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Susan B. Dopart, M.S., R.D.

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Diabetes Prevention: Love Carbs? 6 Steps To Avoid Diabetes

Posted: 01/12/11 08:33 AM ET

As a registered dietitian, I often hear, "I've never met a carbohydrate I didn't like!" I can certainly understand the sentiment. Carbohydrates are everywhere, easily accessible, and made into tasty treats. At the same time, carbs can play a precarious role when it comes to diabetes, wreaking havoc on your blood sugar with potentially serious results.

Without having to "break up with carbohydrates" as one of my clients put it, how can you avoid becoming diabetic or better control your blood sugars if you are diabetic?

1. Read labels or choose foods without labels.
If you pick up an apple or some green beans you won't find a label. Herein lies the clue that you are consuming a healthy, unprocessed form of carbohydrate. Fruits and vegetables have built in fiber that delays the absorption of their sugar. This prevents an insulin spike, followed by a drop, which creates cravings for more carbohydrates or food.

If you choose a carbohydrate with a label, look at how many total carbohydrates are in a serving. The American Diabetes Association uses 15 grams of carbohydrate as one serving of carbohydrate. This is equal to a slice of bread. With this comparison, you can look at how many total carbohydrates are in a particular food, or how many slices of bread worth of carbohydrate you are consuming.

For example, a typical container of juice can be marked for two servings with each serving having 35 grams of carbohydrate. That's equivalent to more than four slices of bread -- without the benefit of the fiber.

2. Squash it! Substitute veggies for starchy carbs.
Most people can name the obvious starchy carbs -- potatoes, rice, pasta, cereal, bread, etc. Even in a less processed, high fiber form (whole grain pastas, breads, etc.) they still contain significant amounts of carbohydrates that can increase blood sugars.

Here are some healthy, nutritious, and satisfying substitutes that will result in fewer spikes to your blood sugar:

• Spaghetti Squash: This yellow squash is easy to prepare and substitutes nicely for pasta. Sprinkle with some parmesan cheese and enjoy with your favorite protein or meatballs and tomato sauce.
• Eggplant: This squash is underused and tastes great as a substitute for noodles in lasagna or in any vegetable dish. Eggplant can also be diced and sautéed with Indian spices for a meat-like side dish.
• Portobello Mushrooms: These mushrooms can be used as a pizza crust (scoop out insides and bake slightly before adding pizza toppings) or as a holder for any protein dish or hearty vegetable side.
• Butternut, Acorn, Delicata or Tahitian Squash: These squashes make great substitutes for potatoes and can be mashed or baked.

3. Increase your activity and move your body.
A landmark study in 2002 showed that even a 30-minute walk or other form of exercise per day can result in a 58 percent decrease in the incidence of diabetes. Activity and exercise have a powerful effect on normalizing blood sugars. Even if you never lost a pound from exercise, the internal changes have powerful benefits.

4. Increase protein and good fats...especially at breakfast.
Protein is not as alluring as carbohydrates, but it has a profound effect on blood sugars. Protein evens out your blood sugars and increases energy and satiety to make you feel full.

Eating more protein and a moderate amount of carbohydrate from unprocessed sources for breakfast sets a good blood sugar tone for the day. If you eat a large bowl of cereal with fruit, your blood sugars go up, spiking your insulin levels and resulting in a large drop. This is followed by a craving for more food and more carbohydrate along with less energy for the rest of the day. It's as if the blood sugars won the race instead of you.

A higher protein option might be cottage cheese topped with fruit and sliced almonds and cinnamon. It has protein, some healthy carbohydrate, and fat.

5. Eat regular, balanced meals.
Here's a phrase that has been way overused. But what does it really mean? Let's break it down to an easy formula:

• Eat within an hour of waking since you've been fasting overnight.
• Don't go more than four hours without food to keep your blood sugar and your metabolism even.
• Choose protein at each meal along with a healthy, unprocessed form of carbohydrate and some healthy fat. Do the same at snack time.

6. Regularly check your blood sugars.
If you're not diabetic, you may be scratching your head on this one. However, if you suspect you have diabetes, or have type 2 diabetes, this is one you don't want to ignore.

