This first video in our four-part nutrition education series will explore healthy choices, the recommended plate model and the recommended eating pattern to help manage your diabetes. Registered Dietitian and Certified Diabetes Educator Pamela Piotrowski will provide nutrition information and tips to maximize your energy and to meet your nutrition goals.
Speaker: Pamela Piotrowski, RD, CDE
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[Music]0:08
welcome to the first episode in our nutrition education series for people living with diabetes whether you're just0:14
starting out on your diabetes Journey or are a Season Pro who could use a quick refresh this session offers all the0:20
basics when it comes to healthy eating and diabetes registered dietitian and certified diabetes educator Pamela0:27
Petroski will explore healthy choices the recommended plate model and the recommended eating pattern to maximize0:34
your energy and nourishment as well as help manage your diabetes over to you0:39
Pam hello my name is Pam and today during today's session we're going to review why healthy eating is essentialOverview0:46
to everyone for promoting good health minimizing injury and reducing the risk0:52
of diseases and why this is so important for diabetes management itself we will examine the rationale0:59
behind this concept of a balanced plate how it applies to your individual meal1:05
choices as well as dive a little bit deeper into the importance of key elements that provide energy from the1:11
foods that we eat and the role they may play in blood sugar control and so you aren't confused I may interchange the1:18
words glucose and sugar when I'm referring to what it is that's in your blood but it's the same thing so I hope1:24
you can keep up we'll start to crack down on the code of reading labels to1:29
help help make better choices it might take you a little bit of time in the beginning to figure out these labels but1:35
once you've got it you'll be well on your and we're going to organize all this information to develop a healthy1:41
eating pattern that works for you let me start by saying the most important thing1:47
there is no diabetes specific diet as diets are hard to follow in the long1:53
term as you may have found out in the past but what is important is the what1:58
somebody eats the how much they eat and the when they eat that's really2:04
important when we talk about making better food choices and planning healthy meals for diabetes2:10
management when people learn how these aspects of their eating habits can impact their health they will be able to2:16
make changes small or large to improve their blood sugar control and reduce the2:21
risk of complications so let's get going hereFood Nutrition2:28
food and nutrition important elements of diabetes management as I mentioned now I2:33
want you to think of food and nutrition as a as a type of treatment no different2:39
than medications or physical activity is for people living with diabetes and throughout this video we are going to2:45
focus on the food and nutritional aspects that are part of your diabetes2:51
selfcare learn how different foods affect your blood sugars because at different times of our lives our blood2:57
sugars may be affected differently by some of the quantities and the types of foods that we're eating and what that3:04
means to your risk of complications down the road as well as how small changes can make big3:11
differences while it's natural to have questions about nutrition and what foods to eat we're going to try to untangle3:17
some of that dietary advice that may be on the internet that you've already noticed or it may come from wellwishers3:23
to help you manage your diabetes that is evidence-based so be careful of the3:29
potential for false promises but maybe with bad diets supplements special3:35
diabetic or dietetic Foods it's always best to talk with your healthc care professional before putting your trust3:42
in potential misinformation out there and this could harm you instead of helping you I encourage you to go to3:50
diabetes.com3:58
stroke.com discussing and throughout keep in mind that there is no one diet fits-all4:04
approach finding out what works for you is most important to keeping youWhat Works For You4:13
healthy because eating is something that we need to do on a daily basis it we need to find out that right balance to4:19
keep ourselves healthy while still promoting good health and quality of life often people think that once they4:26
get their A1c to Target that they can go back to their old eating habits but remember what we said about healthy4:33
eating patterns being like a treatment for diabetes you take away that treatment and the blood sugars will4:38
creep back up so try to find that will what will work for you in the long run4:44
small changes can make the difference and you might find that you're doing all4:49
of these things already and it's still not making a difference it's always best again to talk with your diabetes4:56
educator to see what other changes might need to be made throughout your diabetes5:01
management so let's move on and and try to find what will work for you in the long run picking healthy food choices5:08
more often will help to provide energy to do daily activities fuel your muscles5:14
prevent injury and also help with your mood all things that are most important for managing diabetes and reducing your5:21
risk of diabetes or its complications but beyond controlling blood sugars healthy eating can also5:28
help you manage weight and as I said lower your risk of other complications or other chronic conditions like heart5:34
disease that is more prevalent in people that have diabetes high blood pressure5:40
osteoporosis arthritis certain forms of cancer are all linked to what we eat so5:45
here's another good reason for why healthy eating matters eating well is good for overall5:51
health and there's many ways to do it I want you to pick what might work for5:58
you so what are the basics of healthy eating you might ask or maybe you already know think of it as a shift ofBasics of Healthy Eating6:05
food choices that can be done by eating more of certain types of foods replacing6:11
current choices with better options or limiting your consumption of less desirable Foods as we'll talk about6:17
throughout the session it's key to have a variety of foods but that doesn't mean that you6:23
have to eat all foods to ensure that you're getting all the nutrients like vitamins and minerals that are found in6:30
different food groups those food groups being fruits and vegetables meat and6:35
protein Alternatives dairy products and Grains and starchy Foods by the way I'm6:41
not a fan of kale but I try to pick other green leafy vegetables to get similar nutrients and as always make6:48
sure you're drinking water or low calorie beverage to keep well hydrated that is still part of a healthy eating6:55
pattern I know that cost in availability can be challenging to some where possible pick whole foods to avoid7:02
excess salt sugar preservatives that are usually found in packaged and ultr7:08
processed foods in some cases Frozen and canned can be just as healthy and maybe7:14
a better alternative preparing meals yourself gives you the advantage of knowing how what's going into your meals7:22
how you're preparing them and how it's making a difference on your diabetes control but it does involve a little bit7:29
of planning ahead of time I will warn you about that but once you get the hang of it you'll be right on your way so my7:37
first question to you is what do you do do you eat to live or do you live to eat7:45
some people will say that they know when their body is full and others may have difficulty with figuring out when to7:51
stop and when they're full have you ever eaten because you were bored feeling down or just because7:58
the food was staring at you on the table be aware of the different reasons for why you're eating by all means if you're8:05
feeling hypoglycemic please eat some sugar but be mindful of why you're eating what you do and that can be just8:13
as important as what you're eating some people may find that a strict routine with their food intake8:19
helps manage their blood sugars perfectly but only you will know if that's something that's sustainable for8:25
you meaning can you do it in the long term because this is something that you want to do for the long8:31
run it's important to find a way to enjoy what you're eating because it is8:37
something we have to do on a daily basis please look for ways to prepare meals that work for you because if you don't8:44
enjoy food preparation or perhaps eating becomes socially8:49
undesirable it can be a very stressful part of your day-to-day routine rest assured the more you become8:57
aware of what healthy eating can mean to you you and your blood sugar control and9:02
how you can learn how your body reacts to different foods at different times in9:07
your life uh with different situations you will find eating can be done in a way that is not considered9:14
difficult while still enjoying social aspects and reaping in all the nutritional9:20
benefits if you were to write down what you ate for a week what would your food or meals look like could you make some9:28
changes right now with what we've already talked about we're learning more and more about9:34
the importance of good nutrition and healthy food choices for day-to-day wellness and for reducing the risk of9:39
injury and chronic disease but what it means to you I might say again I may ask9:45
in five years and it might be different information so it's great to keep up to date on this9:54
information now look at this plate it looks amazing but it also looks a bit confusing using so here's what we'reThe Balanced Plate10:00
going to talk about with the concept of a balanced plate it's one of the most important diet habits you can do by10:08
picking half of your plate of vegetables vegetables are high in nutrients that10:13
the body needs to be healthy and because non-starchy vegetables tend to be higher in fiber and water content this can help10:21
to keep you full longer and control the amounts of other foods that are you're putting on your plate and that may10:28
control your blood sugars the other part of that half a plate can be divided up again so that a quarter is10:35
coming from protein foods and you want to be looking for lean proteins and10:40
plant proteins as well as fish to be part of that quarter of your plate try to eat at least two servings10:48
of fish each we week and maybe try different recipes that include plant-based things like tofu or legumes10:55
nuts and seeds as great sources of protein as well and last but not least fill that11:02
remaining quarter of your plate with your carbohydrates or what's commonly known as grains or starchy vegetables11:08
