Meal planning for people with diabetes

Dear Not Too Skinny Minnie,

Your brother is lucky to have such a caring sibling. You can best help your brother by learning more about diabetes, if you're not in the know already. Diabetes is caused either by the body's inability make enough insulin or to use it well — which leads to uncontrolled blood glucose levels. If left untreated, it can increase the risk of hypoglycemia, and damage to the liver, kidneys, and heart. Diet, as you’ve likely deduced, is a major tool in managing a person’s blood glucose level (along with physical activity and a management plan with your health care provider). The good news is that many of the dietary recommendations for diabetes are similar to those for the general healthy population: eat a diet rich in fruits, veggies, and whole grains, with moderate amounts of lean proteins, non-fat or low-fat dairy, and small amounts of healthy fats and oils.

The specifics of diabetic meal planning need to be designed with your brother's individual needs in mind. This is where a registered dietitian (RD) specializing in diabetes can be quite helpful. They can educate your brother about the portion sizes, meal composition, and timing of meals or snacks. Meal plans that are custom-designed by an RD are based on specific tastes, preferences, and lifestyle to meet a patient’s diabetes goals and nutritional requirements. They may also employ tools such as food lists (for each food group that outlines choices with similar amounts of fat, carbs, and protein — and thus, affect blood sugar in the same way), carbohydrate counting, and the glycemic index. Consider asking your brother if you could tag along to a session with a dietitian so that you can better understand his needs. Sometimes, a second pair of ears can help!

Here are some basics about healthy eating for people with diabetes:

• A diet low in fat (especially saturated and trans fat), cholesterol (no more than 300 milligrams a day), and sodium (less than 2,300 milligrams a day) is recommended because people with diabetes are at greater risk for heart disease and stroke than the general population.
• Starches (e.g., potatoes, breads, pasta) are fine to eat in the proper amounts. The healthiest choices are ones that contain vitamins, minerals, and fiber, such as whole grains.
• Carbohydrates need to be eaten around the same time and the same amount each day (especially around the time any medication or insulin is taken).
• Many factors can influence a person’s blood glucose levels, including the size of a meal, the fat or fiber content, how fast a person eats, and the amount and type of medication taken, if any.

Staying within a healthy weight range can also help control blood glucose levels. Regular exercise not only helps with weight maintenance, but it also helps the body's cells to recognize insulin more readily and control blood glucose levels. Your brother's health care provider needs to discuss appropriate goals in terms of blood glucose control, cholesterol levels, body weight, and any other indicators they feel are necessary.

For a good overview of diabetic nutrition as well as sample meal plans, check out the following web sites:

• American Diabetes Association
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
• Academy of Nutrition and Dietetics

A diagnosis of diabetes may leave someone feeling a little down in the dumps. Working together to learn new recipes and make cooking fun may be just what your brother needs to get a successful start on his new diet. With you as his sous chef, your brother can create a diet that is both healthy and enjoyable.