News and Meal Planning Tips for People Affected by Diabetes

BY: Tara DelloIacono Thies

While often the Luna Nutritional Lounge is an informal chat about eating and health issues, because of the rise of diabetes and my own connection to this diabetes community, we decided to devote this month’s article to this important health issue. I recently returned from my second year at Camp De Los Ninos , a diabetic summer camp for kids sponsored by the Diabetes Society of Santa Clara Valley where I served as the camp dietitian and provided diabetes education.

Approximately 16 million Americans have diabetes and it is the 6th leading cause of death. Recent headlining articles such as those in The New York Times and Newsweek discussed the national increase in diabetes and mentioned a startling rise among people in their thirties. Just as startling is recent research that shows that the number of children with Type 2 diabetes has tripled in the last five years.

What is Diabetes?

Diabetes, a life long disease, is diagnosed when blood sugar levels are higher than the normal range. Normal range for blood sugar is about 70-120 mg/dl. Blood sugar fluctuates with the amount and types of foods you eat and activity. Insulin is the hormone produced in the pancreas that helps regulate blood sugar. People with diabetes lack enough insulin or the body does not produce enough insulin to properly metabolize glucose and used to fuel our muscle and brain.

There are two types of diabetes, commonly referred to as Type 1 and Type 2 diabetes:

Type 1 diabetes:

• Body produces very little if any insulin. Sometimes referred to as insulin dependent.
• Usually develops during childhood.
• Cause of Type 1 diabetes is not completely understood; perhaps a disease of the pancreas destroys its capability to produce insulin, perhaps the cause is genetic, or the result of an immune system disorder.

Type 2 diabetes:

• Body produces insulin but cannot use it efficiently due to a resistance.
• Sometimes referred to as non-insulin dependent
• Usually developed later in life.
• Ninety percent of people with diabetes have Type 2.
• Risks for developing Type 2 diabetes include being overweight and inactive, over 45 years old, pregnant, or having a major stress on the body such as surgery or a major illness.
• People of Native American, African American, or Hispanic descent are also at higher risk.

According to a report presented at the 60th Annual American Diabetes Scientific Convention the Type 2 diabetes can be prevented with lifestyle changes in eating and exercise habits. This recent study reported a 58% decrease in incidence in Type 2 diabetes in people with high risk factors who modified their lifestyle.

What is hyper and hypoglycemia?

Hyperglycemia and hypoglycemia are terms frequently heard when referring to blood sugars.

• Hypoglycemia —refers to low blood sugar (less than or equal to 70 mg/dl). Low and fluctuating blood sugar levels are damaging to blood vessels and vision. Although rare, some people may experience hypoglycemia without having diabetes.
• Hyperglycemia —refers to high blood sugar great (greater than or equal to 120 mg/dl). Both Type 1 and Type 2 diabetics experience hyperglycemia. High blood sugar levels are dangerous as they can lead to a diabetic coma.

Severe fluctuations between high and low blood sugar levels are dangerous for people with diabetes because they can lead to kidney damage, vascular diseases, and vision impairment or loss.

How do you know if you may have diabetes?

About 35% of people with diabetes go undiagnosed for several years before realizing they have diabetes. If you want to estimate your level of risk for diabetes take the Risk Test at 1-800-diabetes or visit the American Diabetes Association for detailed information at www.diabetes.org. Symptoms of high blood sugar may be the following: frequent urination, excessive thirst, and blurred vision. If you have risk factors and/or symptoms for diabetes please consult with your physician.

Some Meal Planning Considerations for People with Diabetes

A healthy meal plan can help control blood sugars levels. One old myth of the diabetic meal plan is to simply cut out all sugars. We now know that carbohydrate foods break down into the sugar glucose in the body. Carbohydrate foods including sugar can be part of a healthy meal plan. If you do not consume enough carbohydrates throughout the day, you are at risk for hypoglycemia. However, if too many carbohydrates are eaten at one time the blood sugar level rises too high resulting in hyperglycemia.

While medications can help control diabetes, sometimes people with Type 2 diabetes can control blood sugars with diet and exercise alone.

How do carbohydrate foods fit into a diabetic meal plan?

When making a diabetic meal plan all carbohydrate foods need to be considered for blood sugar control. People with diabetes should consume foods with carbohydrates in moderation—smaller portions spread out throughout the day. Spread foods containing carbohydrates throughout the day to help balance your blood sugar. Other foods containing carbohydrate include grains, cereals, rice, noodles, pasta, starchy vegetables (potatoes, peas, corn, legumes) and dairy.

