Living with Diabetes:
Ingredients, Labels, Recipe
Modification & Eating Out
Barbara Brown, Ph.D., R.D./L.D.
Food Specialist
Oklahoma Cooperative Extension
Service
2005
Oklahoma Cooperative Extension Service
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Today we will
• Examine features of food labels
important for diabetics to read &
understand
• Look at functions of ingredients in
food & available market substitutions
• Receive tips for recipe modification
• Learn suggestions for eating out with
diabetes
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Food labels:
Key points for diabetics
• Ingredient list
• Nutrition Facts panel
• Serving size
• % Daily Value
• Nutrient content claims
• Health claims
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Ingredient list
• In descending order by weight
• Need to know terms for
carbohydrates & fat
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Several formats available
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Using Nutrition Facts
• Top changes with food
• Product-specific info.
(serving size, calories,
nutrient info.
• Bottom footnote with Daily
Values for 2,000 & 2,500
calorie diets
• Found only on larger
packages
• Does not change
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Serving size
• Standardized to ease comparison of
similar foods
• Amounts usually eaten at 1 time
• Given in household & metric measures
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Serving size vs. exchanges
• Nutrition Facts serving may not equal
exchange serving
• Examples
• Fruit juice:
• Nutrition Facts = 1 c, exchange = 1/2
cup
• Oatmeal:
• Nutrition Facts = 1
• Exchange = 1/2 cup
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Daily Values
• Made of 2 dietary
% Daily Value
standards
• Daily Reference
Values (DRVs)
• Reference Daily
Intakes (RDIs)
• Only “Daily Value”
appears on label
• Based on 2000 cal diet
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Trans fat
• Required by 1/1/06
• Increases low-density
lipoprotein (LDL)
cholesterol levels
• Raises risk of
coronary heart
disease
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Hydrogenation changes shape
Unsaturated fat
Trans Fat
H H
| |
-C = C-
H
|
-C = C|
H
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Using Trans fat information
• Combine grams
saturated fat &
trans fat & look
for lowest
combined amount
• Look for lowest
% Daily Value for
cholesterol
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Making the best fat choice
Butter
Saturated Fat: 7g
+ Trans Fat: 0g
Combined Amt: 7g
Cholesterol: 10%
2005
Margarine, stick
Saturated Fat : 2g
+ Trans Fat : 3g
Combined Amt: 5g
Cholesterol: 0%
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Making the best fat choice
Margarine, stick
Saturated Fat: 2g
+ Trans Fat: 3g
Combined Amt: 5g
Cholesterol: 0%
2005
Margarine, tub
Saturated Fat: 1g
+ Trans Fat: 0.5g
Combined Amt: 1.5g
Cholesterol: 0%
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Nutrient content claim: free
• No, only trivial or "physiologically
inconsequential" amount of 1 or more of:
• fat, saturated fat, cholesterol, sodium,
sugars, calories
• "calorie-free" = less than 5/serving
• "sugar-free" & "fat-free" = less than
0.5g/serving
• Synonyms: "without," "no," "zero"
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Nutrient content claim: low
• Can be used on foods that can be
eaten frequently without exceeding
dietary guidelines for one or more of:
• Fat, saturated fat, cholesterol,
sodium, and calories
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Low: descriptors
•
•
•
•
•
low-fat: 3g or less/serving
low-saturated fat: 1g or less/serving
low-sodium: 140mg or less/serving
very low sodium: 35mg or less/serving
low-cholesterol: 20mg or less & 2g or
less of saturated fat/serving
• low-calorie: 40 calories or
less/serving
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“Low-carb” labeling
• “Net carbs,” “effective carbs”
• No federal regulation defines
• Typically used as result when fiber
& certain sweeteners (sugar alcohols
& glycerin) are subtracted from
total carbohydrate content
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Lean & extra lean
• Can describe fat content of meat,
poultry, seafood, & game meats
• Lean: less than 10g fat, 4.5g or
less saturated fat, & less than
95mg cholesterol/serving & per 100g
• Extra lean: less than 5g fat, less
than 2g saturated fat, & less than
95mg cholesterol/serving &
per 100g
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More nutrient content claims
• High: food contains 20% or more of
%DV for a particular nutrient/serving
• Good source: food contains 10-19% of
%DVfor a particular nutrient/serving
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Reduced
• Nutritionally altered food contains at
least 25% less of a nutrient or
calories than the regular food
• Claim can't be made if regular food
already meets requirement "low"
claim
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Less
• Food, whether altered or not,
contains 25% less of a nutrient or
calories than the regular food
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Meanings of Light
