David M. Rider, MD
August 2010
This talk is NOT:
 A substitute for an individualized plan designed by a
nutritionist, dietician or your personal physician
 Universally applicable for all people with Diabetes,
especially those with “brittle” diabetes
 A set of hard and fast rules that you MUST obey
 The final say on the subject of diabetes and diet
Who am I?
I’m not a
nutritionist
I’m not an
expert chef
I’m also
learning
Who am I?
 I have many, many diabetic patients who I
have guided to success in controlling their
diabetes
 One of them had “success” through
medicine alone
 Most of them exercise a LOT
 Most of them eat a LOT of salads
 None of them count carbs
The bottom line:
We all want to look good and feel good
The bottom line:
And most diabetics ended up that way because
food makes us feel good
The bottom line:
We need to re-define “good food.”
Good food not only feels good to
eat but is ALSO protective
against diabetes AND makes
you look and feel great.
Some universal truths:
 Americans eat too many calories every day with not
enough exercise
Weight Gain per Person in pounds from 1988 to 2008
Males
Females
Arkansas
Virginia
Oklahoma
Arizona
Texas
19.9
20.2
20.7
21.2
24.2
California
Alaska
Kansas
Texas
New Jersey
21.7
22.2
22.4
22.6
26.2
Some universal truths:
Not only do we eat too many calories, but the ones we
choose are not the ones we are designed to eat.
How Colorful is your Plate?
Some universal truths:
Sorry!
You can’t lose and keep
off significant
weight/fat without
exercise, and lots of it.
Sustainable success is
not only about burning
fat, but about building
muscle.
The Meat of This Program
Carbohydrates:
 Simple: table sugar, bleached
flour, white rice

Turn right into sugar
 Complex: Whole Grains,
vegetables

Take longer to digest
Sugar Substitutes
Sucralose / Splenda:
- No calories, not recognized as
sugar or carbohydrate but 600
times sweeter than sugar. No
aftertaste, very heat stable,
ideal for baking.
Aspartane / NutraSweet
- No calories, 200 times sweeter
than sugar, does not hold up
as well under heating.
Fiber: AKA yummy plant stuff you
can’t digest
Bulky and Absorbs Water
 Fills you up faster
Keeps blood sugar levels
steady
Slows Down Digestion
 avoid post-meal spikes
 Prolongs satiation
Helps maintain high energy
Binds together waste
 Fluctuations wear you out
 Keeps you regular
Full of Phytochemicals
Reduces fat and cholestrol
in your blood
 The REAL vitamins
 Protects your heart
Deliciou
Fillin’ up with Fiber (20-30g/day)
It’s Whole Wheat or Nuthin’. Period.
2. Don’t Peel the Skins!
3. Add Wheat Germ or bran to meat loafs, casseroles,
yogurt
4. Beans, beans, they’re good for your heart (half cup
with up to 10 grams of fiber!)
1.

Add beans to salad, just open up a can! Chickpeas!
5. White vs Wheat.. Wha?
 The first ingredient should be “Whole Wheat Flour”
Protein
Almost any natural food (vegetables, grains, nuts, beans)
is chock full of proteins.
 Protein takes a lot of work to break down,
so it is digested slowly.
 Causes a more gradual rise in sugar levels
 Decreases Hunger! (no one knows why,
but it seems carbs stimulate it)
What about Fat? ?
Fat is Yummy.
It’s true, don’t deny
the truth, and don’t
deny yourself some
FAT.
Fat helps us feel satiated (full). Most people on low-fat
diets end up consuming far more calories than they do
when they allowed themselves to eat some steak. And
most gain the weight back.
Bad Fat, Good Fat
Saturated Fats
Is it solid at room temperature? Is it
from an animal? It’s probably bad in
excess.
Unsaturated Fats
Is it liquid, from fish, avocado or nuts?
It’s probably great for you – Eat up!
Worst Fat
Counting Carbs
Beyond the scope of this talk.
I have approximately zero patients that do
this regularly.
But that doesn’t make it okay to NOT think
about what you eat.
Instead of Counting What we CANT
eat… Eat these a LOT!
Non-starchy Vegetables
(eat 5 a day!)
Nuts!
Beans!
Avocados and Good Fat!
14 Foods to Eat
 Green Leafies most meals
 Lean, not Mean protein




(seafood, chicken)
Seafood 2-3 x weekly
Beans (at least half a cup a day)
Whole grain or Skip the grain
(eating out? If it’s not whole
wheat rice then get double
veggies)
Cruciferous Veggies (broccoli,
cauliflower, cabbage, turnip,
radish, watercress)
 Handful of Nuts Every day
(lower cholesterol and
improve satiety)
 Berries
 Soy products (chorizo, facon)




Garlic and herbs
Green Tea
Non-fat yogurt
Chocolate and Cacao (dark,
semi-sweet 60-70% cacao. 1st
ingredient should not be sugar!)
 Fiber…
FIBER!
 Improves insulin levels
 Decreases cardiovascular disease
 Fills you up
 Decreases weight
 5 cups of vegetables and fruits per day
 Plate should be COLORFUL
 The best food predictor of losing weight is FIBER
Can I give a shout out to Salad?
… And throw some beans or chickpeas in there!
Serving Sizes
Our serving sizes are TOO BIG! Two tricks to limiting
size:
1. Don’t go out to dinner, cook at home instead.
Is your food touching itself on your plate?
Too much!
2. Go out to eat and share an entrée.
The bottom line:
We all want to look good and feel good
A (sort of) Simple Equation
Want to maintain your weight?
Multiply by 10 and add
a) 300 if you are totally sedentary
b) 500 if you are moderate active
c) 700 if you are very active
(example: 200 lbs and moderately active = 2500 calories)
A (sort of) Simple Equation
Want to LOSE weight?
One pound is 3500 calories.
Half a pound a week is 250 calories less per day
One pound per week is 500 calories less per day
Two pounds per week is 1000 calories less per day
A (sort of) Simple Equation
Want to have some look good and lose weight?
One pound of muscle burns 40 calories a day just
sitting there.
That’s 40 x 365 = 14,600 calories a year or 4.17
pounds. Just sitting there.
The Nutrition Facts Label
The Percent Daily Value
The % DV is based on
100% of the daily value
for each nutrient.
No % Daily Value
 Trans Fat
 Sugars
 Protein
Conclusions
Number One
We need to re-define “good food.”
Good food not only feels good to
eat but is ALSO protective
against diabetes AND makes
you look and feel great.
Conclusions
Number Two
Eating healthy is important, but it’s not
enough. You have to sweat regularly.
Conclusions
Number Three
Non-starchy Vegetables
(eat 5 a day!)
Nuts!
Beans!
Avocados and Good Fat!
Focus on what you CAN eat!
Conclusions
Number Four
Some basic
background can
allow you to
adjust most any
decent recipe to
one that is
SUPER diabetic
friendly
Questions?