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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Learn how to eat well, improve your health, and enjoy life with diabetes The new edition of Diabetes Meal Planning & Nutrition For Dummies offers you a holistic approach to living your best life with diabetes. Optimize your diet and plan delicious meals that will empower you to take control, improve your health, prevent, and even reverse diabetes. Written by an award-winning chef and renowned doctor who are both experts in the field of nutrition, this book helps you understand what defines healthful eating for diabetes, its crucial role to long term health, and how meal planning is a key to successful diabetes management. Learn how to receive all the nutrients necessary for glucose control while managing Type 1 or Type 2 diabetes and maintaining ideal weight. Discover how to supercharge your diet and protect yourself from the complications associated with diabetes with anti-inflammatory and antioxidant-rich foods. To get you started, this indispensable guide includes 22 mouthwatering, easy to recreate, and affordable recipes that maximize the benefits of nutritious ingredients to regulate blood glucose levels. The kitchen and shopping hacks will enable you to master culinary therapy and take delight in preparing meals and cooking. This updated edition includes: * Practical examples of meal plans perfectly suited for prediabetes, Type 1, and Type 2 diabetes * A whole person approach to diabetes that focuses on diet, lifestyle, exercise, and medical treatment * Coverage of new therapies and the latest evidence on how gut health can help with diabetes management * Nutrition facts and health benefits for your favorite ingredients, so you can eat what you love Diabetes Meal Planning & Nutrition For Dummies is an excellent resource for those interested in the latest diabetes-friendly nutrition guidelines, as well as anyone who has been diagnosed with diabetes or has a loved one who has been diagnosed, or would like to prevent it.
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Seitenzahl: 721
Veröffentlichungsjahr: 2023
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Diabetes Meal Planning & Nutrition For Dummies®
To view this book's Cheat Sheet, simply go to www.dummies.com and search for “Diabetes Meal Planning & Nutrition For Dummies Cheat Sheet” in the Search box.
Table of Contents
Cover
Title Page
Copyright
Introduction
About This Book
Foolish Assumptions
Icons Used in This Book
Beyond the Book
Where to Go from Here
Part 1: Diabetes and Food: Culinary Therapy
Chapter 1: Eating Well with Diabetes
Balancing Glucose in the Body
Taking Your Place in Diabetes Management
Understanding Your Brain’s Role in Eating
Deciding What to Eat and When
Making It Easy on Yourself
Chapter 2: Understanding Diabetes : A Holistic Approach
Defining Diabetes Mellitus
Exploring Type 1 Diabetes
Analyzing Type 2 and Gestational Diabetes
Summing Up the Potential Complications of Diabetes
Chapter 3: Managing Diabetes and Blood Glucose
Regulating Your Body’s Blood Glucose Levels
Losing the Glucose Balance
Measuring Blood Glucose
Ensuring the Best Diabetes Care
Seeing a Registered Dietitian or Certified Nutrition Specialist
Chapter 4: Incorporating Easy Lifestyle Hacks
Adopting a Healthful and Enjoyable Diabetes Lifestyle
Prioritizing Your Health
Part 2: Nutrition with Purpose
Chapter 5: Explaining Nutrition Requirements for Diabetes
Five Principles of Excellent Nutrition
Targeting Blood Glucose Control in Type 1 and Type 2 Diabetes
Losing to Win: Weight Loss
Monitoring Cardiovascular Risks
Being Aware of Special Circumstances
Chapter 6: Meeting the Macronutrients: Carbohydrates, Fat, and Protein
Food Is More than Macronutrients
Building a Complete Meal Is Important
Energizing with Quality Carbohydrates
Counting Carbs
Putting Carbs on Your Plate
Filling Fiber and How to Use It
Embracing Healthful Fats
Identifying the Best Quality Proteins
Chapter 7: Making Micronutrients Work for You
Introducing Versatile Vitamins
Finding Marvelous Minerals
Sorting Out Supplements
The Gut Microbiome and Its Role in Diabetes
Chapter 8: Eating a Rainbow: Bioactive Compounds and Polyphenols
Defining Bioactive Compounds
Understanding Bioactives and Their Role in Health
Analyzing Oxidation and Antioxidants
Inflammation: The Good, the Bad, and the Ugly
Getting to Know Carotenoids, Glucosinolates, and Polyphenols
Enjoying the Taste of Bioactives
How to Recognize Foods with Bioactives
Chapter 9: Equipping Yourself for Success
Stocking Your Kitchen
Understanding Nutrition Facts Labels
Calculating Food Choices
Referencing the Right Resources
Considering Exchanges
Part 3: Eating for Pleasure and Better Health
Chapter 10: Exposing Barriers to Healthy Eating
Tracing Changes in the Food Environment
Recognizing Emotional Attachments to Food
Eating Healthier Forever
Chapter 11: Setting Priorities and Staying on Track
Committing to Your Future
Adopting Better Habits
Staying on Track
Achieving Your Goals
Chapter 12: Choosing the Best Food When Shopping
Starting Healthy Meal Planning
Making Your Menus
Assessing the Quality of Your Food
Unraveling Food Terminology
Choosing the Best Foods
Part 4: Ready, Set, Plan
Chapter 13: Customizing Your Meals
Laying the Foundation
Moving Beyond Simple
Salvaging Heirloom Recipes
Chapter 14: Analyzing Popular Diet Plans
Basking in the Mediterranean
Understanding Heritage Diets
Dining with DASH
Preferring Plants: Vegetarian Diets
Thinking About Low-Carb Diets