• 1/3 fewer calories or 1/2
fat of reference food
• Sodium content of lowcalorie, low-fat food
lowered 50%
• Can describe texture &/or
color
• Label must explain
intent
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When label says “More”
• 1 serving contains a nutrient that is
at least 10% of Daily Value more than
in reference food
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Health claims
• Describe how food or
food component relates to
a disease or healthrelated condition
• Wording regulated by
FDA
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3 types of health claims
1. Approved
2. Authorized
3. Qualified health claims
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1. Approved health claims
• 1990 Nutrition Labeling & Education
Act (NLEA) provides for FDA to issue
regulations authorizing health claims
for foods & dietary supplements after
FDA's careful review of scientific
evidence submitted in petitions
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Approved health claims
•
•
•
•
Calcium & osteoporosis
Sodium & hypertension
Dietary fat & cancer
Dietary saturated fat & cholesterol &
risk of coronary heart disease (CHD)
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Approved health claims
• Fiber-containing grain products,
fruits, & vegetables & cancer
• Fruits, vegetables & grain products
that contain fiber, particularly soluble
fiber, & risk of CHD
• Fruits & vegetables & cancer
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Approved health claims
• Folate & neural tube defects
• Dietary sugar alcohol & dental caries
• Soluble fiber from certain foods &
risk of CHD
• Soy protein & risk of CHD
• Plant sterol/stanol esters &
CHD risk
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2. Authorized health claims
•
•
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1997 FDA Modernization Act
(FDAMA) provides for health claims
based on an authoritative statement
of a scientific body of the U.S.
government or National Academy of
Sciences
Such claims may be used after
submission of notification to
FDA
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Claims authorized based on
authoritative statements by
federal scientific bodies
• Whole grain foods & risk of heart
disease & certain cancers
• Potassium & risk of high blood
pressure & stroke
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3. Qualified health claims
•
•
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2003 FDA Consumer Health
Information for Better Nutrition
Initiative provides for qualified
health claims where the quality and
strength of scientific evidence falls
below that required to issue an
authorizing regulation
Claims must be qualified to assure
accuracy & non-misleading
presentation to consumers
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Allowed qualified health claims
• CHD risk
• Nuts, walnuts
• Omega-3 fatty acids
• B vitamins & vascular disease
• Monounsaturated fatty acids from
olive oil
• Neural tube defects
• 0.8mg folic acid
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Ingredients of concern
to diabetics
• Carbohydrates
• Simple—Sugars
• Complex—starches
• Fiber—indigestible carbohydrates
• Low-calorie sweeteners
• Fats
• Sodium
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Simple carbohydrates—
Sugars or caloric sweeteners
• Occur naturally in fruits, dairy
products, some vegetables, honey,
molasses
• Refined sugars used in processing & as
sweetener
• Most high sugar foods have lower
nutritional value
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Functions of sugar in foods
•
•
•
•
•
Sweetener
Tenderizer in baking
Caramelize under heat
Enhance growth of yeast
Control gelling process in
jellies/preserves
• Preservative
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Functions of sugar in foods
• Add to smoothness of frozen desserts
• Increase consumption of nutrient-rich
foods that would probably not be
eaten
• Examples: oatmeal, grapefruit,
cranberries
• Incorporate air into shortening during
creaming
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Functions of sugar in foods
• Stabilize egg foams
• Delay coagulation of egg proteins in
custards
• Improve appearance & tenderness of
canned fruits
• Help retain color & flavor of frozen
fruits
• Enable wide variety of candies
through varying degrees of
recrystallization
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Caloric sweetener choices
• Table sugar is most common
• Contains glucose + fructose
• Includes light & dark brown sugar
• Other high sugar ingredients
• Honey
• Molasses
• Corn syrup
• Maple syrup
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Ingredient label words
meaning sugar
•
•
•
•
•
Sucrose
Fructose
Galactose
Glucose
High-fructose
corn syrup
(HFCS)
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• Lactose
• Maltose
• Other “ose”
words
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More label terms
• “Naturally occurring sugars”
• Those in food/beverages that come
from ingredients themselves
• Fruits, vegetables, milk
• “Added sugars”
• Added during manufacturing,
cooking, at table
• Sucrose, corn syrup, HFCS,
honey, molasses, etc.