picking whole grains and crackers brown or wild rice quinoa oatmeal barley11:14
potatoes with their skins on are all going to be ways to fill that quarter of the plate while keeping you11:22
full now think about it was the plate that at your last meal did it look like11:27
this was the was the balance the same way perhaps there's a little bit more11:33
that you can add to that half of vegetables and a little less to the pasta that you may have consumed last11:39
night eating Foods in moderation will allow you to get the energy that your body needs as well as including enough11:46
fiber enough energy enough protein that all makes a healthy11:52
diet or as I say a healthy meal pattern a couple of tips that I might11:58
add to this is looking for bright vibrant colored vegetables so look for the oranges the12:05
greens the Reds in your vegetables if you can leave the skins on for extra fiber prepare your Foods in a healthy12:12
way baking broiling steaming poaching stir frying but you might say wow a12:18
plate with a piece of plain chicken a baked potato and some steamed broccoli12:24
and carrots just doesn't sound appealing so here's where you want to take some of your favorite recipes or the meals that12:31
you already consume and modify them a bit so that this balance holds true12:37
perhaps it's adding more vegetables to your uh to your meal perhaps it's12:43
pureeing some vegetables and making them into a sauce for your potatoes maybe12:48
it's adding um a salad before your meal so that we still have that balance of a12:55
half coming from vegetables a quarter coming from protein and a order coming from carbohydrates even if you have a13:02
recipe think of the ingredients that you're consuming and how you might rearrange the quantities of the foods in13:08
there so that you have this balance be careful though if you consume13:14
too many of the refr refined grains like bread pasta minate rice these may cause13:20
spikes in your blood glucose even if you are consuming only a quarter of your plate of them so be careful as you will13:27
notice this plate doesn't have any dairy products on it it doesn't have dessert on it so even a glass of milk and a13:33
piece of fruit after your meal could be healthy alternatives but be careful13:39
limit sugars and sweets for desserts that we sometimes have like cookies and ice cream cakes and Pie if you are going13:47
to consume a small quantity of that try to work it back into that balanced plate13:52
perhaps you eat a little less of the pasta or the potato if you know you're going to have some cookies perhaps you13:59
have less fruit and if you're going to be having some pie or an apple crisp so14:04
that you can still balance all the nutrients that your body requires and remember we're trying to do14:11
these things in moderation so it's not a complete Turn Around from today to tomorrow's14:18
meals another thing I want you to be cautious about is high fat and greasy Foods okay they won't necessarily affect14:25
your blood sugar now but they may affect your digestion they may also impact your weight going14:32
down going further and that may impact your diabetes Management in the long term so be careful with fried potatoes14:39
creamy sauces battered or breaded foods and of course that hydration14:45
factor is so important um it could be some low-fat milk it could be having14:50
water unsweetened tea or coffee plain broth could be a great addition to your meals but be cautious with regular pop14:58
even fruit juice or sweetened tea can raise your blood sugar and cause15:03
problems uh down for15:10
you now let's take a look at those sources of energy that I mentioned coming from the balance plate I made aCarbohydrates15:18
comment about carbohydrates or grains and starchy Foods so did you know that15:23
carbohydrates are the body's preferred source of energy the sugar that comes from all sources of carbohydrates is15:30
otherwise known as glucose when it enters into the bloodstream and that's why we have such15:35
an emphasis on carbohydrates when we talk about why we need to be careful with the quantity of the foods15:41
containing and how they impact our diabetes management converting carbs into15:47
immediate usable energy is easier for the body than using fat or protein as an15:54
energy source did you know that your brain muscles cells all need15:59
carbohydrates to function which is why a very low carb diet is not really healthy16:04
at all depending on the type of carbohydrates that you're consuming the food is converted into sugar or glucose16:11
at varying rates as it enters the bloodstream after being digested and metabolized it's either transported into16:18
the body through insulin to the cells or it's used later as a storage of energy16:26
if there's not enough insulin from within your body or you're not taking16:31
the right or enough of diabetes medications to help with that transport16:36
the glucose is left circulating in the bloodstream and this is where the complications of diabetes come into16:42
effect when your blood sugar levels are above Target for too long and cause16:48
damage to the vessels leading to other parts of your body the Dietary Reference16:53
intake for Canadians suggests a minimum of 130 gram of carbohydrates per day or17:00
45 to 60% of the total calorie intake coming from17:05
carbohydrates but what does that mean specifically for you well the easiest way in today's session is to have you17:11
refer back to that balance plate looking at a quarter of what you're eating coming from the starches or the grains17:17
that you're consuming now if you're working with a dietician or diabetes educator they can17:24
help you go into more detail with carb counting and what the ual number might mean for you throughout your meals and17:32
daily intake although being aware of how much carbohydrate you're consuming is key equally important to the is the17:40
quality of that carbohydrate not just the quantity now I probably don't need17:46
to tell you where carbs are found but as a refresher you'll find them most abundantly in grains starchy vegetables17:53
fruit milk and of course various forms of sugars and sweets but the healthiest sources are going to come from17:59
unprocessed or minimally processed foods not only will you naturally get18:06
the most vitamins and minerals but they're probably going to be higher in fiber and more likely to have something18:12
called a lower glycemic index that we're going to talk about in a bit these are also referred to as18:18
complex carbs and your intake of carbs should consist mostly of these18:24
sources now you can still eat other types of carbs and less optimal sources18:30
would be things like white processed bread fruit juices desserts or other18:35
highly refined or processed foods you know honey maple syrup molasses all seem18:42
to have really healthy benefits um and may seem like healthier versions to18:47
sweeteners but really from a diabetes perspective they're no different than just eating straight table sugar and18:54
using it only if you're having a hypoglycemic reaction also known as simple carbs these things19:01
are easily digested and quickly brought to your bloodstream so that's something19:07
to be aware of because if you're not taking enough medication or your insulin19:13
is not working the same way as someone without diabetes this could cause problems with your blood sugar staying19:20
at Target but it also could interfere with weight management increased risk of19:25
heart disease and batty liver many people are confused about19:30
carbohydrates maybe you are right now but keep in mind that if you're just starting out it's important to eat a19:37
moderate amount of carbs and then try to pick the healthier sources then to19:42
follow a strict diet or totally removing them from your eating habits right now remember small changes can produce big19:50
differences in your diabetes management as I previously mentioned protein is anProtein19:56
important part of healthy eating for many reasons including growth and repair of body tissues such as muscle bone skin20:04
hair and virtually every other part of your body and like carbohydrates protein provide energy but it's not the body's20:12
preferred source of fuel from a diabetes perspective it's an important part of a20:17
meal to help regulate how quickly a meal is digested thus keeping you full longer20:24
and helping to reduce those spikes in blood sugars after eating including more20:29
plant-based proteins and fish is also beneficial as I mentioned before from both a diabetes and a heart health20:36
perspective the best picks from this food group would be leaner cuts of meat those with less marbling more fatty20:44
fishes uh low-fat dairy products eggs plant-based choices like soy tofu uh20:51
nuts seeds legumes now you can find small amounts of protein in grains and20:57
some vegetables but I don't consider them one of your better choices be careful with how those21:03
protein foods are prepared as some may be prepared with extra sodium from sauces or extra carbs from batter or21:10
breading and watch out for the skin on poultry or that marbling in your meat21:15
because those can contribute to unhealthy fats that we'll talk about in aFat21:22
minute so what about fat we used to think fat was really bad for us now we21:27
know a little bit different that fat is the most calorie dense food that we eat and we do need some of it not only is it21:34
a source of energy for our body but it assists with the growth and development of cells and helps the body absorb21:41
certain essential fatty acids or fat soluble vitamins the problem is with fats is21:48
that they're not all created equal the key to understanding the health aspect of fats is considering the21:55
total amount and knowing what type of fat is is saturated or trans fats you may have22:02
heard okay are also referred to as the bad fats in the diet and they're primarily found in animal sources22:09
including whole fat dairy products coconut and palm oil are the only two22:15
plant sources that I know of that are saturated fats in the diet and you want22:20
to be careful with them they may have other health benefits but from a cardiovascular perspective uh they can22:28
clog your arteries and contribute to your cholesterol levels unsaturated fats that would be22:34
monounsaturated polyunsaturated aka the good fats in our diet are mostly found22:40
in things like nuts and seeds avocad soybeans as well as all of their oils22:46
and those fatty fishes that I had referred to an easy way to remember the difference between the good and the bad22:52
fats in your diet is that the healthier ones the unsaturated ones are liquid at room temperature as in this picture here23:00
and the unhealthy fats are usually solid and you wouldn't want to have solid fat clogging up your blood23:07
