By: Keri Peterson, MD —

If you suffer from diabetes, you likely have had to make some changes in your lifestyle. Exercising more often and watching your diet are cornerstones of managing your blood sugar levels. Learning about carbohydrates and how much of them you get in your diet are key to healthy eating. Having adequate fiber in your diet can be helpful in managing your diabetes. Fiber can have an impact on lowering blood glucose levels.

Healthy Carbohydrate Consumption

Fiber is a type of carbohydrate.  When you eat fiber, your body does not completely break it down and it passes through your intestines relatively intact. While we see that fiber is listed under total carbohydrates, it actually does not contribute to your caloric intake because it is not absorbed when your body processes food. That is great news for diabetics. It’s like getting free calories. So how do you know how many grams of carbohydrates you are consuming? Take a look at the nutrition label.  When reading a food label you can look for the grams of fiber and deduct it from the total grams of carbohydrates when calculating the amount of carbohydrates you consume.

Increased Portion Control Habits

Fiber also promotes the feeling of fullness for longer periods of time, which can help decrease your appetite. It adds bulk and fills you up without the calories too so you feel satiated without causing weight gain. Because it is a bulking agent it causes the stomach to become more distended when you eat it which sends signals to the brain that suppress appetite.  Another way it makes you feel full is by slowing down the passage of food through the digestive tract. This helps you reduce overeating to maintain a healthy weight which is optimal in diabetes. Several studies have linked high fiber diets to weight loss. Losing even a relatively small amount of weight will improve insulin sensitivity.

Because fiber is not digested, it passes through into the large intestine. Once fiber gets into our colons, the bacteria that reside there feed on it. Through a process called fermentation, the bacteria create something called short chain fatty acids which have healthy effects on blood glucose levels.  Short chain fatty acids signal the body to become more responsive to insulin and suppress glucose production in the liver.

Reduces Glucose Intake

Fiber has another wonderful benefit for diabetics. It slows the absorption of sugar into your blood stream so you will have better controlled blood sugar levels. There is a gradual rise in blood sugar which keeps blood sugars stable. This will prevent spikes in blood glucose and insulin levels.

The current recommendation for fiber intake is 25 grams per day for women and 38 grams per day for men, but most people don’t get anywhere near that amount. To incorporate more fiber in your diet, read the nutrition label. The grams of fiber are listed under total carbohydrates. Try to aim for 3-4 grams per serving. A variety of foods are rich in fiber. These include whole grains, vegetables, beans and nuts.

Keri Peterson, MD is a medical contributor and columnist for Women’s Health and a frequent guest on NBC’s Today, ABC’s Good Morning America, Fox News and CNN. Based in New York City, Dr. Peterson has been in private practice since 1999 and holds appointments at Lenox Hill Hospital and Mount Sinai Medical Center. With a BA from Cornell University and a Medical Degree from Mount Sinai School of Medicine, she completed post-graduate training in Internal Medicine at New York’s Mount Sinai Medical Center and is board certified in Internal Medicine. Dr. Peterson is a member of the American College of Physicians and the American Medical Association, and serves as a medical advisor for the Calorie Control Council.

The post Fiber and Diabetes Awareness Month: How Fiber is Connected to Your Diabetes Management appeared first on Fiber Facts.

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By: Robyn Flipse, MS, MA, RDN —

Eating out now has a permanent place in our busy lives. The restaurant industry reports 20% of Americans eat out at least once a week, while 45% of us eat out multiple times each week. It’s convenient, offers more choices than what we might have at home, and is a great way to relax and socialize with family and friends without having to clean up afterwards.

But this can be a challenge if you’re one of the more than 100 million adults in the U.S. living with diabetes or prediabetes. You may be wondering, “How can I eat out if I’m following a special diet as part of my diabetes care plan?”

Well, the answer is simple. Just as you must make good choices when deciding what and how much to eat at home, you must also do that when eating out. Menu options may be different, but your personal meal plan remains the same. Since you are the expert about what should or shouldn’t be on your plate, it’s your job to help the person taking your order understand exactly what you want.

As you’ve probably experienced already, restaurants vary greatly in how well they can meet your needs. Those with standardized menus, like fast-food eateries, can’t make many changes since most of their food is portioned and partially prepared in advance. Others places make it clear right on the menu whether they allow substitutions and what special diet options are available, such as low-carb, gluten-free, or vegan.