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“No sugar added”
• No form of sugar added during
processing
• No high-sugar ingredients
• May still be high in carbohydrate
• Read Nutrition Facts panel
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Major sources of added
sugars in U.S. diet
Source: Dietary Guidelines for Americans 2005
Food Categories
% of total added
sugars consumed
Regular soft drinks
33.0
Sugars and candy
16.1
Cakes, cookies, pies
12.9
Fruit drinks
9.7
Dairy desserts &
sweetened milk foods
8.6
Other grains
5.8
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Fructose
• A monosaccharide
• Added to foods in liquid or crystalline
form
• Crystalline form made from corn
starch
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Liquid form: High fructose corn
syrup (HFCS)
• Glucose + fructose
• Made from corn syrup
• Examples:
• HFCS 42 used in baking (42%
fructose)
• HFCS 55 used in beverages (55%
fructose)
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HFCS & foods
• Amount eaten has risen in parallel
with increasing obesity
• Does not prove HFCS causes obesity
• Proportion of total sugar in diet has
remained constant since 1970 (1516%)
• Table sugar has gone down
• Total caloric intake rose from 3300
to 3900/person from 1970-2000
• Based on availability data
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Sugar substitutes
(low-calorie sweeteners)
• Don’t affect blood sugar levels
• Some foods containing artificial
sweeteners can still affect blood
sugar because of other carbohydrates
or proteins in the foods
• Foods containing artificial sweeteners
may be sugar-free but may not be
carbohydrate-free
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Choosing sugar-free foods:
read labels carefully
• Compare carb content of sugar-free
with standard food
• Big difference—may be reason to
buy sugar-free
• Little difference—base choice on
taste, cost
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Potential benefits to diabetics
• Offer way to control caloric intake
• Help with weight control & weight loss
• Help reduce calorie intake &
therefore help lose weight
• Provide greater variety of low calorie
foods & beverages
• Easy to incorporated into diet
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Product
Calories
with
Sugar
Soft drink (12 oz.)
150
0
150
35
5
30
230
100
130
170
90
80
70
10
60
160
80
80
Coffee (1 cup)
Strawberry yogurt
(1 cup)
Vanilla ice cream
(1/2 cup)
Gelatin dessert
(1/2 cup)
Chocolate pudding
(1/2 cup)
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With
Cal.
Low-Cal.
Saved
Sweetener
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Low-calorie sweeteners
• Sweet taste with few or no calories
• Undergo extensive safety testing
• All FDA-approved meet same safety
standard
• Will not perform most of sugar’s
functions in recipes
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Currently approved low-calorie
sweeteners
Brand names
Times sweeter
than sucrose
Acesulfame
potassium
Sweet One, Swiss
Sweet, Sunett
600
Aspartame
NutraSweet,
Equal
200
Saccharin
Sweet N Low,
Sugar Twin
300
Sucralose
Splenda
600
Sweetener
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Currently approved low-calorie
sweeteners
Sweetener
Neotame
7,000-13,000
Tagatose (made
from lactose)
Blends
2005
Times sweeter
than sucrose
Almost the same
Synergistic effects
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Problems using low-calorie
sweeteners in food
• Perform few of the functions of sugar
• Do add sweetness
• Some add bulk
• Aspartame/NutraSweet looses flavor
when heated
• Saccharin becomes bitter when
heated
• Use recipe formulated for product
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Sugar alcohols
• “Polyols”
• Chemical structure resembling both
sugar & alcohol
• Contain no ethanol like alcoholic
beverages
• Most are half as sweet as sucrose
• Maltitol & xylitol almost =
sweetness of sucrose
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Sugar alcohols & calories
• Incompletely metabolized & absorbed
so body gets fewer calories
• 1.5 to 3 calories/gram
• Often combined with low-calorie
sweeteners
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Occurrence of sugar alcohols
• Naturally in fruits & vegetables
• Commercially produced from sucrose,
glucose, starch
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Functions in food
• Add bulk & texture
• Replace sugar 1:1
• Also used to replace fat
• Provide cooling effect or taste
• Inhibit browning that occurs during
heating
• Retain moisture in food
• Lower calories in food
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Sugar alcohols in foods
Sugar
alcohol
Cal/
gram
Approx.
