especially green leafy and non-starchy vegetables. Eat potatoes sparingly.

4. Eat three fruits a day, preferably as a dessert after a normal meal. Eat bananas sparingly. Avoid fruit juice.

5. Eat a healthy (protein, vegetable, nuts or seeds, cheese) snack between meals.

6. Avoid products made with flour: bread, crackers, tortillas; use pasta sparingly. Whole grains: whole wheat berries, brown rice, whole barley, oatmeal are acceptable in limited amounts, unless you are gluten sensitive. Bread made from sprouted grains rather than flour are acceptable in limited amounts. DO NOT USE GRAINS IF YOUR BLOOD GLUCOSE REMAINS HIGH ON THIS DIET.

7. Legumes, nuts and seeds are acceptable.

8. Dairy is acceptable if there is no allergy to it.

9. Use healthy fats and oils: olive, sunflower, safflower, grape seed, walnut, etc.

10. Drink 6-8 cups of water a day.

11. Glucose Balance supplement daily.

12. Interval exercising 12 minutes a day.

This way of eating combined with the supplements and exercise program described in a future blog often reduces blood sugar enough to reduce or even come off of medication (under a doctor’s supervision) for Type 2 Diabetes, and often reduce the level of insulin necessary in Type 1 Diabetes, which reduces long-term complications.

Before you start this program, it is important to take your blood sugars four times a day: before each meal and at bedtime, to get a baseline of where your blood sugars are normally, and then continue for the first couple of weeks on the program to see how you are responding to it. Once a month it is useful to take your blood sugars four times a day, if you are not already doing it, to be sure that your regimen is working for you. If your blood sugars start going too low, talk to your doctor about reducing your medication.

After you get used to the basics of this program, having been on it for more than a month, if your glucose readings are still too high, you can modify it in the following steps as needed, one at a time, step by step, until your readings, along with supplements and/or medication, are between 80 and 110 (the majority of diabetics will not have to go beyond the first one to two steps):

1. Using an online carbohydrate counter and reading labels, count the number of grams of carbohydrates you are eating and reduce to 75 grams a day.

2. Use an online glycemic index table, and only eat foods that are given the value of 50 or below.

3. Cut out all gluten (wheat, oatmeal, rye and barley). Some people are sensitive to gluten and it causes an unusual rise in insulin levels.

4. Reduce the number of grams of carbohydrates you eat to 50 grams a day.
5. Reduce the number of grams of carbohydrates to 25 grams a day.

Studies have shown that people who don’t eat gluten (in wheat, oatmeal, rye and barley), lose weight, lower glucose levels, and increase their HDL and ApoA1 levels.

The low number of carbohydrates seems restrictive, but blindness and kidney dialysis and amputations are much more restrictive. Often, when the blood sugars are under control for a year, the body can handle more carbohydrates without a rise in blood sugar.

The next blog will be about supplements that have been shown to assist in lowering and stabilizing glucose and insulin levels.

Until we meet again,
Dr. Judi


Marci said...

Have you heard of the GI diet? It takes the glycemic index and gives you a list of green light food that you can eat to your hearts content. It claims that these foods take longer to digest and thus keep your blood sugar levels stable throughout the day.

Dr. Judi said...

The "glycemic index diet," "GI diet," and "low glycemic diet" refer to a system of ranking carbohydrate foods according to how much a certain amount of each food raises a person's blood sugar levels.

Originally developed as a tool to help diabetics manage blood sugar control, the glycemic index has found its way into the mainstream weight loss market. The glycemic index is the basis for many popular diet plans, such as SouthBeach, The Zone, Sugar Busters, Glucose Revolution, and Ending the Food Fight. It is also the basis for my Sugar Stabilization Program.

The G.I. Diet has taken the foods lower on the Glycemic Index as "free foods," and gives more detailed guidance in the best foods to eat. For those that don't have the time or energy to figure out their own diet from the glycemic index (found easily on line), they can buy the book and have it figured out for them. It can make life easier, which is always good:)