How Diet Affects Blood Glucose Levels July 30

How Diet Affects Blood Glucose Levels July 30, 2007 Liz Weinandy, MPH, RD The Ohio State University Medical Center Liz. Weinandy@osumc. edu

Objectives l At the end of the presentation you will be able to: Describe how different food components affect your blood glucose (BG) levels and your energy level l Read a food label l Count grams of carbohydrate l

Diabetes in the US l 20. 8 million children and adults -- 7. 0% of the population -- have diabetes. l Diagnosed: 14. 6 million people l Undiagnosed: 6. 2 million people l Pre-diabetes: 54 million people l 1. 5 million new cases of diabetes were diagnosed in people aged 20 years or older in 2005. l Source: American Diabetes Association

Diabetes in the US l People with diabetes have increased health risks l Heart disease l Stroke l High cholesterol l Kidney disease l Eyesight problems l Vascular disease

Food and Blood Glucose Levels l Factors l that impact BG levels Food l Eating a healthy diet can help control BG levels Healthy weight l Physical activity l

Food and Blood Glucose Levels l Food is made up of three basic components: Carbohydrates l Protein l Fat l l What component(s) affects the BG the most? l Carbohydrates!

Food and Blood Glucose Levels l Carbs affect BG the most l Proteins affect BG very little l Fats keep BG elevated if eaten with a large carb load, but do not raise BG

Food and Blood Glucose Levels l American l Carbohydrates: 50 - 60% l l Low carb diets are NOT recommended Protein: 15 - 20% l l Diabetes Association recd’s Most from low fat sources Fat: ~30% l Most from mono- and poly- unsaturated fats

Food and Blood Glucose Levels l What l foods have carbohydrates in them? Starches l Bread, cereal, tortillas, pasta, rice, corn, peas, potatoes, crackers, pretzels, popcorn, muffins Fruits l Dairy l Desserts & Sweets l Non- Starchy Vegetables l

Food and Blood Glucose Levels l Different l Simple and processed l l Sugars, refined flour Complex l l Types of Carbs High fiber, whole grains Fiber l Not digested

Food and Blood Glucose Levels l Goal is to eat moderate carbs at all meals and avoid large carb intake at any one meal Eat three meals daily l Snacks optional but good idea l l l Can help prevent getting too hungry Concentrate on eating better carbs l Complex carbs, those high in fiber

Food and Blood Glucose Levels l Source: http: //www. urbanext. uiuc. edu/diabetes 2/subsection. cfm? Sub. Section. ID=26

How Much Carbohydrate? l Individualized approach l Generally, for weight loss: 45 grams per meal for women l 60 grams per meal for men l 15 - 30 grams for 1 -2 snacks a day l 130 grams total minimum per day l l Amount l of carb depends on many factors Gender, age, activity level, BG levels

How Much Carbohydrate l Example l 1800 calorie diet 250 grams of carb total (55% carb) l 60 grams carb each meal l 35 grams carb for 2 snacks l 225 grams of carb total (50% carb) l 60 grams carb each meal l 20 -25 grams carb for 2 snacks l

How Much Carbohydrate? l Remember, if you are trying to lose weight, it is NOT just about the carbs Total calories matter l Low to moderate fat (<30% of total calories) l l l Moderate fat diets result in same or more weight loss as very low fat diets By limiting (not eliminating!) carbs, most people lose weight

Label Reading labels is important in managing BG levels and overall health l Carbohydrate counting l Look at Total Carbohydrate grams l l Can subtract Dietary Fiber grams if 5 g or more Sugars are included in total carb grams l Simple carbohydrates raise BG levels faster

Label Reading

Carbohydrate Content l What if a food item doesn’t have a label? Produce l Specialty cheeses l Meats, Poultry, Seafood l Aunt Martha’s potato casserole l Restaurant Foods l Alcohol l

Carbohydrate Content l Easiest to buy calorie/ carb counter book or look up online l American Diabetes Assoc. l l www. diabetes. org American Dietetic Assoc. l www. eatright. org Calorie King book ($8 Barnes & Noble) l Calorieking. com l Fitday. com l

Carbohydrate Content l Produce l Fruit l Serving is generally small piece fruit (4 oz), ½ cup fruit, ¼ cup dried fruit, or ½ cup (4 oz. ) juice l l 15 g carb, 60 calories Vegetables l Starchy- ½ cup of peas, corn, or potatoes l l 15 g carb, 80 calories Nonstarchy vegetables- 3 cups raw or 1 ½ cups cooked broccoli, carrots, cucumbers, peppers, etc. l 15 g carb or less, 75 calories or less

Carbohydrate Content l Meat l and Meat Substitutes Chicken, fish, beef, eggs, cheese, peanut butter l Generally contain little or no carb, mostly protein and variable amounts of fat l l Moderate portions l l Choose lower fat options except for fish and pb 3 -4 oz or deck of cards Calorie difference is great! l Ex: 4 oz of skinless chicken breast vs 4 oz pork spareribs l Calorie difference is 260 (140 vs 400 calories) l Extra calories all from fat!

Carbohydrate Content l Combination l Casseroles, lasagna, spaghetti w/ meatballs, mac & cheese, chili w/ beans, etc. l l Foods In GENERAL, 1 cup = 30 g carb Pizza, thin crust ¼ of 12 inch (about 5 oz) = 30 g carb l Most of carb is in crust so avoid thick ones or limit portion size greatly l

Carbohydrate Content l Restaurant Food If a chain, look up info l If not a chain, will have to estimate l Caution with portions! l Number one way to eat large amount of carbs l Ask waiter to bring to go container with meal and eat half or split with someone else l Be moderate with bread basket, corn chips, etc. l Decide where you want to “spend” carb grams l

Alcohol l Moderate consumption ok if physician approves l l 1 drink for women a day, 2 for men Always with food l Not on empty stomach Not with high Triglycerides l May cause hypoglycemia, or low blood sugar l Stimulates appetite l

Summary l Carbohydrates affect BG the most l 50 - 60% of calories from carb l Carb counting is an effective way to monitor carb intake l Label reading important l Lose weight if needed or maintain current l Physical activity important

Questions?