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Nutrition

Nutrition seems to be on everybody’s minds these days; from elite athletes to those who want to lose a little weight, everyone wants to know the right combinations and amounts of food to eat.  In fact, the Food Pyramid has recently been redesigned, yet again, for the most up-to-date recommendations that the United States Department of Agriculture (USDA) has come up with.  The following topics will be discussed below:

Whatever happened to the 4 basic food groups?

Do Type 1 Diabetics need a special diet?

 What do the serving sizes look like?

Dining Commons (DC) Specific Clues!

Websites with Nutrition Info and Calculators

 

 Whatever happened to the 4 basic food groups?

 Don’t worry, the food groups you remember from the old pyramid (grains, vegetables, fruits, milk, meat and beans, and oils) are still there, but there has been an addition: activity (which is covered in its own section).  The new recommendations are more closely tailored to individuals.  Different amounts are recommended for different ages, sexes, and activity levels.  All recommendations listed below are appropriate for people who get less than 30 minutes of moderate physical activity per day in addition to normal daily activities.  The new recommendations for each of the food groups are:

bulletGrains:
bulletOld: 6-11 servings per day
bulletNew:  “Make half your grains whole.” 
bulletAt least half of the total daily recommendation for grains should be consumed as Whole Grains. 
bulletRecommendations are now given in “ounce equivalents.”  Generally, a slice of bread, 1 cup ready to eat cereal, or ½ cup of cooked rice, pasta, or cereal (like oatmeal) is considered one equivalent.  This is typically what diabetics consider one carbohydrate exchange.
bulletGirls 14-18 years old→ 6 ounce equivalents, with a minimum of 3 oz equivalents from whole grain;
bulletWomen 19-30 years→ 6 oz equivalents, with a minimum of 3 oz equivalents from whole grain. 
bulletBoys 14-18 years old→ 7 oz equivalents, with a minimum of 3 ½ oz equivalents from whole grain;
bulletMen 19-30 years→8 oz equivalents, with a minimum of 4 oz equivalents from whole grain. 
bulletVegetables:
bulletOld: 3-5 servings
bulletNew:  “Vary your veggies.” 
bulletThere are now 5 subgroups of veggies: dark green, orange, dry beans and peas, starchy, and other vegetables. 
bulletNew emphasis on eating a variety of vegetables throughout the week. 
bulletAmounts are given in cups (or cup equivalents) on both a daily and weekly basis.  One cup of raw or cooked vegetables or vegetable juice and 2 cups of green, leafy vegetables count as a 1 cup serving.  
bulletYou do not necessarily need to eat vegetables from each subgroup daily, but try to eat a variety throughout the week.
bulletGirls 14-18 and women 19-30 years old→ 2 ½ cups daily;
bulletBoys 14-18 and men 19-30 years old→ 3 cups daily.
bulletPlease visit the MyPyramid website for weekly recommendations.
bulletFruits:
bulletOld:  2-4 servings
bulletNew: “Focus on Fruits.” 
bulletThese recommendations are also given in cups or cup equivalents.  In general, 1 cup of fresh fruit or fruit juice or ½ cup of dried fruit counts as 1 cup. 
bulletThough the website does not specifically say to, I would suggest eating a variety of fruits throughout the week. 
bulletGirls 14-18 years→ 1 ½ cups;
bulletWomen 19-30 years→ 2 cups;
bulletBoys 14-18 years→ 2 cups;
bulletMen 19-30 years→ 2 cups.
bulletMilk:
bulletOld:  2-3 servings
bulletNew: “Get your calcium-rich foods.” 
bulletLow-fat or fat-free milk options are strongly encouraged. 
bulletThis is also given in cups and cup equivalents with 1 cup of milk or yogurt, 1 ½ ounces of natural cheese, or 2 ounces of processed cheese counting as a 1 cup serving.
bulletGirls 14-18 years and Women 19-30 years→ 3 cups;
bulletBoys 14-18 years and Men 19-30 years→ 3 cups.
bulletMeat and Beans:
bulletOld:  2-3 servings;
bulletNew: “Go lean on protein.” 
bulletChoosing lean meats and proteins is stressed. 
bulletRecommendations are given in ounce equivalents.  A 1 ounce equivalent is generally considered to be 1 ounce of meat, ¼ cup cooked dry beans, 1 egg, 1 tablespoon peanut butter, or ½ ounce nuts or seeds.
bulletGirls 14-18 years→ 5 ounce equivalents;
bulletWomen 19-30 years→ 5 ½ ounce equivalents;
bulletBoys 14-18 years→ 6 ounce equivalents;
bulletMen 19-30 years→ 6 ½ ounce equivalents.
bulletOils:
bulletOld:  Fats, oils, and sweets, use sparingly; limit fat to 30% of daily calories.
bulletNew:  “Know your fats.”  
bulletChoose oils, which are comprised more of polyunsaturated and monounsaturated fats, over solid fats, which are mostly saturated fats. 
bulletSome fat in the diet is essential because it helps absorb vitamins.  However, as a rule most people do not need to consciously add fat because they normally get plenty from the meats and proteins they eat. 
bulletRecommendations given in teaspoon equivalents.  For instance, 1 ounce of nuts provides the equivalent of 3 teaspoons, 2 tablespoons of Italian salad dressing is 2 teaspoon equivalents, and 1 tablespoon of soft margarine is equal to 2 ½ teaspoons of oil.
bulletGirls 14-18 years→ 5 teaspoons;
bulletWomen 19-30 years→ 6 teaspoons;
bulletBoys 14-18 years→ 6 teaspoons;
bulletMen 19-30 years→ 7 teaspoons.