vessels the main issue health issue with those saturated fats is its effect on cholesterol levels or the risk of heart23:13
disease which is also a significant risk for people living with diabetes so be careful with the quantities and look to23:20
see where they're found in your diet you may not be able to remove all23:25
of the uh saturated fats in your diet but kind back is definitely a healthy23:30
way to go about the heart healthy aspect of your diet but regardless of the types23:37
of fat as I mentioned the total fat content is something you also want to be aware23:43
of as this is something that can contribute to Central adiposity or that23:48
weight that's carried around your middle section which is linked to insulin resistance and diabetesFiber23:57
management o fiber my friend it's a non-digestible carbohydrate Source24:03
naturally found in plant Foods it's found in things like the berries here other fruit veggies nuts24:11
seeds legumes whole grains as well as made into fiber24:17
supplements but the more a food is processed or refined the less natural occurring fiber is left in it unless24:26
it's added back during the processes or the manufacturing the good news about fiber24:32
is that the body is unable to break down and absorb this type of carbohydrate it doesn't cause a spike in blood sugars24:39
the way other carbohydrates can and in fact can actually help reduce the spikes in your blood24:44
sugars now to be clear there are two types of fiber soluble and INF soluble24:51
each one has important health benefits and plays a different role in the body soluble fiber dissolves in water forms a24:59
gel-like substance in your stomach that slows down digestion attaches to fatty25:05
acids to help remove them out of the body and in doing so can help control your blood sugar and cholesterol levels25:13
some good sources of soluble fiber that come to my mind are apples bananas oats25:18
peas black beans limma beans Brussels FRS avocados there's so many different25:24
sources of soluble fiber and you can find those lists on some of those websites ites that I've referred to25:30
previously now insoluble fiber equally as important but doesn't dissolve in25:35
water so if you were to compare two different soluble fi soluble and insoluble you would find that the25:42
insoluble fiber that comes usually um in whole grains uh the skins and the seeds25:49
and everything just sits at the bottom of your water glass there but it's so important because it25:55
actually is not broken down passes through your intestine and is a great way to remove some of the waste that26:02
collects in our intestine while all fiber is good for26:07
you my only word of caution is to be careful on how you increase the amount26:13
of your daily intake make sure you do it gradually and make sure that you're drinking adequate fluids and moving26:20
around otherwise you may run into some distressing bloating or gas or other gastrointestinal side effects as we26:27
learned more and more about its role in the health of our gut immunity and26:32
anti-inflammatory properties this also holds true for how it manages yourGlycemic Index26:40
diabetes now I referred to something called the glycemic index a while back26:46
and what is this glycemic index it's a scale that ranks a carbohydrate containing food or drink by how much it26:53
raises blood glucose level levels after it was consumed so as you can see on26:59
this chart here this graph foods with a high glycemic index rise blood sugars27:06
really quickly and faster than foods with a lower glycemic27:12
index as we know it also as the GI index it assigns a number to a food based on27:19
how drastically it makes your sugar rise and then come back down you will see after two hours your sugars are at the27:27
same level but it's what happens in between during that 2hour period that27:33
can also have an impact on Diabetes management and27:38
complications now these foods are ranked on a scale of 0o to 100 with pure27:43
glucose or table sugar given a value of 100 the lower a food's glycemic index27:50
the slower the blood glucose Rises after eating that food and that's a very good thing as seen in the yellow graph here27:59
generally speaking the more processed a food is um the carbohydrate food is the28:05
higher it's glycemic index is take for example a slice of French baguette bread28:11
its glycemic index is 95 so eating the same amount of grams of carbohydrate of28:19
of white bread when you compare it to something that has more fiber or fat in28:24
it I'm thinking maybe a half a cup of cooked barley that has a lower glycemic28:30
index one of something like 22 you can see how they may impact your blood28:35
sugars at one hour out or at a half an hour out if you were checking your blood28:41
sugars um after your28:46
meals to simplify things there's a chart on the28:52
diabetes.com medium and high glycemic index Foods I don't want you to get28:57
caught up on the exact numbers but to try and collectively put them in as they29:03
have them green categories for go low glycemic index food medium uh ones and29:10
then the high ones that we should try to eat a minimal amount of keep in mind that if you have protein29:17
foods or sources of fat or Fiber um in the foods that you're29:23
consuming or can add them to your meal that can lower the glycemic index of the total Meal which might have the same29:30
benefit than picking just low glycemic index Foods how can this help you make better29:38
choices well choosing lower glycemic index more often than high glycemic index foods will not only help you with29:45
realtime control of your blood sugars as I mentioned if you were checking them um but it'll help you keep full longer29:52
promote weight management and also help lower the risk of some of those diabetes complication in including the risk of29:58
heart disease and stroke and as I mentioned even if you can't remove all the high glycemic index30:04
foods from your diet try just lowering the glycemic index of the meal by adding a source of protein even if it's a glass30:11
of milk or some nuts um to your to your grains leave the30:17
skins on your potatoes have fruits and vegetables where possible um so that you30:23
can add extra fiber to your meal and another thing that people aren't weren't30:28
aware of is to cook pasta and rice undercooked a bit alante you might be30:34
familiar with that term because the more something is processed the higher the glycemic index so if we can undercook30:40
something not meaning you eat it raw um but that's also going to lower the glycemic index uh as your body takes it30:48
in but remember just because a carbohydrate containing food has a low30:54
glycemic index attached to it you still need to be careful with how much you're consuming total because the total grams31:01
of carbs whether it's a low or a high glycemic index food will still impact your blood sugarFood Labels31:10
control so one of the things that most people um have problems or tell me that31:17
they're confused about is reading food labels and just as I mentioned previously about picking less processed31:23
foods it doesn't mean that you can't eat foods that have a a label on them but31:29
the key is being able to understand what you're looking for so let's try to break31:34
this down into three little easy steps so a label can help determine if it is a31:40
good choice or whether you should think twice about something when you're picking it up on the shell when you know what your things31:47
you're looking for this is a great way to be able to compare different foods maybe there's a better option that you31:53
didn't realize in the same category of foods31:58
most Foods packaged in Canada have to have a nutrition fact table like the one you see here on the slide notice the32:05
first red back box that's probably most important because that's the serving32:11
size that all the rest of the information in this nutrition facts table is based32:16
on so if you see this it's 107 calories for this serving but only if you're32:23
eating this serving of 12 crackers so you need to determine is this the32:29
serving size that I'm eating or is it another amount that is my portion and be able to adjust the numbers based on32:38
that specifically though when you're looking at from a diabetes and a blood sugar management um perspective you'll32:46
see in bold that we have those micro or macronutrients we were talking about32:51
before fat carbohydrate and protein and they're bolded underneath and indented below32:59
each of that Bolding listed is subcomponents of those Foods remember I referred to saturated fats before as an33:07
unhealthy part of the total fat intake and for carbohydrates specifically from33:12
a diabetes perspective you'll see that the total amount of carbohydrates in33:17
these 12 crackers is 27 grams but this can be confusing because when you indent33:24
you see that fiber is a component of it sugars might be a component of it from what is added in the preparation of of33:31
these crackers you might see sugar alcohols you might see starch all of33:36
these subcomponents that are indented add up to the total amount of33:42
carbohydrate so if you trying to determine how many grams of carbs you're33:47
actually consuming from this label the number would be 27 but wait because fiber is that33:56
carbohydrate food that your body can't digest it means you get to subtract the fiber content from that total34:03
carbohydrate so really there's 26 grams of carbohydrates in34:08
this so this makes it a little bit easier to see that a food that is34:13
contains a lot of fiber may have a lot more carbohydrates but really you34:18
subtract that amount of fiber from the total carbohydrate and that's how you would determine how many grams of carbs34:26
your body is actually getting and turning into sugar in your34:32
body now one of the things that a lot of people will do is that they will count their carbs and be able to swap things34:37
out meaning that there's 12 crackers for 27 grams of of carbs and if you know34:44
that a slice of sandwich bread is 15 grams of carbs or half a cup of cooked pasta is 15 grams of carbs you could say34:52
do I want some soup broth with 12 crackers or would I like to have two34:57
slices of sandwich bread or do I want six crackers and one slice of sandwich35:03
bread to get 30 gram of carbs let's say if that's what I'm consuming at my meal35:10
this is where it can can get confusing but you know what I think we're going to have more discussion on this in another35:16
session and as well when it talks about fat and protein I'm going to leave that35:22
to another session on label reading now that second box probably35:29
another confusing thing to you what is percent daily value or DV the percent DV35:36
is meant to act as a benchmark to determine if a food is high or low in a certain nutrient compared to what the35:43
