Updated July 21, 2006

Dealing With Meal Plan Blahs

by Kelly Van Horn, R.D., C.D.E.

Milk. Dairy products such as milk and yogurt provide your body with calcium, riboflavin, and protein, as well as carbohydrate. One serving of milk or yogurt provides about 12–15 grams of carbohydrate and 8 grams of protein. Calorie and fat content depends on whether you choose whole, reduced-fat, low-fat, or nonfat products. Low-fat or nonfat dairy products are generally better choices for adults and children over two, but if you eat higher-fat products, don’t forget to count the grams of carbohydrate just the same.

More carbohydrates. It’s no secret anymore that many people with diabetes include some sugar or sugar-sweetened foods in their meal plan without having their blood sugar level zoom sky-high. Their secret? Planning ahead and learning to swap carbohydrate choices. For example, rather than eating lunch, then deciding they want some ice cream, they plan to eat a half-cup serving of ice cream as one of their carbohydrate choices or exchanges for the meal. That way, they get their ice cream but don’t surpass their total carbohydrate goal for lunch. Of course, people who adjust their premeal insulin dose according to the carbohydrate content of a meal might choose to simply add the ice cream to the meal and take more insulin. This tactic can keep blood sugar levels in target range, but it can also lead to weight gain if used too frequently.

How often you substitute sweet items for breads, starches, milk, or fruit is a matter of personal preference. For most people, it’s a good idea to do it only occasionally, since sweets generally have few nutrients other than carbohydrate and sometimes fat. For children or very active people who burn a lot of calories, however, a sweet or snack such as potato chips might be included in their meal plan on a daily basis. Older people generally have lower calorie needs and, ironically, higher vitamin and mineral needs, so eating too many sweets can rob them of needed nutrients and make it harder to maintain a desirable weight.

Another problem with sweets and desserts is that one serving (containing 15 grams of carbohydrate) is often small and not very filling, so it’s tempting to have two or three servings rather than one. You can help quell that urge by including higher-fiber foods such as beans, lentils, or cooked vegetables in the meal preceding dessert or by adding a big green salad with low-fat dressing to your meal; salad greens tend to fill you up without affecting blood glucose levels.

Low-carbohydrate foods
Carbohydrate counting is what gets emphasized most in diabetes meal planning, but foods with little carbohydrate should be counted too—for weight control and heart health as well as for blood sugar control.

Nutrition experts often classify lower-carbohydrate foods into four different categories: vegetables, meats and meat substitutes, fats, and “free foods.” When eaten in moderation, these foods do not have a direct effect on blood sugar level. However, eating too many servings of some free foods can raise blood sugar level, and eating too much meat, meat substitutes, or fat can lead to unwanted weight gain, which can also affect blood sugar control. So portion size is important even for most low-carbohydrate foods.

Vegetables. There is so little carbohydrate or fat in nonstarchy vegetables, it would be hard to eat too much of them, and since they are generally good sources of fiber, vitamins, and minerals (particularly vitamins A and C, iron, folic acid, and magnesium), it’s usually a good idea to eat more. If your current menus leave you feeling a little hungry, or your plate often looks colorless, try adding a serving or two of raw, lightly steamed, or sautéed vegetables. (A serving of vegetables is 1 cup raw or 1/2 cup cooked.) When you start feeling bored with your old favorites, try something new, or experiment with different cooking methods and flavorings. Sometimes a drizzle of olive oil and squeeze of lemon or some sautéed garlic and red pepper flakes are all it takes to liven up an otherwise dull vegetable side dish.

Also in this article:
Shopping Tips
Tools for Meal Planning

Kelly Van Horn is a Nutrition Consultant and Certified Diabetes Educator for Tabletop Nutrition, LLC, in Sammamish, Washington. She is also the Research Dietitian for the Trial to Reduce IDDM in the Genetically at Risk (TRIGR) study at the University of Washington in Seattle. For TRIGR study information, go to www.trigr.org.

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