Since most people living with diabetes need to control the carbohydrates in their meals, two of the most effective ways to do that are to avoid sugar-sweetened drinks and limit servings of bread, pasta, potatoes and other high-carb foods. Ordering a diet drink or adding a low-calorie sweetener to your unsweetened beverage is possible everywhere. Reducing the carb count of your meal can be done by making requests such as:

• No croutons on your salad
• Two vegetable sides instead of one ‘starchy’ side dish and one vegetable
• No bread basket, corn chips or fried noodles on the table
• Toast OR home fries with your eggs, but not both
• Half-portion of pasta, or an appetizer portion, as an entrée

You can find other options by reading the menu thoroughly in order to see everything available in the kitchen. Don’t be afraid to ask for sautéed mushrooms instead of gravy on your chicken or broiled cod in your fish tacos instead of breaded and fried. Chefs are used to getting special requests today and are ready to do what they can to accommodate you. It’s also good for their business if it makes you into a regular customer.

Here are some menu terms that can also help you find better portion sizes and lower prices without even asking.   

A la carte – all menu items are priced separately, salads and side dishes are not typically included with the entrées   

Blue-plate Special – a low-priced meal that typically changes daily and is not on the regular menu

Combination Meal or Combo Meal – typically includes specified food items and a beverage at a lower price if ordered as a “combo” than if ordered separately; sometimes called Value Meal

Early Bird Special – a reduced-priced dinner menu offered during a specified time in late afternoon /early evening

Entrée or Main Course – the most substantial course or dish in a meal (in U.S. and Canada), typically containing the meat, fish or other protein source

Family Style –courses are served on large serving platters to be shared by everyone at the table

Happy Hour – period of time when alcoholic drinks are available at discounted prices with free or reduced-priced appetizers

Prix Fixe or Table d’Hote – a set menu at a fixed price that typically includes an appetizer, entrée with two side dishes and dessert

Small Plates or Tapas – small dishes similar to appetizers ordered a la carte and often shared

Tasting Menu – a chef-selected meal that offers a variety of dishes served in small portions

RESOURCES

Evert AB, et.al (13). Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report. Diabetes Care. 2019;42(5):73-754  https://care.diabetesjournals.org/content/42/5/731

Restaurant Success in 2019. Toast Industry Report. https://d2w1ef2ao9.8r9.cloudfront.net/resource-downloads/2019-Restaurant-Success-Report.pdf

Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2017. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

Robyn Flipse, MS, MA, RDN is a registered dietitian, cultural anthropologist and scientific advisor to the Calorie Control Council, whose 30+ year career includes maintaining a busy nutrition counseling practice, teaching food and nutrition courses at the university level, and authoring 2 popular diet books and numerous articles and blogs on health and fitness. Her ability to make sense out of confusing and sometimes controversial nutrition news has made her a frequent guest on major media outlets, including CNBC, FOX News and USA Today. Her passion is communicating practical nutrition information that empowers people to make the best food decisions they can in their everyday diets.Reach her on Twitter @EverydayRD and check out her blog The Everyday RD.

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By: Karima A. Kendall, PhD, LDN, RDN —

By now, you’ve likely heard all about the infamous “fiber gap”. Dietary fiber was first identified as a nutrient of concern by the 2015-2020 United States Dietary Guidelines Advisory Committee¹ and there is still a substantial disparity between the amount of fiber consumed and dietary recommendations in most countries worldwide.  Those living with diabetes have the added challenge of managing their carbohydrate intake and consuming adequate amounts of dietary fiber.  Luckily, fiber is helpful in more ways than one, as it has a beneficial impact on blood glucose (BG) levels and also increases satiety which can aid in body weight management.

First, it is important to note that there are two types of fiber: insoluble and soluble. Insoluble fiber, which is typically found in wheat bran, vegetables, and whole grains, are largely responsible for increasing the bulk of the feces.  While these fibers keep the digestive system running smoothly, they have little metabolic effect.² Soluble fiber, on the other hand, is found in oatmeal, nuts, seeds, beans, lentils, and peas and may help to improve BG control and even lower cholesterol.  These fibers are not digested and reduce the rate of nutrient absorption, which helps to minimize spikes in BG levels after a meal. Further, numerous studies have demonstrated that the lowered blood glucose levels seen after fiber consumption are associated with either unchanged or lowered insulin levels.^3,4

Fiber consumption also contributes to the feeling of fullness after eating which may reduce intake and aid in weight management. Maintaining a healthy body weight is especially important for those living with diabetes and the expansion of fiber-rich options can play an important role in helping to increase total fiber intake with minimal impact on calories. Advancements in food technology allow for fiber enrichment of a variety of foods, including those that are inherently low in fiber. Certain fibers can be incorporated into foods and beverages, which consumers can easily include into their diet to meet fiber intake recommendations.

