Selected Podcast

Healthy Eating with Diabetes

It’s not hard to develop healthier eating habits. You will look and feel so much better! 

Henry Mayo Fitness and Health Center's, Community Education Department Community Educator wants to set you up for success. 

Listen in as Debra Dangelo, RD , Registered Dietitian, discusses ways to eat healthy, avoid the pitfalls of fad diets and help control and manage your diabetes.
Healthy Eating with Diabetes
Featured Speaker:
Debra Dangelo, RD
Debra Dangelo, RD is a registered dietitian with Henry Mayo Newhall. She teaches classes on how to develop health eating habits and avoid diabetes.  She also teaches and counsels those with diabetes.
Transcription:

Melanie Cole (Host): If you have diabetes, it can be challenging, but not impossible to develop healthier eating habits and you’ll look and feel so much better, and you might also have a very positive effect on your disease. My guest today is Debra D’Angelo. She’s a Registered Dietician and a Certified Diabetes Educator with Henry Mayo Newhall Hospital. Welcome to the show, Debra. So when somebody is trying to prevent diabetes, or they’ve been told they have prediabetes, what is the first, best bit you give them about nutrition?

Debra D’Angelo (Guest): Well, actually per the CDC Diabetes Prevention program a weight loss of 5-7% can help prevent diabetes, so getting on a meal plan that’s making sure their calories are not exceeding their needs so that they can start losing weight.

Melanie: Okay, so when – we’ve heard about diets over the years, calories in, calories out, keeping track of calories, when somebody asks you, Debra, what do you say is one of the best ways to keep track of – are you somebody who likes journaling? What do you tell people?

Debra: I do, I like journaling. There’s several websites that also have phone apps that I encourage folks to use so they can get an idea of how they’re eating and then go towards what I want them to do, which is control their carbohydrates, eat less simple sugars, eat less added sugars. Web sites that have journals have all that information at their fingertips, so I do like journaling.

Melanie: To set us up for success – if somebody has prediabetes and they’re starting to look at all of the different things out there, they hear carbohydrates bad, bad, but not all carbohydrates are created equal, right?

Debra: That’s true. I try to encourage looking for carbohydrates that are full of fiber. That’s one way of helping keep blood sugar down, so whole wheat bread, whole wheat pasta, brown rice, things like that. And then, portioning, so being aware of what a portion is and measuring things out and following that. That’s a big step for a lot of people because they aren’t currently doing that.

Melanie: Sure, so if they are portioning out, looking at all of these things, how do they discern between a good carbohydrate and a bad, because a carrot or a tomato is not going to contribute to your diabetes, but something which is really bad types of sugar, so explain what you do want them to eat as far as grains, brown rice, sweet potatoes versus white potatoes. Give us a working definition here.

Debra: Well one of the umbrellas that it would be under is that it’s not processed, so more foods that haven’t been processed because a lot of times what happens is there’s added sugar, so if you’re getting foods that you have to prepare, you’re going to be assured that you’re not having added sugar. Along with the fiber, really looking for fiber, maybe five to six grams per serving cuts out a lot of foods that aren’t in a good category. If you’re looking at cereal, there’s not many that are five or six grams or more, so that gives you a criteria to start with, as well as bread.

Melanie: But people don’t always know what to do with things with fiber in them, so do you help people with recipes or learning to cook kale, for example. They don’t know what to do with Bok Choy, but they want to try all these interesting things, what do you tell them about a way to do things with them?

Debra: Sure, I share recipes, and there’s a plethora of recipes online, and the Diabetes Association has a lot. There’s a lot of websites that have things that are free, and sometimes I’ll do demonstrations. I like to show how to make healthy smoothies because smoothies can be something that people put a lot of concentrated fruit juice in and I want to get them away from that. I want them to use whole fruit, which has fiber in it.

Melanie: Now fruit is sometimes scary for diabetics, so can they eat fruit?

Debra: They can, and a lot of times they think they can’t, but it comes back to portion size and being aware of how much of that fruit they’re eating and then testing their blood sugar. If they’re not testing their blood sugar, they don’t know what effect that food has on their blood sugar. If they do, and I encourage them to do that, and they see that a certain fruit doesn’t spike their blood sugar then they’re able to relax, and they’re able to include it. Having said that, sometimes there’s some fruits that some people just don’t tolerate well, and it really does raise their blood sugar, so the caveat is you need to test your blood sugar to see how you react to certain fruits. The other advice I give is that you don’t eat them alone, but eat them in the presence of protein, so protein and carbs. Fruit being a carbohydrate, I’d always encourage nuts or string cheese, a hard-boiled egg to go with those or have it in the meal, so the fruit alone doesn’t spike your blood sugar.

