Making wise food choices will help you feel good every day and lose weight if needed. This recipe booklet will help you create healthy meals and learn how to.

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2Ask your healthcare provider to refer you to diabetes self-management education and support services.To find an American Diabetes Association-recognized or an American Association of Diabetes Educator-accredited diabetes program in your area, visit:

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3I Have Diabetes. What Do I Need to Know About Healthy Eating? You can take good care of yourself and your diabetes by learning about healthy eatingŠwhat foods to eat, how much to eat, and when to eat. Healthy eating can help keep your diabetes under control and lower your risk for heart disease, stroke, and other health problems caused by diabetes. Making wise food choices will help you feel good every day and lose weight if needed.This recipe booklet will help you create healthy meals and learn how to follow a healthy eating plan. A healthy eating plan contains many of the foods and beverages you usually eat or drink. Foods fit together like puzzle pieces (see Figure 1) to meet your health needs without going over your calorie limits. Your calorie intake depends on the total calories in your food, which includes your saturated and non-saturated fats, added sugars, and carbohydrates. All kinds of foods, including fresh, canned, dried, and frozen foodsŠincluding special treatsŠcan be included in a healthy eating plan. Whether you have been diagnosed with type 1, type 2, or gestational diabetes, understanding how foods and nutrition affect your body and taking steps to stay healthy will help you manage it successfully. Figure 1: A Healthy Eating Plan Whole GrainsPortion ControlFruits and Vegetables ProteinWater

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4Your Diabetes ABCs A stands for A1C test. This test measures your average blood glucose levels for the past 3 months. Your doctor should test your A1C at least twice a year. The A1C goal for many people with diabetes is below 7. It may be different for you. Ask what your goal should be. B stands for blood pressure, a measurement of how hard your heart needs to work to keep your blood circulating. For most people with diabetes, the goal is to keep blood pressure below 140/90. C stands for cholesterol, a fat found in your blood. There are two kinds of cholesterol in your blood: LDL and HDL. LDL or fibadfl cholesterol can build up and clog your blood vessels. It can cause a heart attack or stroke. HDL or figoodfl cholesterol helps remove the fibadfl cholesterol from your blood vessels.. Ask your doctor what you can do to reach your targets for A1C, blood pressure, and cholesterol.

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5Take steps to manage your diabetes ˜Ask your doctor how often you should check your blood sugar. ˜Learn how to keep your blood sugar in your target range. Ask your doctor about the best range for you. ˜Know your diabetes ABCs (see the call out on the previous page). ˜Ask your doctor for an A1C test at least twice a year. ˜Talk to your doctor about how to plan your meals around taking your medication and being physically active to stabilize your blood sugar. ˚If you are taking insulin, your meals need to be planned around your medications. If you don™t eat or eat later than planned, you may develop low blood sugar (hypoglycemia). ˚In contrast, eating too much food may cause your blood sugar level to climb too high (hyperglycemia). Learn how to keep your blood sugar on target You can prevent health problems by keeping your blood sugar in your target range. Ask your health care team to suggest a blood sugar target range for you. Healthful eating can keep your blood sugar levels on target. Being physically active and taking your diabetes medicines can also help. Make wise food choices and develop healthy eating habits Read the Nutrition Facts labels You can learn how healthy a food is by reading the label (see Figure 2). For help, ask a dietitian or a diabetes educator. Try to eat less of foods high in saturated fat, trans fat (liquid oils turned into solid fats during food processing), added sugar, and salt. ˜To learn more about how to read the Nutrition Facts label so you can make smarter food choices, visit the FDA for Consumers website ( consumerupdates/ucm387114.htm). ˜To find a diabetes educator, visit the American Association of Diabetes Educators website ( resources/find-a-diabetes-educator ). ˜To find a dietitian, visit the Academy of Nutrition and Dietetics website ( ).Figure 2: How to Understand a Nutrition Facts Label10%5%0%7%13%14%10% 20% 45%6%20%160mg8gNutrition Facts Calories 230Amount per serving Total Fat Saturated Fat 1g Trans Fat 0g Cholesterol 0mgSodium Total Carbohydrate 37gDietary Fiber 4g Total Sugars 12g Includes 10g Added Sugars Protein 3gVitamin D 2mcg Calcium 260mg Iron 8mg Potassium 235mg % Daily Value*The % Daily Value (DV) tells you how much a nutrient in a serving of food contributes to a daily diet. 2,000 calories a day is used for general nutrition advice.8 servings per containerServing size 2/3 cup (55g) *