Counting Points: Weight Watchers
Food By Mail
Resisting Fads
Chapter 15: What’s on the Menu: Having a Plan for Eating Out
Making Decisions First
Dining Out
Keeping It Honest
Chapter 16: Choosing Sensible Beverages and Snacks
Beverages
Snacks
Low-Carb Healthy Snacks
Alternative Sweeteners
Part 5: Putting It All Together: Meals to Manage Your Diabetes
Chapter 17: Reviewing a Seven-Day Menu
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Snacks
Chapter 18: Creating Delicious and Nutritious Meals
Bountiful Breakfasts
Looking Forward to Lunch
Delicious Dinners
Must-Have Base Recipes
Part 6: The Part of Tens
Chapter 19: Ten Diabetes “Power Foods”
Extra-Virgin Olive Oil
Beans
Salmon and Tuna
Nuts
Oranges and Lemons
Kale (and Other Leafy Greens)
Dark Chocolate
Soybeans
Full-Fat Greek-Style Plain Yogurt
Whole Grains: Oats and Barley
Chapter 20: Ten Inexpensive Diabetes-Friendly Foods
Beans
Lentils
Apples
Yogurt
Potatoes
Bananas
Carrots
Eggs
Beets
Peanut Butter
Chapter 21: Ten Healthful Food Swaps for Losing Weight
Swap Bottled Dressings for Extra-Virgin Olive Oil and Vinegar or Lemon Juice
Make Your Own Fresh Tomato Sauce
Skip Sour Cream and Go Greek Instead
Flavor Your Foods with Aromatics
Use Raw Vegetables for Dipping
Spice It Up
Reach for a Healthier Chocolate Fix
Choose Fresh or Frozen over Canned and Jarred
Opt For Nutrient-Dense Foods over Processed and Packaged Foods
Eat Fresh Fish or Legumes over Red Meat
Appendix A: Diabetes Exchange Lists
Carbohydrate Exchanges
Meat and Meat Substitutes
Fats
Free Foods
Sweets and Desserts
Appendix B: Glycemic Index and Glycemic Load Values
Appendix C: Examples of Bioactive Compounds in Foods
Index
About the Authors
Connect with Dummies
End User License Agreement
List of Tables
Chapter 5
TABLE 5-1 A1C and Average Blood Glucose Level
Chapter 6
TABLE 6-1 Glycemic Index (GI) Value of Common Foods
TABLE 6-2 Measuring a 15-Gram Carb Choice
TABLE 6-3 Dietary Sources of Monounsaturated and Polyunsaturated Fats
Chapter 7
TABLE 7-1 A Review of the B Vitamins
Chapter 9
TABLE 9-1 One Carbohydrate Choice for Common Foods
Chapter 13
TABLE 13-1 Pantry Creations
Chapter 14
TABLE 14-1 DASH Plan Recommended Servings
*
Chapter 15
TABLE 15-1 Restaurant Meals Compared to Daily Recommendations
Chapter 16
TABLE 16-1 Nutrition Information for Alcoholic Beverages
Appendix A
TABLE A-1 Starches
TABLE A-2 Fruits
TABLE A-3 Vegetables
TABLE A-4 Milk
TABLE A-5 Lean and Very Lean Meat and Meat Substitutes
TABLE A-6 Medium-Fat Meat and Meat Substitutes
TABLE A-7 High-Fat Meats and Meat Substitutes
TABLE A-8 Monounsaturated, Polyunsaturated, and Saturated Fats
TABLE A-9 Free Foods
TABLE A-10 Sweets and Desserts — Portions for 15-Grams Carbohydrate
Appendix B
TABLE B-1 GI and GL Values of Common Foods
Appendix C
TABLE C-1 Polyphenols in Foods and Possible Bioactivity
TABLE C-2 Carotenoids in Foods and Possible Bioactivity
TABLE C-3 Glucosinolates in Foods and Possible Bioactivity
TABLE C-4 Phenolic Compounds in Extra-Virgin Olive Oil
List of Illustrations
Chapter 6
FIGURE 6-1: Blood glucose levels in response to both high GI and low GI food.
Chapter 9
FIGURE 9-1: Nutrition facts label for prepackaged linguine and tomato salad.
Chapter 13
FIGURE 13-1: The current USDA MyPlate icon.
FIGURE 13-2: MyPlate adjusted for a healthy diabetes eating plan.
Guide
Cover
Table of Contents
Title Page
Copyright
Begin Reading
Appendix A: Diabetes Exchange Lists
Appendix B: Glycemic Index and Glycemic Load Values
Appendix C: Examples of Bioactive Compounds in Foods
Index
About the Authors
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Diabetes Meal Planning & Nutrition For Dummies®, 2nd Edition
Published by: John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030-5774, www.wiley.com
Copyright © 2024 by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without the prior written permission of the Publisher. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, or online at http://www.wiley.com/go/permissions.
Trademarks: Wiley, For Dummies, the Dummies Man logo, Dummies.com, Making Everything Easier, and related trade dress are trademarks or registered trademarks of John Wiley & Sons, Inc. and may not be used without written permission. All other trademarks are the property of their respective owners. John Wiley & Sons, Inc. is not associated with any product or vendor mentioned in this book.
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Library of Congress Control Number: 2023946157
ISBN 978-1-394-20686-5 (pbk); ISBN 978-1-394-20688-9 (ebk); ISBN 978-1-394-20689-6 (ebk)
Introduction
This book was written to give you the nutritional and culinary knowledge necessary to prevent, treat, and even reverse diabetes. Armed with simple strategies and sound advice, Diabetes Meal Planning & Nutrition For Dummies enables you to take control of diabetes. Whether you purchased this book for yourself or for a loved one and use it to prevent, treat, or reverse a diabetes diagnosis, you will find the answers you need all in one place.
There should be no such thing as a “diabetic diet.” A person with diabetes should not need to choose from a different restaurant menu or be limited to looking for specifically labeled products that have sugar substituted by an artificial sweetener. With the number of people worldwide estimated to have diabetes projected to rise to 642 million by 2040, there is a compelling case for looking at nutrition for managing type 2 diabetes not only when it occurs but also as a strategy to prevent it from developing.