daily recommended intake value is for Canadians now this is an average it's35:50
based on an average eating of 2,000 calories per adult but what does this35:55
mean specifically to you well a food is considered low in a specific nutrient if36:01
there's less than 5% DV so take a look on that side panel there of the label36:07
and look to see if any of these foods are less than 5% and they would mean that that's a a low intake of that so36:14
there's really not very much fiber uh in this food product but sodium on the other hand has 16% and we will say that36:23
if food is considered high in a nutrient if it has more than 15% % of of daily36:30
value in the case of sodium of course maybe this is something you want to be36:35
aware of and eat less of because you're also watching your blood pressure or you've eaten other high salty foods that36:42
day so this is how you can compare two labels of crackers and pick which one36:48
might be the more desirable choice and last but not least the third box that I36:53
want to draw your attention to is the ingredient list of things okay and that tells us what ingredients37:00
are found in a food which can help us if we have allergies food intolerances um or we don't like a37:08
certain uh ingredient uh in a food um now what you need to be careful though37:14
is is my rule of thumb is to say look at the first three ingredients if the first37:20
three ingredients have a starch a flour uh sugar or anything in the end37:27
with o e dextrose glucose fructose37:33
maltose those are all sources of carbohydrates and you need to be careful37:38
and if it's in the top three ingredients it's likely a higher proportion in that37:43
food um product there so you can be careful watching what you're consuming37:50
and and what's being put into those Foods now I haven't written it down here37:57
it's not on the slide but lastly I think it's really important to take a look at Health claims on labels just because a38:03
food has a health claim doesn't mean that it's a food that's good for you for example there's some kinds of candies38:10
out there that promote fat-free but we know that there's a lot38:15
of sugar in them and there's other things that say no added sugar or dietetic food but they still may have a38:23
lot of carbohydrates in them even if they aren't sugar that's in it or if it's dietetic what does that mean what38:30
do these terms mean so you want to be careful when you're looking at a label and and do a little more38:40
sleuthing now just because you're trying to change your eating habits to uh help38:46
you with diabetes does not mean you can't eat out okay it can be a38:52
significant part of business dinners can be a nice social Gathering or it can38:57
convenient option when you don't have the time to cook and with a bit of planning you can make nutritious choices39:03
the next time you eat out and your blood sugars will appreciate it now keep in39:09
mind many restaurants actually have a menu and their nutrition information listed online so if you have the time39:16
take a look at that menu before you actually go to the restaurant sometimes by the time we're at the restaurant or39:23
the time we're at the the takeout line there we're looking at at at you know the most desirable food and perhaps our39:29
appetite is is on high alert there we may not be picking the best choices so39:35
if you can decide ahead of time that may help make better options for you keep39:41
that balance plate in mind ask for a salad as an appetizer instead of the garlic bread that's put in front of you39:48
uh pick two veggie options instead of potatoes with your steak have the smaller steak not the larger one or if39:55
you want to have a small piece of pie after maybe you don't have as much of the starch with your meal and the40:01
breaded um cheese sticks uh to be start off with watch the portion sizes as I40:08
mentioned about the steak and the large uh amount there portion sizes in fast40:13
food restaurants and uh restaurants tend to be typically much larger than at home40:21
leading us to eat more because wow we paid for it it tastes good why wouldn't40:26
we listen to your body and try to stop before you are full ask for a takeout container leave40:34
it aside put your napkin on it uh you want to be careful because those extra40:40
portions if done on the rare occasion may not be a problem but if eating out40:46
is something you do on a regular basis could be the difference between you managing your blood sugars optimally or40:55
not some of the things that like to suggest to people is ask for half portions share an entree share an41:02
appetizer um as I mentioned package it up to go uh so that you're not stuck41:08
with the food in front of you and just eating because it's there not because you're hungry ask how food is prepared maybe41:16
you prepare your chicken a certain way but the way they do it in the restaurant41:21
might have added salts or or sauces and things like that order foods that have been steamed41:28
baked broiled grilled roasted similar to how I was mentioning how you would do it at at home don't forget about the41:36
breading or the batters that can come on Foods the sauces the dressings they all add some of those extras that you may41:42
not be putting on your foods at home yes it may taste Ultra good but it may have41:48
a a bad effect on your overall health I also caution about the41:54
sweetened drinks or alcohol drinks that that uh that might be served when you're eating out at a restaurant if you do42:01
drink alcohol limit it to when you're eating a meal um as it can affect your blood sugar levels and interact with42:07
some of the medications you take and talking about medications and the timing of your of your eating be careful about42:14
this the more you uh deviate from uh consistency in your medication times42:20
that you take uh me meds or the times that you eat the more can have an impact42:26
on your blood sugars and your diabetes management bottom line healthy eating takes a bit of planning when you're42:33
going out but once you do it you can do it without compromising your diabetes management and enjoy eating out with42:40
friends family or if it's for business now we're getting towards the42:47
end of things here and I'm trying to sum things up here and see if I can help you to find out what is right for you but42:54
healthy eating patterns and healthy eating habits can not be easily defined as just one thing because it's different43:00
for every person as I mentioned before there's no one diet fits all to some43:06
healthy eating May mean eating more variety of foods and that's the change that you make and to others it might43:12
mean trying to eat out less or less take out Foods your healthy eating pattern must43:18
take into consider the factors like health conditions culture and religious43:23
reasons food aversions socioeconomic status any factors that are important to you43:30
okay and working with a diabetes educator or you yourself can look at all these factors to see how they can help43:37
you or how they may become a barrier to planning a healthy meal pattern uh for43:42
diabetes management but it can be done now some of the healthy eating patterns43:47
that I know that I've seen out there that work for people would be following a Mediterranean style diet a Nordic43:54
style eating pattern the DASH diet you may have heard of vegetarian style diet43:59
now these are all dietary patterns that work very well with diabetes friendly food choices they're rich in protective44:06
Foods as I mentioned from a cardiovascular perspective they might have lots of antioxidants they could be44:12
high in fiber they may be low in processed foods um but these are all things that44:17
you want to take a look at when you're planning what your healthy eating pattern is so let's try these things on44:23
for size can you eat three meals a day and snacks as needed okay try to eat44:30
something within two hours of waking and avoid going more than six hours between wake in waking hours between meals and44:38
snacks consistency of meal timing will also help you get a better understanding44:43
of what your blood sugars are doing don't forget to eat a variety of foods to get the right amount of protein44:50
and fiber in your diet because this too will help with your blood glucose44:56
levels remember that plate concept for planning meals try to balance it with three or45:02
four of the food groups that we initially talked about at meal times and as needed with a source of protein with45:09
another food group if you need a snack if there's been long periods of time without eating or perhaps you're doing45:15
extra physical activity um more than usual this balance will help you to get45:20
the fuel that your body needs while avoiding the spikes in blood sugar levels switching to lower glycemic at45:27
foods that might be your healthy eating pattern change that you're going to make um and finding ways to do it that are45:35
enjoyable sip on water or other low calorie fluids throughout the day to stay hydrated watch out for your45:41
caffeine and alcohol intake dipping energy levels can be a result of not45:47
getting enough fluids and getting the right fluids will leave your body and mind feeling much45:54
better and if you don't have those fluids that can leave you feeling mentally and physically exhausted and46:01
putting you at risk for overeating or making inappropriateConclusion46:06
choices cutting back on ultr processed foods you know those packaged foods that46:11
I was referring to before um can be also a way to help develop a healthy eating46:20
pattern now I'm going to say I love this slide here of a puzzle pieces and I46:26
don't know if any of you use puzzles but you might be feeling quite puzzled right now by all this information that I've46:32
shared with you but I assure you once you start fitting all these pieces together you will see the bigger picture46:39
if it's not just through this session but other sessions that you will be46:44
watching improved eating habits feeling more in control of the things that you do have control over are just one step46:51
closer to you having better diabetes management I'll hope you come to realize46:57
that you don't have to have all the pieces to the puzzle here to know what the bigger picture looks like it's not47:03
an All or Nothing But fitting in some of the little pieces bit by bit as you go47:10
along your journey I will finish with leaving you with this 8020 rule when it comes to47:17
eating if you can follow the guidelines 80% of the time you will be in a very good position to having a better47:24
understanding of how your body and your blood sugar respond to your eating habits this will allow you that47:30
flexibility 20% of the time to find out what works best for you and continue to47:36
