Question of the Week: Sugar & Carb Free Diets?

The following question was submitted for discussion on this week's blog post, " I was recently diagnosed with Pre-Diabetes and was wondering how strict my diet really needs to be?  Does every meal and snack need to be completely sugar and carb free?"

First, I want to say that's it is great that you want to make some positive changes to your diet.   Start with small achievable changes and master those as longtime habits are sometimes difficult to break. 

Your meals and snacks should not be carb-free.  Carbohydrates play an important part of everyone's diet no matter who you are.  Carbohydrates are the main source of energy for your body.   The important point that needs to be made is the carbohydrates that you consume should be  those considered "healthy carbohydrates" such as fruits and vegetables, low or nonfat dairy products, and whole grains (i.e. quinoa, brown rice, wheat pasta, multigrain bread).

Unhealthier choices of carbohydrates are those that should be limited or eliminated.  This category consists of items that are usually calorie dense yet lack the proper nutrients.  These "unhealthier" carbohydrates include choices such as baked goods, white rice, white pasta, and white bread.

Healthy carbohydrate choices should consist of approximately 45-65% of your total daily caloric intake.  For example,  if your intake was 1800 kcals for the day, calories from carbohydrate should range from between 810 kcals and 1170 kcals.  Keep an eye on portion sizes to keep your calories in check.

Question of the Week: Fighting the Nightly Sweet Tooth"

The following question was submitted for discussion on this week's blog post: "I have a sweet tooth at night.  I like to reward myself after a hard day at work with a bowl of ice cream before bed.  Is this ok to do since I now have diabetes? "

It is not uncommon to crave something sweet in the evenings or wanting to reward one's self at the end of a hard day with a sweet treat.   Doing this from time to time,  in small portions (1/2 Cup), while watching the rest of your daily intake, and while incorporating exercise (30 minutes minimum) into your daily routine should not be an issue.  Treats such as these are best for special occasions such as social gatherings.

If you choose ice cream as a treat, there are many types available that are low fat (sometimes marketed as "slow churned"), low calorie (such as Weight Watchers or Skinny Cow), and there are no-sugar added varieties frozen treats available.  There are also many very delicious varieties of frozen yogurt available that are a healthier alternative to full-fat ice cream.  Keep in  mind that despite the fact that these aforementioned alternatives are healthier choices, you still need to adhere to the 1/2 Cup portion guideline.

Avoid high calorie/fat/sugar toppings for your frozen dessert.  Whipped Cream, syrups, sauces, and sprinkles will add more calories, fat, and carbohydrates without any nutritional value.  

Question of the week: Ordering Healthy at a Sandwich Shop

The following question was submitted for discussion on this week's blog posting:  "On my lunch breaks I go to a sandwich shop.  I usually get a large deluxe sandwich with a side of potato salad or coleslaw.  Now that I have diabetes, I’m trying to modify my lunch order.  Can you make some suggestions of what to order?"


There are many delicious menu items that you can still order from a sandwich shop despite your recent diagnosis.  Here are some suggestions for modifying your order to make it "healthier":

1.  Instead of having your sandwich on a hoagie roll, choose whole wheat or multigrain bread.  If you make it an open-faced sandwich to eliminate some of the excess bread, even better!

2.  Choose a lean meat such turkey breast, roast beef, or chicken breast.  Avoid processed meats like bologna and salami.  Choose low sodium varieties when available.   Try to keep to 3 - 4 oz of meat on your sandwich (put the rest of it aside to make another sandwich or for lunch the following day). 

3.  If cheese is a must - choose a low fat, low sodium variety.  Watch your portion.  Try to limit to one slice of cheese (for flavor).

4.  Bulk up with veggies.  Load up your sandwich with lettuce, tomato, cucumber slices, and green pepper rings.  This is a great way to get your "5 a Day" and feel full without the extra calories and fat.  Be creative, ask for spinach instead of iceberg lettuce!

5.  Skip the chips,  potato, macaroni, or pasta salads.  Opt for a side garden salad with a light dressing on the side.  If you aren't in the mood for salad, choose a broth based soup (1/2 cup).

6.  Pass on the Mayo:  Choose mustard or ripe avocado to spread on your sandwich.

7.  Watch your portions - If your sandwich is big - Eat half, save half!

Question of the Week: "Comparing the nutrition of Fruit & Vegetable Juices"

The following question was submitted for discussion on this week's blog post: "I have heard I should avoid fruit juice since I have diabetes.  What about vegetable juices?  Can I have tomato juice and other vegetable juices?"

If you were to compare fruit and vegetable juices, vegetable juices tend to have less carbohydrate than fruit juices.  In a 4 oz glass, vegetable juice has 5 grams of carbohydrates (vs. 15 grams in a fruit juice).  However, vegetables juices tend to be high in sodium (if store-bought) and don't have any fiber.  

Vegetable juices can be included in your diet but should not take the place of whole vegetables due to their lack of fiber.  Read the labels (keep an eye on their sodium content) and watch your portion size (stick to 4 oz).