 

Please visit the MyPyramid website for more detailed information.

www.mypyramid.gov

 

Do Type 1 Diabetics need a special diet?

Several studies have shown that people with Type 2 Diabetes and insulin resistance benefit from reduced carbohydrate diets as opposed to high carbohydrate diets.  (However, many of these studies disagree or do not specify what “reduced” or “high” carbohydrate diets are.)  Would Type 1’s benefit as well?

            Here are the facts for people who have functional pancreases, those with insulin resistance, or Type 2 Diabetes:

·        Because carbohydrate ingestion results in the increase of insulin secretion after a meal, eating fewer carbohydrates at each meal results in a lower secretion of insulin;

·        The increase in insulin secretion after a high-carbohydrate meal may cause a reduction in blood glucose such that can result in hypoglycemia, and therefore create a feeling of hunger;

·        Several studies correlate the increased trend of high carbohydrate diets with that of obesity and other metabolic abnormalities (Arora and McFarlane);

·        Other studies have shown greater weight gain and loss of insulin sensitivity with high-fat diets (Kelley);

·        In one study, better glycemic control was achieved with a low-carbohydrate diet than with a low-fat/high-carbohydrate diet (Arora and McFarlane);

·        And yet, other studies have shown over the short-term that diets with a higher proportion of fiber and starches can lead to weight stabilization or even weight loss (Kelley);

·        Extremely low-carbohydrate diets can affect the moods and emotions of people because glucose, which is a product of ingested carbohydrate, is the source of energy for the brain;

·        Fats are important for the diet as well, but some are essential or necessary to get from the diet while others should be more restricted;

·        Saturated fats, mainly found in animal meats, should not exceed 10% of daily calories;

o       There is strong evidence that saturated fats increase the risks of cardiovascular heart disease by increasing insulin resistance, LDL (“bad”) cholesterol, total cholesterol, triglycerides, and lowering HDL (“good”) cholesterol (Kelley).

·        Trans-fats are now being included on nutrition labels because they have been linked with increased risk for cardiovascular disease;

·        Mono-unsaturated and poly-unsaturated fats have been shown to improve lipid profiles and therefore decrease cardiovascular heart disease risks;

o       New recommendations are that carbohydrates and mono-unsaturated fats combined should make up 60-70% of daily caloric intake;

o       Poly-unsaturated fats should make up about 10% of daily caloric intake (Kelley).

