Healthy eating: your path to better management

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[Music]
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welcome to the first episode in our nutrition education series for people living with diabetes whether you're just
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starting out on your diabetes Journey or are a Season Pro who could use a quick refresh this session offers all the
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basics when it comes to healthy eating and diabetes registered dietitian and certified diabetes educator Pamela
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Petroski will explore healthy choices the recommended plate model and the recommended eating pattern to maximize
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your energy and nourishment as well as help manage your diabetes over to you
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Pam hello my name is Pam and today during today's session we're going to review why healthy eating is essential
Overview
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to everyone for promoting good health minimizing injury and reducing the risk
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of diseases and why this is so important for diabetes management itself we will examine the rationale
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behind this concept of a balanced plate how it applies to your individual meal
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choices as well as dive a little bit deeper into the importance of key elements that provide energy from the
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foods that we eat and the role they may play in blood sugar control and so you aren't confused I may interchange the
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words glucose and sugar when I'm referring to what it is that's in your blood but it's the same thing so I hope
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you can keep up we'll start to crack down on the code of reading labels to
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help help make better choices it might take you a little bit of time in the beginning to figure out these labels but
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once you've got it you'll be well on your and we're going to organize all this information to develop a healthy
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eating pattern that works for you let me start by saying the most important thing
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there is no diabetes specific diet as diets are hard to follow in the long
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term as you may have found out in the past but what is important is the what
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somebody eats the how much they eat and the when they eat that's really
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important when we talk about making better food choices and planning healthy meals for diabetes
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management when people learn how these aspects of their eating habits can impact their health they will be able to
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make changes small or large to improve their blood sugar control and reduce the
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risk of complications so let's get going here
Food Nutrition
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food and nutrition important elements of diabetes management as I mentioned now I
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want you to think of food and nutrition as a as a type of treatment no different
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than medications or physical activity is for people living with diabetes and throughout this video we are going to
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focus on the food and nutritional aspects that are part of your diabetes
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selfcare learn how different foods affect your blood sugars because at different times of our lives our blood
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sugars may be affected differently by some of the quantities and the types of foods that we're eating and what that
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means to your risk of complications down the road as well as how small changes can make big
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differences while it's natural to have questions about nutrition and what foods to eat we're going to try to untangle
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some of that dietary advice that may be on the internet that you've already noticed or it may come from wellwishers
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to help you manage your diabetes that is evidence-based so be careful of the
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potential for false promises but maybe with bad diets supplements special
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diabetic or dietetic Foods it's always best to talk with your healthc care professional before putting your trust
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in potential misinformation out there and this could harm you instead of helping you I encourage you to go to
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diabetes.com
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stroke.com discussing and throughout keep in mind that there is no one diet fits-all
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approach finding out what works for you is most important to keeping you
What Works For You
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healthy because eating is something that we need to do on a daily basis it we need to find out that right balance to
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keep ourselves healthy while still promoting good health and quality of life often people think that once they
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get their A1c to Target that they can go back to their old eating habits but remember what we said about healthy
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eating patterns being like a treatment for diabetes you take away that treatment and the blood sugars will
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creep back up so try to find that will what will work for you in the long run
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small changes can make the difference and you might find that you're doing all
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of these things already and it's still not making a difference it's always best again to talk with your diabetes
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educator to see what other changes might need to be made throughout your diabetes
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management so let's move on and and try to find what will work for you in the long run picking healthy food choices
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more often will help to provide energy to do daily activities fuel your muscles
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prevent injury and also help with your mood all things that are most important for managing diabetes and reducing your
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risk of diabetes or its complications but beyond controlling blood sugars healthy eating can also
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help you manage weight and as I said lower your risk of other complications or other chronic conditions like heart
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disease that is more prevalent in people that have diabetes high blood pressure
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osteoporosis arthritis certain forms of cancer are all linked to what we eat so
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here's another good reason for why healthy eating matters eating well is good for overall
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health and there's many ways to do it I want you to pick what might work for
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you so what are the basics of healthy eating you might ask or maybe you already know think of it as a shift of
Basics of Healthy Eating
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food choices that can be done by eating more of certain types of foods replacing
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current choices with better options or limiting your consumption of less desirable Foods as we'll talk about
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throughout the session it's key to have a variety of foods but that doesn't mean that you
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have to eat all foods to ensure that you're getting all the nutrients like vitamins and minerals that are found in
