Nutrition & Diabetes What’s the Connection?Irene Higgins-Bowser, PDt, CDE

Disclosure

• I, Irene Higgins-Bowser, cannot identify any potential conflicts of interest with this presentation.

Clinical Practice Guidelines

• “Nutrition therapy can result in a reduction in A1C of 1-2%, and when used in combination with other components of diabetes care can further improve clinical and metabolic outcomes.”

Cornerstone of Managementmealplanning

medication physical activity

stress management

knowledgeself care

changing behaviour

motivation strategies

self blood glucose monitoring

financial burden

Basic Mealplanning

Eat 3 meals each daySpace meals 4-6 hours apart

8am 12noon

Basic Mealplanning

Balanced Meals( 3 out of 4 main food groups)

StarchFruit & Vegetable Milk & Milk ProductsProtein

Canada’s Food Guide to Healthy Living

“Handy” Portion Guide

1 of starch/grain1 of fruit

Vegetables

Protein

Fat

Basic Mealplanning

Quench thirst with water, sugar free drinks

Avoid juice between meals

Limit intake of sugar and sweets

Yield to Fat

Recognizing FatHow Much Fat do we Need?

Women ~ 50 to 70 grams/day

Men ~ 70 to 90 grams/day

What is a Gram of Fat?5 grams fat :• 1 tsp. butter/margarine• 1 oz. cheese (hidden)• 10 potato chips (hidden)• 10 peanuts (hidden)• 1 slice crisp bacon• 1 treat-size chocolate bar

Quarter Chicken Dinner

1/4 Chicken Dark Meat(with skin)

French Fries & GravyColeslaw

Roll with Butter

Total Grams of Fat

~90 g

1/4 Chicken White(no skin)

Baked Potato with light Sour cream

Mixed VegetablesRoll (no butter)

Total Grams of Fat~20 g

Mealplanning in Type 2 Diabetes

Portion controlReduced overall caloric intake Reduced fat intakeConsistent carbohydrate

Mealplanning with Type 1 Diabetes

Carbohydrate countingConsider glycemic index of foods.Develop insulin to carbohydrate ratios

• A scale that ranks carbohydrate rich foods by how much they raise blood glucose levels compared to a standard food (glucose or white bread)

• Not to be confused with grams of carbohydrate

0102030405060708090

100

glucose mashedpotato

jellybeans

sweetpotato

Glycemic Index

• Low-/medium-GI foods can result in a lower rise in postprandial blood glucose levels

• 1-2 hour postprandial glucose testing

• GI is affected by cooking/processing, fibre, protein and fat

… …

Glycemic Index

GI Values within Food Groups

LOW(Les than 55)

MEDIUM (55 to 69)

HIGH (70 or more)

Milk & Alternates Skim Milk 32

Fruits Apple 39 Banana 60 Watermelon 72

Root Vegetables

Sweet Potato 54

Baked Potato60

Mashed Potato 85

Grains Barley 25 Brown Rice 66 Instant Rice 87

Cereals All Bran 51 Frosted Flakes 55

Corn Flakes 81

• Serving size• Fat• Sodium• Carbohydrate • Fibre• %

Label Reading

Meal Planning Tips

• Keep food record• Awareness of quantity (measure)• Portion control• Mindless eating• Mind “full” eating• Work on 1-2 goals at a time

Web Sites

• www.dietitians.ca• www.eatracker.ca• www.glycemicindex.com• www.diabetes.ca• www.compliments.ca• www.healthyeatingisinstore.ca• www.healthcheck.org• www.becel.ca/healthcare