sweetness
Typical food applications
(sucrose =
100%)
Candies, chewing gum, frozen
desserts, baked goods
Sorbitol
2.6
50-70%
Xylitol
2.4
100%
Chewing gum, gum drops,
hard candy, specialty foods
Hard candy, chewing gum,
chocolates, baked goods, ice
cream
Maltitol
2.1
75%
Isomalt
2.0
45-65%
2005
Candies, toffee, lollipops,
fudge, wafers
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Sugar alcohols in foods
Sugar
alcohol
Lactitol
Mannitol
2005
Approx.
Cal/ sweetness
Typical food applications
gram (sucrose =
100%)
Chocolate, some baked
goods, hard & soft
2.0
30-40%
candy, frozen dairy
desserts
Dusting powder for
chewing gum, chocolate1.6
50-70%
flavored coating for ice
cream & confections
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Sugar alcohols in foods
Approx.
Cal/ sweetness
Sugar alcohol
gram (sucrose =
100%)
Erythritol
Hydrogenated
starch
hydrolysates
(HSH)
2005
0.2
3.0
Typical food
applications
60-80%
Bulk sweetener in
low calorie foods
25-30%
Bulk sweetener in
low calorie foods,
provide sweetness,
texture & bulk to
variety of sugarless
foods
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Labeling & sugar alcohols
• Must include names on ingredient list
• Nutrition Facts
• Company may declare voluntarily the
number of grams/serving
• If more than 1 in food, must use
phrase “sugar alcohol”
• Required if “sugar-free” or “no
sugar added” claim is made
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Modifying sugar in recipes
• Identify ingredient(s) to change
• Sugar, brown sugar, honey,
molasses, corn syrup, maple syrup
• Consider function in recipe
• Options
1.Leave it alone
2.Reduce amount
3.Replace with other sweetener
4.Leave it out
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General suggestions
• Baked goods & desserts: cut by 1/41/2
• In quick bread, cookies, pie fillings,
custard, puddings, & fruit crisps
• Less desirable for some cakes
• Don’t decrease sugar in plain yeast
breads
• Increase sweet spices, vanilla
• Raises impression of sweetness
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General suggestions
• Decrease or
eliminate sugar
when canning &/or
freezing fruits
• Use unsweetened
frozen fruit or
fruit canned in juice
or water
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Complex carbohydrates
• Starch
• Primary part of:
• Grains (bread, rice,
pasta)
• Potatoes
• Beans
• Some vegetables
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Reducing carbohydrates in
traditional foods
• Has been done in
breads, pasta,
cereals, cookies,
cakes, juice, soft
drinks, candy
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Methods to reduce
carbohydrates
• Increase amount of animal or
vegetable protein
• Replacing wheat or corn flour with
soy flour
• Examples: soy-based chips, pasta,
breads
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Methods to reduce
carbohydrates
• Increasing fiber
• Example: fiber such as cellulose
replaces digestible form of
carbohydrate
• Used in candy, cereals, bread,
pasta
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Methods to reduce
carbohydrates
• Sugar substitutes or sugar
alcohols (polyols) used in
place of traditional
sweeteners
• Used in soft drinks, fruit
drinks, baked goods,
frozen desserts
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Methods to reduce
carbohydrates
• Smaller portions
• Used for baked goods
• Bread—thinner slices
• Desserts—smaller
pieces or less/single
serving container
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Dietary fiber
• Excellent source contains five grams
or more/serving
• A good source contains 2.5—4.9
grams/serving
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Ingredients that indicate fiber
• Fruits & vegetables, especially those
with edible skin (apples, beans) &
those with edible seeds (berries,
summer squash)
• Fresh, frozen, canned, dried
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Terms & ingredients that
indicate fiber in grains
• Whole wheat pasta
• Whole grain cereals (whole wheat,
wheat bran, oats)
• Whole grain breads
• To be good source, one slice = at
least three grams fiber
• First ingredient whole grain
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Ingredients that indicate fiber
• Beans & legumes
• Nuts: good source of fiber & healthy
fat
• Watch portion sizes—many calories
in a small amount
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Modifying recipes to
increase fiber
• Keep peel on fruits & vegetables
• Add extra produce to casseroles,
soups, salads & other dishes
• Add produce to muffins, pancakes &
desserts
• Substitute whole-wheat flour for 1/2
of all-purpose flour in making breads,
muffins, pancakes, other grain