Melanie: And so let’s get to proteins for a minute because with all those fad diets out there that said proteins only and no carbohydrates and things – what do you tell them about proteins and the good quality ones that you’d like them to eat.

Debra: Well, lean is always good. And you’re right; there’s a lot of diets out there that they want to cut out carbohydrates, so I actually start with encouraging them not to cut them out, to not go below 120 grams of carbohydrates a day. That’s a guideline for making glucose for your brain. That’s just a major source of energy for us and for our brain to function, and then looking at protein and accompanying that with carbs. Lean is best, about three ounces per meal. When you go back to using the journal you can find out what foods are high in protein.

Melanie: And then where do fats fit in because fats are not necessarily the enemy and we’re learning more and more about those healthy fats -- and avocados, and olive oil – so what do you tell people when they say, “Well, should I just be on this very low-fat diet?”

Debra: Absolutely, no, they should take in fat because fat is actually what helps to keep us satiated and satisfied and when we cut fat out completely, we get hungry more often. It’s the same with protein. If you’re cutting back too much protein or fat, both of those things, you won’t feel satisfied, and the goal is to feel satisfied longer and not feel like you have to snack between meals. If you have protein and a little bit of healthy fat, that carries you a lot longer and helps you feel stronger and have energy.

Melanie: And now onto dairy, Debra. What can we – because yogurt, and there’s so many good dairy products out there, but then again, people think of them as bad fats?

Debra: There’s research that shows, actually for blood sugar control, a little bit of fat in a dairy product is more helpful. It goes back to that fat helps keep a more stable blood sugar so right, greek yogurts are really high in protein, so I always encourage those. Ones that don’t have added sugar would be the best. That cuts out a lot of the market of the yogurt products, but that can be a protein source with a little bit of carbohydrates. I think it’s a good combination food so if people are smart about it, they can use it.

Melanie: We’ve talked about dairy’s and fats and proteins and carbohydrates, now when we’re looking at the things like bread and rice and people think that they really do need to absolutely steer clear -- and you’ve mentioned moderation – but are they allowed to eat rice, and should it only be brown? Can they eat white rice? Speak about some of those grains and where they fit into this balanced picture.

Debra: It’s going to come back to testing their blood sugar for somebody with diabetes. They may not be able to eat brown rice, but what I would normally tell someone is go from white rice to brown rice. The fiber’s going to help control your blood sugar. Same thing with using a higher fiber bread, you need a little bit of carb at each meal, maybe about 45 grams. A typical slice of bread is 15 grams of carbohydrates, but is that a piece of bread that has fiber in it and then how does that affect your blood sugar? Testing two hours after we start eating can give us a good indicator that if it spikes above 180 that was not a good carbohydrate choice. It does put the onus on someone to do a lot of trial and error, and I know that’s frustrating, but my job is to encourage them, let them know that they’re going to find out some good information and it’s going to help them manage their diet and their diabetes.

Melanie: And how often should they check their blood sugar.

Debra: The guideline would be fasting and then after each meal – not always necessary. If anybody’s on insulin, always when they take insulin and sometimes before bed. It could be four to five times a day. Having said that, if someone is tired of doing that, they could skip a couple times a day, only do it twice, but vary it, they could get a trend over several weeks, but they aren’t poking themselves four times a day. They can do fasting and then after dinner, and then the next day they could do after lunch and before bed. They can rotate that through several weeks, and they can see a trend. I’m good in the morning, but then I’m not okay after lunch, or I’m okay after dinner, and that’s what I can help people with when I see them.

Melanie: So you’re a Certified Diabetes Educator, but what would you tell people that don’t have diabetes, but are looking to prevent it in the first place? Just wrap it up for us and give us your best advice for really healthy eating as dietary advice for diabetics and non-diabetics.

Debra: Using whole foods, less processed foods, combinations of proteins, carbs and fat in moderation and actually listening to your hunger and being aware of how you feel when you eat and if you feel hungry soon thereafter you haven’t eaten enough. You might need to incorporate snacks. People think they need to eat several small meals a day. It’s not just that; it’s meals and snacks in between sometimes and sometimes it’s not. Everyone’s different, but you have to be tuned into your activity level and how much that’s going to make you hungry. I think sometimes folks aren’t that tuned in, but they can get there, and they’ll find their energy level is better if they’re eating enough carbohydrates, protein, and fat at each meal.

Melanie: Thank you, so much, Debra, for being with us today. That’s great information. You’re listening to “It’s Your Health” Radio with Henry Mayo Newhall Hospital, and for more information, you can go to HenryMayo.com, that’s HenryMayo.com. This is Melanie Cole. Thanks, so much, for listening.