More than half of the population of many countries is now defined as being overweight and at risk of having established type 2 diabetes, undiagnosed type 2 diabetes, or its precursor, prediabetes. The reasons for the dramatic rise in type 2 diabetes and prediabetes are almost certainly related to the move away from traditional healthy lifestyles to our current so-called “Western” processed diets with refined sugars and additives and sedentary patterns of behavior. It is also clear that the complications of poorly controlled diabetes such as heart disease, stroke, dementia, and kidney disease are conditions that can also cause chronic illnesses in people, especially those with poor diets who do not have diabetes.
The dietary advice we give in this book aims to help you achieve excellent blood glucose control, optimum weight maintenance, and better overall health — things that can benefit the majority of people with or without diabetes. The best nutritional advice for people with or without diabetes is to enjoy a diet of foods and nutrients that reduce the likelihood of many of these chronic illnesses. This makes diabetes, its prevention, possible reversal and management, and reduction in its complications everybody’s business.
Best of all, this book exemplifies how you don’t need to give up good-tasting food in order to maintain a diabetes-friendly lifestyle! On the contrary, it shows how to pair ingredients together for maximum flavor and nutritional benefits. You’ll fall in love with culinary therapy techniques that have the power to transform your life. Food is the simplest, least expensive, most available, and most immediate treatment option for diabetes health and overall wellbeing.
Luckily, the foods used in this book are readily available and offer options for a wide variety of tastes. Many of the simple foods that we take for granted are the most beneficial to our diets, and this book shows you how to unleash their power, all while keeping an eye on the clock and the budget. Many people with diabetes struggle to adopt healthier eating habits, many to the point of giving up. This book, however, was built to inspire with enjoyable practices that will enrich your life as well as your meals.
If the word planning in the title seems like the least important (even least interesting) subject in the pages ahead, you are in for an amazing surprise — maybe even an epiphany. See, the struggle with healthy eating doesn’t come from your stomach, your pancreas, or an uncontrollable hand that sneaks unhealthy food into your mouth when you’re not looking. Your struggle with healthy eating is a struggle between your incredible brain and your primitive survival chemistry, and when it comes to food, chemistry often wins. You’re about to learn how planning can tip the balance, and make healthier eating your newest accomplishment. Adopting the advice in this book can provide a way to establish a balanced, satisfying, and truly enjoyable relationship with food.
About This Book
Diabetes Meal Planning & Nutrition For Dummies zeroes in on the important relationship between diabetes and food, and helps you make choices that benefit your long-term health and satisfy your eating preferences. The book’s focus is on which foods you can, and should, eat to improve your health with diabetes, and not on what you shouldn’t eat. There is no doubt, by the way, that how you choose to eat when you have diabetes can have a remarkable effect on your health — this book helps ensure that effect is a positive one. And it is not just about considering the nutrients we eat in the greatest quantity — for diabetes the all-important carbohydrates, fats, and proteins — but also to understand the vital role of micronutrients such as vitamins and minerals, as well as the new science of our gut microbiome and food constituents called bioactive compounds that can have profound antioxidant and anti-inflammatory effects.
The book acknowledges and explains some of the barriers you may have experienced to adopting healthier eating habits, and how your best intentions can be sabotaged. And, you see how the power of making eating decisions in advance — planning — can get you beyond those barriers and keep you there. More than 80 percent of people with type 2 diabetes are overweight or obese, and many have made attempts to change eating habits without success. This discussion on planning may be just the advice you need.
The target audience is people already diagnosed with type 1 or type 2 diabetes, but the concepts and practical advice for managing diabetes with diet apply to gestational diabetes, to those with prediabetes, and even to people who feel they may be at risk of diabetes. This book doesn’t substitute for medical nutrition therapy from a registered dietitian, but should help you put your personalized diabetes meal plan into action.
Diabetes Meal Planning & Nutrition For Dummies does discuss diabetes as a disease, but if you’re new to diabetes you may want to grab one of Dr. Poole’s and Amy Riolo’s other books, such as Diabetes For Dummies, for a more detailed discussion. Food is an important part of managing diabetes over the long term, but there’s a lot more you need to know.
Diabetes often occurs with medical conditions, like celiac disease or lactose intolerance, that limit food choices. And, diabetes can promote health conditions, like kidney failure, that trigger very specific dietary requirements that are significantly different than general recommendations for a diabetes meal plan. Your doctor and a registered dietitian can advise you in these cases, but advice in this book may not always apply.
You should know that you don’t have to read this book from front to back. All For Dummies books are written so that each chapter will make sense on its own. It’s not necessary that you remember anything either — a detailed table of contents helps you find what you need whenever you need it. This book is meant to be a reference; there will be no final exam to test your memorization skills.
Here are a few other tidbits that may answer your questions before you have to ask:
Blood glucose is often casually called
blood sugar
. Blood glucose is the correct terminology and is used exclusively in the book. In common usage, the terms mean the same.
Blood glucose is measured in milligrams per deciliter (mg/dl) in the United States, but many countries use the International System of Units measure of millimoles per liter (mmol/l). The same is true for cholesterol and triglycerides.
Healthy eating is no less important for people with type 1 diabetes, but insulin does provide a more direct way to control blood glucose. Some discussion about managing food amount and timing may be less relevant to people with type 1 diabetes when rapid acting insulin is used.
The term
diabetic
is not used to refer to a person with diabetes. Diabetes is not who you are; it’s a condition you have.
This book does not spend much time addressing the particulars of insulin dosing, insulin-carbohydrate ratios, or insulin correction factors. These are very individualized and must be worked out with your doctor or diabetes educator.
Foolish Assumptions
Your authors have some preconceived notions about you, and thought you might be interested in knowing what those are. This book assumes the following:
You have diabetes, or have an interest in someone who has diabetes. It’s okay if neither is true, by the way.
You realize that effectively managing diabetes for better health includes managing what and how you eat. Maybe you’ve been advised about the importance of diet, or maybe you learned from previous experience with diabetes.
You are not expecting a miracle answer that requires no further thinking or effort from you.