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different food groups those food groups being fruits and vegetables meat and
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protein Alternatives dairy products and Grains and starchy Foods by the way I'm
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not a fan of kale but I try to pick other green leafy vegetables to get similar nutrients and as always make
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sure you're drinking water or low calorie beverage to keep well hydrated that is still part of a healthy eating
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pattern I know that cost in availability can be challenging to some where possible pick whole foods to avoid
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excess salt sugar preservatives that are usually found in packaged and ultr
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processed foods in some cases Frozen and canned can be just as healthy and maybe
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a better alternative preparing meals yourself gives you the advantage of knowing how what's going into your meals
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how you're preparing them and how it's making a difference on your diabetes control but it does involve a little bit
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of planning ahead of time I will warn you about that but once you get the hang of it you'll be right on your way so my
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first question to you is what do you do do you eat to live or do you live to eat
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some people will say that they know when their body is full and others may have difficulty with figuring out when to
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stop and when they're full have you ever eaten because you were bored feeling down or just because
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the food was staring at you on the table be aware of the different reasons for why you're eating by all means if you're
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feeling hypoglycemic please eat some sugar but be mindful of why you're eating what you do and that can be just
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as important as what you're eating some people may find that a strict routine with their food intake
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helps manage their blood sugars perfectly but only you will know if that's something that's sustainable for
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you meaning can you do it in the long term because this is something that you want to do for the long
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run it's important to find a way to enjoy what you're eating because it is
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something we have to do on a daily basis please look for ways to prepare meals that work for you because if you don't
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enjoy food preparation or perhaps eating becomes socially
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undesirable it can be a very stressful part of your day-to-day routine rest assured the more you become
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aware of what healthy eating can mean to you you and your blood sugar control and
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how you can learn how your body reacts to different foods at different times in
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your life uh with different situations you will find eating can be done in a way that is not considered
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difficult while still enjoying social aspects and reaping in all the nutritional
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benefits if you were to write down what you ate for a week what would your food or meals look like could you make some
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changes right now with what we've already talked about we're learning more and more about
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the importance of good nutrition and healthy food choices for day-to-day wellness and for reducing the risk of
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injury and chronic disease but what it means to you I might say again I may ask
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in five years and it might be different information so it's great to keep up to date on this
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information now look at this plate it looks amazing but it also looks a bit confusing using so here's what we're
The Balanced Plate
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going to talk about with the concept of a balanced plate it's one of the most important diet habits you can do by
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picking half of your plate of vegetables vegetables are high in nutrients that
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the body needs to be healthy and because non-starchy vegetables tend to be higher in fiber and water content this can help
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to keep you full longer and control the amounts of other foods that are you're putting on your plate and that may
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control your blood sugars the other part of that half a plate can be divided up again so that a quarter is
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coming from protein foods and you want to be looking for lean proteins and
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plant proteins as well as fish to be part of that quarter of your plate try to eat at least two servings
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of fish each we week and maybe try different recipes that include plant-based things like tofu or legumes
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nuts and seeds as great sources of protein as well and last but not least fill that
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remaining quarter of your plate with your carbohydrates or what's commonly known as grains or starchy vegetables
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picking whole grains and crackers brown or wild rice quinoa oatmeal barley
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potatoes with their skins on are all going to be ways to fill that quarter of the plate while keeping you
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full now think about it was the plate that at your last meal did it look like
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this was the was the balance the same way perhaps there's a little bit more
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that you can add to that half of vegetables and a little less to the pasta that you may have consumed last
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night eating Foods in moderation will allow you to get the energy that your body needs as well as including enough
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fiber enough energy enough protein that all makes a healthy
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diet or as I say a healthy meal pattern a couple of tips that I might
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add to this is looking for bright vibrant colored vegetables so look for the oranges the
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greens the Reds in your vegetables if you can leave the skins on for extra fiber prepare your Foods in a healthy
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way baking broiling steaming poaching stir frying but you might say wow a
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plate with a piece of plain chicken a baked potato and some steamed broccoli
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and carrots just doesn't sound appealing so here's where you want to take some of your favorite recipes or the meals that
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you already consume and modify them a bit so that this balance holds true
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perhaps it's adding more vegetables to your uh to your meal perhaps it's
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pureeing some vegetables and making them into a sauce for your potatoes maybe
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it's adding um a salad before your meal so that we still have that balance of a
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half coming from vegetables a quarter coming from protein and a order coming from carbohydrates even if you have a
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recipe think of the ingredients that you're consuming and how you might rearrange the quantities of the foods in
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there so that you have this balance be careful though if you consume
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too many of the refr refined grains like bread pasta minate rice these may cause