products
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Fats: Functions in food
•
•
•
•
•
•
2005
Texture
Crispness
Creaminess
Mouthfeel
Volume
Flavor
• Transmit heat
quickly
• “Juiciness”
• Retain moisture
• Extends shelf
life
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Most popular fat-reduced foods
Food Item
% Reduced-fat
consumers
62
Fat-free or low-fat milk
Salad dressings, sauces,
mayonnaise
Cheese/dairy foods
Margarine
Chips/snack foods
Meat products
Ice cream/frozen desserts
Cakes/baked goods
Dinner entrees
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Candy
65
50
44
40
39
36
32
30
18
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Replacing fats:
Systems approach
• May require more than one ingredient
• Synergistic components used to reach
functional & sensory characteristics
of full-fat version
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Sources of fat replacers
• Protein-based
• Carbohydrate-based
• Fat-based
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Fat replacers: protein-based
• Micropaticulated protein: Simplesse
• From whey, milk or egg protein
• Digested as protein
• Modified whey protein concentrate:
Dairy-Lo
• Heat denatured protein
• Other: K-Blazer, Ultra-Bake,
Ultra-Freeze, Lita
• Use different process or base
protein (corn)
2005
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Fat replacers:
carbohydrate-based
• Cellulose: purified & ground to
microparticles that form network with
mouthfeel & flow of fat
• Dextrins: Amylum, N-Oil
• 4 cal/gram
• Fiber: Opta, Oat Fiber, Ultracel, ZTrim
• Gives structure, volume, holds
moisture, adhesiveness, shelf life
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Fat replacers:
carbohydrate-based
• Gums: Kelocgel, Keltrol, Slendid
• Guar gum, gum arabic, locust bean gum
xanthan gum, carrageenan & pectin
• Non-caloric, thicken or gel, promote
creaminess
• Inulin: Raftiline, Fruitafit, Fibruline
• 1-1.2 cal/gram
• Fiber & bulk
• From chicory root
2005
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Fat replacers:
carbohydrate-based
• Maltodextrins: CyrstalLean, Lorelite,
Lycadex, Maltrin, Paselli D-Lite,
Passeli Excel, Paselli SA2, STAR-DRI
• 4 cal/gram
• From corn, potato, wheat & tapioca
• Fat replacer, bulk, texture modifier
2005
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Fat replacers:
carbohydrate-based
• Nu-Trim
• From oat & barley
• Oatrim: Beta-Trim, Trim Choice
• Hydrolyzed oat flour
• Fat replacer, body, texturizer
• 1-4 cal/gram
2005
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Fat replacers:
carbohydrate-based
• Polydextrose: Litesse, Sta-Lite
• 1 calorie/gram
• Fat replacer & bulking agent
• Polyols
• 1.6-3.0 calories/gram
• Plasticizing & humectant properties
allow use as fat replacers
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Fat replacers:
carbohydrate-based
• Starch & Modified Food Starch
• Provide body & texture
• 1-4 cal/gram
• From potato, corn, wheat, oat,
rice, tapioca starches
2005
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Fat replacers:
carbohydrate-based
• Z-Trim
• From insoluble fiber
• Oat, soybean, pea & rice hulls,
corn or wheat bran
2005
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Fat replacers: fat-based
• Emulsifiers
• 9 calories/gram but less is used
• Salatrim
• Short & long-chain acid triglyceride
molecules
• Cal/gram varies
• One with 5 cal/g in use
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Fat replacers: fat-based
• Lipid (Fat/Oil) Analogs
• Olestra
• Calorie-free
• 6-8 fatty acids attached to
sucrose molecule
• Passes through body undigested
• Stable under high heat
• Approved in salty snacks &
crackers
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Olestra
• May reduce absorption of fat soluble
vitamin & carotenoids eaten at same
time as olestra containing food
• Label cautions:
• Some people may experience
temporary digestive effects
• Vitamins A, D, E, K have been
added
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Substituting fat ingredients
with lower fat options
•
•
•
•
2005
Cream, whole milk: evaporated fat-free
milk or chicken broth thickened with
cornstarch or flour
Butter: soft tub margarine
Cheese: non-fat or low fat cheeses or
1/2 original cheese & ½ low fat or replace
with reduced amount of sharper cheese
Meat: use lower fat cut or meat, or
replace with soy-based substitute
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Substituting fat ingredients
with lower fat options
• Ice cream: lowfat or fat-free
versions
• Whole eggs: 2 egg whites for each
whole egg or egg substitutes
• Sour cream: mix nonfat yogurt with
light sour cream, or nonfat sour
cream or plain lowfat or nonfat yogurt
• Whipped cream: nonfat or lowfat
versions of commercial products
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Low fat guidelines for recipes
• For recipe to be low fat, 1 serving should
have 10g fat or less for main dish, & 5g or
less for dessert, side dish, snack
• 1 teaspoon fat = 5g so look at total oil or
margarine in recipe & number of servings
• 1 cup of oil = 48 teaspoons
• To be “low fat” recipe with 1 cup oil
needs to serve 48 as side dish, 24 as
main dish
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Low fat guidelines for recipes
• Recipes with more than 1/2 cup fat
are probably too high in fat to bother
trying to modify
• Take recipe with 1/2 cup or less &
cut fat by half
• May need additional liquid
• Use skim milk, water, fruit juices
as appropriate
2005
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Low fat guidelines for recipes
• If cutting fat in 1/2 worked well,
next time cut fat a little more, until
product has right amount of fat per
serving & still tastes good
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Fat modified recipe problems?
• Replace only 1 source of fat at a time
• Reduce fat slowly to level where
changes are unacceptable
• Choices if changes are unsatisfactory
• Have favorite recipe less often
• Cut down on serving size
• Serve dish with lowfat foods
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Supermarkets “health” trends
from the Center for Science in the Public Interest
• Health trends caused by
• Pressure to sell health
• Obesity, trans fat, whole grains
• Replacing carbs
• FDA allows more health claims on
foods
• “scientific evidence suggests…”
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1. More whole grains
• General Mills: All GM Cereals are
made with WHOLE GRAIN!
• Example: Trix
• Means some, not all flour, flour is
whole grain
• Still high in sugar
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2. Less sugar
• Sugar-free Milanos, SnackWell’s
Sugar-Free Fudge Brownie & oatmeal
cookies label: “not for weight control”
• Ask:
• Is it lower in calories?
• Has the serving size changed?
• Does it use only Splenda?
• Is it nutrient dense?
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3. No trans fat
• Hershey’s Chocolate Dipped cookies
have no trans fat but 5g saturated
fat/serving
• Ask:
• Did it ever have any?
• Is it high in saturate fat?
• Is it really trans-free?
• “free” = 0.5g or less
• If 0.49/serving x 3 = 1.47g
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4. More functional fiber
• Fiber in Dannon yogurt fiber from
maltodextrin—3g/1/2 cup
• Breyer’s CarbSmart ice cream fiber
from polydextrose
• Many breads raise fiber with cellulose
from oat hull fiber, wheat fiber, pea
fiber, soy fiber, cottonseed fiber,
wood pulp
• Most are low in phyotchemicals
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4. Functional fiber
• Ask
• How much fiber?
• Is it naturally occurring fiber?
• Studies on benefits generally use
dietary, not functional
• Could it cause cramps or diarrhea?
• Sugar alcohols may
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5. Weaker claims
• FDA allows qualified claims “scientific
evidence suggests,” not “proves”
• Claims based on weaker evidence
• Example: Kashi Heart to Heart
• Ask:
• Weak claim words: “supports,”
“maintains,” “promotes,” “evidence
suggests”
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6. More omega-3 fats
• Added to pasta from ground flaxseed
• Example: Barilla Plus pasta
• Also found in margarine spreads,
breads, eggs, bars
• Other ALA sources include walnuts,
canola & soy oils
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6. More omega-3 fats
• Problem: flaxseed high in alphalinolenic (ALA) acid not a longer-chain
omega-3’s eicosapentaenoic acid (EPA)
& docosahexaenoic acid (DHA)
• Not clear if ALA lowers sudden
death heart attack risk like EPA,
DHA
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7. Self-styled symbols
• Companies highlight healthier products
• Example: Life cereal
• “Smart Choices Made Easy” logo
• Kraft products may have “Sensible
Solution” logo
• Kellogg’s “Healthy Beginnings”
program has 5 logos
• Problem: companies develop own
criteria for healthy foods
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8. More phytosterols
• Natural compounds in small amounts in
fruits, vegetables, nuts & beans
• At high levels can lower LDL
cholesterol about 10%
• Example: Yoplait
• Ask:
• How much per serving? (at least
0.8g)
• Over 3/day, no increased effect
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9. Added vitamins & minerals
• Added liberally to cereals, breakfast
bars
• Example: Kellogg’s Smart Start
• Ask:
• Do you need it?
