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Ask Lisa, a dietitian. Ask me anything! Part 1

Posted by on Feb. 5, 2013 at 3:15 PM
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 I was recently asked a question about meal planning and diabetes. This is important, because food affects blood sugar and it’s essential that diabetics manage their blood sugar. If they don’t, they put themselves at potential risk of complications such as heart problems, kidney issues, nerve damage, vision problems, amputations and more.

Close to 26 million Americans have diabetes. Another approximate 79 million have prediabetes. While not diabetic, these individuals have started hiking the road toward diabetes and many of them take the path straight to it. Those who have diabetes have it for life. But that doesn’t mean it can’t be controlled.

When discussing diabetes, I tell my patients to imagine a see-saw. There’s a person on each end but neither one has sat down. So the see-saw is in a nice horizontal line. That’s how you want your blood sugar to be. When we do things like carry too much weight on our frames, don’t take our medication properly, eat too much carbohydrate, don’t exercise, etc., one of the people on that see-saw sits down and we tilt. That’s our blood sugar. The goal is to avoid the tilting.

Carbohydrates affect our blood sugar very quickly. Carbs are foods like pasta, rice, bread, crackers, potatoes, corn, peas, beans, winter squash, fruit, jam, jelly, sugar, honey, pie, cake and more. Milk and yogurt have carbohydrate and protein. Our bodies break down carbs into sugar (glucose) and send it to our blood where it hangs around. Our pancreas makes insulin, which I liken to taxi cabs that go into the blood and pick up the sugar and take it to the areas of our bodies, like muscles, where we use it for energy. Depending on the type of diabetes that we have, we either don’t make any taxi cabs (type 1), enough taxi cabs or our bodies have become resistant to them (type 2). Either way, too much sugar lingers in our blood where it travels through our arteries, small and large, causing damage.

If you’re diabetic, you want your fasting blood sugar readings to be between 80 to 120 and less than 160 two hours after the first bite of food of your largest meal. From a food standpoint, here are some tips to help achieve these goals:


  1. Don’t skip meals. Eat 3 meals per day, spread out about 4 to 5 hours apart.
  2. Get a little less than 50% of your total calories from carbohydrate. Don’t go on a low carb diet.
  3. Follow the healthy plate method: One-half of your plate is non-starchy veggies prepared in a healthy manner, one-quarter is starch, and one-quarter is protein. Fruit and dairy are on the placemat.
  4. One serving of total carbohydrate is 15 grams. This is an individualized thing based on height, gender and exercise level, so ask your personal doctor or dietitian for specifics particular to you, but a lot of diabetics aim for 3 to 4 servings of total carbohydrate per meal, or 45 to 60 grams. One serving of total carbohydrate, 15 grams, is appropriate for a snack.
  5. Eat appropriate serving sizes. For example, a serving size of rice or pasta is one-third of a cup, beans one-half of a cup, a small piece of whole fruit, half a large banana (or a 4 ounce banana) and one-quarter of a bagel. A great guide for serving sizes is the book Choose Your Foods by the American Diabetic Association and the American Dietetic Association. I highly recommend it.
  6. Don’t eat carbohydrate by itself (unless you have low blood sugar). Pair it with a protein source. Protein slows the absorption of sugar in the blood.
  7. Don’t drink juice unless you have low blood sugar. Eat the whole fruit instead.
  8. Increase fiber in your diet. Fiber slows absorption of sugar in the blood. Whole grains are better choices than processed ones. So, whole wheat bread is better than white bread, etc. Add the fiber slowly and drink water.
  9. Read nutrition facts labels. Knowledge is power and can help us to make better decisions.
  10. Lose weight if you need to. Carrying too much weight on our frames and diabetes love each either. They’re husband and wife, best friends for life. Cutting 500 calories per day through diet and exercise can result in a 1 pound weight loss per week. I don’t recommend going below 1200 calories without medical supervision.
  11. Exercise a minimum of 30 minutes most days of the week. If you need to lose weight, 60 minutes most days of the week is advised. You don’t have to do this all at once. Please consult your doctor before embarking on an exercise program to make sure that you’re set to go.
  12. If you have been told not to eat certain foods and/or if you have other disease states that impact what you eat, please take these into account when meal planning.

Make no mistake about it. Everything that we put in our mouths affects our bodies, good and

bad. So, choose the healthier eating path. It’s always a good one to take.

by on Feb. 5, 2013 at 3:15 PM
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