Meal planning in Diabetes

As soon as you are diagnosed with Diabetes, whatever you put in your mouth becomes important. Meal planning in Diabetes can be a challenging task, but with a good nutritional knowledge food doesn't have to be a problem, it can be the solution. A healthy meal plan can be approached on three levels: What to eat, when to eat and how much to eat..What to eatAmongstthreemacronutrientscarbohydrates(carbs),proteinsandfats-carbohydrateshavethemajorimpactonbloodglucoselevels.Theyarethemaincontributorforbloodglucose.Butitdoesn'tmeanthatyouneedtoavoidyourcarbintake.The American Diabetes Association (ADA) recommends that people with Diabetes eat no less than 130 grams of carbs daily as carbs not only provide energy but are good source of other essential nutrients like vitamins, minerals and fibres- all essential for good health. Glycaemic response will depend on type of carbohydrate (simple or complex carbs) and amount of carbohydrate ingested.There is no such a diabetic diet, rather a balanced meal plan which contains all food groups in recommended amount is the key to a healthy life. A balanced meal plan includes whole grains, pulses, legumes and lean protein, good fats, fruits and vegetables in a recommended portion. A nutrition prescription needs to be tailored considering an individual's age, activity, weight, food intake, metabolic status, lifestyle and cultural practices. When to eatRegularity in meal timings is very crucial for good glycaemic control. Eat at least three meals with snacks spaced throughout the day. Eating a consistent amount of carbs in each major meal and in each small meal for each day can help for good glycaemic control. Do not skip meals. People with Diabetes who are on medications or insulin need to match their doses with the grams of carbohydrates to be taken for each major meal. Waiting too long for meals after insulin can lead to hypoglycaemia (very low blood glucose levels). One way to keep track of your intake and medicines is to maintain your own log book. How much to eatPortion control is the key for good glycaemic control.Carbohydrate counting is the tool to measure the grams of carbohydrates in each meal. There are different types of measuring tools available for counting the carbohydrates in the meals. Portion control and learning what a serving size looks like is critical part of meal planning. The tools that can help you to consume right amounts of foods include:. Measuring cups. Measuring spoons. Weighing scale. Nutrition facts label on food packages can guide on how much calories and carbohydrates are there in one serving. Hand guide for measuring the food portionInitially weighing foods can be a little tricky, but with practice one will be able to visualise correct portion sizes. A very simple visual tool to estimate portions is a plate method. It is very useful for people who have just been recently diagnosed with Diabetes. 9 inch plate is an ideal plate for major meals like lunch and dinner whereas.7 inch diameter plate is an ideal plate for breakfast. Ideal meal plate is divided into three sections.. Ensure half the plate is covered with non-starchy vegetables like spinach, lettuce, fenugreek and other greens, cabbage, green beans, broccoli, cauliflower, pumpkin, bottle gourd, bitter gourd, ridge gourd, tomatoes, onion, cucumber, okra, mushrooms, peppers, turnip.. One quarter of the plate should contain protein such as pulses, legumes like dals or sprouts or lean meats, fish, low fat cheeses, eggs, or soya and dairy.. One quarter of the plate should contain cereals like chapatti, rice, whole wheat bread.. A fruit portion can be add for small meals.This meal planning approach is easy to use at restaurants and other settings where it is difficult to measure foods.Another tool to gauge a healthy serving size is to use your hands. People can use their hands to estimate the correct portion size of the food that they should eat. This simple nutritional strategy can be adopted when eating away from home. Based on average sized woman's hands, the amount may vary from person to personSome more tips for portion control:. Do not multi-task while eating. Avoid snacking in front of computer or television.. Size matters, stick to regular or standard sizes of foods and beverages instead of large or oversized meals.. Use smaller plates, spoons and bowls. Research shows that large plates and bowls cause portion sizes to increase.. Learn to say “No” to second serving. If still hungry, opt for vegetables , soups or buttermilk.. Know what you eat. Read food labels.They give valuable information on servings sizes and quantity of nutrients present.. Restaurants usually serve large portions.Split meals with friends or relatives, when eating out.. Eat slowly and savour your meal.Nutritional guidelinesEating balanced meals - including carbohydrates, proteins and fats based on individual nutritional requirements, is the key to healthy eating. The total number of calories is divided into 3 macronutrients: carbs, proteins and fats. Carbohydrates should comprise 55-60 per cent of total calories; 15-20 per cent of calories should come from protein, while 20-25 per cent of calories should come from fats.Do not skip meals .Eating smaller meals through out the day will keep your energy going and metabolism ontrack. Also,Include all the food groups in your daily routine like whole grains,fruits,vegetables, low fat dairy products, protein foods like fish, poultry, eggs, pulses and legumes.Among macronutrients, carbohydrates have the highest impact on blood glucose. For people with Diabetes, it is important to control the total amount of carbohydrates in their diets. Direct sugars or sweets eaten after a meal are simple carbohydrates and are immediately converted into glucose.Avoiding all simple carbohydrates like sugar, jaggery, honey, refined flour products, bakery products, soft drinks etc. is a good practice for good glycemic control.Remember, a Diabetes plan is a healthy eating plan that encourages portion control and eating a wide variety of nutritious foods. So eat wisely! Rutuja Mahajan is a Registered Dietician.