• Are you getting too much?
• Is it nutrient dense?
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10. Repackaging
• Smaller servings of foods
• Pre-portioned packs inside a large
container
• Example: Oreo Thin Crisps
• Ask:
• Is it nutrient dense?
• How much does packaging cost?
• Is this environmentally friendly?
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11. Low-glycemic foods
• Next big fad???
• Glycemic index measures speed
carbohydrate is digested & raised
blood sugar
• Refined grains/sugars are high
• Whole grains are low
• New products introduced
• 2 in 1999
• 175 in 2004
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Eating out with diabetes
• Requires planning, wise choices
• Work with health care team to
identify goals
• Know how to make changes in meal
plan if restaurant doesn’t have what
you want
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How to order at restaurants
• Phone ahead
• Ask to see menu—what fits plan
• Are changes possible?
• Be assertive, ask questions about
food, ingredients, preparation
• Try to eat same portions as at home
• Share, to-go container, leave on
plate
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How to order at restaurants
• Get meat & fish
• Broiled without added fat
• No breaded & fried—peel off if
can’t avoid
• Order baked potatoes plain & add:
• 1 tsp. margarine or low-cal sour
cream and/or vegetable from salad
bar or menu
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How to order at restaurants
• Ask for no added salt
• “On the side”—sauces, dressings,
gravies
• Read menu creatively
• Fruit cup for appetizer
• Breakfast melon for dessert
• Combine salad with low fat
appetizer as entrée
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How to order at restaurants
• Substitute or omit:
double vegetables instead
of fries or ask for no
fries
• Ask for low fat version of
dressing, margarine, milk
• Limit alcohol to cut
calories
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Eat on time
• Ask others to eat at
your regular time
• Plan to avoid waiting
for a table
• Be on time for
reservation
• Do special dishes take
extra time?
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Eat on time
• If late lunch eat fruit
or starch serving from
that meal at usual time
• For very late dinner
eat bedtime snack at
usual dinner time
• May need to adjust
insulin
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Fast food in America
• 47% of money spent on food will be
spent at restaurants in 2005
• Healthy food is not trend at fast
food restaurants—healthy is for home
• “Taste” important to 93.6%
• “Healthy” important to 69.1%
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Fast food in America
• Fried chicken
fastest-growing
food category
in 2004
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Burger King
• Enormous Omelet
Sandwich:
• 2 eggs, 2 slices
cheese, 3 strips
bacon, 1 sausage
patty
• 730 calories,
47g fat
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Pizza Hut—3Cheese Stuffed
Crust Pizza
• Pepperoni/slice: 360 cal, 14g fat, 7g
saturated fat, 990mg sodium,
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KFC & Ben & Jerry’s
• KFC: Considering
returning to full name
• Ben & Jerry’s—wider
cone holds 2 scoops,
not 1, & no more low
carb choices
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Carl’s Jr.
Monster Thick Burger
•
•
•
•
2/3 pound beef
3 slices cheese
Bacon
Mayonnaisebased sauce
1,420 calories
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Fast food
• Know nutritional value
of foods ordered
• Fast food only once a
day
• Order grilled,
broiled, lean without
fat-based toppings &
breading
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Ordering fast food
• Choose fat-free
milk, sugar-free
beverages
• Watch for “big”
words or “double”
• Choose buns,
bread, English
muffins
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Ordering fast food
• Choose thin crust
pizza with veggies
• Limit dressings on
salads & high-fat
salad bar items
• Limit cheese
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Today you
• Examined features of food labels
important for diabetics to read &
understand
• Looked at functions of ingredients in
food & substitutions available on the
market
• Received tips for recipe modification
• Learned suggestions for eating out
with diabetes
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