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6Develop a healthy eating plan Make an appointment with a dietitian as soon as you find out you have diabetes or if you have had diabetes for a while but don™t have a meal plan. Your dietitian will teach you about healthy food choices, portion planning, and help you make a meal plan that works for you. Your dietitian should review your meal plan at least once a year. Discuss how to make a healthy eating plan work with the foods you like, your daily routine, and any medicines you take. Check serving sizes on the Nutrition Facts label It is easy to eat more food than you need without realizing it. A dietitian or a diabetes educator can show you simple ways to learn the right serving size for you without overeating. A serving size is a fixed amount, a standard amount that is used to measure foods (for example, one cup, one part or one ounce), and is also a unit of measure for food. For example, a serving of protein, such as chicken or fish, is the size of a deck of cards or the palm of your hand. A portion is the amount that you choose to drink or to eat. A dietitian can help you make a daily meal plan that will keep you satisfied without overeating. There are many factors that affect your personal meal plan. A dietitian or diabetes educator is specially trained to help you make the best plan for you. See Figures 3 through 5 (pages 10, 11, and 12), to help you manage your portions and visually estimate how much you are eating. Manage your meal plan with the Nutrition Facts label Using the Nutrition Facts label, you can compare the salt content of foods and choose the product with less salt. ˜Use the Nutrition Facts label and ingredients list on the package to find the amounts of saturated fat, salt, and added sugars in the foods and beverages you choose. ˜Look for foods and drinks that are lower in saturated fat, salt, and added sugar.

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8Don™t skip meals Skipping a meal can make you very hungry and make it easy to eat too much at the next meal so you take in more total calories for the day. Be sure to space your meals evenly through the day. Work with your dietitian or health care team to find the best meal plan for you. Include a variety of healthy, low-fat, and low-calorie foods. Remember that eating too little could result in hypoglycemia (low blood sugar). Learn how carbs affect your blood sugar Carbs are found in many foods and drinks, including bread, pasta, fruit, desserts, dairy products, sodas, juices, and starchy vegetables like potatoes and corn. Complex carbs, such as whole grain bread and whole grain pasta, provide more nutrition than other carbs. Cut back on sweets such as cake, cookies, and pies. Sweets are high in fat, calories, and carbs, so save them for a special treat once in a while. Knowing where you are getting carbohydrates, not only in what you eat, can give key information to help you manage your blood sugar. Your dietitian can guide you on how many carbs to aim for at each meal. Foods high in carbs have the biggest effect on your blood sugar. It’s important for people taking insulin at mealtime to know how many carbs are in the foods they eat and drink. Knowing the number of carbs you are eating helps you estimate the correct dose of insulin. Some examples of foods high in carbs are: ˜Bread, pretzels, crackers, and tortillas. ˜Pasta, noodles. ˜Rice, cereal. ˜Corn. ˜Beans and lentils. ˜Yams, yuca, and other root vegetables, such as potatoes, ñame, yautía, malanga, and camote, (batata). ˜Green bananas or plantains.

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9Reduce added sugars, saturated fats, and salt, and drink alcohol in moderation or not at all ˜Limit fruit drinks and sodas, or coffee or tea sweetened with sugar and honey. ˜The two main sources of added sugars are sugary drinks such as sodas and sweet snacks such as ice cream, cookies, and cakes. ˜Watch out for hidden sugar, like tomato sauces, fat-free salad dressings, and condiments. ˜Most of the sodium Americans eat comes from packaged, processed, store-bought, and restaurant foods. Only a small amount comes from salt added during cooking or at the table. Foods that come in cans including beans, vegetables, soups and other processed foods, such as canned and instant soups, processed meats (such as cold cuts), and canned beans have high levels of salt. Rinsing beans and vegetables and eating fewer canned foods can help you maintain blood pressure at normal levels. Also, use less salt when you cook, and take the salt shaker off the table to avoid using it during your meal. ˜Saturated fat is solid at room temperature and is most often found in animal products (high-fat meat and dairy foods), some fried and baked foods, and palm and coconut oils. ˜Reduce saturated fats. These fats come from burgers, sandwiches, tacos, pizza, and mixed dishes that contain meat or cheese or both (such as rice, pasta, and grain dishes with meat or cheese; and meat, poultry, and seafood dishes with cheese). ˜Limit alcohol if you drink. That means no more than one drink per day for women and two drinks per day for men. For those who choose to drink, small amounts of alcohol can fit into most healthy eating plans. Keep in mind that drinking alcohol may increase your risk for low blood sugar, especially if you are taking insulin or diabetes medicines.

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10Figure 3: Use these pictures to estimate the portion size of foods you eat. These tools can serve as a good guide, but may not be exact enough for dosing nieat 1-800-DIABETES (1-800-3 42-2383) © 2018 American Diabetes Association PLACEYOUR FIST HERE TO COMPARE PLACEYOUR FIST HERE TO COMPARE Your fist is a handy tool that is always with you. Place your fist on these outlines to see how it compares to a measuring cup. This fist = 1 cup This fist = 1½ cups My fist = _____ cups © American Diabetes Association 2018

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11Figure 4: All fats are high in calories, so keep the portion size small (less than 1 tablespoon in most cases).EAT OFTEN Oil-based salad dressing: vinaigrette, oil and vinegarOils: canola, olive, sunflower, peanut Trans fat-free spreads Avocado, olives, seeds, peanut or almond butterSOMETIMESLow-fat creamy salad dressing like light ranchOils: corn, soybean, safflower, sesame MayonnaiseLIMITFull-fat creamy salad dressing like ranch or blue cheeseButter, lard, coconut oil Margarine Cream © American Diabetes Association 2018 11

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