·        Balancing energy (caloric) intake with energy expenditure is important; when expenditure is greater than intake (which can lead to weight loss) has been shown to increase insulin sensitivity; an increase in caloric intake greater then expenditure (which will eventually lead to weight gain) has been shown to increase insulin resistance regardless of the source of calories (fat or carbohydrate).

 Neither carbohydrates nor fats should be totally eliminated from anybody’s diet, no matter whether the person has diabetes or not.  After all, carbohydrates are the preferred energy source of the brain and fats are essential for certain functions to be performed in the body.  But, we all should know that too much of a good thing can be a bad thing.  Therefore, moderation is really the “key” to the “diabetic diet.”  Maintaining a healthy weight and getting the right balance of nutrients is important for everyone, and the best and easiest way to do that is by eating a variety of foods from day-to-day and meal-to-meal.  However, having Type 1 Diabetes means you’ve got to pay more attention than just eating a variety of foods.  At the least, you’ve got to be able to know the carbohydrate content of the meal in order to properly match the insulin dose, and counting carbs can be a daunting task at times, especially when eating out.

 

What do the serving sizes look like?

 This following is from the USDA Nutritive Value of Foods online pamphlet (page #4, but it will be the 10th page according to Adobe Reader) that was revised in 2002.  While this still has the “old” food guide pyramid, it still is full of relevant and helpful information. 

The link at which you can find the entire article is www.nal.usda.gov/fnic/foodcomp/Data/HG72/hg72_2002.pdf

 Table 2. Tips for Estimating Amount of Food Consumed

This table lists some handy tips to help you estimate the amount of food you eat when you cannot measure or weigh it.

 Breads and grains

1/2 cup cooked cereal, pasta, rice….. volume of cupcake wrapper or half a baseball

4-oz bagel (large)…………………... diameter of a compact disc (CD)

medium piece of cornbread………… medium bar of soap

 Fruits and vegetables

medium apple, orange, peach….. tennis ball

1/4 cup dried fruit……………… golf ball or scant handful for average adult

1/2 cup fruit or vegetable………. half a baseball

1 cup broccoli…………………... light bulb

medium potato…………………. computer mouse

1 cup raw leafy greens…………. baseball or fist of average adult

1/2 cup………………………… 6 asparagus spears, 7 or 8 baby carrots or carrot sticks, or a medium ear of corn

 Meat, fish, and poultry, cooked

1 oz…………. about 3 tbsp meat or poultry

2 oz…………. small chicken drumstick or thigh

3 oz…………. average deck of cards, palm of average adult’s hand, half of a whole, small chicken breast, medium pork chop

 Cheese

1 oz hard cheese…………... average person’s thumb, 2 dominoes, 4 dice

 Other

2 tbsp peanut butter………. Ping-Pong ball

1/3 c cup nuts……………. level handful for average adult

1/2 cup ……………………half a baseball or base of computer mouse

1 cup ………………………tennis ball or fist of average adult

Note: The serving size indicated in the Food Guide Pyramid and on food labels is a standardized unit of measure and may not represent the portion of food a person actually eats on one occasion.

Sources: Schuster (1997), American Institute of Cancer Research (2001).

 By “base of computer mouse” they mean the part your palm sits on, as if you’ve chopped off the buttons

 Here are some other tips and ideas that I’ve found that may be helpful:

 ½ cup………a hockey puck

¾ cup………an average computer mouse

1 cup……….a baseball

3 ounces of meat, poultry, or fish………..just a little bigger dimensions than most insulin pumps; most pumps weigh about 3 ounces (for example the Deltec Cozmo weighs 2.7 oz empty and 3.3 oz w/ battery and full cartridge; the MiniMed Paradigm is the heaviest pump at 3.8 oz without battery or reservoir), so if you have a pump and you feel like comparing the weight of your meet and your pump, go for it

            About the size of an I-pod

1/3 cup (nuts)……..2 C batteries

 

DC Specific Clues!