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spikes in your blood glucose even if you are consuming only a quarter of your plate of them so be careful as you will
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notice this plate doesn't have any dairy products on it it doesn't have dessert on it so even a glass of milk and a
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piece of fruit after your meal could be healthy alternatives but be careful
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limit sugars and sweets for desserts that we sometimes have like cookies and ice cream cakes and Pie if you are going
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to consume a small quantity of that try to work it back into that balanced plate
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perhaps you eat a little less of the pasta or the potato if you know you're going to have some cookies perhaps you
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have less fruit and if you're going to be having some pie or an apple crisp so
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that you can still balance all the nutrients that your body requires and remember we're trying to do
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these things in moderation so it's not a complete Turn Around from today to tomorrow's
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meals another thing I want you to be cautious about is high fat and greasy Foods okay they won't necessarily affect
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your blood sugar now but they may affect your digestion they may also impact your weight going
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down going further and that may impact your diabetes Management in the long term so be careful with fried potatoes
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creamy sauces battered or breaded foods and of course that hydration
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factor is so important um it could be some low-fat milk it could be having
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water unsweetened tea or coffee plain broth could be a great addition to your meals but be cautious with regular pop
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even fruit juice or sweetened tea can raise your blood sugar and cause
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problems uh down for
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you now let's take a look at those sources of energy that I mentioned coming from the balance plate I made a
Carbohydrates
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comment about carbohydrates or grains and starchy Foods so did you know that
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carbohydrates are the body's preferred source of energy the sugar that comes from all sources of carbohydrates is
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otherwise known as glucose when it enters into the bloodstream and that's why we have such
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an emphasis on carbohydrates when we talk about why we need to be careful with the quantity of the foods
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containing and how they impact our diabetes management converting carbs into
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immediate usable energy is easier for the body than using fat or protein as an
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energy source did you know that your brain muscles cells all need
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carbohydrates to function which is why a very low carb diet is not really healthy
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at all depending on the type of carbohydrates that you're consuming the food is converted into sugar or glucose
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at varying rates as it enters the bloodstream after being digested and metabolized it's either transported into
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the body through insulin to the cells or it's used later as a storage of energy
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if there's not enough insulin from within your body or you're not taking
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the right or enough of diabetes medications to help with that transport
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the glucose is left circulating in the bloodstream and this is where the complications of diabetes come into
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effect when your blood sugar levels are above Target for too long and cause
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damage to the vessels leading to other parts of your body the Dietary Reference
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intake for Canadians suggests a minimum of 130 gram of carbohydrates per day or
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45 to 60% of the total calorie intake coming from
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carbohydrates but what does that mean specifically for you well the easiest way in today's session is to have you
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refer back to that balance plate looking at a quarter of what you're eating coming from the starches or the grains
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that you're consuming now if you're working with a dietician or diabetes educator they can
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help you go into more detail with carb counting and what the ual number might mean for you throughout your meals and
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daily intake although being aware of how much carbohydrate you're consuming is key equally important to the is the
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quality of that carbohydrate not just the quantity now I probably don't need
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to tell you where carbs are found but as a refresher you'll find them most abundantly in grains starchy vegetables
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fruit milk and of course various forms of sugars and sweets but the healthiest sources are going to come from
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unprocessed or minimally processed foods not only will you naturally get
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the most vitamins and minerals but they're probably going to be higher in fiber and more likely to have something
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called a lower glycemic index that we're going to talk about in a bit these are also referred to as
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complex carbs and your intake of carbs should consist mostly of these
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sources now you can still eat other types of carbs and less optimal sources
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would be things like white processed bread fruit juices desserts or other
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highly refined or processed foods you know honey maple syrup molasses all seem
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to have really healthy benefits um and may seem like healthier versions to
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sweeteners but really from a diabetes perspective they're no different than just eating straight table sugar and
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using it only if you're having a hypoglycemic reaction also known as simple carbs these things
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are easily digested and quickly brought to your bloodstream so that's something
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to be aware of because if you're not taking enough medication or your insulin
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is not working the same way as someone without diabetes this could cause problems with your blood sugar staying
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at Target but it also could interfere with weight management increased risk of
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heart disease and batty liver many people are confused about
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carbohydrates maybe you are right now but keep in mind that if you're just starting out it's important to eat a
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moderate amount of carbs and then try to pick the healthier sources then to
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follow a strict diet or totally removing them from your eating habits right now remember small changes can produce big
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differences in your diabetes management as I previously mentioned protein is an
Protein
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important part of healthy eating for many reasons including growth and repair of body tissues such as muscle bone skin
