How To Plan Nutritious Meals

Simply put, you have diabetes either because your body does not produce enough insulin or because your body's cells cannot use the insulin that is produced.

Insulin helps your cells absorb and use the glucose (sugar) in your blood. If you do not have enough insulin, or if your cells cannot use it, the level of glucose in your blood rises. High blood glucose levels sometimes cause common symptoms of diabetes: tiredness, increased thirst, increased urination, infections and cuts that do not heal, blurred vision, hunger, and weight loss.

Non-insulin dependent diabetes mellitus (NIDDM), also known as "type II" diabetes, usually occurs after age 40, but younger adults sometimes get it. Heredity and obesity are the two usual causes of this type of diabetes.

Everyone who has diabetes needs to follow a meal plan, and most should follow an exercise program as well. For some people, weight loss and exercise are enough to control their blood glucose levels and maintain good health. For others, pills or injections may also be needed to help keep blood glucose levels under control.

If you have just found out you have diabetes, you may feel quite healthy. This can make it hard to remember to stick with your meal plan and exercise program. But remember that the early years of diabetes are when you can do the most to protect your body from the long-term hazards of this disease. If your blood glucose level is high for long periods over a number of years, it may cause major damage to your nervous system and to the blood vessels in your eyes, kidneys, heart, and feet. The good news is that you can prevent or reduce this damage if you work closely with a registered dietitian, doctor, nurse, and other health-care providers. This in turn may help you live a longer life with fewer problems.

Healthful Meal Planning For Non-Insulin-Dependent Diabetes Mellitus (NIDDM)

Your new meal plan doesn't mean you'll have to eat differently from everyone else in the family. It includes a wide variety of foods and is a more healthful way of eating for the whole family.

If you are at or near your desirable weight, try to stay there. If, like most people with NIDDM, you are somewhat overweight, any amount of weight loss, even a few pounds, will help control your diabetes. A registered dietitian can work with you to set short-term and long-term weight-loss goals.

Whether you have weight to lose or not, you will need to stick to some fairly simple rules for a healthful meal plan to help control both your weight and blood glucose level.

Get On The Lowfat Bandwagon

These days, a lowfat diet is recommended for all Americans, not just those with diabetes. Cutting down on all types of fats and oils is important both to control your weight and to reduce your risk for heart disease. Some ways you can cut down on the fat in your diet are:

- Use less margarine, butter, and cream cheese. Try low-sugar jelly instead.

- Avoid regular salad dressings. Use reduced-calorie or fat-free varieties. Or try flavored vinegars or lemon juice.

- Use less mayonnaise. Try low-calorie types or use mustard instead.

- Use lowfat yogurt in place of sour cream.

- Skim the fat from your gravies and homemade soups.

Choose Healthful Foods From The Different Food Groups

Consult a registered dietitian for food choices that are best for you, as well as the sizes and exact numbers of servings that are right for your daily meal plan. He or she can also give you some recipe suggestions.

Meats, Fish, Poultry, Cheese & Peanut Butter

- Choose lean and lowfat cuts of red meats, such as eye of round, round tip, top loin, top round, sirloin, and tenderloin.

- Take the skin off poultry.

- Cut down on fried meat, chicken, or fish.

- Use fattier meats such as these less often: sausages, bacon, hot dogs, spare ribs, short ribs, bologna, salami, and similar lunch meats.

- Eat meat no more than twice a day, and when you do, keep the portions small.

- Eat small amounts of nuts, seeds, and nut or seed butters. They are nutritious but high in fat and calories.

- Make more dishes using dried peas and beans. They are high in nutrition and fiber and low in fat. The type of fiber found in peas and beans may help lower your blood glucose level.

- Replace ricotta cheese with lowfat cottage cheese in many recipes. Use other cheeses in small amounts because they are rich in fat and calories.

Milk

- Choose lowfat or nonfat milks and lowfat yogurt.

- For an excellent snack, look for the fruit-flavored yogurts made with sugar substitutes.

- Try using plain, lowfat yogurt in place of sour cream in your favorite recipes.

- Choose sugar-free, nonfat frozen yogurt rather than ice cream.

Vegetables

- Eat raw and cooked vegetables as often as you like, they're great for you.

- Steer away from vegetables in cream or cheese sauces or those that are coated and deep-fried.

- Use only small amounts of salad dressings or try some of the low-calorie dressings.

Fruits

- When selecting fruit, fresh is your best bet. It's higher in fiber than canned fruit.

- If you use canned fruit, buy a juice- or water-packed variety and drain before serving.

- Even unsweetened juices cause your blood glucose level to rise if you drink them too often. If you like juice, keep the serving size to 1/2 cup and eat fresh fruit instead. For a thirst-quenching beverage, try water, mineral water, or noncaloric carbonated water.

Breads, Cereals & Grains

- Forget all the stories that starches are fattening or should be avoided by people with diabetes. A healthful diet should contain at least four servings each day from this group, including whole-grain breads, cereals, pasta, and rice.

- Corn tortillas are made without fat and are a better choice than flour tortillas.

- Choose French rolls, which are made with little or no fat, instead of croissants.

- Pass on greasy snack crackers, bakery muffins, and biscuits. Instead, try melba toast, puffed rice, popcorn or rice cakes, French bread, whole-grain breads, bagels, and English muffins.

At this time, it's worth repeating one point: Do everything you can to cut down on fried foods or adding fats to food. Every tablespoon of oil, shortening, or butter used in frying adds at least 100 calories of fat to the meal!

Eat Less Sugar & Sugary Foods

Sweets are usually high in calories and may also be high in fat. Limit the amount of sugar, candies, regular soft drinks, jams, jellies, pies, cakes, cookies, ice cream, fruit punches, and other "sweets" you consume. Talk to a registered dietitian about healthful low-sugar or sugar-free foods that you can buy or make. Remember, a diet without sugar can still be sweet! A registered dietitian can also tell you more about nonsugar sweeteners such as aspartame (Nutrasweet), saccharin, and acesulfame-K (Sunette TM). In general they are safe and allow for more sweetness and variety in your diet.

Get Moving!

Regular exercise - at least three times a week - is an important part of your health program. Exercise burns calories, makes weight loss easier, and can help lower your blood glucose level. A doctor, together with a registered dietitian, can work with you to develop an exercise plan. Walking, swimming, and bicycling are the forms of exercise most commonly recommended.

Sensible Salt Use

For many people, eating too much salt or salty foods can cause their blood pressure to go up. People with diabetes often have high blood pressure or will get it, so it's a good idea to watch your salt intake each day.

- Decrease or cut out the salt you use when you prepare food. Try lemon juice, herbs, and salt-free seasoning blends to add zip to meats, poultry, fish, and vegetables.

- At the table, get in the habit of tasting your food before you add any salt to it. Most people find they can get by with less and less salt if they cut down gradually over a few weeks.

- Some popular seasonings - including soy sauce, steak sauces, and many barbecue sauces - contain a lot of salt.

- Many dishes at fast-food and family restaurants are high in salt. A registered dietitian can suggest foods to help keep your salt intake at a sensible level.

- A lot of salt is hidden in the prepared foods you eat each day. Most canned foods, such as vegetables, sauces, soups, meats, and stews, are heavily salted. Use fewer of these foods if you can, and ask a registered dietitian how to select and use the ones you do wish to eat.

- Lunch can be a very salty meal. Lunch meats, cheeses, canned and dried soups, cottage cheese, and pickles are all high in salt. Good lunchtime choices might be a sandwich made with sliced, leftover chicken, lettuce, and tomato, a piece of fresh fruit, and a glass of nonfat or lowfat milk.

Is Alcohol Allowed?

This question can only be answered by your doctor, and it is very important to discuss this with him or her before you drink any alcohol.

For some people, the answer will be no because alcohol use may not agree with their medical condition or some of their medications. If your doctor allows you to drink alcohol, ask a registered dietitian how you can work it into your meal plan, and keep these guidelines in mind:

- A "serving" of alcohol is 4 ounces of wine, 12 ounces of beer, or 1 1/2 ounces of liquor. At most, you could have one or two servings once or twice a week. Again, discuss the exact amounts with your doctor and registered dietitian.

- If possible, choose "light" beers and dry wines because they have fewer calories.

- Watch out for sugary drinks such as wine coolers and mixed drinks made with regular sodas and juices.

Putting It All Together

There's no single right way to eat. A registered dietitian can help you plan menus that include many of your favorite foods. A good meal plan has variety and a lot of tasty foods. A registered dietitian can work with you on portion sizes, eating for special occasions, and eating out. If you are on any other special diets for cholesterol-lowering, weight loss, or other medical needs, he or she can help you eat well and stay within your food budget.

Here are a few menu ideas to get you started.

Breakfast

Oatmeal or bran-type cereal with sliced banana and lowfat milk

Whole-wheat toast with margarine and low-sugar jelly, or

Vegetable omelette made with egg substitute

Toasted English muffin with margarine

Fresh orange, or

1/2 grapefruit

Toasted bagel with margarine

Lowfat or nonfat milk

Lunch

Black-eyed peas seasoned with lean ham

Steamed greens

Cornbread, or

Tuna salad made with low-calorie mayonnaise on pumpernickel bread

Carrots and celery sticks

Apple, or

Boiled pinto beans

Corn tortillas

Chopped lettuce and tomatoes, or

Homemade bean soup

Whole-wheat bread

Banana, or

Dinner

Skinless barbecued chicken breast

Baked potato

Steamed broccoli

Sugar-free pudding, or

Homemade turkey vegetable soup

Dinner roll

Baked apple with cinnamon, or

Broiled hamburger patty on a bun

Cole slaw made with reduced-calorie mayonnaise

Watermelon, or

Stir-fried chicken with mushrooms and broccoli

Rice

Fresh strawberries