To learn more about the calories in your foods, refer to food labels, pick up a pocket-sized calorie counter at the bookstore, and visit websites like ChooseMyPlate.gov and MyFoodAdvisor.com.
Although calories directly affect weight, monitoring fats and carbs is also important to your health. As a general rule, you should be able to consume at least 45 grams of carbohydrate at each meal with no more than a 40-mg/dl rise in blood glucose from your first bite at a meal until two hours later. If you need additional diabetes medications, or if you do not currently take any medications and find that you’re having trouble with your blood glucose, talk with your doctor or nurse. You need balanced meals to lose weight healthfully, enjoy your food, and prevent the complications of diabetes and other health problems, so keep tabs on your blood glucose and adjust your carbohydrate intake as needed.
Example
Sample Meal Containing about 45 Grams of Carbohydrate
2 slices whole-wheat bread (30 grams) with sliced chicken, reduced-fat cheese, roasted red peppers, lettuce, tomato, onion, and mustard
1 medium peach (15 grams)
Unsweetened iced tea, artificial sweetener if desired
Blood glucose before eating: 103 mg/dl
Blood glucose two hours after the first bite: 138 mg/dl
138 mg/dl – 103 mg/dl = 35 mg/dl
This is acceptable because the change in blood glucose is less than 40 mg/dl.
Food records work. Writing down your food intake can double your weight-loss success, according to research funded by the National Institutes of Health. In a study of nearly 17,000 people, those who recorded their daily calorie intake lost twice as much weight as those who kept no records. The simple act of recording your food choices increases your awareness and makes you accountable to yourself. Grab a notebook or buy a journal and get started. Look at the example below to see how it’s done. There’s a blank food record in the Appendix.
Record your intake as you go through the day, even if you have to use scratch paper and rewrite it or tape it into your journal later. Don’t wait until the end of the day to jot everything down. It’s easy to forget what you’ve eaten or to fall a few days behind. Waiting may also mean that it’s easier to give in to temptation. Having to reach for your journal and a pencil will make you mindful of the five French fries you could grab from your spouse’s plate and all of the other mindless nibbles that add up to quite a lot over time. Each day, review your food record and try to learn from it. Look for patterns of overeating or mindless munching. Then, take steps to do better tomorrow.
Bill K’s Story
A lot of people ask, “How many carbs should I have each day or how much fat should I eat to lose weight? What diet is best?”
The truth is that there’s probably no best diet. Some people have very strong opinions, but there are good arguments for many diet plans. Some people lose weight and manage their blood glucose on very-high-carbohydrate vegetarian diets. Others eat meat with most meals and prefer less carbohydrate. Some people use the glycemic index or another ranking method to help them select food. The plan you choose must be one that works with your life and your preferences, but it must also include a variety of wholesome foods from the various food groups, with special attention to including whole grains and a variety of colorful fruits and vegetables. Additionally, you’ll need to tweak your diet periodically based on your blood glucose levels, cholesterol, blood pressure, and other health markers.
The USDA and U.S. Department of Health and Human Services jointly publish their Dietary Guidelines for Americans every five years and provide helpful nutrition information and recommendations for all Americans. The 2010 edition includes four healthful meal patterns (which are described in the Appendix), including USDA meal patterns, vegetarian and vegan adaptations, and the DASH (Dietary Approaches to Stop Hypertension) eating plan. A fifth meal pattern, the Mediterranean eating style, is also featured in the Dietary Guidelines for Americans. You can learn more about the Mediterranean diet at Oldways (www.oldwayspt.org) and in The Mediterranean Diabetes Cookbook by Amy Riolo (American Diabetes Association, 2010). In short, the Mediterranean diet includes fruits, vegetables, and whole grains at most meals. Beans and fish are important sources of protein, and nuts, seeds, olives, and olive oil provide good-for-you fats. Cheese and yogurt are eaten regularly, but in small amounts, and herbs and spices—not salt—season foods. If you haven’t done so yet, now is a great time to see a registered dietitian (RD) for an individualized diet plan. Visit eatright.org to find an RD in your area.
TIP!
If you choose to use the glycemic index to help plan your meals, keep in mind that it’s best to use it in conjunction with another meal-planning method, such as carb counting. You can learn more about the glycemic index at www.glycemicindex.com or by reading The Low GI Shopper’s Guide to GI Values 2011: The Authoritative Source of Glycemic Index Values for 1200 Foods, by Dr. Jennie Brand-Miller and Kaye Foster-Powell.
If you’re not already active, it’s time to start. Assuming you’re relatively healthy, you can begin walking. If you’re unsure, have complications of diabetes, or want to begin something more vigorous than walking, get the go ahead from your health care team first.
Physical activity is perhaps the best medicine available. It makes weight loss easier by burning extra calories. It also improves blood glucose control and cholesterol levels, lowers blood pressure, reduces the risk for heart disease and other chronic diseases, relieves stress, and improves quality of life. Guidelines issued jointly by the American Diabetes Association and the American College of Sports Medicine call for individuals with type 2 diabetes to engage in brisk walking, or other moderate to vigorous aerobic exercise, at least three times per week for a total of 150 minutes or more and to engage in strength training exercises two to three times a week. Don’t jump right in. If you’re not used to strenuous activity, start off slowly. For example, take several 5-minute walks over the day.
What Is Exercise?
A complete exercise program consists of each of the following components.
Aerobic: activities that use large muscle groups and cause you to breathe heavily as you take in more oxygen; improves fitness of the heart and lungs; good for burning calories • Walking, swimming, jogging, biking, skating, dancing, cross-country skiing
Strength: activities that use repeated movements against resistance; builds and tones muscle; increases strength • Weight lifting, resistance bands, pushups, lunges, sit ups
Flexibility: increases ability of a joint to move through a full range of motion • Stretching, yoga, Pilates
Balance: