First, Let’s Dispel Two Myths
Myth: A diabetic diet exists that every person with diabetes must follow.
Fact: There’s no one diabetic diet. The foods you eat to manage your diabetes should be customized for you. Your eating plan should be based on your food preferences, eating habits, lifestyle, daily schedule, blood glucose levels and diabetes goals.
Myth: The only approach to diabetes meal planning is the exchange system.
Fact: The exchange system was the only approach to diabetes meal planning until recently. Today, several meal planning approaches are available. The meal planning system that works best for you—your food habits, temperament and diabetes—is what’s ideal.
Three Main Meal Planning Approaches
Today, a variety of approaches to meal planning are in use to help people better understand the task of meal planning. You and your diabetes educator should partner to find the method that best helps you plan meals, eat healthy and maintain proper weight and blood fat (lipid) goals. And if one system doesn’t work for you, try another.
Diabetes Exchange System
The exchange system was introduced in 1950 as a cooperative effort among the American Diabetes Association, the American Dietetic Association and the United States Public Health Service. The goal was to make meal planning easier for people with diabetes and to develop a consistent approach so that health professionals could have a common language.
The exchange system divides foods into three main groups: carbohydrates, meat and meat substitutes (poultry, eggs, cheese, etc.) and fat. Foods in the carbohydrate group are subdivided into five groups: starch, fruit, milk, other carbohydrates (sugary foods) and vegetables.
The exchange lists for each food group contain a list of foods and the amount of each food to eat to equal similar nutritional values. An advantage of choosing the exchange system as your approach is that exchanges are the common language of food and diabetes. Resources, such as cookbooks, magazine articles about food and even food labels, often use the exchange system.
Diabetes Food Pyramid
In 1995, the American Diabetes Association and American Dietetic Association adapted the United States Department of Agriculture Food Guide Pyramid for use in diabetes meal planning. The pyramids are quite similar. The diabetes food pyramid has six sections, or food groups. They vary in size based on the relative amount that each food group should contribute to a healthy eating plan. The largest group—grains, beans and starchy vegetables—is on the bottom. It forms the foundation of the pyramid and should be the staple of one’s daily food intake. The smallest group—fats, sweets and alcohol—is at the tip of the pyramid, suggesting fewer portions of these foods should be consumed. An advantage of this approach is that the serving sizes are virtually identical to those in the exchange system. This enables you to interchange the resources that refer to exchanges.
Carbohydrate Counting
The meal planning approach that has attracted a strong following in recent years is carbohydrate counting. It has gained popularity because nutrition research points to the fact that carbohydrates are the main nutrients contributing to raising blood glucose levels. In addition, the American Diabetes Association nutrition recommendations continue to conclude that the first priority in meal planning should be to focus on the total amount of carbohydrates you eat, rather than the sources of the carbohydrates, such as starch or sugar.
Carbohydrate counting can be a basic or advanced meal planning approach and can be used by people with type 1 or type 2 diabetes. As a basic approach, you learn to eat a certain number of grams or servings of carbohydrates at your meals and snacks (if needed). The goal is to eat a consistent number of carbohydrates to keep your blood glucose levels in control.
With advanced carbohydrate counting, you figure out how many carbohydrates you eat at each meal and snack (if needed) and then apply your individualized carbohydrates (grams-to-insulin ratio) to determine the amount of quick-acting insulin you need. People who learn advanced carbohydrate counting most often take quick-acting insulin before meals or use an insulin pump.
These are the most common meal planning approaches. Others do exist. It is well known that following a meal plan and changing eating habits are difficult. To be successful, partner with an educator to determine the best meal planning approach for your lifestyle and diabetes control.
Think of your meal plan as a guide to healthy eating. Then concentrate your efforts at setting goals to make realistic changes in your eating habits and food choices.
Healthy Nutrition Tips
- Eat a variety of foods.
- Maintain a healthy weight.
- Choose foods low in total fat, saturated fat and cholesterol.
- Choose plenty of vegetables, fruits and grain products.
- Eat sweets only in moderation.
- If you drink alcoholic beverages, do so in moderation.
