Many type I diabetics need to eat regular snacks in addition to their regular breakfast, lunch and dinner. The doctor may recommend a snack midmorning, another in midafternoon, and finally another one at bedtime.
In spite of the fact that he eats six times a day, Steven Lee comments, “I more or less eat like a regular person.” Usually his regular meals are not heavy meals. Even so, he says, “When I eat dinner, I eat dinner. I eat just about as much as my wife does.”
Larry doesn’t feel the need of the afternoon and bedtime snacks. But the five or six hours between breakfast and lunch is just too long. His insulin dosage causes his blood sugar level to drop, and he needs a snack to help him make it through until lunchtime. So at about 11 o’clock he takes some whole grain biscuits (crackers), nuts or raisins.
The snacks which a diabetic takes should not be like the junk food tidbits which we so often think of as snacks. Instead, they should be nutritious supplements to his smaller-than-normal regular meals. In planning his meals, he must count these snacks as part of his day’s total calories, or food exchanges.
It is very important that the insulin-dependent diabetic always carry some form of emergency energy supply with him. Any increase in the day’s activity or stress level may cause the blood sugar level to drop too low. Delayed meals can lead to serious problems for the diabetic unless he remembers to take an extra snack at the normal meal time. Skipping a meal can also have serious effects if the diabetic has taken his usual insulin.
When Larry gets stuck in a long committee meeting, he has to have a little food to keep him going. So his wife, Carole, keeps small portions of crackers and nuts where he will see them and put them into his pocket as he goes out the door each morning. Sometimes an alert secretary will see that all committee members are served a drink of juice at the time her diabetic boss needs a snack.
When a person begins to exercise more than usual, it is especially important for him to be careful about what and when he eats. Besides eating some additional food, he may also need to reduce the amount of insulin he takes. At first, the diabetic may need to work closely with his doctor or dietitian to figure out what changes to make for extra exercise. Later on, however, as he comes to understand his own body’s responses to activity, he will likely be able to make the adjustments on his own.
With careful attention to the survival guidelines, however, the insulin-dependent diabetic should be able to avoid trouble.
DIET IN TYPE II DIABETES
Probably one of the main differences between the two groups is that the type I diabetic has to be careful that he doesn’t lose weight, while the type II diabetic has the opposite problem.
As we noted earlier, overweight or obesity is a major cause of type II diabetes, heart attack, cancer, osteoarthritis, and numerous other problems. In fact, even five or 10 pounds of extra weight can increase the chances of death!
Recent studies have suggested that as soon as an overweight person loses as little as five to 10 pounds (three to five kg.), his blood glucose levels will begin to improve. So let’s take a look at some tips on healthful methods of weight control.
Control Your Weight
First of all, stay away from the crash diets or fad diets which promise large amounts of weight loss quickly! It’s true that you may be able to lose large amounts of weight in a short amount of time, but such diets often have their problems and their dangers.
Such weight loss is usually only temporary, and once you leave the diet, the weight may soon return. In fact, more than 90 percent of all dieters regain their lost weight within one year, then they have to begin dieting all over again!
A few people have even died from dieting. Some of the diet pills are addicting, others are just plain dangerous. Crash dieting may cause gall bladder disease, poor muscle tissue, and chemical imbalance in the body. Quite a number of diets must be “under doctor’s supervision”, but if dieting is that risky, maybe we’d better choose something safer!
There is a better way. Slower? Yes. More difficult? Maybe, but maybe not. You will definitely have to make some changes, which may not always be easy. But less expensive, for sure. And safer—by far! What’s more, you don’t even have to starve yourself in the process! Would you believe that you can eat all you want? Of the right kinds of foods, of course.
The answer to dieting successfully and permanently is lifestyle. Changes in the way you eat, drink, rest, exercise, and live in general, can add several happier, healthier—and slimmer—years to your life.
Exercise is a vital part of any weight-reduction program. When you exercise, you “burn up” calories. When you eat fewer calories and burn more through exercise, the net result will be a loss of weight. Watch out, though. Exercise is likely to increase your appetite, so make sure that you don’t eat more food. In the chapter on exercise, we will see more about how to lose weight by exercising. But for now, let’s look at the food angle of losing weight.
Eat Fewer Calories
Naturally, the most logical way to lose weight is to eat less. For every 3,500 calories less that you eat, you will lose one pound. This means that if you cut out 500 calories every day, you will be able to lose one pound in a week, or about four or five pounds in a month. This may seem like slow progress, but it is actually a safe and ideal rate of weight reduction.
Don’t Snack Between Meals
Although the insulin-dependent diabetic may need to take the between-meal snack to prevent a hypoglycemic reaction, the usual type II diabetic should avoid these snacks. He is not as likely to have hypoglycemia. And since he may be overweight anyway, snacks would simply add extra calories which he does not need. He should stick to three regular meals a day with nothing in between.
Decide with your doctor or dietitian how much food—how many calories—you really should be eating each meal or each day. Then limit yourself to that amount. Eating too much of the wrong foods can easily lead to overweight and the problems it brings with it. Even the right foods should be eaten in moderate quantity.
DIET FOR ALL DIABETICS
The diet for a non-insulin-dependent diabetic may be somewhat different than that of the type I diabetic, but certainly both need a wide variety of healthful, nutritious foods.
Both type I and type II diabetics need to eat fewer simple sugars and more of the complex carbohydrates. Both need to eat low-cholesterol diets with less of the saturated fats. And both should take more of the high-fiber, unrefined foods. But let’s look at some of the specifics of planning the daily diet.
Reduce the Amount of Fat in Your Daily Diet
In diabetes, too much fat traveling in the bloodstream interferes with the insulin receptors—the “doorbells” to allow glucose into the body cells. The fat can decrease the number of receptors, and it can make the remaining receptors insensitive and inefficient—unable to “open the cell doors” to allow the glucose in. Thus more insulin is required to handle the glucose from the foods we eat. The body may be able to increase its insulin production up to a certain point. But when the body is unable to make enough insulin for its needs, diabetes is the result.
Logically the best solution to the problem is to reduce the body’s need for insulin. And in very simplified terms, there are three main ways to reduce the insulin requirement: (1) eat fewer calories each day so that less insulin will be needed; (2) eat a more natural diet, lower in fat and higher in fiber, which will increase the quantity and the sensitivity of the cell receptors; (3) get more exercise on a regular basis.
Although many doctors and diabetes educators recommend that 25-30 percent of the daily calories be from fat, there is strong disagreement in this area. Some world-renowned nutritionists working with diabetics recommend a very lowfat diet that is high in natural food fiber. This advice is not really so new. It was around in the 1930s, and it reappeared in the 1950s when medical researchers again experimented—very successfully—with lowfat diets for their diabetic patients.
In the 1980s, new lifestyle change programs and research reports began to show the remarkable results of lowfat diets in diabetes treatment. (Some programs limited the total fat to as little as five percent of the total calories, while others allowed as much as 10 percent or slightly more.)
World-renowned physician James Anderson, diet-educator Nathan Pritikin, and others as well, have been able to take almost all of their type II diabetics and about half of their insulin-dependent diabetics off of all diabetes medicines within just a few weeks. Their secret? Lowfat, high-fiber, unrefined diets and regular exercise.
Watch Out for Hidden Fats!
There are a lot of hidden fats in the foods we eat. Did you know that even such innocent-appearing foods as apples and watermelon have small amounts of fat? Almost all foods have some fat, but some are much worse than others.
A plate of chicken rice, for example, has 38 percent of its calories in the form of fats. In a serving of tapsilog, 40.8 percent of the calories are from fat, while 10 sticks of beef or pork barbecue with peanut sauce have 59 percent of their calories in the form of fat!
The American Diabetes Association says that any food which has less than three grams of fat for every 100 calories is desirably low in fat. But how many of us are going to go to a diet book and look up the amount of fat in every food we want to eat? The easiest solution is to avoid fried foods. And stay away from junk foods, French fries and other fast foods, and cookies, pastries, cakes and other high-fat goodies. They all may be tasty, but they may also spell trouble in the form of diabetes and heart disease or stroke.
Especially Avoid Saturated Fats
There are two major classes of fats—saturated and unsaturated. Generally speaking, the saturated fats are all those which are from animal sources or which are solid at room temperature. Some of the saturated animal fats are butter, ghee, lard, dripping and suet. Eggs and meats also contain a lot of saturated fat. In addition, however, plant oils such as coconut oil and palm oil are also highly saturated fats. Although the saturated fats do not actually contain cholesterol, they do cause the body to produce more cholesterol, which collects on the walls of the arteries and later may cause heart attack or stroke.
Margarine and vegetable shortening are not made from animal products, yet they appear to affect the body in much the same way as saturated fats. To become solid at room temperature, they have undergone a process called hydrogenation which makes them closely resemble the saturated fats.
The unsaturated fats include corn oil, sesame oil, olive oil, soybean oil, sunflower oil and peanut oil. They are the preferred fats to use because they do not have the same cholesterol-producing effect. Even these should be used in very small amounts, however, because of the large number of calories they contain.