Now that you know the major benefits of dietary fiber, keep these tips in mind as you incorporate more fiber-enriched food into your diet:

1. Read the Nutrition Facts Label. Note that the term “whole grain” does not always mean that the product is high in fiber.  Read the nutrition facts label to determine exactly how much dietary fiber the product contains

• Get Your Fiber From A Variety Of Sources. In addition to fruit and vegetables, keep an eye out for foods that have been enhanced with additional fiber, including cereals, yogurts and even beverages.

• Pace Yourself. In order to prevent potential gastrointestinal discomfort, slowly incorporate more fiber into your diet. Abruptly consuming large amounts of fibrous foods may lead to gas and bloating.

References:

1. Millen BE, Abrams S, Adams-Campbell L, Anderson CA, Brenna JT, et al. The 2015 Dietary Guidelines Advisory Committee Scientific Report: Development and Major Conclusions. Adv. Nutr. 7:438, 2016.

2. Vinik AI and Jenkins DJA. Dietary Fiber in Management of Diabetes. Diabetes Care 11:160-73,1988

3. Jenkins DJA, Leeds AR, Gassull MA, Cochet B, Alberti KGMM: Decrease in postprandial insulin and glucose concentrations by guar and pectin. Ann Intern Med 86:2023, 1977

4. Kay RM, Grobin W, Track NS: Diets rich in natural fiber improve carbohydrate tolerance in maturity-onset, noninsulin dependent diabetics. Diabetologia 20:18-21, 1981

Karima A. Kendall, PhD, LDN, RDN  is a Scientific and Nutrition Manager at The Calorie Control Council.  With over 10 years of experience in health research and clinical nutrition, her activities include addressing and monitoring regulatory and scientific activities, as well as the development of relevant communications content. Dr. Kendall holds a Bachelor of Science degree in Biological Sciences from Hampton University in Hampton, VA, and a Doctor of Philosophy degree in Pharmaceutical Sciences from Howard University in Washington, DC. Post-doctorate, she obtained a second Bachelor of Science degree in Human Nutrition and Dietetics from Eastern Michigan University in Ypsilanti, MI.  She is a Registered Dietitian-Nutritionist, licensed in Maryland.

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By: Jill Weisenberger, MS, RDN, CDE, CHWC, FAND –

When you wake up with diabetes, you start your day with a few extra things on your to-do list: medications, finger sticks, balancing exercise and meal timing, and perhaps hypoglycemia prevention and so much more. But each morning is an opportunity to set the day right. Try these strategies to say good morning diabetes and to affirm that you’re ready to rock this day.

Wake up gently. Let your first awareness of the day be a pleasant one. Toss out the screaming alarm clock and shut off the loud radio announcer. Choose a morning alarm with soothing sounds of nature or pleasant music. Buying a sunrise alarm clock a few years ago was a gamechanger for me. Now I hate to be without the 30-minute simulated sunrise that gradually fills my bedroom with light.

Center yourself. After a gentle rising, be sure to spend some time in a morning ritual – even if it’s only a few minutes. A ritual is different from a routine in that it has a deeper meaning than simply fulfilling a task. You may have a set routine in the morning that helps you get from bed to work or chores. With a routine, you run on autopilot. But a ritual is something you do with greater awareness, and it has a side benefit such as feeling centered or energized or filling you with a sense of purpose. My morning ritual includes quiet time with a cup of coffee. While sipping, I think about my day, my goals, and potential obstacles to those goals. I continue the same thoughts during my morning jog. And I start everyday reminding myself that something good will happen today and that I need to take notice of it. It’s this ritual that helps me feel ready to manage my day. A carefully chosen morning ritual will help you manage your diabetes in an indirect way. By feeling ready to start your day and reminding yourself of your values and goals, you’ll be better able to practice self-care.

Eat a health-boosting breakfast. Sit down to a breakfast made to nourish and fuel your body. You have an infinite number of choices, but do include wholesome foods packed with both protein and fiber. Some options include savory oats topped with an egg or Greek yogurt with fruit and muesli. Whether it’s to sweeten the yogurt or some coffee, be mindful of extra carbohydrates. Skip the sugar and jazz up your breakfast with a non-calorie or low-calorie sweetener.

Gather your supplies for the day. Before walking out the door or getting started on at-home projects, be sure you have everything you need for the day. Do you have these?

