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October 1999 Issue
Diet and Diabetes
by Ronda L. Halpin
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Nutritional Goals for People With Diabetes

Below is a chart with general guidelines for people with diabetes. As always, if you have specific questions or concerns regarding your diet or condition, consult your physician.

Diet Goals
Calories Caloric intake should be enough to achieve and maintain ideal body weight.
Use the following guidelines to get an idea of your caloric needs:
  • Calories to Lose Weight = Body Weight (lbs.) x 10
  • Calories to Maintain Weight= Body Weight (lbs.) x 15
  • Calories to Gain Weight = Body Weight (lbs.) x 20
Carbohydrates 55-60 percent of calories should come from carbohydrates.
Carbohydrates should come mainly from unrefined starches and breads high in fiber.
Cholesterol Dietary cholesterol should be no more than 300 milligrams per day.
Fat Less than 30 percent of calories should come from fat (for anyone, not just people with diabetes).
Less than 10 percent of the calories that come from fat should come from saturated fats.
Fiber The recommended daily amount of fiber is 25-30 grams.
Fiber slows digestion, which causes blood sugar to rise more slowly when you eat carbohydrates. (This characteristic is defined by the Glycemic Index of foods.)
Protein 10-20 percent of calories should come from protein.
Lean animal proteins and complete vegetable protein (soy protein) are preferred.
The Recommended Dietary Allowance (RDA) for protein for adults is 0.8 grams per kilogram of body weight. (To figure out your weight in kilograms, divide your weight in pounds by 2.2.)
Sodium People with diabetes should have no more than the recommended amount for anyone: 2,400 milligrams a day.
Sugar A modest amount of sugar may be all right, depending on how well you are controlling your blood sugar and body weight.
When sugar replaces some carbohydrates in the diet, blood sugar levels do not change.
Non-nutritive Substances Alcohol tends to lower blood sugar; if you drink, you must adjust your diet and medication accordingly; always check with your doctor about drinking alcohol.
Artificial sweeteners are generally fine.

Planning Your Meals

The Exchange System is a widely used food grouping system used by the American Diabetes Association and the American Dietetic Association. It has the following characteristics and advantages:

  • The plan is based on the use of six exchange lists which group like foods together.

  • Every food on each list has about the same amount of carbohydrate, protein, fat and calories.

  • In the amounts listed, all the choices on one list are equal.

  • Any food can be exchanged for any other food on the same list.

  • This is a good choice for people who need a fixed number of calories for weight control and prefer a fairly regimented eating style.

  • The plan requires very little knowledge of food composition.

Here is a quick rundown on the types of food and serving sizes for each of the six lists:

  1. Starches/Bread
    • Typical serving: 1 slice of bread or 1/2 cup of cereal, grains or pasta
    • Also includes rice, crackers, biscuits, muffins, pretzels, popcorn
    • Also refers to legumes and starchy vegetables like potatoes, peas, corn, sweet potatoes
    • Most starchy low-fat snacks also can be worked into this group in 80-calorie units.

  2. Meat
    • Serving size: 1 oz. of cooked meat
    • Lean meats: lean cuts of beef, veal and pork
    • Other foods in the Lean category: fish, skinless poultry, low-fat cheese, cottage cheese, egg whites, seafood
    • Medium-fat meats: lean ground beef, egg, lamb and cuts of poultry, beef, veal and pork that are not very lean
    • High-fat meats: sausage, hot dogs, fried fish, mixed luncheon meats, peanut butter
    • With so many low-fat products available, you can find a favorite meat and fit it into the appropriate group based on its fat content.

  3. Vegetable
    • One serving = 1/2 cup cooked or 1 cup raw vegetables
    • Category of food refers to green leafy and bright yellow vegetables (except corn and peas, which are categorized as starches)

  4. Fruit
    • Serving size for most fruits: 4 oz. (1/2 cup) fresh fruit or fruit juice or 1/4 cup dried fruit
    • Bananas are higher in calories than most other fruits, so half of a banana is considered one serving.

  5. Milk
    • Standard serving size: 8 oz. (1 cup)

  6. Fat
    • Each exchange in this group contains 5 grams of fat or 45 calories.
    • A unit = a teaspoon of oil, margarine, mayonnaise or butter
    • The equivalent of a unit for salad dressings, diet margarine and other products will vary; to determine what amount of any of these amounts to one fat exchange, just compare the fat in the product to the fat exchange of 5 grams
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