In the body all carbohydrate foods break down into sugar called glucose. Carbohydrates all lead to a blood sugar response and some complex carbohydrates (starches) are absorbed faster than simple sugars (added sweetener). Total carbohydrate intake is important to consider because it reflects the total amount of food that will break down into glucose (sugar) in the body.

Eating a variety of foods from all major food groups, grains, vegetables, fruits, proteins, dairy and fat ensures that you are getting the fiber, vitamins and minerals that you need. A balanced combination of fat, protein, and carbohydrate helps slow digestion providing a steady glycemic response, meaning that the body gradually absorbs the carbohydrates over a longer period of time. According to the leading sports nutritionist, Nancy Clark, “Today we know that a carbohydrate’s effect on blood sugar cannot be determined by whether it is a simple or complex carbohydrate” Nancy Clark’s Sports Nutrition Guide Book, pg. 109.

Choose a Diet Low in Fat and Saturated Fat

People with diabetes are at higher risk for developing heart disease and should limit added fat to 3-5 servings per day. Limit foods made with butter and lard and avoid foods that are deep fat fried. When adding fat to the diet, choose non-animal sources such as olive oil, peanuts, and avocado.

Meal planning is challenging and very individualized. The amount of food each person needs varies with size and activity level. To develop a meal plan specific to your needs meet with your registered dietitian. You can learn more about healthy meal planning and locate a registered dietitian in you area at the American Dietetic Association web site www.eatright.org and the American Diabetes Society web site www.diabetes.org.

The following describes the incorporation of Clif Bar & Company products into a diabetic meal plan

Talk with your healthcare professional about whether these suggestions are right for you.

CLIF Bar (2 1/2 – 3 carbohydrate servings, 39-44 g carbs, 8-12 g protein, 2-5 g fat per serving)

When: Use on days when you need to carry balanced food (containing carbs, fat, & protein) in a small, lightweight package. CLIF Bar is approximately equal in carbs, fat, and protein to a 3oz bagel with one tsp. of butter and 8oz low fat yogurt.
Where: When your usual food choices are not available: on a several hour hike, traveling on a long road trip, or a full day at the amusement park.
How: If you know that your next meal is going to be over 3-4 hours away, having a CLIF Bar with a glass of milk or with a small piece of fruit or yogurt can hold you over.
For example: You ate breakfast at 7:30am and you ate a small snack, (an apple) at 9:30 am but you know that your day is going to be busy, and there will be no time for another meal until around 2:00 pm- or 3:00 pm. A CLIF Bar with an 8 oz glass of milk around noon can help hold you over until the next time you can eat.

LUNA bar (1.5-2 carbohydrate servings, 24-27 g carbs, 10 g protein, 3- 4.5 fat g per serving)

When: LUNA bar is a good snack between meals. It has a balance of carbohydrate, fat and protein.
Where: LUNA bar is convenient to carry in your backpack, car, or to keep in your desk drawer or anytime you need an easy snack.
How: LUNA bar can be eaten between meals as part of a balanced meal plan. A Luna bar is equal in carbs, fat, and protein to approximately 2.5 graham cracker squares with a tablespoon of peanut butter.

CLIF SHOT (23-24 g carbs per serving-maltose)

When: The non-caffeinated flavors of CLIF SHOT can quickly raise a low blood sugar. It is absorbed into the body in about 5-10 minutes and it tastes good!
Where: CLIF SHOT is small and easy to store in a pocket, school bag, glove box, desk, or even in a wet suit. If you feel as though you are experiencing a low blood sugar, Shot can help bring it up.
How: Tolerances vary with individuals. If it only takes you 3 BD™ glucose tabs to get higher than 70 try only using 2/3 of CLIF Shot®. If it generally takes you 4-5 BD™ glucose tabs to bring your sugar higher than 70 you probably would be able to tolerate a whole CLIF Shot. Re-check in 15 minutes to see if your blood sugar is greater than 70. Remember, if your next meal is 2 or more hours away after experiencing a low blood sugar you will need a snack to prevent a low blood sugar before the next meal.

If you have further questions regarding the use of Clif Bar & Company products in a diabetic meal plan, please contact me at Tara@clifbar.com. For more general information on carbohydrate counting and diabetic meal planning contact the American Diabetes Society at 1-800-232-3472 or locate a dietitian in your area through the American Dietetics Association 1-800-366-1655.