Monday, November 13, 2017

Diabetes Month Tip of the Day

Question
I did what you said and I tried to keep track of the amount of carbohydrates in the foods that l eat.  30-45 grams for one meal doesn’t seem like very much. And for the people who have to eat less than that at one meal....wow, I can see why this might be a huge learning curve. And hard to follow if you have budget restrictions that cause you to rely on staples like pasta and rice.
Answer
You are right, those numbers are much less than many people in the United States are used to eating.  My personal carbohydrate tolerance (based on my what my blood glucose meter says) is only about 30 grams per meal, and even as a Registered Dietitian who is proficient in carbohydrate counting, that can be tough to maintain!
If you eat roughly a cup of pasta you’ve eaten 30 grams of carbohydrate, so you’re done for that meal.  Fortunately you do get to fill in with lean protein, healthy fats, and vegetables to make a complete meal (more about that later), but that’s still a big adjustment for some people.  Now, hopefully you are also be getting an idea why many people who successfully control their blood sugars with diet alone usually give up their sodas (40 or more grams of carbohydrate for one can of Coke), fruit juices (30 grams of carbohydrate for 8 oz. of juice), and/or their morning breakfast cereal (45 grams for 1 cup of cereal), etc. And some people even wind up giving up bread, pasta, or certain fruits because they don’t want to bother with the small portions "required" to keep their blood glucose below a certain amount. (In other words, they know that a little bit of rice will just leave them wanting more, so they don't bother).
Keep in mind it’s not just a lack of motivation/lack of desire to “cut back” or “give up” foods that keeps people from controlling their carbohydrate intake, it can also be a lack of access to food for physical or financial reasons.  Foods like pasta and other refined carbohydrates are cheap and easy to prepare, so some people have to make that decision to either eat the bowl of Ramen or not eat anything at all.  Some people who have trouble chewing, swallowing, or other digestive issues wind up eating a lot of carbohydrate foods because they seem easier to chew, swallow, or digest (mashed potatoes, anyone?). And as I said before, some people have made the conscious decision to not give up/limit certain foods because of how it affects their quality of life.
Meanwhile, if you are trying to reduce your carbohydrate intake here are a few suggestions for reducing carbohydrates without necessarily counting them. Just make sure you still look at the labels as “sugar-free” doesn’t mean “carbohydrate free!”
  1. Trade your favorite cola out for iced tea with your favorite sugar substitute (or drink unsweetened).
  2. Trade out your favorite soft drink for flavored sparkling water.
  3. Trade out your favorite cold cereal for a small portion of whole rolled oats (yes, you can make them in the microwave!)
  4. Trade out your favorite fruit juice for a small piece of fruit.
  5. Trade out favorite fruit juice for flavored sparkling water or a carbohydrate free beverage (like crystal lite).
  6. Use bread for sandwiches only, and avoid eating bread at meal times.
  7. Choose “lite” bread or “thins” instead of “regular” bread. (Check labels and serving size to make sure you are really reducing your carbohydrate intake).
  8. Use large lettuce leaves instead of bread or tortillas to make “wraps.”
  9. If you have potatoes at your meal, avoid having pasta/corn/rice at the same meal (and vice versa).
  10. Switch to corn tortillas instead of flour (just check the label and the quantity!).
  11. Cook more meals at home so you don’t get “hidden” carbohydrates as fillers in processed foods.
  12. Add  more green vegetables to your plate so there is less room for starches.
  13. Use pureed cauliflower instead of mashed potatoes (many recipes can be found on line, and some grocery stores sell finely chopped cauliflower in bags).
  14. Use spiralized vegetables instead of pasta (again, many recipes and techniques for preparation can be found online).
  15. Experiment with non-wheat flours like almond flour or coconut flour.  If you are not used to cooking with these flours though, make sure you follow the recipes as listed first so you reduce your chance of having a gooey mess.
  16. When donating to a food pantry, try to focus on donating protein rich foods so they have more than pasta and rice to give out.

Tomorrow we will talk about which carbohydrate foods carry a bit more nutrition than others, and we will discuss a bit more about the formation of resistant starch.

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