Managing Diabetes And Your Di... Health Article

No matter how clear the principles of healthy eating may be, putting them into practice can be downright confusing. How does "30 percent of calories from fat" or "2 Carbohydrate Servings" translate to what's on your plate? And where does your eating plan come in when your only choice for a meal is a convenience store? In this section, we'll address many of the issues that may come up in everyday eating.

Start with Your Team

Many resources can point you toward good eating, including guidelines from the American Diabetes Association and the International Diabetes Center. But for the most practical advice that applies to your own health situation and lifestyle, start with a diabetes specialist. This person is likely to be a Registered Dietitian (RD) and/or a Certified Diabetes Educator (CDE)—both are experts in translating the abstract principles of nutrition into real-life eating.

Divide and Conquer

Getting started on eating better would be much easier if there were a simple, "big picture" image of what a sensible eating pattern looks like. The current debate about the relevance of the U.S. Department of Agriculture's Food Guide Pyramid, as well as the many competing pyramids produced by others, is a case in point. But one method is winning converts and praise across the board—perhaps because of its utter simplicity. Call it the "Divide Your Plate" strategy.

• Imagine a plate and divide it in half. Fill one half with vegetables, and divide the other half into two quarters.

• Fill one quarter with a lean protein, such as fish, skinless poultry, beans or tofu.

• Fill the other quarter with a grain-based or starchy side dish, preferably whole grains, like brown rice, whole-wheat pasta or a slice of whole-grain bread.

What this method lacks in precision it more than makes up for in good sense. If you focus on making most of your meals look this way, you'll automatically be following sound nutrition guidelines and choosing appropriate portions—without having to pull out a nutrition guide or a measuring cup every time.

A Primer on Portion Size

A key first step in building sound eating habits is to understand what reasonable portions of foods look like. For most of us, that requires a bit of re-education—and downscaling.

Many nutrition authorities believe our ability to estimate correct portions is deteriorating—largely because we are becoming used to the ever-bigger food helpings served up to us in restaurants and other venues. From soft drinks to muffins, the foods we buy in the marketplace are almost always larger than standard portion sizes—sometimes two to eight times bigger. Consider "standard"-size bagels: not long ago, they averaged 2 to 3 ounces; today, they can weigh in at up to 7 ounces. That's equivalent to seven slices of bread, and that's just at breakfast! Restaurant-size helpings of pasta, too, can be big enough to feed a family of six. Imagine what your blood-glucose levels would look like if you considered either of these carbohydrate bonanzas as a "single serving."

The insidious effect of these overblown portions is that larger helpings almost always encourage us to eat more. Several studies have shown that when adults and children are repeatedly served bigger-than-normal portions of food, they tend to eat more—regardless of how hungry they were when they sat down. This is standard procedure in restaurants, where we almost always feel compelled to clean our plates, but it also happens at home, when we serve ourselves the supersized portions we've come to perceive as "normal." No wonder our nation's obesity rate has risen in parallel with rising average portion sizes.

The best way to reclaim normal portion sizes, say experts, is by measuring them out repeatedly until it becomes instinctive. To begin, ask your diabetes-care team to provide a food list or a standard food guide that includes portion sizes. The American Diabetes Association is another good information source.

Use measuring cups and spoons and, if needed, a kitchen scale to portion out your foods. Don't forget to measure the serving utensils you use, so you'll know how "one ladleful" of soup or stew measures up. Take note of how the food looks on a plate—and try to use the same plate each time you eat that item, so you'll have a second visual reference. Continue practicing and measuring until the portions become second nature to you. This can take a few days or a few weeks; some people might opt for always measuring rather than eyeballing. It's a good idea to recheck your portion-size skills every so often, as they tend to creep up with time.

What does a portion look like?

1 teaspoon oil = The tip of your thumb

1 tablespoon salad dressing = Your whole thumb

2 tablespoons peanut butter = A Ping-Pong ball

1 to 2 ounces nuts = Your cupped hand

1 1/2 ounces cheese = A 9-volt battery

1/2 cup cottage cheese = A tennis ball

1 cup cereal = A baseball

1 small baked potato = A computer mouse

3-ounce serving of meat, fish or poultry = A cassette tape

1 standard pancake or waffle = A 4-inch DVD

Eating on Schedule, and When Life Gets in the Way

Eating at regular intervals helps ensure that your blood-glucose levels are fairly constant, so your diabetes food plan likely includes designated times for eating breakfast, lunch, dinner and, if appropriate, snacks. If you're taking insulin or other glucose-lowering medications, it's even more important to stay within those time ranges. But disruptions can throw off the best-laid plans, particularly when you're eating away from home: planes get delayed, dinner takes longer than anticipated to cook, food deliveries arrive late.

If you are within 30 minutes to an hour of your designated mealtime, there's probably no need for concern. But what should you do if a mealtime gets delayed, or moved up, significantly? Most people with diabetes carry a supply of emergency snacks or glucose to help them handle these situations (see 10 possibilities at left); your diabetes-care team can help you create your own contingency plan. Some general rules: