Question of the week- Pre-Diabetes?

Message from Christine:When it comes to Carbohydrate Counting, fiber and sugar alcohol are treated a little differently according to the American Diabetes Association.  If a food contains more than 5 grams of fiber, half of the grams of fiber should be subtracted from the total carbohydrate on a food label.  For example:

  • suppose a food contains 20 grams of total carbohydrate and 6 grams fiber
  • divide 6 grams of fiber by 2 = 3 grams of fiber to subtract from total carbohydrate
  • 20 grams of total carbohydrate – 3 grams fiber = 17 grams total carbohydrate

The same is true for sugar alcohol.  If a food contains more than 5 grams sugar alcohol, half of the grams of sugar alcohol should be subtracted from the total carbohydrate. Christine Carlson, MS, RD, BC-ADM, CDE, Registered Dietitian & Certified Diabetes Educator

This week’s question for your nutrition blog: From: Ann W. (e-mail not disclosed for privacy)
Date: 4/22/2011

Pre-Diabetes diet? I was recently diagnosed with Pre-Diabetes and was wondering how strict my diet really needs to be?  Does every meal and snack need to be completely sugar and carb free?

To start by answer this question, I would like to point out that just because you may have diabetes or even pre-diabetes does not mean that all of your meals and snacks need to be sugar and/or carb “free”.  Absolutely not, anatomically this may not be the most realistic dietary plan.  However, I would recommend that your beverages are sugar-free, best bet choose water. Don’t be fooled, remember that even “sugar-free” foods may have carbohydrates in them, refer to get the facts on reading food labels. I see a lot of diabetes eating “sugar-free cake”, without realizing that the carbohydrate content in it still affects their blood sugar levels.

Mayo- Clinic; Put sugar-free products in their place

  • Sugar-free doesn’t mean carbohydrate-free. Sugar-free foods may play a role in your diabetes diet — but sugar-free doesn’t mean carbohydrate-free. When you’re choosing between standard products and their sugar-free counterparts, compare the food labels side by side. If the sugar-free product has noticeably fewer carbohydrates, the sugar-free product might be the better choice. But if there’s little difference in carbohydrate grams between the two foods, let taste — or price — be your guide.
  • No sugar added, but not necessarily no carbohydrates. The same caveat applies to products sporting a “no sugar added” label. Although these foods don’t contain high-sugar ingredients and no sugar is added during processing or packaging, foods without added sugar may still be high in carbohydrates.
  • Sugar alcohols contain carbohydrates and calories, too. Likewise, products that contain sugar alcohols — such as sorbitol, xylitol and mannitol — aren’t necessarily low in carbohydrates or calories.

You may want to consider becoming more strict with yourself depending on your current food intake. Now that you have pre-diabetes the amount that you are eating at each meal and snack will be most important, because your body is not sure how to ‘balance’ blood sugars from what you are eating the way that it used to.  It is important to focus on the portion sizes and amounts of different foods that  you choose, often the key word “moderation”.  I would also recommend for you to start monitoring your blood sugars and compare them to the types and times of your meals and snacks.  This is a great toll and recommend the plate method and portion control guidelines through WEBMD to my patients when referring to portion control.  As you will learn as you begin to research health risks, nutrition, and other disease related components, our body still needs carbohydrate components from vegetables, fruits, dairy, whole grains and fiber, to survive and live healthfully.

Have you been given a specific level of calories to follow per day, or the content of carbohydrates that you should be consuming per meal or snack?  Even though you may have pre-diabetes, it is important to start monitoring these things.  I would recommend small and frequent meals and snacks to help “balance/maintain” your blood sugar. Try not to skip meals, or eat excessively large ones. Looking at it from a positive note, pre-diabetes means prevention!  Prevent diabetes, this is the time for you to consider all angles of your eating and food choices, follow the food guide pyramid and portion size recommendations for your age and BMI, partake in routine physical activity patterns, and prevent the disease from worsening into Type 2 Diabetes Mellitus.

Hope this helps and good luck in your plan to prevention!!!!


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