Q: I am a 54-year-old woman withdiabetes, trying to lose a substantialamount of weight. I want to be healthier andwant nutrition that will help my goal. I seemto be at a standstill. Can you give me someeasy nutrition ideas?
A: Losing weight can be difficult. Itsounds like you’ve taken a greatfirst step by committing to making a lifestylechange. Here are some ideas you mightwant to consider.
Keep a record of food, activity, bloodglucose and your feelings for one or twoweeks. Write down everything you eatand the amount; the types and amounts ofexercise you do; your blood glucose levels;and notes about your moods or feelings.Don’t judge these things or make anychanges; just record what you are currentlydoing.
After a week or two, carefully review yourlog. Look for any eating or activity patternsthat you might want to change. For instance,maybe your log shows that you often eat at9 o’clock every night, and your log showsthat you’re often bored at that time. Youmight decide to find a way to deal with theboredom instead of eating.
Whatever you discover from your foodactivity-feelings record, remember to workon only one or two changes at a time; yourchances for success will be greater.
Make an appointment with a registereddietitian. A dietitian can help you identifycurrent eating patterns and work with youto make changes. Your dietitian can alsoprovide you with a nutrient analysis of yourcurrent food intake, which you can comparewith your daily energy and nutrient needs.To locate a registered dietitian in your area,contact your local hospital or physicianclinic or check the Yellow Pages. Look forsomeone who specializes in diabetes care.You can also log on to the American DieteticAssociation Web site at www.eatright.organd search their directory for a dietitian inyour area.
Ask a friend to help. Some people find it iseasier to make behavioral changes if theyhave a support buddy. If you do best withthis type of support, ask a friend to supportyou as you work toward your goals.
Give yourself permission to include allkinds of foods in your new eating plan.Completely eliminating a food from yourdiet can sometimes make you crave thatfood more. All kinds of foods can fit into ahealthy diet; for those foods that are higherin calories, fat or sugar, try to just savor thetaste and opt for a smaller portion.
Make a goal of increasing your physicalactivity. Physical activity is a key componentof diabetes management and a healthylifestyle. Whether you like to walk at the mallor run marathons, physical activity buildsmuscle and burns calories. Look for waysyou can be more active each day. Wearing apedometer can be helpful.
Remember: Take small steps toward success.Incorporate changes one at a time. It takesat least six weeks to form a new habit. So,if you change your mid-morning snack orevening activity routine, give yourself sometime to adjust before trying to form anothernew habit.
Q: I noticed that some snackfoods claim to have notrans fats. The labels, however, listpartially hydrogenated soybeanor cottonseed oil as an ingredient.Please explain how this is possible,as I always believed these items weretrans fats.
Howard Beach, New York
A: You are correct that transfats can be found in foodssuch as vegetable shortening, somemargarines, crackers, cookies, snackfoods and other foods made with orfried in partially hydrogenated oils.
The U.S. Food and DrugAdministration has decided thatstarting January 1, 2006, listingall trans fats will be required onthe Nutrition Facts panel. Dietarysupplements will also be requiredto list trans fats on the label ifthey contain reportable amounts(0.5 gram or more) of trans fat. Anexample of a dietary supplementwith trans fats are many energy andnutrition bars.
Trans fat intake has been linkedto increased risk of coronaryheart disease. To avoid trans fats,replace saturated fats and transfats with monounsaturated andpolyunsaturated fats in your diet.This could mean eating moreolive, canola, soybean, corn andsunflower oils, nuts and fish. Avoidcoconut oil and solid margarinesand shortenings, which have higheramounts of trans fats.
Q: What foods do yourecommend for treating ahypoglycemic episode if I don’t haveglucose tabs at the ready?
A: Most diabetes expertsrecommend followingthe rule of 15/15 for treatinghypoglycemia. If possible, checkyour blood glucose first to see if it is70 mg/dl or less (hypoglycemia). Ifit isn’t possible to check your bloodglucose, and if symptoms of lowblood glucose are present, suchas feeling shaky, sweaty, irritableor lightheaded, treat this as youwould hypoglycemia. Start with 15grams of carbohydrate and wait 15minutes. If your blood glucose is lessthan 50 mg/dl, start with 20 gramsof carbohydrate. Check your bloodglucose. If it is still less the 70 mg/dl,then repeat the 15/15 plan.
The chart below lists some foods thatcontain 15 grams of carbohydrateper serving.
15-Gram Carbohydrate Choices
|Fruit juice||4 ounces|
|Regular (non-diet) soda||4 ounces|
|Glucose tablets||3 to 4 (check the label)|
|Jelly or honey||1 tablespoon|
|Life Savers or hard candy||3 to 6 pieces|
|Glucose gel||1 tube (check the label)|