make modifications I thank you for participating in today's session I wish47:42
you good health and I hope you found a couple of key takeaways that you can start working on in the days to47:55
follow
Speaker: Pamela Piotrowski, RD, CDE
0:00
[Music]0:08
welcome to the first episode in our nutrition education series for people living with diabetes whether you're just0:14
starting out on your diabetes Journey or are a Season Pro who could use a quick refresh this session offers all the0:20
basics when it comes to healthy eating and diabetes registered dietitian and certified diabetes educator Pamela0:27
Petroski will explore healthy choices the recommended plate model and the recommended eating pattern to maximize0:34
your energy and nourishment as well as help manage your diabetes over to you0:39
Pam hello my name is Pam and today during today's session we're going to review why healthy eating is essentialOverview0:46
to everyone for promoting good health minimizing injury and reducing the risk0:52
of diseases and why this is so important for diabetes management itself we will examine the rationale0:59
behind this concept of a balanced plate how it applies to your individual meal1:05
choices as well as dive a little bit deeper into the importance of key elements that provide energy from the1:11
foods that we eat and the role they may play in blood sugar control and so you aren't confused I may interchange the1:18
words glucose and sugar when I'm referring to what it is that's in your blood but it's the same thing so I hope1:24
you can keep up we'll start to crack down on the code of reading labels to1:29
help help make better choices it might take you a little bit of time in the beginning to figure out these labels but1:35
once you've got it you'll be well on your and we're going to organize all this information to develop a healthy1:41
eating pattern that works for you let me start by saying the most important thing1:47
there is no diabetes specific diet as diets are hard to follow in the long1:53
term as you may have found out in the past but what is important is the what1:58
somebody eats the how much they eat and the when they eat that's really2:04
important when we talk about making better food choices and planning healthy meals for diabetes2:10
management when people learn how these aspects of their eating habits can impact their health they will be able to2:16
make changes small or large to improve their blood sugar control and reduce the2:21
risk of complications so let's get going hereFood Nutrition2:28
food and nutrition important elements of diabetes management as I mentioned now I2:33
want you to think of food and nutrition as a as a type of treatment no different2:39
than medications or physical activity is for people living with diabetes and throughout this video we are going to2:45
focus on the food and nutritional aspects that are part of your diabetes2:51
selfcare learn how different foods affect your blood sugars because at different times of our lives our blood2:57
sugars may be affected differently by some of the quantities and the types of foods that we're eating and what that3:04
means to your risk of complications down the road as well as how small changes can make big3:11
differences while it's natural to have questions about nutrition and what foods to eat we're going to try to untangle3:17
some of that dietary advice that may be on the internet that you've already noticed or it may come from wellwishers3:23
to help you manage your diabetes that is evidence-based so be careful of the3:29
potential for false promises but maybe with bad diets supplements special3:35
diabetic or dietetic Foods it's always best to talk with your healthc care professional before putting your trust3:42
in potential misinformation out there and this could harm you instead of helping you I encourage you to go to3:50
diabetes.com3:58
stroke.com discussing and throughout keep in mind that there is no one diet fits-all4:04
approach finding out what works for you is most important to keeping youWhat Works For You4:13
healthy because eating is something that we need to do on a daily basis it we need to find out that right balance to4:19
keep ourselves healthy while still promoting good health and quality of life often people think that once they4:26
get their A1c to Target that they can go back to their old eating habits but remember what we said about healthy4:33
eating patterns being like a treatment for diabetes you take away that treatment and the blood sugars will4:38
creep back up so try to find that will what will work for you in the long run4:44
small changes can make the difference and you might find that you're doing all4:49
of these things already and it's still not making a difference it's always best again to talk with your diabetes4:56
educator to see what other changes might need to be made throughout your diabetes5:01
management so let's move on and and try to find what will work for you in the long run picking healthy food choices5:08
more often will help to provide energy to do daily activities fuel your muscles5:14
prevent injury and also help with your mood all things that are most important for managing diabetes and reducing your5:21
risk of diabetes or its complications but beyond controlling blood sugars healthy eating can also5:28
help you manage weight and as I said lower your risk of other complications or other chronic conditions like heart5:34
disease that is more prevalent in people that have diabetes high blood pressure5:40
osteoporosis arthritis certain forms of cancer are all linked to what we eat so5:45
here's another good reason for why healthy eating matters eating well is good for overall5:51
health and there's many ways to do it I want you to pick what might work for5:58
you so what are the basics of healthy eating you might ask or maybe you already know think of it as a shift ofBasics of Healthy Eating6:05
food choices that can be done by eating more of certain types of foods replacing6:11
current choices with better options or limiting your consumption of less desirable Foods as we'll talk about6:17
throughout the session it's key to have a variety of foods but that doesn't mean that you6:23
have to eat all foods to ensure that you're getting all the nutrients like vitamins and minerals that are found in6:30
different food groups those food groups being fruits and vegetables meat and6:35
protein Alternatives dairy products and Grains and starchy Foods by the way I'm6:41
not a fan of kale but I try to pick other green leafy vegetables to get similar nutrients and as always make6:48
sure you're drinking water or low calorie beverage to keep well hydrated that is still part of a healthy eating6:55
pattern I know that cost in availability can be challenging to some where possible pick whole foods to avoid7:02
excess salt sugar preservatives that are usually found in packaged and ultr7:08
processed foods in some cases Frozen and canned can be just as healthy and maybe7:14
a better alternative preparing meals yourself gives you the advantage of knowing how what's going into your meals7:22
how you're preparing them and how it's making a difference on your diabetes control but it does involve a little bit7:29
of planning ahead of time I will warn you about that but once you get the hang of it you'll be right on your way so my7:37
first question to you is what do you do do you eat to live or do you live to eat7:45
some people will say that they know when their body is full and others may have difficulty with figuring out when to7:51
stop and when they're full have you ever eaten because you were bored feeling down or just because7:58
the food was staring at you on the table be aware of the different reasons for why you're eating by all means if you're8:05
feeling hypoglycemic please eat some sugar but be mindful of why you're eating what you do and that can be just8:13
as important as what you're eating some people may find that a strict routine with their food intake8:19
helps manage their blood sugars perfectly but only you will know if that's something that's sustainable for8:25
you meaning can you do it in the long term because this is something that you want to do for the long8:31
run it's important to find a way to enjoy what you're eating because it is8:37
something we have to do on a daily basis please look for ways to prepare meals that work for you because if you don't8:44
enjoy food preparation or perhaps eating becomes socially8:49
undesirable it can be a very stressful part of your day-to-day routine rest assured the more you become8:57
aware of what healthy eating can mean to you you and your blood sugar control and9:02
how you can learn how your body reacts to different foods at different times in9:07
your life uh with different situations you will find eating can be done in a way that is not considered9:14
difficult while still enjoying social aspects and reaping in all the nutritional9:20
benefits if you were to write down what you ate for a week what would your food or meals look like could you make some9:28
changes right now with what we've already talked about we're learning more and more about9:34
the importance of good nutrition and healthy food choices for day-to-day wellness and for reducing the risk of9:39
injury and chronic disease but what it means to you I might say again I may ask9:45
in five years and it might be different information so it's great to keep up to date on this9:54
information now look at this plate it looks amazing but it also looks a bit confusing using so here's what we'reThe Balanced Plate10:00
going to talk about with the concept of a balanced plate it's one of the most important diet habits you can do by10:08
picking half of your plate of vegetables vegetables are high in nutrients that10:13
the body needs to be healthy and because non-starchy vegetables tend to be higher in fiber and water content this can help10:21
to keep you full longer and control the amounts of other foods that are you're putting on your plate and that may10:28
control your blood sugars the other part of that half a plate can be divided up again so that a quarter is10:35
coming from protein foods and you want to be looking for lean proteins and10:40
plant proteins as well as fish to be part of that quarter of your plate try to eat at least two servings10:48
of fish each we week and maybe try different recipes that include plant-based things like tofu or legumes10:55
nuts and seeds as great sources of protein as well and last but not least fill that11:02
remaining quarter of your plate with your carbohydrates or what's commonly known as grains or starchy vegetables11:08
picking whole grains and crackers brown or wild rice quinoa oatmeal barley11:14
potatoes with their skins on are all going to be ways to fill that quarter of the plate while keeping you11:22
full now think about it was the plate that at your last meal did it look like11:27