Checking your blood sugars first thing in the morning can show you how your body responded to the food you ate on the previous day. Below 95 is ideal. If your morning blood sugar is over 100, you could be diabetic or pre-diabetic.

Checking your blood sugars two hours after a meal shows you how your body responded to the meal. Less than 126 is the number to achieve. My most successful clients -- those who avoided diabetes or avoided the long-term effects of diabetes -- were diligent about checking their sugars. Most pharmacies carry several types of glucometers which are more user friendly than in the past and can impart power in a way no medical professional ever could.

Seem like a lot to do? Start with small reasonable changes. Eat a high-protein breakfast for a few weeks and slowly increase your walks. Small changes cause noticeable results in the body.

The diabetic epidemic is rising, but you can avoid becoming a statistic. A few lifestyle changes can mean a healthier you in 2011.

Susan is the author of "A Recipe for Life by the Doctor's Dietitian." For more information, visit susandopart.com.

 
 
 

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As a registered dietitian, I often hear, "I've never met a carbohydrate I didn't like!" I can certainly understand the sentiment. Carbohydrates are everywhere, easily accessible, and made into tasty t...
As a registered dietitian, I often hear, "I've never met a carbohydrate I didn't like!" I can certainly understand the sentiment. Carbohydrates are everywhere, easily accessible, and made into tasty t...
 
 
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HUFFPOST SUPER USER
w84it
02:30 PM on 01/28/2011
Here's the deal for me. Eat chicken or pork? I get lethargic and my stomach hurts. Eat beef? I also feel lethargic with the added benefit of wanting to vomit. So, I cut meat, except for occaisional fish, out of my diet years ago. This wasn't done for "moral" reasons. Meat literally makes me ill.
06:36 PM on 01/17/2011
I would add to this list that if you are young and taking meds, especially meds that can make you tired and weak, consider manual labor of some kind to pay the bills and stay healthy.
12:57 PM on 01/17/2011
Super information! We all need to take steps to stay as healthy as possible and enjoy life to the fullest.

New information out of UCLA shows that drinking coffee (especially with women) can prevent the onset of type 2 diabetes:

http://www.espresso-and-coffee-makers.com/benefits-of-coffee

So, drink up!
Here's to your continued god health,
Betty Z
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HUFFPOST SUPER USER
DavidMG
OWS Senior Citizen
11:00 AM on 01/16/2011
To help your kids accept vegetables and fruit take a look a book called "The ABC's of Fruit & Vegetables and Beyond." If yiour kids are young you can teach them to read with its produce based alphabet poems and then go on to activities. Many schools are now using it.
01:10 AM on 01/14/2011
What's the skinny on portion size? Since the body must be lean to control diabetes, the Am. Diabetic Assoc, is saying less body fat is more important the weight. We can still gain weight eating too much healthy food. Anything over 25% body fat is bad. To control diabetes I believe it needs to be even lower than that.
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HUFFPOST SUPER USER
eLucida
Liberate Fitzwalkerstan, defeat A.L.E.C.
01:36 PM on 01/15/2011
It's still comes down to carbohydrate reduction.

http://www.garytaubes.com/2010/12/calories-fat-or-carbohydrates/

"Virtually any diet that significantly restricts the number of calories consumed, even a diet that is described as low-fat (because the subjects are instructed to reduce the proportion of fat calories they consume), will cut the total amount of carbohydrate calories consumed as well. This is just simple arithmetic. If we cut all the calories we consume by half, for instance, then we’re cutting the carbohydrates by half, too. And because these typically constitute the largest proportion of calories in our diet to begin with, these will see the greatest absolute reduction. If we preferentially try to cut fat calories, we’ll find it exceedingly difficult to cut more than 400 or 500 calories a day by reducing fat — depending on how much fat we were eating to begin with — and so we’ll have to eat fewer carbohydrates as well.

"Put simply, low-fat diets that also cut significant calories will cut carbohydrates significantly as well, and often by more than they cut fat."
HUFFPOST SUPER USER
DrP
11:03 PM on 01/16/2011
Obesity does not cause diabetes. Both obesity and the chronic high blood sugar readings used to diagnose "diabetes" are symptoms of insulin-resistance. Lowering body fat or weight will not "cure" insulin resistance. However, the symptoms can be well-managed on a low-carbohydrate diet.
10:39 PM on 01/12/2011
"A landmark study in 2002 showed that even a 30-minute walk or other form of exercise per day can result in a 58 percent decrease in the incidence of diabetes."