• Blood glucose monitoring supplies
• Medications
• Packed lunch or snacks (or simply planned if you’ll be eating at home)
• Refillable water bottle
• Packets of low-calorie or non-calorie sweetener for coffee or tea
• Treatment for hypoglycemia, if you’re at risk. Some good choices are glucose tablets, glucose gel, and small boxes of 100% fruit juice.

Build some muscle or take a walk after breakfast. Better yet, if time allows, do both. Any exercise you do boosts your body’s sensitivity to insulin. Aim to strength train at least a couple times each week to maintain or build muscle. Why? More muscle is more storage space for blood sugar to go after a meal. Can you walk to work, walk your dog, or walk your kids to school? Taking a 20-minute walk after a meal is a great way to lower post meal blood sugar levels and to boost your insulin sensitivity for hours!

These strategies should help you prepare to tackle anything your day or your diabetes throws at you.

Jill Weisenberger, MS, RDN, CDE, FAND, has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is the author of Diabetes Weight Loss – Week by Week and two upcoming books, The Overworked Person’s Guide to Better Nutrition and 21 Things You Need to Know about Diabetes and Your Heart. She is a member of the Academy of Nutrition and Dietetics, the American Association of Diabetes Educators and the American Diabetes Association. Jill is a paid contributor to Sucralose.org. Follow Jill on Twitter @NutritionJill and find more at www.JillWeisenberger.com

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By: Rosanne Rust MS, RDN, LDN  — 

A diagnosis with diabetes is life-changing, but it’s also a chance to prioritize your daily health choices more than you ever have. Hopefully you’ve had the opportunity to see a registered dietitian and certified diabetes educator since your diagnosis, and were given a plan for diet, activity and blood glucose monitoring.

Understanding that what you eat can affect your blood sugar (or blood glucose) is the first step to successful blood sugar management. It also can help you plan for, and handle, the holiday season and other special occasions.

Daily Routine

Knowing that holidays and celebrations occur on a periodic basis, a cornerstone to good blood sugar management is establishing, and sticking with, a daily routine. Since food has an immediate impact on blood sugar, eating around the same amount, at about the same times, can help you understand and better match your insulin needs and help you establish consistency in your blood sugar, eating, and exercise schedule.

It’s also important to apply these key principles to diabetes management:

• Avoid regular intake of high sugar foods
• Lower the glycemic effect of carbohydrate foods by balancing them with protein and fiber
• Get regular exercise
• Reduce stress (stress hormones can increase blood sugar levels)
• Take your medication according to advice from your endocrinologist

Having diabetes doesn’t mean you can’t occasionally enjoy a sweet treat. However, high sugar foods may wreak havoc on your blood glucose levels, contain lots of calories,  and are generally void of nutrients. With this in mind, you may rationalize removing all sweets from your diet is a good plan, but avoiding sugar may not make your sweet cravings disappear. Further, what happens when special occasions or holidays arise that threaten your daily routine?

Have a Plan for Sweet Cravings and Special Occasions

Thanksgiving will usher in the holiday season of special foods and family gatherings, so now is a good time to prepare for those occasions. Having a strategy in place will help you maintain good blood glucose control.

Many people with diabetes struggle with their choices during the holidays, when they attend more public or family gatherings that revolve around indulgent food. It’s okay to plan for higher sugar foods, but it’s also a good idea to offer to bring a healthy dish, or an alternative dessert.

Talk to your diabetes educator about adjustments in insulin or activity in order to manage splurges. These options allow you to enjoy a sweet treat, while contributing less carbohydrate to your diet:

• Whenever possible, volunteer to bring a dish, snack, or dessert that you know you can enjoy without going overboard.
• Use nonnutritive sweeteners, such as sucralose, to replace sugar in baked goods.
• Enjoying a calorie-free diet beverage, for instance, has no impact on blood sugar. 
• Substituting sugar-free pudding mix into a pie recipe can significantly reduce the total carbohydrate, as can substituting the sugar in your favorite confections with a low calorie sweetener (such as Stevia).
• Serve or bring low-sugar alternatives to gatherings. Offer low glycemic snacks that everyone will enjoy such as nuts or a homemade trail mix.
• This no-sugar cheesecake is a crowd-pleaser that won’t send your blood sugar soaring.
• For parties, include a crudité platter of raw carrots, celery, olives, cucumber slices or other veggie to use as a vehicle for dips instead of chips.
• Enjoy a special coffee, like a Pumpkin Latte by either requesting sugar-free syrup, or making your own
• Be a gracious hostess and mix up a diabetes-friendly holiday punch. Even guests without diabetes will appreciate having a lower calorie, lower sugar beverage to choose from.
• If you do include sweets made with caloric sweeteners, be sure to count them as part of your calorie budget. Also, keep in mind that even though replacing sugars with low calorie sweeteners will reduce the glycemic effect, you still need consider the calories or total carbohydrate of a food or dish.
• Limit your alcohol intake to 1-2 drinks. Enjoy calorie-free options such as diet soda, club soda or a no-calorie seltzer in between drinks, or in place of alcohol.
• If you know you’re going to attend or host a holiday or celebration and be tempted by indulgent food, schedule a workout earlier that day.
• Be aware of portion sizes. Simply cutting back on portions will help you manage blood sugar. Instead of taking a larger portion of a favorite side dish, make an effort to enjoy smaller portions (and, avoid second helpings).