this was the was the balance the same way perhaps there's a little bit more11:33
that you can add to that half of vegetables and a little less to the pasta that you may have consumed last11:39
night eating Foods in moderation will allow you to get the energy that your body needs as well as including enough11:46
fiber enough energy enough protein that all makes a healthy11:52
diet or as I say a healthy meal pattern a couple of tips that I might11:58
add to this is looking for bright vibrant colored vegetables so look for the oranges the12:05
greens the Reds in your vegetables if you can leave the skins on for extra fiber prepare your Foods in a healthy12:12
way baking broiling steaming poaching stir frying but you might say wow a12:18
plate with a piece of plain chicken a baked potato and some steamed broccoli12:24
and carrots just doesn't sound appealing so here's where you want to take some of your favorite recipes or the meals that12:31
you already consume and modify them a bit so that this balance holds true12:37
perhaps it's adding more vegetables to your uh to your meal perhaps it's12:43
pureeing some vegetables and making them into a sauce for your potatoes maybe12:48
it's adding um a salad before your meal so that we still have that balance of a12:55
half coming from vegetables a quarter coming from protein and a order coming from carbohydrates even if you have a13:02
recipe think of the ingredients that you're consuming and how you might rearrange the quantities of the foods in13:08
there so that you have this balance be careful though if you consume13:14
too many of the refr refined grains like bread pasta minate rice these may cause13:20
spikes in your blood glucose even if you are consuming only a quarter of your plate of them so be careful as you will13:27
notice this plate doesn't have any dairy products on it it doesn't have dessert on it so even a glass of milk and a13:33
piece of fruit after your meal could be healthy alternatives but be careful13:39
limit sugars and sweets for desserts that we sometimes have like cookies and ice cream cakes and Pie if you are going13:47
to consume a small quantity of that try to work it back into that balanced plate13:52
perhaps you eat a little less of the pasta or the potato if you know you're going to have some cookies perhaps you13:59
have less fruit and if you're going to be having some pie or an apple crisp so14:04
that you can still balance all the nutrients that your body requires and remember we're trying to do14:11
these things in moderation so it's not a complete Turn Around from today to tomorrow's14:18
meals another thing I want you to be cautious about is high fat and greasy Foods okay they won't necessarily affect14:25
your blood sugar now but they may affect your digestion they may also impact your weight going14:32
down going further and that may impact your diabetes Management in the long term so be careful with fried potatoes14:39
creamy sauces battered or breaded foods and of course that hydration14:45
factor is so important um it could be some low-fat milk it could be having14:50
water unsweetened tea or coffee plain broth could be a great addition to your meals but be cautious with regular pop14:58
even fruit juice or sweetened tea can raise your blood sugar and cause15:03
problems uh down for15:10
you now let's take a look at those sources of energy that I mentioned coming from the balance plate I made aCarbohydrates15:18
comment about carbohydrates or grains and starchy Foods so did you know that15:23
carbohydrates are the body's preferred source of energy the sugar that comes from all sources of carbohydrates is15:30
otherwise known as glucose when it enters into the bloodstream and that's why we have such15:35
an emphasis on carbohydrates when we talk about why we need to be careful with the quantity of the foods15:41
containing and how they impact our diabetes management converting carbs into15:47
immediate usable energy is easier for the body than using fat or protein as an15:54
energy source did you know that your brain muscles cells all need15:59
carbohydrates to function which is why a very low carb diet is not really healthy16:04
at all depending on the type of carbohydrates that you're consuming the food is converted into sugar or glucose16:11
at varying rates as it enters the bloodstream after being digested and metabolized it's either transported into16:18
the body through insulin to the cells or it's used later as a storage of energy16:26
if there's not enough insulin from within your body or you're not taking16:31
the right or enough of diabetes medications to help with that transport16:36
the glucose is left circulating in the bloodstream and this is where the complications of diabetes come into16:42
effect when your blood sugar levels are above Target for too long and cause16:48
damage to the vessels leading to other parts of your body the Dietary Reference16:53
intake for Canadians suggests a minimum of 130 gram of carbohydrates per day or17:00
45 to 60% of the total calorie intake coming from17:05
carbohydrates but what does that mean specifically for you well the easiest way in today's session is to have you17:11
refer back to that balance plate looking at a quarter of what you're eating coming from the starches or the grains17:17
that you're consuming now if you're working with a dietician or diabetes educator they can17:24
help you go into more detail with carb counting and what the ual number might mean for you throughout your meals and17:32
daily intake although being aware of how much carbohydrate you're consuming is key equally important to the is the17:40
quality of that carbohydrate not just the quantity now I probably don't need17:46
to tell you where carbs are found but as a refresher you'll find them most abundantly in grains starchy vegetables17:53
fruit milk and of course various forms of sugars and sweets but the healthiest sources are going to come from17:59
unprocessed or minimally processed foods not only will you naturally get18:06
the most vitamins and minerals but they're probably going to be higher in fiber and more likely to have something18:12
called a lower glycemic index that we're going to talk about in a bit these are also referred to as18:18
complex carbs and your intake of carbs should consist mostly of these18:24
sources now you can still eat other types of carbs and less optimal sources18:30
would be things like white processed bread fruit juices desserts or other18:35
highly refined or processed foods you know honey maple syrup molasses all seem18:42
to have really healthy benefits um and may seem like healthier versions to18:47
sweeteners but really from a diabetes perspective they're no different than just eating straight table sugar and18:54
using it only if you're having a hypoglycemic reaction also known as simple carbs these things19:01
are easily digested and quickly brought to your bloodstream so that's something19:07
to be aware of because if you're not taking enough medication or your insulin19:13
is not working the same way as someone without diabetes this could cause problems with your blood sugar staying19:20
at Target but it also could interfere with weight management increased risk of19:25
heart disease and batty liver many people are confused about19:30
carbohydrates maybe you are right now but keep in mind that if you're just starting out it's important to eat a19:37
moderate amount of carbs and then try to pick the healthier sources then to19:42
follow a strict diet or totally removing them from your eating habits right now remember small changes can produce big19:50
differences in your diabetes management as I previously mentioned protein is anProtein19:56
important part of healthy eating for many reasons including growth and repair of body tissues such as muscle bone skin20:04
hair and virtually every other part of your body and like carbohydrates protein provide energy but it's not the body's20:12
preferred source of fuel from a diabetes perspective it's an important part of a20:17
meal to help regulate how quickly a meal is digested thus keeping you full longer20:24
and helping to reduce those spikes in blood sugars after eating including more20:29
plant-based proteins and fish is also beneficial as I mentioned before from both a diabetes and a heart health20:36
perspective the best picks from this food group would be leaner cuts of meat those with less marbling more fatty20:44
fishes uh low-fat dairy products eggs plant-based choices like soy tofu uh20:51
nuts seeds legumes now you can find small amounts of protein in grains and20:57
some vegetables but I don't consider them one of your better choices be careful with how those21:03
protein foods are prepared as some may be prepared with extra sodium from sauces or extra carbs from batter or21:10
breading and watch out for the skin on poultry or that marbling in your meat21:15
because those can contribute to unhealthy fats that we'll talk about in aFat21:22
minute so what about fat we used to think fat was really bad for us now we21:27
know a little bit different that fat is the most calorie dense food that we eat and we do need some of it not only is it21:34
a source of energy for our body but it assists with the growth and development of cells and helps the body absorb21:41
certain essential fatty acids or fat soluble vitamins the problem is with fats is21:48
that they're not all created equal the key to understanding the health aspect of fats is considering the21:55
total amount and knowing what type of fat is is saturated or trans fats you may have22:02
heard okay are also referred to as the bad fats in the diet and they're primarily found in animal sources22:09
including whole fat dairy products coconut and palm oil are the only two22:15
plant sources that I know of that are saturated fats in the diet and you want22:20
to be careful with them they may have other health benefits but from a cardiovascular perspective uh they can22:28
clog your arteries and contribute to your cholesterol levels unsaturated fats that would be22:34
monounsaturated polyunsaturated aka the good fats in our diet are mostly found22:40
in things like nuts and seeds avocad soybeans as well as all of their oils22:46
and those fatty fishes that I had referred to an easy way to remember the difference between the good and the bad22:52
fats in your diet is that the healthier ones the unsaturated ones are liquid at room temperature as in this picture here23:00
and the unhealthy fats are usually solid and you wouldn't want to have solid fat clogging up your blood23:07
vessels the main issue health issue with those saturated fats is its effect on cholesterol levels or the risk of heart23:13
disease which is also a significant risk for people living with diabetes so be careful with the quantities and look to23:20
