Preventing diabetes: Learning to eat healthier and in the right portions can do wonders
“Diabetes is very, very common,” said Darcy Girres, registered nurse and certified diabetes educator at Buena Vista Regional Medical Center. Over 30 million Americans have diabetes, and another 86 million have pre-diabetes, which makes developing diabetes more likely.
Together, that’s about one-third of the country’s population.
But with healthy diet and exercise, diabetes can often be prevented.
What diabetes is
Diabetes is when your fasting blood glucose is 126 or higher. Prediabetes has a fasting blood glucose of 100 to 125. Normal blood glucose levels are 100 or less.
A1C tests can show your blood glucose’s activity over time. A diabetic’s A1C will be around 6.5 percent, which means their blood glucose has been an average of 140.
“Our red blood cells live in blood for about two to three months,” said Girres. “If we get high glucose levels, sugar sticks to them.”
Risk factors for diabetes include being overweight, having high blood pressure, high lipid levels and a sedentary lifestyle. Other unchangeable factors include age, family history, race/ethnicity and experiencing gestational diabetes.
A big culprit in blood glucose behavior is carbohydrate intake. As food enters the stomach, it breaks down into glucose. Glucose then enters the bloodstream, prompting your pancreas to release insulin, which unlocks receptors. Glucose then enters the cells.
“Then those cells have energy to do their job,” Girres said. “When I say what your blood sugar is, that’s just saying how much glucose is in the blood at the moment.”
But receptors can build resistance to being unlocked by insulin over time with the development of type 2 diabetes. Physical activity is an important part of preventing insulin resistance—experts recommend 30 minutes of exercise five days per week.
Exercise is particularly important for those with pre-diabetes to prevent it from escalating to diabetes.
Signs of high blood sugar indicating diabetes can vary, but common symptoms include frequent urination, constant thirst, constant hunger, blurred vision, fatigue, unexplained weight loss, dry skin, frequent infections or sores that are slow to heal, or losing feeling or getting a tingly feeling in the feet.
As cells become more resistant to the body’s natural insulin, the pancreas starts to produce more, Girres said, overcompensating when diabetes has been developed. But eventually, the pancreas gets tired, causing production of insulin to go down and making symptoms more apparent.
Managing nutrition and portion sizes
“Good nutrition is important for everybody,” said diabetes educator Julie Clark, particularly if you’re trying to avoid diabetes.
To maintain good nutrition, you should attempt to have a good mixture of carbs, protein and fat in a healthy diet.
“Looking for color is really important. The healthier your diet, the more colorful it will be,” she said, with a mixture of healthy grains, color-rich vegetables and fruits and meat.
An appropriate portion of meat is about 3 ounces, the size of a deck of cards. Try to go with lower fat cuts of meat, avoiding marbled meat cuts, or trim the visible fat around the meat. Trimming skin off of poultry can help with fat, too.
Stick with fresh or frozen seafood, and avoid breading. Get tuna or salmon that is canned in water instead of oil for less fat.
While it’s a good idea to eat less fat, it’s important to know there are healthier types of fat, too.
Clark recommends less saturated and trans fats such as those in butter, bacon, meat fat and high-fat dairy. Trans fat is also found when vegetable oil (liquid at rom temperature) is chemically changed to make it into things like margarine or shortening.
Healthier fat alternatives are found in olive oil, canola oil, and peanut oil.
The plate method
To control portions, try the plate method. Half of your plate should be non-starch vegetables. Another quarter should be reserved for starchy foods such as pasta or potatoes, and another quarter for a lean protein source.
Keep in mind that vegetables like peas, corn and potatoes are rich in starch and carbs.
The size of a lightbulb is an appropriate amount for one serving of fresh vegetables. A serving of cheese is about four dice. The size of a tennis ball is an appropriate amount of pasta.
Counting carbs is an easy way to get to your blood sugar goals, Clark said, useful for those with and without diabetes.
“Most glucose in blood comes from carbs,” said the diabetes nutrition educator.
But carbs are in a lot of healthy foods too, including veggies, grains, cereals, milk products and fruit.
“We’re not talking about carbs being bad at all,” she said—just something to monitor and take in moderation.
One serving of carbohydrates is 15 grams. That amount is present in a small peach, a half-cup of corn, 1 slice of multi-grain bread, 1 cup of milk or a half-cup of dry beans.
When looking at nutritional facts labels, look at the “total carbs” line.
To lose weight, women and men with an inactive lifestyle should eat no more than two to three or three to four servings of carbohydrates, respectively, per meal. For maintaining weight, add one serving.
Clark recommends spacing meals apart and avoiding snacks within two hours of a meal to give glucose in the blood a chance to go down.
Avoid sugars and sweets that present carbs in the form of empty calories, such as in sweeteners, soft drinks, juices, candy, cookies, cakes and other processed foods.
“Empty calories are a great place to cut back if you need to lose or maintain weight,” she said. While they do not necessarily need to be eliminated in a healthy diet, taking them in smaller portions will be much better for your overall carb intake.
When grocery shopping, sticking to the outer perimeter of the grocery store generally helps one to avoid less healthy foods, hitting the fresh meat, dairy, vegetables and fruits.
Avoid shopping when hungry, make a list and stick to it to avoid unhealthy impulse purchases. Look at food labels before purchasing, not after.
With fruits and vegetables, buy fresh or frozen to avoid a lot of added sodium and calories. Buy fruit canned in its own juice instead of syrup to avoid unnecessary sugar (which translates to carbs when ingested), and rinse canned veggies to get rid of some added sodium.
With dairy, stick to fat-free or 1 percent options, instead of 2 percent or whole milk. Try it for several days when getting used to the taste, Clark said.
A few tactics can help you avoid overeating when dining out. Try ordering a child’s size or appetizer portion, or have the server box half of a large meal before serving you.
Watch out for words like jumbo, giant and deluxe on the menu, and remember that you’re in charge when dining out—feel free to try making requests for healthier substitutes.
Plan to be active on days you are eating out more, such as celebrations, and look for healthier choices when out and about.