Be Realistic

We see a lot of extremes being promoted when it comes to diets these days. Only people who have diabetes truly understand what it’s like to have diabetes. Seek support, be realistic with your goals, and don’t be too hard on yourself. (Check in annually with your certified diabetes educator or endocrinologist as needed). If your blood sugar is higher than usual after a holiday meal, or a vacation day, don’t panic or get down on yourself.

Getting off track isn’t the end of the world, but getting back on track is important. If you overeat, continue to check your blood sugar, remind yourself of your daily routine, and focus on getting back under control. You can still enjoy the holiday season, allow a few treats, and stay on track as long as you stay active, have a plan, and be kind to yourself.

Rosanne Rust MS, RDN, LDN is a registered, licensed dietitian-nutritionist with over 25 years experience. As a Nutrition Communications Consultant  she delivers clear messages helping you understand the science of nutrition so you can enjoy eating for better health. Rosanne is the co-author of several books, including DASH Diet For Dummies® and the The Glycemic Index Cookbook For Dummies®. A wife, and mother of 3 boys, she practices what she preaches, enjoying regular exercise, good food and festive entertaining. Follow her on Twitter @RustNutrition.

The post Living Well with Diabetes: Celebrating, Enjoying a Treat, and Staying In Control appeared first on Calorie Control Council.

Keith Ayoob, EdD, RDN, FAND —

Making an extreme dietary change makes great headlines, clickbait, and party conversation. 

I prefer the real world of small changes.  Call them “baby steps” if you like.  I prefer baby steps when dealing with lifestyle changes because baby steps are easier to make, and they are less taxing and stressful, to both our bodies and our emotions. 

Best thing about making baby steps?  Behavior research has long shown that making small, gradual changes to be the most lasting and permanent.  Ask any registered dietitian-nutritionist (RDN) who provides dietary counseling or medical nutrition therapy.  We always look for a “win-win”, and making small dietary changes is both easier and more permanent: a win-win.

Making small, gradual dietary changes also takes longer.  Progress is less dramatic, but I will swap “dramatic” for “permanent” any day.  Does it take more persistence and patience?  I would say it “teaches” patience and persistence.

When I hear someone say they are going to “cut out all the added sugars from my diet,” the first thing I want to ask is, “How long are you going to give yourself to do that?”   It does not have to be done suddenly, especially since doing it suddenly may produce failed results.  Transitioning to your dietary goals more gradually may take longer, but there is no need to rush and IU want them to enjoy the journey.

Where LCS fit into transitional diets

The single largest source of added sugars in our diets is from beverages: soda, flavored waters, iced tea, fruit-flavored drinks, etc.  These beverages don’t provide much nutrition, just calories.  You may want to switch over to just water as your primary beverage.  That’s great and I’m a huge fan of drinking water.  If you don’t drink much water, it’s time to start.

Replacing added sugar however, can start immediately, and may have to, in those newly diagnosed with diabetes or someone who is seriously overweight.  It’s unrealistic to expect someone to go “all-water” immediately, especially when there are other calorie-free options. 

Drinks with LCS, whether carbonated, non-carbonated, or hot or iced tea or coffee, also count toward your hydration, and can be considered “water-alternatives.”  Here’s why:

• They all have no calories and are sugar-free.
• They are hydrating.
• They are TOOLS for reducing total added sugars in your diet.

It is still good to drink water, but know that these are alternatives that can help make the transition to drinking more water much easier and more enjoyable. 

Variety: The Sweetness of Life

You do not have to be living with diabetes or be overweight to enjoy the benefits of beverages with LCS.  Even people who have transitioned to drinking more water and unsweetened beverages like variety sometimes.  A drink with a LCS brings that variety without any added calories.

