# Presentation: 085544

## Diabetes 

- How Food Affects Blood Sugar Levels

## Food raises blood glucose 

- What, when and how much food you eat affects how much the blood glucose increases
- The more you know about what is in food, the better you understand how it affects your sugar levels, the more control you have over your blood glucose levels
- This helps you make decisions about what to eat, when and how much

## Importance of Meal Planning

- To achieve as near normal blood glucose levels as possible
- To achieve and maintain healthy levels of blood fats
- Prevent, delay or treat diabetes related complications
- Appropriate calorie intake
- Appropriate nutrient intake for optimal health

**Notes:**
There is no one eating plan t control blood sugar.
Food choices are based on food preferences and lifestyles.
There is no one size fits all, a meal plan is most effective if it is individualized to increase compliance and help a person achieve his/her health goals.

## There are three components to foods

- Carbohydrates
- Proteins
- Fats

**Notes:**
Identify examples of CHO,PRO,FT

## 100% of the Carbohydrates Turn To Sugar Enter the Blood 10-90 Minutes

## Which carbs raise glucose levels faster?

- Carbs with more complex structures (high in fiber) take longer to digest and enter the blood slower.
- Carbs with more simple sugars, sucrose, lactose and fructose

**Notes:**
Compare juice/orange
	white/whole wheat
	pasta/beans
	cookie/apple

## FIBER

- When the fiber is removed, the carb is digested more rapidly causing a spike in blood glucose
- In some products, the fiber has been removed to reduce cooking time (instant oatmeal)
- To get more fiber, you could use a fiber supplement, but it won’t provide all the health benefits
- Increase fiber intake slowly to avoid bloating, cramping, increased laxative affect
- Good sources of fiber all have carbohydrates

**Notes:**
Fiber handout
Benefiber, Fiber 7, benefiber can be mixed into foods, works with food in the gut at that time

## It doesn’t matter if it  is bread, fruit or candy, it all enters the blood as sugarThe difference is:

***Time****-it takes to enter the blood*
***Quantity****-how much will affect *_*you*_

## Must look at the total carbohydrates not just sugars to determine how much a food or meal will affect blood sugar

- 1 cup cereal	30g
- 8 ounces milk	12g
- 1 banana	20g
- BS 210

- 2 eggs
- 1 ounce cheese
- 1slice bread	15g
- Butter
- Bacon
- 1 Banana	20g
- BS 135

**Notes:**
Don’t look at good food/ bad food
Look at total carbs 62g vs 35g
Better BS with more food because total carbs was less
Cant eat 2nd bkfst if you are trying to lose weight or are concerned about heart health

## Slide 10

## Serving sizes are determined by the manufacturer and are not standardized to represent one serving 

- Manufacturer will decrease serving size to be able to claim low fat (less than 3 grams)

**Notes:**
15 grams carbs, one slice bread, 6 saltines, 

## With insulin, you adjust the amount of insulin before the meal based on the total carbohydrates in the meal you are about to eat.

## On oral medications or in the absence of medication, you need a specific amount of carbs at meals and snacks predetermined by how efficiently your body handles the blood glucose as well as your individual blood glucose goals

## Sugar Alcohols

- Not technically a sugar
- Takes longer to be absorbed, longer to break down, absorbed lower in the intestine causing _less_ affect on blood glucose levels
- Sugar free is not calorie free
- People tend to eat more of a sugar free food
- May cause bloating and intestinal gas

## Sugar vs. Sugar Alcohol

- 5 sugar free cookie		3 regular cookies
- 155 calories			150 calories
- 19g carbs				17g carbs
- No clear advantage
- Choose what is satisfying and match serving size to how many carbs you can manage within BS goal and calorie needs

## Sugar Substitutes

- Can satisfy the inborn taste for sweets without increasing blood glucose
- Saccharin: 300-400X sweeter than sugar, no calories, some reported bitter aftertaste
- Aspartame (Nutrisweet, Equal): 180-200X sweeter than sugar,4cal/gm but used in such small amounts contributes no significant calories, can not be used in cooking more than 15 minutes
- Sucralose (Splenda): no calories, form of sugar not recognized by the body, stable at all temperatures, long shelf life

**Notes:**
Saccharin-1000mg/day adults,50-70 packets
Aspartame-50mg/kg,12-17 cans diet soda or 71 packets, contraindicated with PKU

## 20-50% of the ProteinsTurn To SugarEnter the Blood2-4 Hours 

## Protein does not have as dramatic an affect on blood sugars.

- Notice the two differences:
- Much less of the protein will turn to sugar
- It takes longer to enter the blood and is more gradual
- Therefore, the affect of protein on blood glucose levels is not really significant

**Notes:**
Note: protein does not need an insulin adjustment

## 10% of the FatsTurn To SugarEnter the Blood5 Hours or More

## Most Important To Consider

- Portion Size

## Need to be able to estimate portion sizes

- Measure for a few weeks
- You will begin to choose correct portion sizes by sight and memory

**Notes:**
Same cup of breakfast cereal in same bowl
Props and body parts

## The place to start is knowing when to stop

- Read Food Labels
- Check serving size
- Look at calories-to lose weight reduce calories
- Check total carbohydrates-don’t concentrate on sugar, its all sugar eventually
- 	Fiber total can be deducted from total carbohydrates to assess affect on blood sugar
- Look at fats-important for heart health and weight loss

## Nutrisense Inc.Amy Shapiro R.D., C.D.N.

- 373 Route 111
- Smithtown New York 11787
- (631) 979-6699