Additional Nutrition Information:

Low Sodium V8 lists 140mg of Sodium in an 8 oz serving.  Be aware that 8 oz is actually 2 servings of carbohydrate (10 grams).    Regular V8 has 480 mg of Sodium in an 8 oz serving!!!

Campbell's Tomato Juice has 680 mg of Sodium in an 8oz portion.   Their low sodium variety has 140 mg of Sodium.  Campbell's makes a Healthy Request variety that still contains 480 mg of Sodium in an 8 oz. portion.

Question of the Week: "What if I can't have Milk?"

The following question was submitted to me for discussion on my blog: "I have type 2 diabetes and cannot tolerate milk.  What may I substitute for my recommended two milk servings per day?  Would I substitute a carbohydrate or a protein?"

My first question to you would be are you allergic to milk or do you have a lactose intolerance?  My answer will depend on how you answer that question.

 If you are lactose intolerant (and not allergic to milk), there are many products available that you can take advantage of such as lactose-free milk or lactase tablets (which can be taken prior to consuming a dairy product) which will allow you to consume milk without the undesirable side effects.  In some cases, people who are lactose intolerant are able to tolerate some dairy products such as yogurt if not consumed in large amounts.

In the case of a milk allergy, you may want to try either rice milk, soy milk or almond milk.  In some cases, they are fortified with calcium.  There are varieties that are flavored with chocolate or vanilla but they may have added sugar (so check your labels!).

Milk is counted as a carbohydrate on a Carbohydrate Counting/Controlled diet.  It has 12g of carbohydrate and 8g of protein per serving. 

Question of the Week: "Microwave Dinners / Convenience Foods"

The following question was submitted for discussion on this week's blog, "I am writing on behalf of my sister. She does NOT cook.  She is living alone and has been diagnosed with pre-diabetes.  She lives mainly on microwave dinners and convenience foods.  She is not open to learning to cook.  Do you have any helpful hints for someone like this?"

First I would ask what your sister's aversion to cooking is?  Is it a lack of time?  Has she ever tried to cook?  Cooking can be fun - plus it puts you in control of what is in your food and gives you more available healthy options.  Additionally, she'll find it is much cheaper to buy ingredients and make your own food than "ready to eat".  There are many of quick recipes you can put together that don't require much time or effort. 

Microwave dinners and pre-prepared foods are very convenient but not necessarily healthy choices.  They tend to be high in sodium, carbohydrates, calories, and fat.  It is important that she reads (and understands) the nutrition labels of these products that she is buying.

Here are some suggestions for some healthier meals that don't require cooking:

1.  Rotisserie Chicken :  Many supermarkets have this ready to purchase. Remove the skin before eating. Serve with the frozen green vegetable of your choice (which can be microwaved) and parboiled microwaveable brown rice (which is done in 90 seconds).

2.  Grilled Chicken Strips:  Several brands sells them (not the breaded kind).  Put over a bed of bagged baby spinach and other cut vegetables.  Lightly dress with olive oil and lemon juice.

3.  Tuna fish (or use canned salmon) packed in water over salad greens and fresh vegetables

4.  Hummus with sliced veggies (red peppers, cucumbers, tomatoes) in a whole wheat pita

5.  Homemade Mini Pizzas --Multi Grain English Muffins with Tomato Sauce, Low Fat Shredded Mozzarella and veggies.

6.  Hardboiled Eggs (which can be purchased pre-made) over bagged salad greens and cut vegetables.

7.  Pasta Primavera:  Get various frozen vegetables such as broccoli and spinach and microwave them.  Toss with pasta and sauce.

Question of the Week: "What to do if I don't like vegetables?"

The following question was submitted for discussion on this week's blog: "I have a very big issue when it comes to having diabetes and that is I do not eat vegetables.  I have tried.  I want control my diabetes and be around to raise my young children.  What suggestions do you have to add vegetables to my diet?"

Vegetables are an important part of a balanced diet.  Not only are they full of important vitamins, minerals, and phytonutrients, but they are full of fiber which will make you feel fuller, for longer.  Additionally, if your young children see you eating vegetables as part of your diet, they will be more likely to do the same.

First you need to ask yourself what was it about the vegetables that you didn't enjoy?  Was it the texture?  Vegetables don't need to be raw in order to be healthy.   You can cook them if it is the "crunch" that you disliked.  

There is an infinite amount of ways to prepare vegetables:  grilling, sauteing, stewing, roasting.  Maybe preparing them in a different fashion will change your mind.   Try a vegetable kebab - grill the vegetables until tender and include pineapple chunks to add a sweet flavor to the vegetables.

Why not try adding seasonings to the vegetables may increase your enjoyment of them?  Try onion, garlic olive oil.... Open your pantry and try a new seasoning or spice.  Create a sauce to simmer them in such as tomato, pesto, ......  Let your imagination go wild.

There are countless types of vegetables to choose from.  Go to your market and try something new.  It's possible that you may find something else you may enjoy. 

Grab a cookbook or look up recipes on line and give something new a shot.