Those with Diabetes and anyone trying to lose weight or reduce their daily calories deserve to have access to as wide a variety of tools as possible to help them achieve their goals. 

Concerned that beverages with LCS will hamper your efforts to eat a better diet or make it harder to steer away from sweets?  No worries, according to the conclusions of the C.H.O.I.C.E. (Choosing Healthy Options Consciously Everyday) study.  This study looked at groups that replaced their sugar-sweetened drinks with either water or diet beverages for six months.  Compared to the all-water drinkers, the group using diet beverages showed:

• Greater reduction in consumption of caloric drinks.
• Ate FEWER desserts than the water group.
• No evidence that the diet beverages increased a preference for sweet foods or drinks.

Bottom Line Takeaways:

• It’s great to drink water as your primary beverage. 
• Water isn’t the only way to get water or to hydrate. 
• Replacing your sugar-sweetened drinks with both water and some drinks sweetened with LCS may make your diet more palatable and enjoyable, and leave you feeling less deprived. 

Feeling less deprived may even help you avoid high-calorie snacks and desserts a little more.  Use all the tools you can to make your transition diet as easy to follow as possible.

Keith Ayoob, EdD, RDN, FAND, is an Associate Clinical Professor Emeritus at the Albert Einstein College of Medicine. As a pediatric nutritionist and registered dietitian, Dr. Ayoob is also a past national spokesperson for the Academy of Nutrition and Dietetics. Dr. Ayoob is a consultant with the Calorie Control Council Advisory Board and the Global Stevia Institute (GSI), GSI is supported by PureCircle Ltd, a global leader in purified stevia leaf extract production.

The post Using Low- and No-Calorie Sweeteners in a “Transition Diet” appeared first on Calorie Control Council.

By: Keith Ayoob, EdD, RDN, FAND —

With diabetes now affecting 1 in 11 Americans, it is one of the most common chronic health conditions today.

The two most common forms of diabetes are known as “type 1” and “type 2”.  Type 1 usually happens in childhood, it is permanent, and unpreventable.  Type 2 diabetes however, is acquired and can be prevented.  No matter the type of diabetes , both  need to be carefully managed with diet and physical activity.

Diabetes Management = “Project Management”

Diabetes isn’t a death sentence. It is more of an ongoing “project”.  Like any project, diabetes requires proper management. 

You would never clean your house without having the right supplies on hand, or drive a car without first getting lessons and studying the driver’s manual.  It is no different with diabetes. Having the right skills and tools is critical to successful management.

Diabetes: It’s a Balancing Act

When you are diagnosed with any form of diabetes, the most important first step is to see a certified diabetes educator (CDE) or a registered dietitian-nutritionist.  Your doctor or nurse practitioner can refer you. 

A great additional tool is the Calorie Control Council’s Healthy Weight Tool Kit.  Among the skills you’ll need to have under your belt to keep your blood glucose levels under control are:

• Distributing your calories and carbohydrates throughout the day.  This helps keep blood glucose levels from spiking.  It can also keep you from getting too hungry, which can lead to overeating.
• Using physical activity to manage your weight and blood glucose level.  If you’re able to be mobile, you will need to be physically active.  Along with diet, you will learn why being active can be one of the most important tools you have for managing your diabetes.  Activity itself helps bring down blood glucose levels and it actually helps your body become more “insulin sensitive” and less “insulin resistant”.  Being insulin sensitive means your body responds more to the insulin you have. 
•  Adjusting your calories and carbohydrates up to accommodate your higher activity level.  Check with your CDE first, but sometimes eating a few more calories can be OK when you’ve been more active.
• Learning to remove “empty” calories that contribute to dietary and blood glucose imbalances.

Where Might Low-Calorie Sweeteners (LCS) Fit In Diabetes “Project Management”?

Managing diabetes takes some work!  Diabetes takes no days off for weekends or holidays, unfortunately.   It is a chronic condition, so you need to be in it for the long haul.  That said, this is exactly where LCS can be your allies, they can make the job of managing diabetes more enjoyable and seem less like hard work.  Essentially, LCS help make it easier to stick to your plans and reach your management goals. 

Please note, however, using LCS is not mandatory.  You may not even use them daily.  Still, knowing they are available and safe to use, and knowing when and how to use them wisely can make life with diabetes easier, more productive, and less limiting.

Most people, even those without diabetes, eat more added sugar than recommended, so careful “spending” of sugar calories is important.  LCS help us direct that calorie “spending” more wisely, making them a useful tool for anyone who wants to reduce added sugars in their diet.  