Even though you are not expecting a miracle, you appreciate advice that makes healthy eating for diabetes easier.
Icons Used in This Book
Throughout For Dummies books you find icons that call your attention to something especially important, or something technical. This book includes the following icons:
A Tip icon often suggests you try something or check something out, and it usually points to something surprising about food or nutrition.
A Warning icon does exactly what it sounds like. It warns against potential problems.
The Remember icon might re-emphasize something discussed earlier in the section, or it may be a reminder to follow specific advice when you put what you’ve learned in practice.
The Technical Stuff icon highlights information that is beyond what’s key to the book’s message, but something some curious readers might find interesting.
This icon points out where Dr. Simon Poole added special insight from his medical expertise and practice.
This icon designates instances where Dr. Simon Poole and Chef Amy Riolo describe anecdotes and special tips from their experience.
Beyond the Book
There is much more information available from your authors and from the For Dummies brand for your learning pleasure. Check out these resources to learn more about diabetes and nutrition or to find some great recipes:
Check out this book’s online Cheat Sheet for more help and information. Just go to
www.dummies.com
and search for “Diabetes Meal Planning & Nutrition For Dummies Cheat Sheet.”
You can meet your authors face to face, literally, on their respective websites so that you can get an idea of who’s giving you the wonderful advice in this book. You can find Dr. Poole at
www.drsimonpoole.com
and Amy Riolo at
www.amyriolo.com
.
And, although this book includes 25 diabetes-friendly complete meal recipes so that you don’t have to worry about covering nutritional requirements and glucose managing in your meals, you can use what you learn about choosing diabetes-friendly dishes from other resources, too. An excellent place to start is
Diabetes For Dummies,
6th Edition, published by Wiley.
Where to Go from Here
You can start anywhere with For Dummies books, but there’s a logic to beginning at the beginning. If that’s not in your personality, consider starting with Chapter 10 to see why healthy eating — diabetes or not — is so difficult in this society. Chapter 14 reviews how some popular diet plans will fit with effective diabetes self-management, and if you’re not sure what diabetes self-management means, try Chapter 3.
Chapter 11 addresses how you can stay motivated and offers simple tricks that usually bring big rewards. If you’re heading straight to the buffet or restaurant, check Chapter 15; the grocery can be found in Chapter 12.
Some final advice is don’t get in such a rush. Diabetes will still be there, and changes often come slowly. Take your time, try different approaches to eating healthier, and be patient about seeing real improvements in your lab work. We find that lasting change is best achieved when done gradually. Little changes add up and are more easily sustained than drastic life changes. Start wherever you are with good intentions, knowing that you will eventually reach your objectives. In addition, if you have been living an unhealthy lifestyle or suffering from diabetes symptoms without any treatment at all, once you start making positive changes you will begin feeling better than before, and that is the best motivator of all.
Don’t forget the famous speech Dr. Martin Luther King Jr. delivered at Spelman College in 1960: “If you can’t fly then run, if you can’t run then walk, if you can’t walk then crawl, but whatever you do you have to keep moving forward.”
Part 1
Diabetes and Food: Culinary Therapy
IN THIS PART …
Find out how to eat well with diabetes so that you can enjoy food while improving your health and balancing blood glucose levels.
Understand how the concept of culinary therapy can help you look and feel your best while enjoying yourself in the process.
Understand the difference between prediabetes, type 1, and type 2.
Know how to test your blood glucose levels at home, especially with type 1 diabetes. With so many different ways to test, you no longer have to guess your blood glucose level.
Be inspired to incorporate easy lifestyle hacks to take charge of your health and happiness.
Chapter 1
Eating Well with Diabetes
IN THIS CHAPTER
Realizing food is an effective medicine for diabetes
Considering your essential role in preserving your health
Keeping your brain working for you
Impacting your health by how you choose to eat
Hippocrates, sometimes called the father of modern medicine, once said “let food be thy medicine, and medicine be thy food.” When it comes to diabetes, Hippocrates was absolutely correct. It would be difficult to think of another serious medical condition that’s so intimately and immediately connected to food. Yes, there are drugs for diabetes — eight different classes of diabetes drugs, numerous formulations of insulin, drugs that help other drugs work better, and a few drugs that seem to benefit diabetes by accident — and diabetes drugs are extremely important. Without insulin, people with type 1 diabetes cannot live. However, putting your confidence in drugs alone is insufficient to keep diabetes from affecting your long-term health, and you don’t have to rely on advice that’s more than 2,300 years old to believe that.
Making healthy lifestyle choices that include eating the best foods and getting regular exercise dramatically improves diabetes control and may also prevent and even reverse type 2 diabetes. An excellent diet can protect us from many of the chronic diseases, including heart disease and stroke, that are common complications of type 1 and type 2 diabetes and that also frequently affect people without diabetes. A healthy and sustainable dietary pattern is one that will support achieving and maintaining an optimum weight.
Chances are you already have at least a vague idea that what you eat is important to diabetes. With or without diabetes, our food choices can contribute to a happy and heathy life. This book gives you the whole story on just how the food choices you make can work to add healthy and active years to your life — without sacrificing delicious foods and flavors. To start, this chapter explains how food is effective medicine for prediabetes, as well as type 1 and type 2. In the pages ahead you explore your role in preserving your health, how to make your brain work for you, and how to choose the most nutrient-boosting foods.
Balancing Glucose in the Body
Whether you have type 1 diabetes or type 2 diabetes, you share one crucial responsibility from your diagnosis going forward — doing your part. In simple terms, you must now become an active helper in your body’s metabolism, and the better helper you become, the less likely you are to experience the damage that diabetes can do to your body.
Type 1 diabetes results when your capacity to produce insulin is lost. Type 2 diabetes is related more to your natural insulin being unable to do its job effectively. If you were a car and insulin was gasoline, type 1 diabetes is having an empty tank, and type 2 diabetes is more like lost efficiency from clogged fuel injectors. Managing type 1 diabetes requires constantly adding gasoline; type 2 diabetes requires that you get your fuel injectors to work better. The real story is a little more complicated.
