Toby Smithson

Step by Step / Updated 06-24-2016

Some foods are just big-time healthy, and with diabetes so closely connected to food and nutrition, these are the foods you want to incorporate into your daily eating habits.

Step by Step / Updated 06-24-2016

Much about managing diabetes can be costly, but food doesn’t need to be one of them. A diet that’s right for diabetes is a diet that’s right for virtually anyone, and there are enough foods that fit the bill for blood glucose control and heart health that your budget can remain flexible, and your choices are still many. The short version of diabetes nutrition is to eat lean protein, mostly unsaturated fats, whole grains, fruits, low-fat dairy, beans and starchy vegetables, nuts in moderation, sweets in moderation, lots of nonstarchy vegetables, and all the while keeping sodium low.

Step by Step / Updated 06-24-2016

An elevated body mass index (BMI), where body weight to height falls into the overweight, obese, or even higher category on that scale, is very common among people with type 2 diabetes, and it isn’t just a coincidence. Excess weight is a distinct risk factor for developing type 2 diabetes, and excess weight makes blood glucose more difficult to control after diabetes is diagnosed. The connection between weight and type 2 diabetes is insulin resistance, where cells that normally respond to insulin, by allowing glucose molecules to leave the blood and enter those cells, become unresponsive to this powerful hormone. Fortunately, losing only a modest amount of weight — as little as 7 to 10 percent of your current weight — can have a profound effect on insulin resistance. That’s in part because visceral fat appears to be the first fat to disappear as the pounds come off. Modest weight loss can have a huge effect on the course of diabetes. A list of ten food swaps should not be considered a weight loss program in any sense. But, this simple list represents an important concept — little changes make big results. And importantly, little changes that are simple and easy can become new habits that eventually happen without thinking.

Article / Updated 03-26-2016

Many people with diabetes think that they can't have "fun food," such as good breads or sweet and creamy ice cream. With a little tweaking and swapping, you can enjoy many different kinds of foods that you might have believed were off limits! Ice cream: Choose low-fat, no-sugar-added ice cream and count the carbohydrates. French fries: Choose low-fat, frozen, baked fries and count the carbohydrates. Margarine: Tub margarines contain mostly healthy unsaturated fat and no unhealthy trans fat. Bread: Choose whole-grain breads and count the carbohydrates. Fruit: Fruits are a key source of nutrients and a healthy way to satisfy your cravings for sweets. Count the carbohydrates and choose canned fruit packed in juice, not syrup. Adult beverages: Alcohol in moderation is healthy. Have no more than two drinks a day for men and one drink a day for women — and count the carbohydrates. The one constant theme throughout this list is to count the carbohydrates. Keep carbs in mind and you can enjoy a wide variety of foods.

Article / Updated 03-26-2016

Preparation for diabetes meal planning and nutrition starts with a very minor kitchen makeover. Your kitchen should be set up for ease of food preparation, and that includes everything from measuring cups and scales to the right ingredients. Preparing food at home more often than not simply makes diabetes management easier, so your kitchen should make food preparation convenient. Some kitchen tools you want to have handy include: Food scale for weighing food portions Steamer basket for cooking fresh vegetables without oil Oil mister — less expensive than nonstick sprays, and reduces added fat Measuring scoops for easy measuring of oats and grains A grater for citrus zest, fresh ginger, and other flavors that can replace salt in your food Salad spinner to wash and dry salad fixings Vegetable peeler to take the work out of prepping fresh fruits and veggies Sharp knives can make a huge difference in the work involved A carb counting book or smart phone app so you’re not guessing After you get your ingredients together and your meal ready for preparation, remember that the healthiest ways to cook are: Steaming Baking Broiling Grilling Stir fry