see where they're found in your diet you may not be able to remove all23:25
of the uh saturated fats in your diet but kind back is definitely a healthy23:30
way to go about the heart healthy aspect of your diet but regardless of the types23:37
of fat as I mentioned the total fat content is something you also want to be aware23:43
of as this is something that can contribute to Central adiposity or that23:48
weight that's carried around your middle section which is linked to insulin resistance and diabetesFiber23:57
management o fiber my friend it's a non-digestible carbohydrate Source24:03
naturally found in plant Foods it's found in things like the berries here other fruit veggies nuts24:11
seeds legumes whole grains as well as made into fiber24:17
supplements but the more a food is processed or refined the less natural occurring fiber is left in it unless24:26
it's added back during the processes or the manufacturing the good news about fiber24:32
is that the body is unable to break down and absorb this type of carbohydrate it doesn't cause a spike in blood sugars24:39
the way other carbohydrates can and in fact can actually help reduce the spikes in your blood24:44
sugars now to be clear there are two types of fiber soluble and INF soluble24:51
each one has important health benefits and plays a different role in the body soluble fiber dissolves in water forms a24:59
gel-like substance in your stomach that slows down digestion attaches to fatty25:05
acids to help remove them out of the body and in doing so can help control your blood sugar and cholesterol levels25:13
some good sources of soluble fiber that come to my mind are apples bananas oats25:18
peas black beans limma beans Brussels FRS avocados there's so many different25:24
sources of soluble fiber and you can find those lists on some of those websites ites that I've referred to25:30
previously now insoluble fiber equally as important but doesn't dissolve in25:35
water so if you were to compare two different soluble fi soluble and insoluble you would find that the25:42
insoluble fiber that comes usually um in whole grains uh the skins and the seeds25:49
and everything just sits at the bottom of your water glass there but it's so important because it25:55
actually is not broken down passes through your intestine and is a great way to remove some of the waste that26:02
collects in our intestine while all fiber is good for26:07
you my only word of caution is to be careful on how you increase the amount26:13
of your daily intake make sure you do it gradually and make sure that you're drinking adequate fluids and moving26:20
around otherwise you may run into some distressing bloating or gas or other gastrointestinal side effects as we26:27
learned more and more about its role in the health of our gut immunity and26:32
anti-inflammatory properties this also holds true for how it manages yourGlycemic Index26:40
diabetes now I referred to something called the glycemic index a while back26:46
and what is this glycemic index it's a scale that ranks a carbohydrate containing food or drink by how much it26:53
raises blood glucose level levels after it was consumed so as you can see on26:59
this chart here this graph foods with a high glycemic index rise blood sugars27:06
really quickly and faster than foods with a lower glycemic27:12
index as we know it also as the GI index it assigns a number to a food based on27:19
how drastically it makes your sugar rise and then come back down you will see after two hours your sugars are at the27:27
same level but it's what happens in between during that 2hour period that27:33
can also have an impact on Diabetes management and27:38
complications now these foods are ranked on a scale of 0o to 100 with pure27:43
glucose or table sugar given a value of 100 the lower a food's glycemic index27:50
the slower the blood glucose Rises after eating that food and that's a very good thing as seen in the yellow graph here27:59
generally speaking the more processed a food is um the carbohydrate food is the28:05
higher it's glycemic index is take for example a slice of French baguette bread28:11
its glycemic index is 95 so eating the same amount of grams of carbohydrate of28:19
of white bread when you compare it to something that has more fiber or fat in28:24
it I'm thinking maybe a half a cup of cooked barley that has a lower glycemic28:30
index one of something like 22 you can see how they may impact your blood28:35
sugars at one hour out or at a half an hour out if you were checking your blood28:41
sugars um after your28:46
meals to simplify things there's a chart on the28:52
diabetes.com medium and high glycemic index Foods I don't want you to get28:57
caught up on the exact numbers but to try and collectively put them in as they29:03
have them green categories for go low glycemic index food medium uh ones and29:10
then the high ones that we should try to eat a minimal amount of keep in mind that if you have protein29:17
foods or sources of fat or Fiber um in the foods that you're29:23
consuming or can add them to your meal that can lower the glycemic index of the total Meal which might have the same29:30
benefit than picking just low glycemic index Foods how can this help you make better29:38
choices well choosing lower glycemic index more often than high glycemic index foods will not only help you with29:45
realtime control of your blood sugars as I mentioned if you were checking them um but it'll help you keep full longer29:52
promote weight management and also help lower the risk of some of those diabetes complication in including the risk of29:58
heart disease and stroke and as I mentioned even if you can't remove all the high glycemic index30:04
foods from your diet try just lowering the glycemic index of the meal by adding a source of protein even if it's a glass30:11
of milk or some nuts um to your to your grains leave the30:17
skins on your potatoes have fruits and vegetables where possible um so that you30:23
can add extra fiber to your meal and another thing that people aren't weren't30:28
aware of is to cook pasta and rice undercooked a bit alante you might be30:34
familiar with that term because the more something is processed the higher the glycemic index so if we can undercook30:40
something not meaning you eat it raw um but that's also going to lower the glycemic index uh as your body takes it30:48
in but remember just because a carbohydrate containing food has a low30:54
glycemic index attached to it you still need to be careful with how much you're consuming total because the total grams31:01
of carbs whether it's a low or a high glycemic index food will still impact your blood sugarFood Labels31:10
control so one of the things that most people um have problems or tell me that31:17
they're confused about is reading food labels and just as I mentioned previously about picking less processed31:23
foods it doesn't mean that you can't eat foods that have a a label on them but31:29
the key is being able to understand what you're looking for so let's try to break31:34
this down into three little easy steps so a label can help determine if it is a31:40
good choice or whether you should think twice about something when you're picking it up on the shell when you know what your things31:47
you're looking for this is a great way to be able to compare different foods maybe there's a better option that you31:53
didn't realize in the same category of foods31:58
most Foods packaged in Canada have to have a nutrition fact table like the one you see here on the slide notice the32:05
first red back box that's probably most important because that's the serving32:11
size that all the rest of the information in this nutrition facts table is based32:16
on so if you see this it's 107 calories for this serving but only if you're32:23
eating this serving of 12 crackers so you need to determine is this the32:29
serving size that I'm eating or is it another amount that is my portion and be able to adjust the numbers based on32:38
that specifically though when you're looking at from a diabetes and a blood sugar management um perspective you'll32:46
see in bold that we have those micro or macronutrients we were talking about32:51
before fat carbohydrate and protein and they're bolded underneath and indented below32:59
each of that Bolding listed is subcomponents of those Foods remember I referred to saturated fats before as an33:07
unhealthy part of the total fat intake and for carbohydrates specifically from33:12
a diabetes perspective you'll see that the total amount of carbohydrates in33:17
these 12 crackers is 27 grams but this can be confusing because when you indent33:24
you see that fiber is a component of it sugars might be a component of it from what is added in the preparation of of33:31
these crackers you might see sugar alcohols you might see starch all of33:36
these subcomponents that are indented add up to the total amount of33:42
carbohydrate so if you trying to determine how many grams of carbs you're33:47
actually consuming from this label the number would be 27 but wait because fiber is that33:56
carbohydrate food that your body can't digest it means you get to subtract the fiber content from that total34:03
carbohydrate so really there's 26 grams of carbohydrates in34:08
this so this makes it a little bit easier to see that a food that is34:13
contains a lot of fiber may have a lot more carbohydrates but really you34:18
subtract that amount of fiber from the total carbohydrate and that's how you would determine how many grams of carbs34:26
your body is actually getting and turning into sugar in your34:32
body now one of the things that a lot of people will do is that they will count their carbs and be able to swap things34:37
out meaning that there's 12 crackers for 27 grams of of carbs and if you know34:44
that a slice of sandwich bread is 15 grams of carbs or half a cup of cooked pasta is 15 grams of carbs you could say34:52
do I want some soup broth with 12 crackers or would I like to have two34:57
slices of sandwich bread or do I want six crackers and one slice of sandwich35:03
bread to get 30 gram of carbs let's say if that's what I'm consuming at my meal35:10
this is where it can can get confusing but you know what I think we're going to have more discussion on this in another35:16
session and as well when it talks about fat and protein I'm going to leave that35:22
to another session on label reading now that second box probably35:29
another confusing thing to you what is percent daily value or DV the percent DV35:36
is meant to act as a benchmark to determine if a food is high or low in a certain nutrient compared to what the35:43
daily recommended intake value is for Canadians now this is an average it's35:50
based on an average eating of 2,000 calories per adult but what does this35:55
mean specifically to you well a food is considered low in a specific nutrient if36:01
