As a dietitian and diabetes educator, some of the comments I’ve repeatedly heard from many people with diabetes over the years are "I need a diabetic diet" and "I can’t figure out those exchanges. Just tell me what to eat." It’s true that meal planning can be challenging when you have diabetes. The good news, though, is that meal planning has changed quite a bit over the years. In fact, there’s no such thing as a "diabetic diet" anymore. The best "diet" for you is one that is flexible enough to fit in with your lifestyle and help you control your blood glucose levels. In fact, there are many different ways to help you eat and manage your diabetes at the same time. This week, we’ll explore a couple of different meal planning methods that are available. Next week, we’ll look at some more.
If you’re a history buff, you might be interested to know that before insulin was discovered in 1921, the only way to “treat” diabetes was essentially by starvation. People with Type 1 diabetes were fed diets that were very low in calories, high in fat, and contained very little carbohydrate. Later, in 1950, the American Diabetes Association introduced the exchange system. The exchange system is still used today, although other meal planning methods, such as carbohydrate counting, have become more popular.
The exchange system is a meal planning method that divides foods into six different groups: starches/breads, fruit, milk, vegetables, meat/protein and fat. The foods in each group have specific portion sizes, and are all similar in calories, carbohydrate, protein and fat. You can “exchange” a food on the list for another food on the same list. For example, instead of eating 1 slice of bread, you can eat 1/3 cup cooked rice. Your dietitian figures out how many exchanges (also called “servings” or “choices”) you should aim for from each food group for each meal and snack. The number of exchanges you need is based, in part, on your calorie needs, activity level and eating style. While some people find the concept of “exchanging” to be confusing, this meal planning approach is actually pretty helpful and flexible once you get the hang of it.
Another meal planning approach that is well suited for people new to diabetes is called the plate method. No complicated lists or counting is needed. All you need is your plate! First, start off with a 9-inch dinner plate. Fill half your plate with non-starchy vegetables, such as broccoli, green beans, carrots, summer squash, or salad. Then, in one quarter of the plate, put 3 to 4 ounces of lean protein (poultry, fish, lean meat). Fill the other quarter with a carbohydrate food, such as brown rice, whole grain pasta, or a small baked potato. Supplement your meal with either an 8 ounce glass of skim or lowfat milk or a small piece of fruit, as well as 1 to 2 teaspoons of a heart healthy fat (tub margarine, olive oil or salad dressing), and there’s your meal! Pretty easy, right? The Plate Method is great for people with diabetes, but is also useful for anyone trying to control portions.
Talk with your dietitian if you’re interested in learning more about either the exchange system or the plate method. Next week, we’ll look at two different ways of carbohydrate counting.