Article / Updated 03-26-2016

One trick to eating healthier is keeping diabetic-friendly choices available at all times. You can fight the urge to hit the fast-food drive-through and instead whip up a convenient and healthy breakfast, lunch, dinner, or snack if you keep the right foods handy. Some healthy foods to always have on hand in your pantry include: Olive oil or canola oil for healthy, unsaturated fats Egg substitute for the high-quality egg white protein without the fat and cholesterol Frozen fruits and vegetables for healthy choices at every meal Herbs and spices, fresh or dried, to replace salt with intense flavors Whole-grain, high-fiber tortillas for sandwich-like lunches without the full amount of carbohydrates in bread Canned tuna (in water) to have healthy seafood available anytime — aim to eat seafood twice each week Almonds, walnuts, or peanuts for healthy fats Black beans (or your favorite beans) for healthy carbohydrate, protein, and soluble fiber Buy no-added-salt varieties of canned beans Low-fat dairy products, including 1 percent or skim milk, and no-fat regular or Greek yogurt. Remember that milk products include carbohydrates Tea, for relaxation and powerful phytonutrients

Article / Updated 03-26-2016

A heart-healthy diet can help prevent the complications of diabetes for years to come. Part of that healthy diet is learning to manage your intake of carbohydrate foods. You can do a lot to help your body work better by adopting and sticking to a heart-healthy diet. When it comes to diabetes, food is medicine. Carbohydrates are found in lots of different foods. But the healthiest carbohydrate choices include whole grains, vegetables, fruits, legumes, beans, and low-fat dairy products. The following table shows a single serving of carbohydrate-containing foods, which equals 15 grams. Food One 15-Gram Serving Apple or orange medium sized Bagel 1/2 small bagel Banana 1/2 medium Bread 1 slice French fries 10 fries Honeydew melon 1 cup Hot cereal (oatmeal, grits) 1/2 cup, cooked Milk 1 cup Orange juice 1/2 cup Plain yogurt (no fruit) 2/3 cup Popcorn 3 cups, popped Pudding (sugar-free) 1/2 cup Raisins 2 tablespoons Raspberries 1 cup Rice or pasta 1/3 cup, cooked Unsweetened cereal 1/2 cup White potato 3 ounces