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hair and virtually every other part of your body and like carbohydrates protein provide energy but it's not the body's
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preferred source of fuel from a diabetes perspective it's an important part of a
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meal to help regulate how quickly a meal is digested thus keeping you full longer
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and helping to reduce those spikes in blood sugars after eating including more
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plant-based proteins and fish is also beneficial as I mentioned before from both a diabetes and a heart health
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perspective the best picks from this food group would be leaner cuts of meat those with less marbling more fatty
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fishes uh low-fat dairy products eggs plant-based choices like soy tofu uh
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nuts seeds legumes now you can find small amounts of protein in grains and
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some vegetables but I don't consider them one of your better choices be careful with how those
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protein foods are prepared as some may be prepared with extra sodium from sauces or extra carbs from batter or
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breading and watch out for the skin on poultry or that marbling in your meat
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because those can contribute to unhealthy fats that we'll talk about in a
Fat
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minute so what about fat we used to think fat was really bad for us now we
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know a little bit different that fat is the most calorie dense food that we eat and we do need some of it not only is it
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a source of energy for our body but it assists with the growth and development of cells and helps the body absorb
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certain essential fatty acids or fat soluble vitamins the problem is with fats is
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that they're not all created equal the key to understanding the health aspect of fats is considering the
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total amount and knowing what type of fat is is saturated or trans fats you may have
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heard okay are also referred to as the bad fats in the diet and they're primarily found in animal sources
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including whole fat dairy products coconut and palm oil are the only two
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plant sources that I know of that are saturated fats in the diet and you want
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to be careful with them they may have other health benefits but from a cardiovascular perspective uh they can
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clog your arteries and contribute to your cholesterol levels unsaturated fats that would be
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monounsaturated polyunsaturated aka the good fats in our diet are mostly found
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in things like nuts and seeds avocad soybeans as well as all of their oils
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and those fatty fishes that I had referred to an easy way to remember the difference between the good and the bad
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fats in your diet is that the healthier ones the unsaturated ones are liquid at room temperature as in this picture here
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and the unhealthy fats are usually solid and you wouldn't want to have solid fat clogging up your blood
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vessels the main issue health issue with those saturated fats is its effect on cholesterol levels or the risk of heart
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disease which is also a significant risk for people living with diabetes so be careful with the quantities and look to
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see where they're found in your diet you may not be able to remove all
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of the uh saturated fats in your diet but kind back is definitely a healthy
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way to go about the heart healthy aspect of your diet but regardless of the types
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of fat as I mentioned the total fat content is something you also want to be aware
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of as this is something that can contribute to Central adiposity or that
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weight that's carried around your middle section which is linked to insulin resistance and diabetes
Fiber
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management o fiber my friend it's a non-digestible carbohydrate Source
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naturally found in plant Foods it's found in things like the berries here other fruit veggies nuts
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seeds legumes whole grains as well as made into fiber
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supplements but the more a food is processed or refined the less natural occurring fiber is left in it unless
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it's added back during the processes or the manufacturing the good news about fiber
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is that the body is unable to break down and absorb this type of carbohydrate it doesn't cause a spike in blood sugars
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the way other carbohydrates can and in fact can actually help reduce the spikes in your blood
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sugars now to be clear there are two types of fiber soluble and INF soluble
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each one has important health benefits and plays a different role in the body soluble fiber dissolves in water forms a
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gel-like substance in your stomach that slows down digestion attaches to fatty
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acids to help remove them out of the body and in doing so can help control your blood sugar and cholesterol levels
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some good sources of soluble fiber that come to my mind are apples bananas oats
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peas black beans limma beans Brussels FRS avocados there's so many different
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sources of soluble fiber and you can find those lists on some of those websites ites that I've referred to
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previously now insoluble fiber equally as important but doesn't dissolve in
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water so if you were to compare two different soluble fi soluble and insoluble you would find that the
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insoluble fiber that comes usually um in whole grains uh the skins and the seeds
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and everything just sits at the bottom of your water glass there but it's so important because it
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actually is not broken down passes through your intestine and is a great way to remove some of the waste that
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collects in our intestine while all fiber is good for
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you my only word of caution is to be careful on how you increase the amount
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of your daily intake make sure you do it gradually and make sure that you're drinking adequate fluids and moving
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around otherwise you may run into some distressing bloating or gas or other gastrointestinal side effects as we
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learned more and more about its role in the health of our gut immunity and
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anti-inflammatory properties this also holds true for how it manages your
Glycemic Index
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diabetes now I referred to something called the glycemic index a while back
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and what is this glycemic index it's a scale that ranks a carbohydrate containing food or drink by how much it
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raises blood glucose level levels after it was consumed so as you can see on
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this chart here this graph foods with a high glycemic index rise blood sugars
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really quickly and faster than foods with a lower glycemic
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index as we know it also as the GI index it assigns a number to a food based on
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how drastically it makes your sugar rise and then come back down you will see after two hours your sugars are at the
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same level but it's what happens in between during that 2hour period that
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can also have an impact on Diabetes management and
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complications now these foods are ranked on a scale of 0o to 100 with pure
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glucose or table sugar given a value of 100 the lower a food's glycemic index
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the slower the blood glucose Rises after eating that food and that's a very good thing as seen in the yellow graph here
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generally speaking the more processed a food is um the carbohydrate food is the
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higher it's glycemic index is take for example a slice of French baguette bread
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its glycemic index is 95 so eating the same amount of grams of carbohydrate of
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of white bread when you compare it to something that has more fiber or fat in
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it I'm thinking maybe a half a cup of cooked barley that has a lower glycemic
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index one of something like 22 you can see how they may impact your blood
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sugars at one hour out or at a half an hour out if you were checking your blood
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sugars um after your
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meals to simplify things there's a chart on the
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diabetes.com medium and high glycemic index Foods I don't want you to get
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caught up on the exact numbers but to try and collectively put them in as they
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have them green categories for go low glycemic index food medium uh ones and
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then the high ones that we should try to eat a minimal amount of keep in mind that if you have protein
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foods or sources of fat or Fiber um in the foods that you're
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consuming or can add them to your meal that can lower the glycemic index of the total Meal which might have the same
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benefit than picking just low glycemic index Foods how can this help you make better
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choices well choosing lower glycemic index more often than high glycemic index foods will not only help you with
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realtime control of your blood sugars as I mentioned if you were checking them um but it'll help you keep full longer
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promote weight management and also help lower the risk of some of those diabetes complication in including the risk of
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heart disease and stroke and as I mentioned even if you can't remove all the high glycemic index
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foods from your diet try just lowering the glycemic index of the meal by adding a source of protein even if it's a glass
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of milk or some nuts um to your to your grains leave the
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skins on your potatoes have fruits and vegetables where possible um so that you
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can add extra fiber to your meal and another thing that people aren't weren't
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aware of is to cook pasta and rice undercooked a bit alante you might be
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familiar with that term because the more something is processed the higher the glycemic index so if we can undercook
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something not meaning you eat it raw um but that's also going to lower the glycemic index uh as your body takes it
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in but remember just because a carbohydrate containing food has a low
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glycemic index attached to it you still need to be careful with how much you're consuming total because the total grams
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of carbs whether it's a low or a high glycemic index food will still impact your blood sugar
Food Labels
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control so one of the things that most people um have problems or tell me that
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they're confused about is reading food labels and just as I mentioned previously about picking less processed
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foods it doesn't mean that you can't eat foods that have a a label on them but
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the key is being able to understand what you're looking for so let's try to break
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this down into three little easy steps so a label can help determine if it is a
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good choice or whether you should think twice about something when you're picking it up on the shell when you know what your things
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you're looking for this is a great way to be able to compare different foods maybe there's a better option that you
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didn't realize in the same category of foods
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most Foods packaged in Canada have to have a nutrition fact table like the one you see here on the slide notice the
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first red back box that's probably most important because that's the serving
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size that all the rest of the information in this nutrition facts table is based
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on so if you see this it's 107 calories for this serving but only if you're
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eating this serving of 12 crackers so you need to determine is this the
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serving size that I'm eating or is it another amount that is my portion and be able to adjust the numbers based on
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that specifically though when you're looking at from a diabetes and a blood sugar management um perspective you'll
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see in bold that we have those micro or macronutrients we were talking about
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before fat carbohydrate and protein and they're bolded underneath and indented below
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each of that Bolding listed is subcomponents of those Foods remember I referred to saturated fats before as an
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unhealthy part of the total fat intake and for carbohydrates specifically from
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a diabetes perspective you'll see that the total amount of carbohydrates in
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these 12 crackers is 27 grams but this can be confusing because when you indent
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you see that fiber is a component of it sugars might be a component of it from what is added in the preparation of of
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these crackers you might see sugar alcohols you might see starch all of
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these subcomponents that are indented add up to the total amount of
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carbohydrate so if you trying to determine how many grams of carbs you're
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actually consuming from this label the number would be 27 but wait because fiber is that
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carbohydrate food that your body can't digest it means you get to subtract the fiber content from that total
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carbohydrate so really there's 26 grams of carbohydrates in
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this so this makes it a little bit easier to see that a food that is
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contains a lot of fiber may have a lot more carbohydrates but really you
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subtract that amount of fiber from the total carbohydrate and that's how you would determine how many grams of carbs
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your body is actually getting and turning into sugar in your
34:32
body now one of the things that a lot of people will do is that they will count their carbs and be able to swap things
34:37
out meaning that there's 12 crackers for 27 grams of of carbs and if you know
34:44
that a slice of sandwich bread is 15 grams of carbs or half a cup of cooked pasta is 15 grams of carbs you could say
34:52
do I want some soup broth with 12 crackers or would I like to have two
34:57
slices of sandwich bread or do I want six crackers and one slice of sandwich
35:03
bread to get 30 gram of carbs let's say if that's what I'm consuming at my meal
35:10
this is where it can can get confusing but you know what I think we're going to have more discussion on this in another
35:16
session and as well when it talks about fat and protein I'm going to leave that
35:22
to another session on label reading now that second box probably
35:29
another confusing thing to you what is percent daily value or DV the percent DV
35:36
is meant to act as a benchmark to determine if a food is high or low in a certain nutrient compared to what the
35:43
daily recommended intake value is for Canadians now this is an average it's
35:50
based on an average eating of 2,000 calories per adult but what does this
35:55
mean specifically to you well a food is considered low in a specific nutrient if
36:01
there's less than 5% DV so take a look on that side panel there of the label
36:07
and look to see if any of these foods are less than 5% and they would mean that that's a a low intake of that so
36:14
there's really not very much fiber uh in this food product but sodium on the other hand has 16% and we will say that
36:23
if food is considered high in a nutrient if it has more than 15% % of of daily
36:30
value in the case of sodium of course maybe this is something you want to be
36:35
aware of and eat less of because you're also watching your blood pressure or you've eaten other high salty foods that
36:42
day so this is how you can compare two labels of crackers and pick which one
36:48
might be the more desirable choice and last but not least the third box that I
36:53
want to draw your attention to is the ingredient list of things okay and that tells us what ingredients
37:00
are found in a food which can help us if we have allergies food intolerances um or we don't like a
37:08
certain uh ingredient uh in a food um now what you need to be careful though
37:14
is is my rule of thumb is to say look at the first three ingredients if the first
37:20
three ingredients have a starch a flour uh sugar or anything in the end
37:27
with o e dextrose glucose fructose
37:33
maltose those are all sources of carbohydrates and you need to be careful
37:38
and if it's in the top three ingredients it's likely a higher proportion in that
37:43
food um product there so you can be careful watching what you're consuming
37:50
and and what's being put into those Foods now I haven't written it down here
37:57
it's not on the slide but lastly I think it's really important to take a look at Health claims on labels just because a
38:03
food has a health claim doesn't mean that it's a food that's good for you for example there's some kinds of candies
38:10
out there that promote fat-free but we know that there's a lot
38:15
of sugar in them and there's other things that say no added sugar or dietetic food but they still may have a
38:23
lot of carbohydrates in them even if they aren't sugar that's in it or if it's dietetic what does that mean what
38:30
do these terms mean so you want to be careful when you're looking at a label and and do a little more
38:40
sleuthing now just because you're trying to change your eating habits to uh help
38:46
you with diabetes does not mean you can't eat out okay it can be a
38:52
significant part of business dinners can be a nice social Gathering or it can
38:57
convenient option when you don't have the time to cook and with a bit of planning you can make nutritious choices
39:03
the next time you eat out and your blood sugars will appreciate it now keep in
39:09
mind many restaurants actually have a menu and their nutrition information listed online so if you have the time
39:16
take a look at that menu before you actually go to the restaurant sometimes by the time we're at the restaurant or
39:23
the time we're at the the takeout line there we're looking at at at you know the most desirable food and perhaps our
39:29
appetite is is on high alert there we may not be picking the best choices so
39:35
if you can decide ahead of time that may help make better options for you keep
39:41
that balance plate in mind ask for a salad as an appetizer instead of the garlic bread that's put in front of you
39:48
uh pick two veggie options instead of potatoes with your steak have the smaller steak not the larger one or if
39:55
you want to have a small piece of pie after maybe you don't have as much of the starch with your meal and the
40:01
breaded um cheese sticks uh to be start off with watch the portion sizes as I
40:08
mentioned about the steak and the large uh amount there portion sizes in fast
40:13
food restaurants and uh restaurants tend to be typically much larger than at home
40:21
leading us to eat more because wow we paid for it it tastes good why wouldn't
40:26
we listen to your body and try to stop before you are full ask for a takeout container leave
40:34
it aside put your napkin on it uh you want to be careful because those extra
40:40
portions if done on the rare occasion may not be a problem but if eating out
40:46
is something you do on a regular basis could be the difference between you managing your blood sugars optimally or
40:55
not some of the things that like to suggest to people is ask for half portions share an entree share an
41:02
appetizer um as I mentioned package it up to go uh so that you're not stuck
41:08
with the food in front of you and just eating because it's there not because you're hungry ask how food is prepared maybe
41:16
you prepare your chicken a certain way but the way they do it in the restaurant
41:21
might have added salts or or sauces and things like that order foods that have been steamed
41:28
baked broiled grilled roasted similar to how I was mentioning how you would do it at at home don't forget about the
41:36
breading or the batters that can come on Foods the sauces the dressings they all add some of those extras that you may
41:42
not be putting on your foods at home yes it may taste Ultra good but it may have
41:48
a a bad effect on your overall health I also caution about the
41:54
sweetened drinks or alcohol drinks that that uh that might be served when you're eating out at a restaurant if you do
42:01
drink alcohol limit it to when you're eating a meal um as it can affect your blood sugar levels and interact with
42:07
some of the medications you take and talking about medications and the timing of your of your eating be careful about
42:14
this the more you uh deviate from uh consistency in your medication times
42:20
that you take uh me meds or the times that you eat the more can have an impact
42:26
on your blood sugars and your diabetes management bottom line healthy eating takes a bit of planning when you're
42:33
going out but once you do it you can do it without compromising your diabetes management and enjoy eating out with
42:40
friends family or if it's for business now we're getting towards the
42:47
end of things here and I'm trying to sum things up here and see if I can help you to find out what is right for you but
42:54
healthy eating patterns and healthy eating habits can not be easily defined as just one thing because it's different
43:00
for every person as I mentioned before there's no one diet fits all to some
43:06
healthy eating May mean eating more variety of foods and that's the change that you make and to others it might
43:12
mean trying to eat out less or less take out Foods your healthy eating pattern must
43:18
take into consider the factors like health conditions culture and religious
43:23
reasons food aversions socioeconomic status any factors that are important to you
43:30
okay and working with a diabetes educator or you yourself can look at all these factors to see how they can help
43:37
you or how they may become a barrier to planning a healthy meal pattern uh for
43:42
diabetes management but it can be done now some of the healthy eating patterns
43:47
that I know that I've seen out there that work for people would be following a Mediterranean style diet a Nordic