Your body needs to keep a certain concentration of glucose circulating in your blood — a normal blood glucose level. Glucose is the favorite fuel of your trillions of cells, and some really important cells — your brain cells — can’t get their energy from anything else. Glucose in your bloodstream is all about energy — it’s delivered right to the doorstep of every cell that needs it.
Because glucose enters your blood after you eat carbohydrate foods, causing your blood glucose levels to rise, your body has a way to return those levels back to normal by storing the excess for later. The stored glucose can be released back into the blood when glucose levels drop between meals, keeping a constant supply available for your brain. This kind of balance in a biological system is called homeostasis.
The hormone responsible for escorting glucose into storage is insulin, and insulin is automatically released from special cells on your pancreas when blood glucose levels are going higher after eating. If insulin isn’t available or isn’t working properly, blood glucose can’t be stored, and blood glucose levels remain high. High blood glucose levels not only upset glucose homeostasis, but begin to damage cells and tissue.
Chronic high blood glucose levels is diabetes — literally. It’s important that you understand diabetes, and Chapters 2 and 3 include a more in-depth explanation. In the simplest terms, having diabetes means your blood glucose levels go up after eating and don’t come down to normal levels in a normal amount of time.
Type 1 diabetes results when insulin production capacity is destroyed, and no insulin is available to facilitate glucose homeostasis. Type 2 diabetes begins when the cells that normally store excess glucose stop responding to insulin. So, even though insulin may be available, blood glucose levels remain high. The long-term damage caused by high blood glucose, in either case, can progress to very serious consequences like heart attack, stroke, vision loss, nerve damage, kidney failure, and more. These secondary conditions are called complications of diabetes, and avoiding these outcomes is one reason that lowering blood glucose levels is so important.
High glucose levels not only mean that excess glucose can’t get into cells to be stockpiled, but also that glucose can’t get into cells to properly fuel energy needs. That means your microscopic cells, like the muscle cells you need to move, don’t have access to their favored fuel and must turn to plan B or plan C for generating energy. Plans B and C are ordinarily temporary plans for times of shortage — generating energy without glucose is inefficient, and even produces toxic waste products. Diabetes upsets your entire energy balance.
Taking Your Place in Diabetes Management
Treating diabetes is not like treating an infected cut, where the problem goes away after a week or two. In fact, diabetes treatment is called diabetes management, hinting at a responsibility that requires continuous oversight. And, that’s exactly what diabetes management is — continuous oversight. Managing diabetes is like managing a company, or a sports team, or a lawn, or anything else where the goal is to achieve and sustain a certain level of performance. The manager works to provide the best environment and materials for success, looks at performance indicators, sets priorities, makes adjustments to improve efficiency, tries to avoid disruptions, and always keeps a focus on surviving and prospering over the long term.
Effective management is a key to success in business, sports, lawn care, and diabetes. But, while the management responsibilities for businesses, sports teams, and even lawn care can be delegated to professional experts, the extraordinarily important job of managing your diabetes has suddenly fallen on you — diabetes self-management. Not only that, you’ve inherited responsibility for the equivalent of a business that’s experiencing challenges, a sports team with some of its stars on injured reserve, and a lawn that’s been overcome by weeds — and the stake is your long-term health.
Fortunately, if you’re willing to take this responsibility seriously, there is a proven plan that can turn you into a successful manager of your body’s metabolism. And, as daunting as this might sound, with some dedication and practice you’ll be managing your metabolism like a pro and enjoying the rest of your life’s activities even more than before. How’s that? Well, like any good manager, success is a little bit of participating, but a whole lot of setting up a system where success is possible. You will also have professional advice as well as help from your team of supporters to guide you on your journey.
You may not be able to permanently fix your glucose metabolism. You can, however, provide the best environment and materials for success, look at performance indicators, set priorities, make adjustments to improve efficiency, try to avoid disruptions, and always keep a focus on flourishing and prospering over the long term. That sort of management strategy lets your natural metabolism work as well as it possibly can, and that’s effective diabetes self-management at its best. And, you can do it.
LEARNING TO MANAGE AND REVERSE DIABETES
The aim of eating well for diabetes is to optimize blood glucose control and to minimize the risks of complications, but it is also possible to prevent diabetes in someone who has prediabetes where measurements are suggesting signs of long-term blood glucose levels progressing toward the range of a type 2 diabetes diagnosis. Even when a person has been diagnosed with type 2 diabetes, it is possible to reverse the diagnosis and to remain in a range of blood glucose that is considered normal as long as dietary patterns and lifestyle changes can be sustained.
Understanding Your Brain’s Role in Eating
Right between your ears is your incredible and mysterious brain, and your brain plays essential roles in managing diabetes. But, the different roles your brain plays in diabetes management aren’t always in your best interests, and more often than you might imagine messages from your brain make managing diabetes more difficult.
On the surface, literally and anatomically, it’s obvious that your brain helps you to understand diabetes, to remember what your healthcare team has advised you to do, to schedule your time, to decide what you’re going to eat, and to comprehend what you read in this book. The part of your brain doing your thinking, the outer cerebral cortex layer, is an amazing problem-solver that has never been duplicated biologically or electronically. Your thinking brain can evaluate hundreds of variables, look at issues from every direction, factor in previous experience, apply concepts that are only abstract, project future outcomes, and come to solidly logical conclusions. When your thinking brain is in charge, it’s hard to go wrong. And, if things do go wrong, your thinking brain will figure out exactly why and make sure the same thing doesn’t go wrong again.
But, guess what? Your thinking brain isn’t always in charge. At times, the well-thought recommendations from your marvelous thinking brain get outvoted. At other times, your thinking brain takes too long to make decisions, allowing another part of your brain to beat it to the punch. There’s nothing abnormal about this. In fact, some completely illogical behaviors, like risking personal safety to assist another person, make humans human. But recognizing how your thinking brain can be nullified in diabetes management can lead to more success — you can change the circumstances and give power back to that part of your brain best suited for management.