Article / Updated 03-26-2016

Healthcare professionals could probably put together a list of 1,000 myths and inaccuracies surrounding diabetes, and new ones pop up regularly in patient interactions. Nutrition inaccuracies may not rise to the level of mythical, but in this information age there is a self-proclaimed expert around every turn. Some myths and inaccuracies are relatively harmless, but others — like claims an herbal remedy can replace real medication — can have serious consequences. Likewise, broad generalizations can be dangerous, unnecessarily discouraging, or even insulting. This list includes a few inaccuracies about diabetes, a couple about nutrition, and the rest about nutrition and diabetes. The most important message from any list of myths and inaccuracies is to be sure you get the right information from credible sources before you believe anything as fact. When you have diabetes, there's no hope Nothing is as discouraging as helplessness, and where diabetes is concerned, nothing is as inaccurate as the notion that a tragic ending is inevitable. But, at precisely the time when gathering the motivation to address diabetes is so important, this inaccuracy sends the most counter-motivating message possible. The truth, of course, is that diabetes can be effectively managed with a combination of medication and lifestyle, especially diet and exercise. It does demand attention, and positive motivation is essential. But, there is no inevitable bad ending, and the person with diabetes has the power to influence the outcome in remarkable ways. Managing diabetes requires a special diet The truth is that a diet effective for managing diabetes is a diet much closer to normal than the diet too many people currently eat. In fact, the term Western diet, the high-fat and high-calorie eating that's become standard for many Americans, is the diet medical and public health professionals consider as special — for its overwhelmingly negative effects on health. An eating plan to manage diabetes effectively includes an incredibly broad and balanced selection of delicious foods, prepared to improve overall health. There are no special foods, and no expensive foods — eating healthy for diabetes health is simply making wiser choices. Drinking whole milk gives you more nutrients and calcium than skim milk The truth is that switching from whole milk to skim, or to 1 percent, reduces the saturated fat and the calories that fat brings along — period. The natural calcium in whole milk and skim (or low-fat) milk is the same, the vitamin D content is the same (vitamin D is an added ingredient in milk), and the carbohydrate content is the same. Switching from whole milk to no-fat or low-fat milk is a profoundly positive switch for better nutrition. Type 1 diabetes is "bad" diabetes There are surely many aspects of type 1 diabetes that make it more inconvenient than type 2, and people with type 1 are more at risk for dangerously extreme high or low blood glucose levels. But, labeling type 1 as bad diabetes clearly implies that type 2 diabetes is not such a big deal. The truth — type 2 diabetes is a big deal in its own right, and failing to take it seriously is a mistake. Carbohydrates make you fat This statement is simply wrong. Popular culture is in a constant search for the simple solution to weight loss, and the ironic thing is that the real solution is relatively simple. Excess calories are stored as fat in your body, whether the calories come from carbohydrate, protein, fat, or even alcohol. Excess calories make you fat — period. Vegetables are always healthier raw than cooked As with most myths, there's sometimes a kernel of truth, and some vegetables do lose nutrients when cooked. Other foods, like tomatoes, are more nutritious when cooked — even better when processed at high temperatures for canning. And, the fiber content of some vegetables actually is higher in cooked versus raw, too. A good rule of thumb is to steam or microwave vegetables to reduce nutrient loss. The bottom line is to eat more low-carbohydrate-containing vegetables cooked or raw. Type 1 diabetes is genetic, type 2 diabetes is from being overweight More kernels of truth mask the real story. Type 1 diabetes does have a genetic component, and excess weight is a clear risk factor for type 2 diabetes. But, the genetic component for type 2 diabetes is actually stronger than for type 1 diabetes, and some people — even some entire ethnic groups — can have a high risk for type 2 diabetes without being overweight. The real difference between type 1 diabetes and type 2 diabetes is that the body is attacking and killing its own insulin producing cells in type 1 diabetes — an autoimmune disease — and the result is having virtually no ability to produce insulin. Type 2 diabetes begins with plenty of naturally produced insulin that is not working in a normal way. And, no single specific cause has been found for either type 1 or type 2 diabetes. Foods with a low glycemic index value don't affect blood glucose Carbohydrate foods with a low glycemic index value digest more slowly, and release glucose into your bloodstream more slowly than foods with a high glycemic index value. But, all carbohydrate foods affect blood glucose. When people have a normal insulin response, insulin may be able to efficiently counteract the slow rise in blood glucose from low glycemic index foods. People with diabetes do not, by definition, have a normal insulin response. Low glycemic foods are recommended and generally healthier for everyone, but the blood glucose response is different in every person with diabetes — count the carbohydrates as you would any other food, and test your blood glucose levels after eating to know for sure. It's insulin that causes diabetes complications This myth is not only illogical, but scientifically proven wrong. Many people with type 2 diabetes resist their doctor's recommendation to begin insulin therapy based upon this incorrect belief (people with type 1 have no choice about whether to take insulin or not). Insulin is the most effective option for controlling blood glucose levels — it is, after all, how your body controls blood glucose levels when healthy. High average blood glucose levels and poor cardiovascular health habits are the cause of diabetes related complications, not insulin. People with diabetes can't eat sweets Sweets — sugars — are carbohydrates, and managing diabetes well does mean managing carbohydrates in your diet. But, people with diabetes can eat sweets. The real questions are how often, and what kinds of sweets represent good choices. The question of how often is addressed in every healthy eating guide, including the current USDA MyPlate — sweets should make up a relatively small percentage of everyone's diet. With diabetes, sweets raise blood glucose levels like any carbohydrate food, and must fit into your daily carbohydrate budget. But, sweets are one of life's enjoyments, and a diabetes eating plan has room for wise choices, which include foods and drinks with nutritional value coming along with sugar. Foods like regular soft drinks, for example, are called empty calories and carbohydrates because of their zero nutritional value.