 It can be difficult in the DC to look at your plate and figure out how much you have.  So, here are some DC specific clues:  Click on the descriptions for a picture (pictures will be added soon!).

 Large white plates are 9 inches in diameter.

            ½ cup of pasta on plate

            1 cup of pasta on plate

 Small white plates are 6 inches in diameter.

 The paper cups by the coffee and tea hold 12 ounces, or about 1 ½ cups when filled to the brim.

 The glasses also hold 12 ounces or 1 ½ cups when filled to the brim.

            1 cup of milk in glass

 Those small porcelain bowls hold about 10 ounces or 1 ¼ cups when filled to the brim.

            ½ cup of cereal in bowl

            1 cup of cereal in bowl

 The large porcelain bowls hold about 16 ounces or 2 cups when filled to the brim.

            ½ cup of cereal in bowl

            1 cup of cereal in bowl

 One full scoop of cereal from the cereal bins is ¾ cup.

 Small clear cups (often at the ice cream stations) hold 2/3 cup to the brim.

            ½ cup, 1/3 cup, and ¼ cup liquid in cups

 Small white plastic bowls (also at the ice cream stations) hold about ½ cup.

            ½ cup, 1/3 cup, and ¼ cup liquid in bowls

 Eating spoons (the “teaspoons” not the soup spoons) really are 1 tsp.

 And to further help plan your DC feasts:

Nutrition Info from the UMass Dining Commons:

http://www.umass.edu/diningservices/nutrition/nutrient_analysis.htm

 Daily Menu from the DC:

http://www.umass.edu/diningservices/menu.php

 

Websites with Nutrition Info and Calculators

 Nutrition Info for various foods pgs 14-89 of the USDA Nutritive Value of Foods (20-95th pages of Adobe Reader): www.nal.usda.gov/fnic/foodcomp/Data/HG72/hg72_2002.pdf

 Nutrition Calculators:

1)      http://www.principalhealthnews.com/topic/nutritiontoolbox

2)      http://www.caloriesperhour.com/index_food.html

 Restaurants and Fast Food:

Pizza Hut: http://www.pizzahut.com/menu/nutritioninfo.asp

Domino’s: http://www.dominos.com/Public-EN/resources/file/eb02a009bd702e6/nutritional_guidelines.pdf

Papa Gino’s: http://papaginos.com/nutrition.html

Chili’s family restaurant:  http://www.chilis.com/menu/default.asp?Unit_ID=001%2E005%2E0831&tierID=15&menuType=Dine+In&menu=1

Burger King:  http://www.bk.com/food/nutrition/index.aspx

McDonald’s:  http://www.mcdonalds.com/usa/eat/nutrition_info.html

KFC:  http://www.yum.com/nutrition/menu.asp?brandID_Abbr=2_KFC

Taco Bell:  http://www.tacobell.com/

Wendy’s:  http://www.wendys.com/food/index.jsp?country=US&lang=EN

Includes Diabetic Exchanges (under nutrition topics)

Subway:  http://www.subway.com/applications/NutritionInfo/index.aspx

Starbucks: http://www.starbucks.com/retail/nutrition_info.asp?cookie%5Ftest=1


References:

 Arora, Surender K and Samy I McFarlane.  The case for low carbohydrate diets in diabetes management.  Nutr Metab (Lond) 2005; 2: 16. 

DAFNE Study Group.  Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomized controlled trial.  BMJ 5 Oct 2002; 325: 746-

Gebhardt, Susan E., and Robin G. Thomas. 2002.  Nutritive Value of Foods. U.S. Department of Agriculture, Agricultural Research Service, Home and Garden Bulletin 72.  www.nal.usda.gov/fnic/foodcomp/Data/HG72/hg72_2002.pdf.  October 2002.

Kelly, David E.  Sugars and starch in the nutritional management of diabetes mellitus.  American Journal of Clinical Nutrition 2003; 78 (suppl): 858S

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