This is a gross oversimplification of the results of this study.

The "58 percent decrease in the incidence of diabetes" was in a group that followed "lifestyle interventions" that included a reduced-calorie diet in addition to exercise.

Reduced calories, other things being equal, means reduced carbohydrate, and the exercise amounts were self-reported.

So, we don't know how much the participants actually exercised, only how much they said they exercised. But even if they really did exercise 150 minutes a week, we have no way of knowing if the reduction in diabetes was due to exercise, reduced calories, or reduced carbohydrate.
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HUFFPOST SUPER USER
VanessaFas
09:26 PM on 01/12/2011
Exercise is the easiest to add. I've found that if I exercise every day, even a little, then my body does not crave the salt and sugar at all. At least except for the apples and raisins, which are without labels (see above). If you add exercise first, the diet/nutrition part becomes much easier!
08:04 PM on 01/12/2011
Thank you Susan for a handfull of very relevant comments. As you rightly write, I can't emphasise enough that an excellent way to eat less carb is to avoid any industrially processed food.This is why my partner and I have even decided to go a step further, and explained in a recent post why we have decided to stop buying food from supermarkets altogether… (http://makingsenseofthings.info/2011/01/why-weve-decided-to-stop-buying-food-from-supermarkets/) It will probably sound weird for most, but to us, it just makes sense!… Anyway, where do you buy your food then?

jsr
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HUFFPOST SUPER USER
PlantGod72
Intelligence = wisdom___If only....
07:40 PM on 01/12/2011
I didn't make the changes I should have years ago till my partner (only 40 years old) was recently diagnosed with type II diabetes. It was a shocking (even though his blood sugar had been creeping up over the past several years) wake-up call, and we've both made some adjustments to our diet.

Gone are most breads (rye crisps are now close at hand at meals), pasta (hello spaghetti squash), potatoes and rice (wild rice is tastier and nice and chewy) and most processed foods.

No more drive-bys at McD's or other fast food stops; planning and preparing healthy meals has actually become an unexpectedly welcome activity in our lives!

It's only been 1 month since these adjustments, and neither of us are ever going hungry, and yet we've both dropped about 10 lbs each, and we haven't even really started upping our exercise regime yet.
This user has chosen to opt out of the Badges program
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04:42 PM on 01/12/2011
Controlling my weight, exercising fairly strenuously on a Stairmaster and Lifecycle or walking 5-6 miles, eating lots of fruits like apples and bananas, less meat and sweets has enabled me to eat whatever I wish.

At a family reunion recently, I was the only one who could eat rice. All my cousins are type 2 diabetics and cannot eat rice. For a Japanese person to not be able to eat rice, it's sad. There's a price to pay, exercising and controlling diet is not an easy thing, but wouldn't that be preferable to getting diabetic?
HUFFPOST SUPER USER
DrP
04:36 PM on 01/12/2011
The advice here is basically sound, which is refreshing. However, I take issue with a blanket recommendation to eat fruit and whole grains. Those with a high degree of insulin-resistance who are the most likely to incur abnormal blood sugar levels (I refuse to call this "Type II Diabetes" and I am on a campaign to eliminate the term and stop considering it a disease) may not be able to handle any grains or fruit (which does contain fructose which is just as harmful as that found in HFCS; some people may be able to tolerate up to 15 grams of fructose a day from fruit, but it does need to be limited; get your fiber and vitamins from non-starchy vegetables). I find that the lower my carb intake and the higher the fat intake, the better I feel. My family has severe insulin-resistance and before we discovered the truth about insulin and it's effect on so many health problems, we suffered high blood sugar, blood pressure, GERD, ADHD, obesity, IBS, mood swings...you name it. Carb restriction has helped all of us. Happily, at 58, I show no signs of any of these issues, but was marching straight towards disaster until I read Atkins. My hero now is Gary Taubes..hopefully "Why we get fat and what to do about it" will become required reading in medical schools.
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HUFFPOST SUPER USER
PlantGod72
Intelligence = wisdom___If only....
07:43 PM on 01/12/2011
Some good info, and congrats on your improving your health and wellbeing!
10:41 PM on 01/12/2011
Word.
02:56 PM on 01/12/2011
Diet-wise, I'd say that the biggest factor for me in terms of weight loss and blood sugar control has been reduced portion size coupled with the complete elimination of highly-sugared beverages.
01:51 PM on 01/12/2011
Saying that sugar and carbs aren't a problem for you, unless you are diabetic, is exactly like saying cigarettes aren't a problem for you, unless you have lung cancer.