43:54
style eating pattern the DASH diet you may have heard of vegetarian style diet
43:59
now these are all dietary patterns that work very well with diabetes friendly food choices they're rich in protective
44:06
Foods as I mentioned from a cardiovascular perspective they might have lots of antioxidants they could be
44:12
high in fiber they may be low in processed foods um but these are all things that
44:17
you want to take a look at when you're planning what your healthy eating pattern is so let's try these things on
44:23
for size can you eat three meals a day and snacks as needed okay try to eat
44:30
something within two hours of waking and avoid going more than six hours between wake in waking hours between meals and
44:38
snacks consistency of meal timing will also help you get a better understanding
44:43
of what your blood sugars are doing don't forget to eat a variety of foods to get the right amount of protein
44:50
and fiber in your diet because this too will help with your blood glucose
44:56
levels remember that plate concept for planning meals try to balance it with three or
45:02
four of the food groups that we initially talked about at meal times and as needed with a source of protein with
45:09
another food group if you need a snack if there's been long periods of time without eating or perhaps you're doing
45:15
extra physical activity um more than usual this balance will help you to get
45:20
the fuel that your body needs while avoiding the spikes in blood sugar levels switching to lower glycemic at
45:27
foods that might be your healthy eating pattern change that you're going to make um and finding ways to do it that are
45:35
enjoyable sip on water or other low calorie fluids throughout the day to stay hydrated watch out for your
45:41
caffeine and alcohol intake dipping energy levels can be a result of not
45:47
getting enough fluids and getting the right fluids will leave your body and mind feeling much
45:54
better and if you don't have those fluids that can leave you feeling mentally and physically exhausted and
46:01
putting you at risk for overeating or making inappropriate
Conclusion
46:06
choices cutting back on ultr processed foods you know those packaged foods that
46:11
I was referring to before um can be also a way to help develop a healthy eating
46:20
pattern now I'm going to say I love this slide here of a puzzle pieces and I
46:26
don't know if any of you use puzzles but you might be feeling quite puzzled right now by all this information that I've
46:32
shared with you but I assure you once you start fitting all these pieces together you will see the bigger picture
46:39
if it's not just through this session but other sessions that you will be
46:44
watching improved eating habits feeling more in control of the things that you do have control over are just one step
46:51
closer to you having better diabetes management I'll hope you come to realize
46:57
that you don't have to have all the pieces to the puzzle here to know what the bigger picture looks like it's not
47:03
an All or Nothing But fitting in some of the little pieces bit by bit as you go
47:10
along your journey I will finish with leaving you with this 8020 rule when it comes to
47:17
eating if you can follow the guidelines 80% of the time you will be in a very good position to having a better
47:24
understanding of how your body and your blood sugar respond to your eating habits this will allow you that
47:30
flexibility 20% of the time to find out what works best for you and continue to
47:36
make modifications I thank you for participating in today's session I wish
47:42
you good health and I hope you found a couple of key takeaways that you can start working on in the days to
47:55
follow

0:00
[Music]
0:07
hello and welcome to the second session
0:09
in our nutrition education series for
0:11
people living with diabetes this session
0:14
is intended to support people with
0:15
diabetes to assess and understand their
0:18
relationship with food and how to heal
0:20
that relationship if necessary
0:22
registered dietitian and Ellen sder
0:24
Institute faculty member Sandy Maxwell
0:27
will outline what a positive
0:29
relationship with is how eating
0:31
competence can play a role and how to
0:33
achieve non-weight related food and
0:35
health goals take it away
0:37
Sandy hello and thanks for joining our
0:40
discussion
Overview
0:42
today I'll be going over what it means
0:45
to have a positive relationship with
0:47
food how to be competent with your
0:50
eating and how your relationship with
0:52
food supports
0:54
Wellness if some of these Concepts and
0:56
terms are unfamiliar to you not to worry
0:59
I will be EXP exping them my hope is
1:02
that you will gain some new information
1:03
about eating that will benefit you while
1:05
living with
1:08
diabetes let's start by looking at what
1:10
it means by having a positive
1:12
relationship with
Positive Relationship with Food
1:15
food for one thing you feel good about
1:18
eating you enjoy food and feel
1:21
comfortable eating with
1:22
others you look forward to eating rather
1:25
than being filled with
1:27
worry you take an interest in food
1:30
even unfamiliar Foods at the same time
1:33
you give yourself permission to eat
1:35
familiar foods that you
1:38
enjoy you eat to satisfy your hunger you
1:42
go along with your natural desire to eat
1:44
enough of food that you enjoy rather
1:46
than fighting against
1:49
it you feed yourself regularly and
1:52
reliably because you enjoy food and feel
1:55
comfortable with eating it is rewarding
1:57
to make feeding yourself priority
Current Relationship with Food
2:02
so would you say that you currently have
2:04
a positive relationship with food or do
2:07
you often worry about your eating and or
2:09
your weight do you feel happy when you
2:12
eat so-called good foods and guilty when
2:15
you eat so-called bad
2:17
foods do you try to eat less than you're
2:20
hungry for or do you worry that if you
2:22
eat certain foods you might not
2:25
stop almost everyone can answer yes to
2:28
at least one of these questions
2:30
in today's world feeling conflicted and
2:32
anxious about eating is so common that
2:34
it may seem the way it's supposed to be
2:37
but it isn't and doesn't have to be that
2:39
way for you even while living with
Eating Competence
2:44
diabetes today I'm going to introduce
2:46
you to the concept of eating competence
2:49
as the way to have a positive
2:50
relationship with
2:52
food this approach is proven to work
2:55
including for people living with
2:57
diabetes eating competent as to find by
3:01
the sder eating competence model is
3:03
being positive comfortable and flexible
3:06
with eating as well as matter of fact
3:09
and reliable about getting enough to eat
3:11
of personally enjoyable nourishing
3:13
food people who are eating competent
3:16
have better diets better metabolic
3:19
profiles including blood sugars more
3:22
positive quality of life indicators and
3:25
are more
3:26
active I'm going to walk through the
3:28
basic steps to WS eating
3:30
competence many people are able to
3:32
follow the steps on their own however
3:35
others need more support if that's you
3:38
not to worry I'll talk a bit more about
3:40
that
3:42
later the first step toward eating
Feed Yourself
3:45
competence is to feed yourself
3:48
Faithfully reassure yourself you will be
3:50
fed and that you will get to eat food
3:52
you genuinely
3:54
enjoy develop a meal and snack routine
3:57
that works for you take time to sit down
4:00
to
4:01
eat eating is more enjoyable when you
4:03
allow time to eat and pay attention to
4:06
your
4:07
eating having a consistent pattern of
4:10
meals and snacks supports you in taking
4:12
care of yourself with
4:14
food knowing when you'll be fed can
4:17
increase your peace and
4:18
comfort it can also let you forget about
4:21
between meal and snack times
4:24
eating this structure is especially
4:27
important while living with diabetes as
4:29
it helps to reduce the highs and lows of
4:31
blood sugars throughout the
Give Yourself Permission
4:35
day give yourself permission to eat a
4:37
variety of foods including Foods you
4:40
truly
4:41
enjoy don't let your eating competence
4:44
be spoiled by lists of good foods and
4:46
bad foods all foods nourish your body
4:49
and have nutritional value protein
4:52
energy vitamins minerals and other
4:56
nutrients even foods with added sugar
4:59
can be included in your meals and
5:01
snacks in fact doing this often enough
5:04
can help you relax about the impact they
5:06
may have on your blood
Connect with Your Eating
5:09
sugar another step in developing eating
5:12
competence is to connect with your
5:14
eating connecting with your eating will
5:17
transform it it's about getting in touch
5:20
with your inner self which knows how to
5:23
eat this involves taking time to
5:27
pause breathe
5:30
and say to
5:31
yourself it's all right to eat I just
5:33
have to pay
5:35
attention as you connect with your
5:36
eating ask yourself what am I
5:40
experiencing while I
5:42
eat at first you may get selft talk that
5:45
interferes with
5:47
connecting you may worry about what or
5:49
