February 09, 2010
By Jill Weisenberger, M.S., R.D., C.D.E., Lifescript Nutrition Expert
According to the U.S. Department of Health and Human Services Office of Minority Health, American Indian and Alaska Native adults are 2.3 times as likely as white adults to be diagnosed with diabetes. The disease is the fourth leading cause of death for American Indians and Alaska Natives, affecting about 16% of the population. Information about diabetes from Tanka friend Lifescript runs every other week in our blog, Walking the Way of Wellness.
Diabetes care is exhausting, isn't it? You measure your blood sugar, take meds, drag yourself out of bed to exercise and schedule in extra time to pack a healthy lunch.
And in the never-ending quest to stay in control of your disease, you read everything you can find and listen to everyone's well-meaning advice and stories about diabetes.
Guess what? A lot of what you read and hear is just plain wrong. Read on to learn the truth about 10 persistent diabetes myths:
False. Many people with diabetes believe that white food is bad because it's starchy, sugary and lacking nutrition.
But that belief "has no scientific basis and it's confusing," says Anne Daly, registered dietitian and certified diabetes educator at the Springfield (Ill.) Diabetes and Endocrine Center.
Some white foods -- cauliflower, apples, potatoes, cottage cheese and milk, for example -- provide important nutrients, she explains.
Size matters too. Sure, brown rice is healthier than white, but when it comes to your blood sugar levels, portion has more impact than the actual food.
How can you control portions? Start by digging out your measuring cups.
"If they're covered in dust, there's a problem," Daly says.
To judge a meal's effect on your blood sugar, check levels about two hours after eating. If your numbers are too high, she recommends:
-- Reducing portions
-- Taking a 15- to 30-minute walk at mealtime
-- Asking your doctor to review your medications for a possible change
True. If you're overweight, dropping a few pounds is a good idea and should be part of your treatment plan. But weight loss probably won't reverse a disease that has been developing for years.
High blood sugar level is just one sign in the long-term development of the disease, explains Hope Warshaw, registered dietitian, diabetes educator and author of Diabetes Meal Planning Made Easy (American Diabetes Association). The precursors to that include:
-- Insulin resistance
-- A dwindling supply of insulin and other important blood glucose-control hormones
-- Abnormal cholesterol and triglycerides levels
Discouraging, yes, but don't let it derail your diet. Although weight-loss won't cure diabetes, it may slow its progression.
"Losing even 10-20 pounds -- and figuring out how to keep those pounds off -- may help you control your blood glucose, blood pressure and blood lipids for longer and on fewer medications," she adds.
See a diabetes educator or a registered dietitian to help you develop a comfortable eating plan to rein in blood sugar and trim calories. Many insurance companies will pay for your diabetes education or nutrition therapy.
False. Don't fear fruit's natural sugars. Your body needs all types of produce for good health.
"Learning how much carbohydrate is in all food groups -- including fruits and vegetables -- and what the portion size is for a single serving helps avoid carbohydrate excesses," Daly says.
In fact, she recommends at least 5 servings of fruits or vegetables a day. Eat them at every meal.
False. Do you eat snacks when you aren't hungry? It may explain why you're not slimming down and seeing healthier blood sugar numbers.
Years ago, few diabetes medications were available and snacks helped prevent blood glucose from dropping too low between meals, Warshaw says. But with today's treatment options, that's no longer true.
So should you snack or not? Warshaw ask her clients: "Do you like to snack? Does snacking help you eat less, eat healthier?"
If the answer is yes, then snacks can fit into a healthy eating plan, she says.
If the answer is no, you need to look at meal and medication timing, exercise and other factors to minimize low blood glucose levels between meals.
True. Sure, sugar raises blood glucose, but so do other types of carbohydrate, such as wheat flour, oats and other starches. Again, the amount trumps the type.
So how can you tell if a treat is going to have a bad effect on blood sugar control?
"Learn to read food labels," Daly urges. Look for the serving size and the total amount of carbohydrates.
False. Sugar-free pies and cakes are popular, but they aren't necessarily low calorie, low fat or even low carbohydrate. You must read the labels or make substitutions to satisfy your sweet tooth, Daly says.
Craving a pie? Instead, use your favorite fruits in a crisp. You'll eat fewer carbs and get more nutrition than from most other desserts.
False. Too much of a good thing is bad for you. The average person doesn't need a dinner of 8-ounces of grilled salmon or two cups of whole-wheat pasta.
Start trimming your portions by 10% or 20% at each meal.
Serve your food on a smaller plate. too. Big plates mean big servings, says Brain Wansink, Ph.D., author of "Mindless Eating: Why We Eat More Than We Think" (Hay House UK Ltd, 2009).
False. Are you so panicked by the shakiness, dizziness or confusion that often accompanies hypoglycemia (low blood glucose) that you gorge on sugary delights until you're almost nauseous?
Low blood sugar isn't an excuse to eat extra junk food. Hypoglycemia, typically blood glucose less than 70 mg/dl, should not be treated with so much sugar that you "super-spike" your blood glucose. You're just trading one problem for another.
Candy, cookies and brownies will have more calories (and often unhealthy saturated fats too) than the recommended treatment, and it may take longer to raise your blood glucose.
For starters, limit yourself to just 15 grams of carbohydrate so you don't overshoot your blood glucose target, Warshaw says.
It's best to use pure glucose in tablets, gel or liquid.
"They work quickly, are pre-portioned, contain a minimum amount of calories and are easy to keep with you," she says.
Other appropriate foods to have on hand: 4-ounce juice boxes, hard candies and sugar cubes and packets.
Here's the American Diabetes Association's (ADA) advice on treating low blood sugar:
-- Wait 15 minutes after treatment before eating anything else.
-- If your blood glucose is still low, consume another 15 grams of carbohydrate.
-- Recheck your blood glucose in another 15 minutes.
Once your symptoms are gone and your blood glucose is above 70 mg/dl, you may still need a snack if your next meal is a while away.
If you don't have a preferred treatment food, use any carbohydrate-rich food.
True. Who doesn't want a big celebratory meal now and then? Thanksgiving, birthdays, anniversaries or just a visit to your favorite restaurant can push an appetite into overdrive.
Before you had diabetes, you might have been able to get away with skimping on breakfast and lunch to save up for your big plate of pasta or other favorite meal. But those days are gone. How much you eat at meals matters now.
Eating too much is like getting too much rain. Imagine a torrential downpour for hours. That much falling from the sky in such a short time is sure to flood the streets.
That's what happens in your body; giving it more than it can handle at one time floods the blood with glucose.
Spreading food out over the day and avoiding large quantities gives your body time to level out your blood glucose before the next onslaught.
False. Because blood sugar jumps with carbohydrate, but not with fat, many people with diabetes ignore the fat content of their meals.
But "dietary fat is just as much a problem as sugar," Daly says.
Fat provides many calories (about 120 per tablespoon) and hinders weight control.
And the type of fat matters. Saturated and trans fats are linked to higher cholesterol levels and increase the risk for heart disease - already your most likely cause of death. Studies also suggest that saturated fat worsens blood glucose control by affecting your body's response to insulin.
Limit unhealthy fats by avoiding stick margarine and packaged foods made with partially hydrogenated oils, poultry skin, animal fat including dairy and fried foods.
Still unsure? For more advice, speak to a diabetes educator or other member of your health care team and visit the ADA Web site.
For more about diabetes: LifeScript
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