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Managing Diabetes Magazine - diabetes

Beyond Basic Meal Planning
Healthy eating, diabetes management and prevention

How many times have you picked up reading material about healthy eating to find a totally different message from the last article you scanned? Are you confused by all the different nutrition messages the media is sending? What’s the difference between a high and low carb diet or good and bad fats? What choices are healthiest for you and your family?

Planning healthy meals is an essential part of managing diabetes. Still, it can be hard to know how to get started. Over the last five years, the Canadian Diabetes Association (CDA) has been developing new nutrition teaching tools to help people make healthy food choices.

A group of dietitians from across Canada worked together to develop Beyond The Basics, a completely new meal planning system. It builds on Just the Basics and Canada’s Food Guide, and replaces the Good Health Eating Guide System. Beyond the Basics, launched in March 2005, better suits busy and diverse lifestyles. Foods are grouped into two main categories: food groups that contain carbohydrates and therefore raise blood glucose levels and food groups that contain little or no carbohydrates. With the help of your dietitian, you can use Beyond the Basics to plan a personal nutrition update this fall.

The new system

Although the previous system was produced as a poster, the new version appears as a four-page booklet. The centre spread shows the meal plan. A place setting serves as a reminder that how much is eaten at one sitting can affect blood glucose control. When it comes to managing diabetes, eating the right amount of food at the right time is key.

Within the booklet you will find a description of the food groups and healthy eating tips. A sample label provides information on how to compare and choose food products. The Canadian Diabetes Association website and other nutrition sources are also listed. You may want to look all of them up!

A final section provides space to list goals for healthy eating and living with diabetes. Research shows that setting small, step-by-step goals is the best way to change old habits. Once you have succeeded in changing unhealthy eating patterns, expect to see a positive change in your health. For instance, you might decide to incorporate more veggies in your diet. You could set a small goal of replacing your usual afternoon snack of four cookies with half a cup of vegetables. Within a few days of meeting this goal, you would probably notice better blood glucose control in the late afternoon. In the longer run, you might even lose a few pounds.

The centre pages of the booklet conveniently group all carbohydrate foods together. Carbohydrates can be found in four groups: grains and starches, fruits, milk and alternates, and other choices (such as snacks or sweet foods). The portions have been changed, so each one provides 15 grams of available carbohydrate. With this portion system, it is much easier to count carbohydrates. Meals are simply planned around a certain number of carb choices.

Using the system

Let’s imagine that Mary, a senior, has diabetes and high cholesterol. She wants to lose ten pounds and lower her cholesterol. Mary is used to eating five carbohydrate choices each day at breakfast. Her old meal included half a cup of orange juice (1), one medium banana (2), three-quarters of a cup of frosted flake cereal (almost 2), and less than half a cup of whole milk (1⁄2). It is no wonder that Mary’s blood glucose was 14 mmol/L an hour after her meal.

Working with her dietitian, Mary sets a new goal of eating three carb choices at breakfast. In the past, her meal plan advised one starch, one fruit, and two milk exchanges. However, this did not make sense to Mary, who would prefer not to eat the same thing every morning.

Using carb choices to plan her meals, Mary comes up with three appealing alternatives. On Monday she has two slices of toasted flax bread (2) and one cup of blueberries (1). On Tuesday she chooses a cup and a half of oatmeal (2), two tablespoons of dried fruit (1⁄2), and a half-cup of low fat milk (1⁄2). On Wednesday, she decides on two wild rice pancakes (2) and one-quarter of a cup of diet syrup (1).

By revising her meal plan using the new system, Mary is able to be flexible, make healthier choices and better control her blood glucose.

Helpful tips

Keep Canada’s Food Guide in mind when making everyday choices. To achieve balanced nutrition, try to include most of the food groups most of the time.

The new method of carb counting allows you to plan meals with foods that your family is used to eating. You may crave certain foods that contain more fat or lack vitamins. By controlling the number of times a month you eat them, you can still enjoy these foods as part of a healthier diet.

Learn to use the nutrition facts portion of food labels. This can provide you with the most accurate information for carb counting.

The new meal planning booklet makes it easier than ever to decide on healthy food choices:

• Green ‘choose more often’ boxes indicate foods that include fibre, are higher in nutrients or have a lower glycemic index (GI).
• Amber ‘choose less often’ boxes show foods low in fibre, high GI, or low in nutrients.
• Blank boxes are included with each group so that you can write in your personal favourites.
• Heart healthy choices have been considered in designing the meal plan.
• Some low-glycemic foods like milk, high-fibre grains and fruits have larger portion sizes.
• Foods that contain little or no carbohydrates include vegetables, meat and meat alternatives, fats and ‘extras’ such as sugar-free foods and beverages, herbs, spices and condiments.
• The vegetable group has been presented in a different way. Most choices are free if you eat less than 1⁄2 cup, since there are less than five grams of available carbohydrate. Although many carb-counters consider less than five grams to be free, you may want to narrow your range to less than three grams if you pump insulin. Four vegetables fall outside this category – turnips, squash, peas and parsnips all have seven grams of available carbohydrate for 1⁄2 cup. Ask for your dietitian’s advice if you choose these four vegetables or eat bigger portions at one sitting.
• Consumer tips and frequently asked questions are now on line at www.diabetes.ca.
• As of spring 2006 , you can buy a comprehensive resource manual from the CDA which includes the longer food lists, detailed nutrition information and practical tips for managing diabetes.

The new system promises to help make managing diabetes easier. If you need advice, see your dietition and plan a personal nutrition update based on Beyond the Basics.

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