Making the mind-body connection
Modern societies are only now beginning to appreciate the positive ways in which our mind influences our bodies. The old Italian adage, mente sana, corpo sano means “healthy mind, healthy body.” For that reason, if we want to truly perform at our best, we need to make sure our minds are performing optimally.
In the United States and in some other cultures, the word “emotions” is often used with a negative connotation. “Emotional eating,” “too emotional,” “put your emotions aside,” and “leave your emotions out of it” are phrases we hear repeatedly in the English language. Yet without our positive emotions like love, gratitude, joy, passion, and affection, the world would be a horrible place. It is through positive emotions that we can transform negative situations into blessings, sickness into health, and enjoy our lives.
THE MIND-BODY CONNECTION IN ACTION
Years ago, Amy was suffering from what she believed to be an incurable disease. She did everything her teams of doctors told her to do, as well as additional complimentary therapies, but she was legally disabled and progressing slowly. She remembers the day her doctor suggested she see a mind-body therapist. She was so offended by this because she thought her doctor thought she had mental problems. When she expressed her concerns, he said, “Amy, anyone with as many medical symptoms and pain as you have should talk to someone, if for nothing else than just to have a confidant who understands what you’re going through.” Amy followed his advice, and meeting her therapist eventually saved her life and led her to a new career. If she had known then what she knows now, she would never have thought twice about exploring the emotional factors she was dealing with. In fact, she would have gone sooner.
A modern discipline of healthcare based on ancient principles called mind-body therapy teaches people how to listen to their bodies to identify old patterns of thought that are keeping them stuck in undesirable situations and clear them out so that they can move forward in healing physically and mentally. It is worth exploring any thoughts and feelings that you think and feel in order to see if they might be contributing to your diabetes diagnosis. Conversely, if you have been suffering from any physical disease, this, as well as other types of therapy, can be helpful in coping with what you’ve experienced.
Exploring how emotion and eating are connected
It’s easy to see how your thinking brain gets overruled if you think about emotions. Everyone makes emotional decisions, sometimes to feel a positive emotion, and sometimes to avoid a negative one. Emotional decisions are often completely conscious — you know the decision may not be completely logical, but you’re willing to accept that. There’s really no way to avoid some emotional decisions, and seeking or avoiding an emotion in a specific circumstance has an emotional benefit. An illogical decision now and then about diabetes is unavoidable.
It’s when a particular pattern of emotional decision-making becomes a way of life that problems can arise, and when diabetes is involved, illogical emotional behavior can be dangerous. Chapter 10 gives you some important insight of how emotion and eating are tied together, but here are some common emotional patterns that really interfere with self-care:
You are unable to digest the “sweetness of life.”
Anger and resentment are common, and completely understandable, among people with type 1 diabetes. Type 1 diabetes is a virtually random and completely life-changing event that happens suddenly, mostly to young and otherwise healthy individuals. And, the management responsibilities are more complex than with type 2 diabetes and are unending. But, when natural anger and resentment at fate turns into a defiant refusal to give in to the management responsibilities of type 1 diabetes, serious consequences can result.
You feel guilty.
Guilt can play a similar role in type 2 diabetes because type 2 diabetes usually develops slowly, and in many cases could have been prevented. Guilt is anger, but directed at oneself rather than at fate. Guilt about type 2 diabetes can lead to thinking you deserve the worst diabetes can offer, and that emotion is incompatible with managing diabetes to preserve your health.
You view your illness as a personal weakness.
Viewing illness as a personal weakness keeps people from even acknowledging diabetes, or has them looking to challenge diabetes to a strength contest. Ironically, the greatest strength is acknowledging the reality of diabetes and taking self-management responsibilities seriously.
You put your needs second.
Misplaced selflessness is an emotional reaction that can also be unhelpful. Managing diabetes effectively does require prioritizing your own health, and taking time for exercise or changing a family’s eating patterns can take a back seat to what’s perceived as caring for others.
These emotional patterns usually impact the whole range of diabetes management, not just eating. With some self-analysis, maybe helped by counseling and easy-to-implement daily practices such as breathwork, meditation, and positive visioning, misdirected emotional responses to diabetes can be changed for the better.
Explaining impulsive eating
If you’re like most people, you probably have a mobile phone full of photographs. To you, these photos are colorful and represent pleasant memories. But in computer language, your photos are just a series of black and white ones and zeros — it’s a secret language, but looking at millions of ones and zeros won’t stimulate any pleasant memories for you. Your body has a secret language, too — a chemical language. Although you don’t consciously understand this chemical language any more than the ones and zeros on your computer, this chemical language stores vivid memories, especially about food, and you can understand those memories very, very well.
It’s an amazing system that has helped humans survive the toughest times. For an overly simplistic explanation, consider that the part of your brain responsible for survival doesn’t trust your thinking brain with some very important responsibilities. Your thinking brain can be so wrapped up evaluating something logically that it might forget to eat when food is available. And, in tough times, you have to grab food whenever you can. So this part of your brain gives you a chemical reward when you remember to eat — a chemical that brings a comforting feeling of wellbeing. It’s a reward that’s so satisfying that you’ll remember to eat no matter what your thinking brain is preoccupied with. And to make doubly sure you won’t miss an eating opportunity, your brain gives you a little boost even if you think about food, or see a picture of food. Eventually, impulsive eating when food is available is second nature and completely unconscious. Most important, in the contest between your impulse to eat and your thinking brain, impulse usually wins.
However, this amazing biological system is obsolete in a society where food is constantly available, and it runs on overload when images of unhealthful food surround you everywhere you look. It does not, however, have an off switch. Chapter 10 explains how being surrounded by food and food images doesn’t need to trigger unhealthy impulses; in fact, it can actually do the opposite.