Article / Updated 03-26-2016

It's a legitimate question: In the U.S., how does someone with diabetes come to grips with the crucial issues of nutrition when he suddenly finds himself expected to think about food as a gram of this and a milligram of that? Americans are used to thinking in terms of ounces and pounds, after all. It's confusing, and it's entirely possible that the metric system keeps some people with diabetes resistant to thinking about food in the way that's necessary to effectively manage their diet. Americans have a visceral resistance to the metric system, and official attempts for almost 50 years to implement metrication in the U.S. have had no significant impact. It's just something that doesn't fit — consider the line, "It took every last 28.349 grams of courage she could find to open that door." No thanks. If the metric system of measurements is giving you meal planning brain freeze, here's the answer — stop trying to make sense of it. The amount of carbohydrate in foods has little to do with the weight of foods. Sure, it may be the same amount of carbohydrate in an ounce of one potato as another potato, but it's much different for watermelon, and different still for a slice of bread. In many ways, the carbohydrate grams in different foods are just an abstract number, and if the recommendation for effective diabetes management was to eat, say, 200 atoms of carbohydrate each day, you might find the whole concept easier. Three ounces of potato, 1 1/4 cups cubed watermelon, and one slice of bread each have 15 atoms of carbohydrate — it's just stuff you need to know. But, for Americans — proud citizens of one of the three remaining countries still resisting the metric system — the words gram or milligram set off a paralyzing anxiety. If that could be you when it comes to diabetes meal planning, it's time to relax. Think of the atom, and forget that grams and milligrams are strangely related to the ounces and pounds you know so well. When it comes to planning your carbohydrate food, it's the ounces, or the cups, or the slices that matter.

Article / Updated 03-26-2016

When diabetes is involved, the one thing you learn right away as you begin to seriously consider eating healthier is that Mom was right — eat your vegetables. You will hear that declaration more often and more emphatically. Eating healthy with diabetes has two clear objectives — controlling blood glucose and reducing the risk for heart disease. When you're on track, improving in one area almost automatically leads to improvements in the other. When you're off track, the consequences are multiplied. So, what's with vegetables? Well, it's much more than just the vitamins and nutrients when diabetes is concerned — it's about volume, too. If you move a few starchy vegetables aside — potatoes, corn, and peas — vegetables are one group of foods you can eat in considerable quantity with no real concern. Meat, fish, eggs, cheese, and nuts — watch the high-calorie fat and the saturated fat that increases your risk for heart disease. With grains, fruits, beans, starchy vegetables, and milk, be careful with the carbohydrates, because if you overdo those your blood glucose control becomes trickier. With nonstarchy vegetables, you can go back for seconds. It's really a double bonus — extraordinarily healthy vegetables are the foods you can eat most freely. At first glance, maybe being a strict vegetarian — a vegan — would be a simple way to put yourself in a place where you'd never have to worry about what you're eating again. Hardly anyone who takes diabetes seriously hasn't fantasized about never having to think about food. So, is being vegan the answer? Being vegan is not the Shangri-La of diets. It's not that anything is wrong with choosing to be a vegan — it's that vegans have their own unique worries, and at least a couple of serious ones. You only need a microscopic amount of vitamin B12 every day, but it is virtually impossible to get enough from plants. And, a deficiency can do permanent nerve damage. Food producers catering to vegetarians responsibly fortify many foods with vitamin B12, but as a vegan you still have to make sure you're getting enough. Getting adequate, quality protein can be challenging for vegans and so can calcium. Protein is necessary for cell growth and tissue repair and calcium not only goes for building strong bones, but is also intimately involved in key metabolic processes. The richest sources of vitamin B12, quality protein, and calcium come from animals, but the point isn't to prove that vegans should eat meat. The point is to prove that anyone who wants to eat healthy, and especially when diabetes is involved, has to know what they need, know how to find it, and do it as well as they can.