Keith Ayoob, EdD, RDN, FAND, is an Associate Clinical Professor Emeritus at the Albert Einstein College of Medicine. As a pediatric nutritionist and registered dietitian, Dr. Ayoob is also a past national spokesperson for the Academy of Nutrition and Dietetics. Dr. Ayoob is a consultant with the Calorie Control Council Advisory Board and the Global Stevia Institute (GSI), GSI is supported by PureCircle Ltd, a global leader in purified stevia leaf extract production.

The post Are You Using All the Tools You Can to Manage Diabetes? appeared first on Calorie Control Council.

Keith Ayoob, EdD, RDN, FAND —

The latest statistics from the Centers for Disease Control indicate that 9.4% of the US population – more than 1 in 11 persons – has some form of diabetes.

The most common types of diabetes are called “type 1” and “type 2”. Type 1 usually emerges in childhood and is also called “insulin-dependent” diabetes, because the body’s pancreas malfunctions and produces little or no insulin. 

More than 90% of diabetes however, is type 2, in which the body still produces insulin, but not enough to reduce blood glucose to normal levels in a reasonable amount of time, if at all. 

As troubling as the statistics on diabetes are, more than 1 in 4 Americans has “pre-diabetes” —  where blood glucose levels are often higher than normal but not high enough to be considered full-blown diabetes. Without any intervention, pre-diabetes is likely to transition into type 2 diabetes. However, with proper intervention, this transition to diabetes can be prevented or delayed.  At the same time, most people with pre-diabetes don’t seek out medical advice or support for their pre-diabetes because they don’t even know they have it.  

A few of the facts about pre-diabetes

How does someone become pre-diabetic?  

Genetics play a role, but so does family history of diabetes or simply being overweight or obese. Poor diet and having a sedentary lifestyle play important roles as well. Pre-diabetes is also tied to other silent health conditions, such as metabolic syndrome, hypertension and high blood cholesterol levels.

Does sugar “cause” diabetes? 

No. But eating too much sugar can aggravate the condition by forcing your body to work extra hard to lower your blood glucose levels.

Does obesity cause diabetes? 

Here things get more tricky. Obesity doesn’t directly cause diabetes, but it can cause “insulin resistance”. Having excess body fat can cause your cells to react differently to the insulin your body puts out. Insulin resistant people react LESS to the same amount of insulin that they did before they gained weight. As a result, your body has to produce more and more insulin to keep blood glucose levels under control. Eventually, even those higher levels of insulin just don’t do the trick, and blood glucose stays high. Then you’re either prediabetic or diabetic. 

Preventing Type 2 Diabetes Is Possible! 

Prevention is where nutrition, diet, and lifestyle have their greatest impact.  If you have pre-diabetes, the good news is that you’re at a “fork in the road” — you still have a chance to determine your direction. 

Overweight or obesity usually accompany pre-diabetes, so losing weight is key, but you don’t need to lose massive amounts of weight to get healthier.  Losing as little as 5% of your weight (think 10 pounds if you’re 200 pounds now) can be enough to bring blood glucose levels under control.  Keeping it under control also requires some tweaks to your diet and lifestyle so you don’t regain the weight and perhaps approach an even healthier weight.

Gradually becoming more physically active can go a long way towards managing your blood glucose level.  There’s no need for extreme activity, but a 20-minute brisk walk on most days can not only help with weight management but helps prevent spikes in blood glucose. 

Even being “less sedentary” throughout the day helps.  Taking the stairs when you can, parking further away from the store, and going to pick up your lunch instead of having it delivered, can get you moving and prevent your metabolism from slowing down. 

Low-Calorie Sweeteners: A Huge Tool

Most people eat too much added sugar.  As you can see here, beverages are the largest source of added sugars, followed by snacks and sweets like candy:

Data Source: What We Eat in America (WWEIA) Food Category analyses for the 2015 Dietary Guidelines Advisory Committee

Using LCS is an ideal way to replace most or even all the added sugars in beverages.  According to the above graph, doing so would reduce our added sugars by a whopping 47%!

It’s also key to look at where we are drinking those beverages.  The CDC determined that slightly more than half (53%) of our consumption of sugar-added beverages are consumed at home, the rest away from home: 

              Drink At Home (53%)                                                 Drink Away From Home (47%)

Source: NCHS Data Brief No. 71, Figure 6. August 2011

Whether we’re home or away, we can do a lot to reduce the added sugars in our diets, help manage our blood glucose levels, and reduce the amount of “empty calories” we eat.