how much to eat or whether giving
5:51
yourself permission will affect your
5:53
weight that selft talk gets in the way
5:56
of your knowing what goes on inside you
5:59
your hunger appetite and feelings of
6:02
reward and satisfaction from
6:04
eating as time goes on you'll be less
6:07
bothered by that selft talk and more and
6:10
more be tuned into your inner self while
6:12
you
6:13
eat the payoff is that you may feel more
6:16
comfortable about providing yourself
6:17
with food you may feel better about your
6:20
eating calmer or more tuned
6:24
in you'll also want to trust your body
6:26
to know how much to eat and to eat what
6:28
is good for you
6:30
say to yourself it's all right to eat I
6:33
just need to pay
6:35
attention trying to ignore and outwit
6:37
your body lets you feel Only the
6:39
strongest feelings being famished or
6:41
being
6:42
stuffed at first you may not feel hungry
6:45
when you start on the road to eating
6:47
competence or you may not feel full when
6:50
you stop if you stay the course your
6:53
hunger rhythms will adjust to your
6:54
eating
6:55
pattern then you will re recover more
6:59
feelings maybe a twinge of hunger maybe
7:02
a bit of
7:04
fullness your feelings of hunger and
7:06
fullness will get stronger then you will
7:09
ReDiscover your stopping
Weight
7:13
Place one quick note about weight if you
7:17
deprive yourself in an effort to keep
7:19
your weight down you will gain it back
7:22
if you overeat to force your weight up
7:25
you will lose it back when you first
7:27
connect and give permission with eating
7:30
your weight may be a bit variable
7:32
especially if up to this time you've
7:34
been undereating or
7:36
overeating but please know your weight
7:38
will
7:39
stabilize when you are competent with
7:42
your eating your weight will be right
7:43
for
7:44
you being competent with your eating
7:47
helps you gain confidence and comfort
7:49
with your eating and with your
7:53
hunger as you develop eating competence
7:55
you'll want to be prepared to resist
7:58
interference and protect yourself so you
Eating
8:01
can hang on to your competence with
8:03
eating negative messages about eating
8:06
food and weight are all around you learn
8:09
to identify and ignore these messages
8:13
they can undermind you being a competent
8:15
eater this includes messages that you
8:18
impose on
8:20
yourself for example saying to yourself
8:23
I should need that or indulging in
8:25
weight talk can be
8:27
traumatic the trauma is all the negative
8:30
feelings that go along with food
8:32
restriction being constantly hungry
8:35
being preoccupied with what to eat or
8:37
not to eat being demoralized when your
8:40
weight stays the
8:41
same being a competent eater and feeding
8:44
yourself Faithfully lets you eat
8:46
enjoyably and well you feed yourself
8:50
Faithfully by establishing a structure
8:52
of meals and snacks each day and you
8:54
tune in and pay attention to your
8:57
eating a bonus of of course is that
9:00
competent eaters do better medically
9:02
nutritionally emotionally and
9:06
socially being competent with eating
9:08
also means that you can eat all kinds of
9:11
foods but the good food bad food monkey
9:14
on your back can send you out of control
9:16
when you want to eat certain
9:18
foods give yourself permission to
9:20
connect with these Foods you will find
9:23
yourself becoming calm around them
9:25
rather than being a big
9:27
Temptation at first may eat a lot but
9:30
soon the newness will wear off and you
9:32
will eat less sometimes more another the
9:36
same as you do with other
9:37
Foods giving yourself permission to eat
9:40
these foods will allow them to become
9:44
neutral and once you are comfortable
9:46
with how to eat what to eat will fall
9:49
into place you may enjoy planning
9:52
shopping and cooking and use it for fun
9:55
and
9:56
relaxation on the other hand you may
9:58
want to do as little as possible to get
10:00
the job
10:01
done however you feel about it is
Being Competent
10:07
okay being confident and eating
10:10
competent means being deliberate about
10:12
feeding yourself it means that you seek
10:14
food rather than avoid it don't wait
10:17
till you're hungry to think about it or
10:19
you'll just grab something you might not
10:22
enjoy be
10:24
intentional and pay attention to
10:26
Cravings you don't have to give in to
10:28
every eating impulse
10:29
but do pay attention to Cravings that
10:32
keep coming
10:33
back eating competently encourages
10:36
eating a nutritionally adequate diet
10:38
made up of a variety of foods as you
10:41
tune into your eating you will notice
10:43
that you'll get tired of eating the same
10:45
food all the time and you'll start
10:47
looking for
10:48
variety you'll find yourself taking an
10:50
interest in food being more comfortable
10:52
with unfamiliar food and gradually
10:55
getting so you enjoy a few new
10:58
foods
10:59
you'll also want to make planning your
11:01
friend not your enemy use planning to
11:04
make it easier to feed yourself you
11:06
abuse planning when you make your meals
11:08
complicated and pile on so much work you
11:11
can't sustain the effort or when you say
11:14
I shouldn't eat that or it isn't good
11:15
for
Living with Diabetes
11:18
me as a person living with diabetes the
11:21
tenants of being a competent eater apply
11:23
to you you can't eat Foods you enjoy you
11:27
just need to pay particular attention to
11:29
maintaining
11:30
structure as you know it's all about
11:33
balance living with diabetes means that
11:36
your body has access to only so much
11:38
insulin at a time this is true whether
11:42
you were managing with diet alone taking
11:44
medication to help your body's insulin
11:46
work better or injecting
11:49
insulin structure helps you balance your
11:52
food intake with your available insulin
11:54
and your activity to keep your blood
11:56
sugar within a stable range that helps
11:58
you feel good
12:00
skimping at one meal and overdoing it at
12:03
another gives you lows then highs in
12:05
blood
12:07
sugar you can have good tasting filling
12:10
and sustaining meals and snacks your
12:13
Diabetes Care team can help you
12:15
understand how different nutrients
12:16
behave in your body which can help you
12:18
in making food
12:20
choices for example you can slow down
12:23
the release of sugar in your body from
12:24
sweets by having them with other Foods
12:26
at a meal rather than on their own
12:32
so while this has been a brief overview
12:34
of what it means to have a positive
12:36
relationship with food as it relates to
12:38
eating competence and diabetes I
12:40
appreciate that after watching this
12:42
video you might feel more conflicted
12:44
about your eating and you may wonder
12:46
what to do
What to do next
12:49
next perhaps a good place to start is to
12:52
think differently about food health and
12:57
weight optimism
12:59
self trust and a sense of adventure are
13:02
healthier for you in guiding your eating
13:04
than negativity self-denial and
13:07
avoidance in our weight obsessed culture
13:10
EA incompetence can be
13:12
challenging but be reassured that trust
13:15
is better than
13:16
control and remember that eating
13:18
competence supports
13:20
Wellness competent eaters do better
13:23
medically and nutritionally have more
13:25
stable body weights and feel good about
13:27
their bodies
13:30
with eating as in life competent eaters
13:33
are tuned in and responsive to
13:35
information coming from within and use
13:38
that information to guide them in taking
13:40
care of
Summary
13:44
themselves The Joy of Eating and Trust
13:46
in your body guide you um requires
13:50
nurturing be kind to yourself and
13:53
remember your self-care with eating can
13:55
help you through the ups and downs of
13:58
life
13:59
in summary a positive relationship with
14:02
food and being competent with your
14:04
eating is possible and
14:07
rewarding it may be easy for you or you
14:11
may require some
14:12
work as a start you'll want to feed
14:16
yourself Faithfully by developing a meal
14:18
and snack routine that works for you and
14:20
that includes foods that you truly
14:24
enjoy you'll want to take time to
14:26
connect with your eating by slowing down
14:29
down paying attention and telling
14:31
yourself it's all right to
14:35
eat you'll also want to be prepared for
14:37
interference from negative messages
14:39
around you including NE negative
14:42
messages you impose on
14:46
yourself you also may want to reach out
14:48
for help from trained eating competence
14:51
professionals as it isn't always easy
14:53
changing long-standing attitudes and
14:56
behaviors it's also important to discuss
14:59
any concerns or potential changes to
15:01
your eating with your Diabetes Care
15:05
team I'll conclude with a quote from
15:08
Ellen
15:09
sder when the joy goes out of eating
15:12
nutrition
15:15
suffers thank you for watching and
15:17
please feel free to reach out to the
15:19
Ellen sat Institute with your questions
15:21
at support at Ellen sat institute.org
15:24
and visit the website to learn more
15:26
about eating competence and joyful
15:28
eating
15:40
me