Impulsive eating has a negative connotation in the modern world, but it doesn’t have to. Hunger is our body’s way of encouraging us to nourish ourselves. Even cravings for certain foods, which are often viewed as problematic, can deliver great clues into what your body needs. A strong urge to eat chocolate can be as a result of a zinc deficiency, for example, while craving leafy greens might be a sign that the body is fighting off an infection.
With industrialization, advertising propaganda, and the invention of fast and junk food, however, many people are no longer in control of their cravings. A late night TV ad may stir desires for a double cheeseburger with bacon, and a billboard will make a candy bar look like something you can’t live without. When coupled with subliminal messages that these items provide “a break,” “a complete meal,” or “a sinful delight,” it can be easy to get into temptation.
Many times we crave certain food styles when we are truly craving an emotional state. It is said that those who crave salty foods most (if their cortisol levels are not unbalanced) are truly craving adventure. Those who love comforting pastas and carbohydrate-rich products are truly in need of comfort. Craving sugary snacks and sweet treats most often is because of a lack of perceived sweetness in life. If any of these scenarios sound like you, it’s worth exploring whether you are truly craving the emotion associated with that type of food.
Because our lives change, so do our cravings. You may have a particular craving for sweets more than normal while in a particular stressful period of life. When things get hard, you might find yourself craving more comforting foods.
It’s worth taking a few minutes to pause each time you have strong cravings for certain foods. Try sitting with your feet flat on the floor. Put one hand on your heart and the other on your belly and breathe in and out very slowly three times. Ask yourself:
Why am I craving this food?
What is it that I’m truly craving?
If I had a magic wand and could be doing anything right now, what would I rather be doing?
Then take a deep breath and write down your answers. Reminding yourself that your health is your first priority, ask yourself whether you can achieve the desired emotion (comfort, love, sweetness) another way. Calling a friend, going for a walk, watching a comedy, and eating more healthful versions of the foods you’re craving can help a great deal in breaking negative habits.
Deciding What to Eat and When
A significant portion of this book is dedicated to giving you the nutrition facts you need to make the most out of your meals. Contrary to popular belief, eating well with diabetes doesn’t have to be difficult or boring. With a little effort and consideration, you may be surprised to find yourself eating better-tasting meals than before. In addition, your body will respond favorably once you give it the supercharged fuel it needs.
That’s where meal planning comes in because it enables you to eat with both pleasure and health in mind. Planning ahead puts your thinking brain in charge, and it’s your thinking brain that understands how important what you eat today and tomorrow can be to your health ten years from now. Your thinking brain may not be good for making spur-of-the-moment decisions, but when you give it time, without standing in front of an open refrigerator or watching a waiter deliver food to the next table, you win.
That is precisely what makes diabetes meal planning so crucial. Taking emotion and impulse out of your eating decisions means better decisions, and better decisions about food can have a direct and immediate benefit to your health.
Helping your body manage blood glucose
“Diabetic diet” is a phrase you’ll hear constantly, and what is more discouraging than to imagine yourself sentenced to an eating plan that’s so restrictive that only people with diabetes have to subject themselves to it? The truth is almost the complete opposite. An eating plan that works for diabetes is an appropriate eating plan for nearly anyone. It’s a balanced eating plan with five clear objectives:
Help your body manage blood glucose levels as effectively as possible
Provide adequate nutrition with a focus on reducing recognized risks for chronic diseases, especially those associated as potential complications of diabetes
Be an enjoyable diet that can be maintained in the long term
Optimize weight and body fat
Be ethical and sustainable for the environment and planet
Other medical conditions, including common comorbidities like celiac disease or complications caused by long-term poorly controlled diabetes, may lead to adding an emphasis to other dietary concerns, too. Without any pressing health issues other than diabetes, however, the story is pretty simple.
The specific focus for accomplishing those two objectives is managing carbohydrates and managing dietary fat. Be assured, however, that managing does not mean eliminating. An effective diabetes eating plan commonly recommends that 50 percent of daily calories come from carbohydrates, and 30 percent of daily calories come from fat. It won’t shock you to learn that whole-grain pasta primavera with a little olive oil is a better option to satisfy this calorie distribution than a frosted donut. It may shock you to learn that pasta is allowed at all.
Considering carbohydrates
Earlier in this chapter you read a short discussion of glucose homeostasis — glucose balance. Glucose is a sugar, and carbohydrates are made of glucose molecules bound together in chains. That is an oversimplification — other sugars join glucose to form some carbohydrates, too, but glucose is the most prominent, and the most relevant, to diabetes.
Carbohydrates have a prominent role in this book, and Chapter 6 is devoted to understanding carbohydrates in your diet. Carbohydrates are sugars, starches, and fiber, and if you can digest them (some fiber you can’t), glucose molecules are unchained and absorbed directly into your blood. The glucose in table sugar is indistinguishable from the glucose in potatoes or milk or an orange. That does not mean these foods are equivalent, but only that a glucose molecule is a glucose molecule.
Glucose is your body’s favorite fuel and the only fuel your brain can use. When you eat carbohydrates, your blood glucose levels go higher, whether you have diabetes or not. High blood glucose levels stimulate insulin secretion; low blood glucose levels stimulate another hormone, glucagon. Insulin and glucagon work together to lower, or to raise, blood glucose so a normal level is maintained.
Insulin reduces high blood glucose levels by signaling muscle, fat, and liver cells to pull glucose into the cells, and pack it into a unique starch molecule called glycogen until it’s needed for energy. As explained earlier in this chapter, diabetes results when sufficient insulin isn’t available, or when cells don’t respond normally to insulin. Your body can compensate for having no glucose available inside of cells for energy production, but only for a short time. The life expectancy of people with type 1 diabetes before treatment was available may be extended by starving them of carbohydrates, but not for long. Carbohydrate — glucose — is necessary.