It’s not just about beverages though.  LCS can also reduce the added sugar in many nutritious dairy foods like yogurt, allowing us to get great taste and nutrition with fewer calories.

The true cause of obesity is EXCESS – whether that excess comes from sugar, total calories, or excess inactivity.  LCS are great tools for reducing one of those excesses: added sugar.  And they can be useful to pre-diabetics or anyone who desires less added sugar.

Data Source: What We Eat in America (WWEIA) Food Category analyses for the 2015 Dietary Guidelines Advisory Committee

Keith Ayoob, EdD, RDN, FAND, is an Associate Clinical Professor Emeritus at the Albert Einstein College of Medicine. As a pediatric nutritionist and registered dietitian, Dr. Ayoob is also a past national spokesperson for the Academy of Nutrition and Dietetics. Dr. Ayoob is a consultant with the Calorie Control Council Advisory Board and the Global Stevia Institute (GSI), GSI is supported by PureCircle Ltd, a global leader in purified stevia leaf extract production.

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While some people ignore or merely glance at the nutrition information on food and beverage packaging, others closely review the label for carbohydrate information if they are on a certain low-carb diet and want to lose a few pounds. However, for those with type I or type II diabetes, the carbohydrate information provided on nutrition labels serves an even more critical role, helping those populations to manage a potentially life-threatening disease in large part through their diet. Without reliable, accurate nutrition information, those with diabetes are unable to accurately calculate the amount of insulin needed for the carbohydrates in the foods and beverages they consume.

Why are carbohydrates the most important nutrient for those with diabetes to monitor? Of the three main nutrients – protein, carbohydrates, and fat – carbohydrates have the greatest impact on blood sugar levels because the body breaks carbohydrates down into glucose, or, in simple terms, sugar. Those who do not have diabetes produce insulin, the hormone needed to let glucose into cells so that the glucose can in turn fuel the body’s activities. Those with diabetes have a problem producing insulin, and need to inject insulin or take medication when consuming carbohydrates in order to enable the glucose to be used by their body’s cells, instead of remaining as sugar in the blood stream (hence the term “high blood sugar”). This is why accurate information about the carbohydrate content of foods and beverages is essential for calculating an appropriate insulin dosage. It is also important to note that various components comprise the total carbohydrate count, and there are different types of physiological effects of each. For example, the total sugar and added sugars declared on labels would increase blood sugar levels, while dietary fiber, which is also considered a carbohydrate, would not.

As you can see, people with diabetes expect that the carbohydrates, specifically sugars and added sugars, listed on nutrition labels will have an impact on their blood glucose level. This is why listing the new low-calorie sweetener allulose as a total sugar and added sugar under the total carbohydrate count on nutrition labels would be especially misleading, confusing, and potentially dangerous for the over 100 million U.S. adults now living with diabetes or prediabetes[1]. Allulose, a “rare sugar” discovered in small quantities in natural sources such as figs and maple syrup, is technically a monosaccharide and classified as a “sugar” based on its molecular formula. However, allulose is not metabolized by the body and therefore contributes negligible calories and does not impact blood glucose levels. A comprehensive label study included in a citizen petition[2] to the U.S. Food and Drug Administration (FDA) corroborates the belief that consumers will be misled by the labeling of allulose as a carbohydrate and sugar. In this study of over 4,000 U.S. adults, the labeling of allulose as an added sugar led to confusion about the impact on blood glucose. In total, 52 to 65 percent of respondents with diabetes evaluating labels mistakenly believed that a flavored beverage with allulose contained sugar.   

The FDA is responsible for protecting public health by ensuring the safety, efficacy, and security of the nation’s food supply. Those living with type I and type II diabetes must place significant trust in FDA, and other regulatory bodies when abroad, to protect the accuracy and integrity of nutrition information provided on food and beverage packaging. New draft guidance published in April 2019 indicates FDA’s efforts to reduce consumer confusion over the new nutrition facts label by allowing allulose to be excluded from total and added sugar listings on labels when used as a food ingredient. For those living with or without diabetes, this will help provide additional clarity around the total carbohydrate counts on nutrition labels and allow for the enjoyment of foods and beverages sweetened with allulose, while hopefully minimizing unintended health consequences of misinformation.     

[1] New CDC report: More than 100 million Americans have diabetes or prediabetes. CDC Online Newsroom. CDC. (2017, July 18). Retrieved from https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html

[2] Citizen Petition from Tate and Lyle. Regulations.gov. https://www.regulations.gov/document?D=FDA-2015-P-1201-0001. Published April 14, 2015. 

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