EVERYBODY should be avoiding sugar, and eating only limited amounts of complex carbs.

The irony of the "low" carb diet, is that it really isn't low carb at all. Your typical "low" carb diet has even proportions of protein, healthy fats, and carbs. But people perceive this as being low carb, because the standard American diet contains an egregiously high ratio of carbs.
HUFFPOST SUPER USER
Repubnomore
02:46 PM on 01/12/2011
Good points. I might add;

Fructose - one half of table sugar and more than half of high fructose corn syrup (HFCS) is metabolized in the liver like saturated fat and alcohol. Fructose elevates triglyceride levels putting one at increased risk of inflammation, plaque formation, heart attack and stroke.

Fructose from whole fruit (not fruit juice) is safe because it contains fiber. HFCS does not.

Fructose also suppresses the hormone Grehlin that signals satiety. Basically, you keep on eating because you don't feel full. This is one of the reasons HFCS is found in nearly every processed food including bread, potato chips, and those foods formerly sweetened with sugar.

HFCS, as well as added sugar, is contributing to the obesity epidemic which in turn contributes to metabolic syndrome - diabetes, heart disease, and stroke.

Everyone is at risk with a diet high in sugar.
04:18 PM on 01/12/2011
You both have that right!
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Medicine13ear
Jesus wore a hoodie.
08:34 AM on 01/13/2011
Great post! Faved & Fan #1!!!
12:57 PM on 01/12/2011
Here's an approach that controls fat intake. and is very effective:
http://www.pcrm.org/health/prevmed/diabetes.html
HUFFPOST SUPER USER
DrP
04:44 PM on 01/12/2011
Controlling fat intake is precisely the wrong thing to do if you have insulin-resistance.
Read Gary Taubes.
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HUFFPOST SUPER USER
elcerritan
My bio is not micro
02:59 PM on 01/17/2011
Did you read the article? Controlling fat intake is NOT the issue. And any advice from the PCRM is suspect because it's essentially an anti-meat, PETA-affiliated, animal rights organization, most of whose members are not even doctors. Its president, Neal Barnard, is a vegan animal-rights activist whose medical training is in psychiatry and who has no business giving diet and nutrition advice, IMO, because everything he says is based on his political agenda, not on science.
Hijacked
No bird soars so high if it has to do on its own
12:36 PM on 01/12/2011
There is a particular vegetable that controls and reduces blood sugar levels. In English it’s called Bitter Gourd, but cannot be found in regular grocery stores. You can definitely find it in Indian or Pakistani grocery stores and its Indian name is Kerala, or Kerela. It is green in color; shaped somewhat like a cucumber though not exactly like that; it is pointed at the end; its average size is about six inches and has ridges running parallel to its length. Growing up, we used to have it fried or cooked and true to its name, it is bitter but tasty when cooked.

However, to get its real effect to lower/control blood sugar levels, follow the method below since cooking would destroy its essential qualities. My father used it this way to control his sugar levels and never took anything other than this for the purpose. I have recommended it to several of my friends who are very thankful for the information.

METHOD: Cut the vegetable in half; remove the seeds; then slice into thin pieces; fill half of an 8 ounce glass; fill the glass with water; keep it over night; drink the water in the morning and eat the vegetable if you for higher effect though it may be bitter.
Hijacked
No bird soars so high if it has to do on its own
03:50 PM on 01/12/2011
Or you can mix the slices and eat it fresh as a salad mixed with olive oil, onions, vinegar and black pepper. This mixture will reduce the bitterness, but if it does good to your body, you will certainly bear the taste. Test your sugar levels after eating for a week, but you must also follow the other precautions that most of the contributors have advised about.