Fortunately, injectable insulin is available for treating type 1 diabetes, and it works much like natural insulin to move glucose into cells. And, while type 2 diabetes is a loss of the natural response to insulin, it’s not a total loss — glucose will still move into cells, albeit slowly. People with diabetes must eat carbohydrate foods to provide energy.
The amount of carbohydrate, the timing of carbohydrate consumption, and the quality of carbohydrate in the food can either help your body and medication manage blood glucose levels, or complicate the issue. If you eat a lot of carbohydrate at one time, and eat carbohydrate that is digested and absorbed into your blood quickly, blood glucose levels go up very quickly and can overtax your capacity to bring levels down. Even when injecting insulin doses matched to your carbohydrate intake, managing the amount, timing, and quality of carbohydrates pays off. Your personal diabetes meal plan will map this out for you.
So, what about sugar? In some ways, sugar is not much different than any other carbohydrate, and there’s a common and dangerous misconception that to manage diabetes one only needs to avoid sugar. You now know that all carbohydrates raise blood glucose levels, and managing carbohydrates, rather than avoiding them, is the best strategy. But sugar does deserve some extra scrutiny. Eating sugar, especially in some industrially produced forms such as high fructose corn syrup, raises glucose levels faster than less refined carbohydrates. For example, cooking pasta al dente (for a lesser period of time) slows down your body’s digestion of it and modulates glucose better than well-cooked pasta.
There’s mounting evidence that too much sugar is unhealthy for anyone — if sugar causes metabolic disruptions in healthy people, it certainly should be consumed in serious moderation with diabetes. Also, sugar breaks down very quickly during digestion and spikes blood glucose levels — low blood glucose levels can be raised quickly with candy, for instance. Finally, sugar often comes in foods that offer no nutritional value — empty calories and carbohydrates. It’s always best to eat carbohydrates that have secondary benefits.
Some of you may realize that fruit and milk contain simple sugars — fruit even contains free glucose that can be absorbed directly. But Mother Nature has a way, and even though fruit raises blood glucose fairly quickly, the sugar from fruit, which is delivered with fiber and other nutrients, doesn’t have the same long-term negative impact on health that refined sugars have.
Keeping your heart healthy
Most people know that diet can contribute to unhealthy cholesterol levels, and those unhealthy cholesterol levels raise the risk for heart disease. A heart-healthy diet can do more than improve cholesterol levels, and a heart-healthy diet is especially important for people with diabetes.
Heart health is so important to diabetes because diabetes itself raises the risk of heart attack or stroke two to four times higher than the risk for people without diabetes. Having high LDL cholesterol, high triglycerides, and high blood pressure along with diabetes multiplies the risk even more. High blood pressure, called hypertension, and diabetes together are double trouble for kidney function, too — the two leading causes of kidney failure working together. Heart disease, however, is by far the greatest threat to a person with diabetes.
Your eating habits can contribute to that risk or can work to reduce the threat. You probably know that saturated fat, and especially trans fat, contributes to heart disease, and a healthy diabetes eating plan emphasizes limiting saturated fat. Excess body weight, common among people with type 2 diabetes, is an independent risk factor for heart disease. But, eating a heart-healthy diet is as much about what you should be including in your meals, as what you shouldn’t. Consider the following:
Soluble fiber, like the fiber in leafy greens, legumes, whole grains, and beans, sweeps unhealthy LDL cholesterol from your system.
The Dietary Approaches to Stop Hypertension (DASH) eating plan developed by the National Institutes of Health, which emphasizes eating whole grains, fruits, and vegetables, and getting high levels of calcium, magnesium, and potassium from food, can lower blood pressure within two weeks.
Eating foods consistent with the Mediterranean diet, including fruits and vegetables, whole grains, fish, and olive oil, can reduce insulin resistance, reduce general inflammation (which is now known to be a very important factor in chronic diseases), and reduce the risk of heart attack or stroke.
People with diabetes seem to excrete vitamin B1 (thiamine) at a higher than normal level, and the lowered thiamine levels may contribute to the accelerated formation of blockages in arteries among people with diabetes. Whole grains are a source of thiamine.
Plant compounds called
polyphenols
found in many ingredients of Mediterranean and vegetarian diets including extra-virgin olive oil, nuts, colored vegetables, green tea, cocoa, and citrus fruits, are antioxidants that improve cholesterol levels, and work to prevent the formation and inflammation of plaques that can block arteries.
The list of how foods benefit heart health and diabetes too, often by improving sensitivity to insulin, goes on and on, and in some cases it’s clear the compounds can’t come from supplements. There simply is no substitute for a balanced diet rich in whole grains, fruits, vegetables, and healthy fats. You get specific information on how foods can directly benefit your health in several chapters later in the book. Most important, a healthy diabetes eating plan includes foods you are pleased to eat. In fact, if you’ve fallen into poor eating habits for the convenience, you will be amazed how satisfying real food will be to your tastes.
Making It Easy on Yourself
Managing diabetes well is a commitment that has to be followed by action, but there aren’t many commitments of your time and attention that have a bigger payoff. And, if you honestly look at where you invest your time and efforts now, you can surely justify that little more be devoted to your health — Chapter 11 is devoted to strategies that will keep you motivated. The life expectancy of people with diabetes is ten years shorter on average, but it’s not diabetes itself that steals those years — it’s indifference to self-management responsibilities.
If doing diabetes management well every day can give you those ten years, and it can, then for every two days you attend to diabetes, you get one extra day of living in return if your diagnosis was at age 50. Nothing is guaranteed, of course, but even if your diagnosis was at an earlier age, the return on investment is unbeatable.
What’s required of you to get such a deal? Here’s the plan for success:
See your doctor regularly, ask questions, get your lab work done when requested, and ask to see a registered dietitian and a certified diabetes educator for a personalized meal plan, and for continuing education. If your doctor doesn’t take diabetes seriously, find another doctor.
Take your medication as prescribed and test your blood glucose often.