there's less than 5% DV so take a look on that side panel there of the label36:07
and look to see if any of these foods are less than 5% and they would mean that that's a a low intake of that so36:14
there's really not very much fiber uh in this food product but sodium on the other hand has 16% and we will say that36:23
if food is considered high in a nutrient if it has more than 15% % of of daily36:30
value in the case of sodium of course maybe this is something you want to be36:35
aware of and eat less of because you're also watching your blood pressure or you've eaten other high salty foods that36:42
day so this is how you can compare two labels of crackers and pick which one36:48
might be the more desirable choice and last but not least the third box that I36:53
want to draw your attention to is the ingredient list of things okay and that tells us what ingredients37:00
are found in a food which can help us if we have allergies food intolerances um or we don't like a37:08
certain uh ingredient uh in a food um now what you need to be careful though37:14
is is my rule of thumb is to say look at the first three ingredients if the first37:20
three ingredients have a starch a flour uh sugar or anything in the end37:27
with o e dextrose glucose fructose37:33
maltose those are all sources of carbohydrates and you need to be careful37:38
and if it's in the top three ingredients it's likely a higher proportion in that37:43
food um product there so you can be careful watching what you're consuming37:50
and and what's being put into those Foods now I haven't written it down here37:57
it's not on the slide but lastly I think it's really important to take a look at Health claims on labels just because a38:03
food has a health claim doesn't mean that it's a food that's good for you for example there's some kinds of candies38:10
out there that promote fat-free but we know that there's a lot38:15
of sugar in them and there's other things that say no added sugar or dietetic food but they still may have a38:23
lot of carbohydrates in them even if they aren't sugar that's in it or if it's dietetic what does that mean what38:30
do these terms mean so you want to be careful when you're looking at a label and and do a little more38:40
sleuthing now just because you're trying to change your eating habits to uh help38:46
you with diabetes does not mean you can't eat out okay it can be a38:52
significant part of business dinners can be a nice social Gathering or it can38:57
convenient option when you don't have the time to cook and with a bit of planning you can make nutritious choices39:03
the next time you eat out and your blood sugars will appreciate it now keep in39:09
mind many restaurants actually have a menu and their nutrition information listed online so if you have the time39:16
take a look at that menu before you actually go to the restaurant sometimes by the time we're at the restaurant or39:23
the time we're at the the takeout line there we're looking at at at you know the most desirable food and perhaps our39:29
appetite is is on high alert there we may not be picking the best choices so39:35
if you can decide ahead of time that may help make better options for you keep39:41
that balance plate in mind ask for a salad as an appetizer instead of the garlic bread that's put in front of you39:48
uh pick two veggie options instead of potatoes with your steak have the smaller steak not the larger one or if39:55
you want to have a small piece of pie after maybe you don't have as much of the starch with your meal and the40:01
breaded um cheese sticks uh to be start off with watch the portion sizes as I40:08
mentioned about the steak and the large uh amount there portion sizes in fast40:13
food restaurants and uh restaurants tend to be typically much larger than at home40:21
leading us to eat more because wow we paid for it it tastes good why wouldn't40:26
we listen to your body and try to stop before you are full ask for a takeout container leave40:34
it aside put your napkin on it uh you want to be careful because those extra40:40
portions if done on the rare occasion may not be a problem but if eating out40:46
is something you do on a regular basis could be the difference between you managing your blood sugars optimally or40:55
not some of the things that like to suggest to people is ask for half portions share an entree share an41:02
appetizer um as I mentioned package it up to go uh so that you're not stuck41:08
with the food in front of you and just eating because it's there not because you're hungry ask how food is prepared maybe41:16
you prepare your chicken a certain way but the way they do it in the restaurant41:21
might have added salts or or sauces and things like that order foods that have been steamed41:28
baked broiled grilled roasted similar to how I was mentioning how you would do it at at home don't forget about the41:36
breading or the batters that can come on Foods the sauces the dressings they all add some of those extras that you may41:42
not be putting on your foods at home yes it may taste Ultra good but it may have41:48
a a bad effect on your overall health I also caution about the41:54
sweetened drinks or alcohol drinks that that uh that might be served when you're eating out at a restaurant if you do42:01
drink alcohol limit it to when you're eating a meal um as it can affect your blood sugar levels and interact with42:07
some of the medications you take and talking about medications and the timing of your of your eating be careful about42:14
this the more you uh deviate from uh consistency in your medication times42:20
that you take uh me meds or the times that you eat the more can have an impact42:26
on your blood sugars and your diabetes management bottom line healthy eating takes a bit of planning when you're42:33
going out but once you do it you can do it without compromising your diabetes management and enjoy eating out with42:40
friends family or if it's for business now we're getting towards the42:47
end of things here and I'm trying to sum things up here and see if I can help you to find out what is right for you but42:54
healthy eating patterns and healthy eating habits can not be easily defined as just one thing because it's different43:00
for every person as I mentioned before there's no one diet fits all to some43:06
healthy eating May mean eating more variety of foods and that's the change that you make and to others it might43:12
mean trying to eat out less or less take out Foods your healthy eating pattern must43:18
take into consider the factors like health conditions culture and religious43:23
reasons food aversions socioeconomic status any factors that are important to you43:30
okay and working with a diabetes educator or you yourself can look at all these factors to see how they can help43:37
you or how they may become a barrier to planning a healthy meal pattern uh for43:42
diabetes management but it can be done now some of the healthy eating patterns43:47
that I know that I've seen out there that work for people would be following a Mediterranean style diet a Nordic43:54
style eating pattern the DASH diet you may have heard of vegetarian style diet43:59
now these are all dietary patterns that work very well with diabetes friendly food choices they're rich in protective44:06
Foods as I mentioned from a cardiovascular perspective they might have lots of antioxidants they could be44:12
high in fiber they may be low in processed foods um but these are all things that44:17
you want to take a look at when you're planning what your healthy eating pattern is so let's try these things on44:23
for size can you eat three meals a day and snacks as needed okay try to eat44:30
something within two hours of waking and avoid going more than six hours between wake in waking hours between meals and44:38
snacks consistency of meal timing will also help you get a better understanding44:43
of what your blood sugars are doing don't forget to eat a variety of foods to get the right amount of protein44:50
and fiber in your diet because this too will help with your blood glucose44:56
levels remember that plate concept for planning meals try to balance it with three or45:02
four of the food groups that we initially talked about at meal times and as needed with a source of protein with45:09
another food group if you need a snack if there's been long periods of time without eating or perhaps you're doing45:15
extra physical activity um more than usual this balance will help you to get45:20
the fuel that your body needs while avoiding the spikes in blood sugar levels switching to lower glycemic at45:27
foods that might be your healthy eating pattern change that you're going to make um and finding ways to do it that are45:35
enjoyable sip on water or other low calorie fluids throughout the day to stay hydrated watch out for your45:41
caffeine and alcohol intake dipping energy levels can be a result of not45:47
getting enough fluids and getting the right fluids will leave your body and mind feeling much45:54
better and if you don't have those fluids that can leave you feeling mentally and physically exhausted and46:01
putting you at risk for overeating or making inappropriateConclusion46:06
choices cutting back on ultr processed foods you know those packaged foods that46:11
I was referring to before um can be also a way to help develop a healthy eating46:20
pattern now I'm going to say I love this slide here of a puzzle pieces and I46:26
don't know if any of you use puzzles but you might be feeling quite puzzled right now by all this information that I've46:32
shared with you but I assure you once you start fitting all these pieces together you will see the bigger picture46:39
if it's not just through this session but other sessions that you will be46:44
watching improved eating habits feeling more in control of the things that you do have control over are just one step46:51
closer to you having better diabetes management I'll hope you come to realize46:57
that you don't have to have all the pieces to the puzzle here to know what the bigger picture looks like it's not47:03
an All or Nothing But fitting in some of the little pieces bit by bit as you go47:10
along your journey I will finish with leaving you with this 8020 rule when it comes to47:17
eating if you can follow the guidelines 80% of the time you will be in a very good position to having a better47:24
understanding of how your body and your blood sugar respond to your eating habits this will allow you that47:30
flexibility 20% of the time to find out what works best for you and continue to47:36
make modifications I thank you for participating in today's session I wish47:42
you good health and I hope you found a couple of key takeaways that you can start working on in the days to47:55
follow
Category Tags: Diet & Nutrition, Just the Basics, Healthy Living;