Buffalo News Refresh – November 2016

Good nutrition choices can help you treat, and sometimes control, diabetes

By: Holly R. Layer

*Please excuse the fact that this is month late–I was waiting for it to appear on the Refresh website! December column coming soon!

November is American Diabetes Month and with numbers of those diagnosed growing, it’s important to raise awareness.

According to data from the Centers for Disease Control, almost 10% of the US population has diabetes, with approximately 28% more cases undiagnosed in 2015.

Diabetes is diagnosed when blood sugar levels are greater than or equal to 126 mg/dL after a fasting plasma glucose test. If your blood sugar level is between 100 – 125 mg/dL, you may be diagnosed with what is called ‘prediabetes.’ Being diagnosed with prediabetes does not mean you will definitely develop diabetes, but it does place you at greater risk for both diabetes and cardiovascular disease. You can lower your risk for developing diabetes by losing approximately 5-10% of your body weight and doing moderate exercise for 30 minutes five times per week.

There are two types of diabetes. Type 1, which was previously known as ‘juvenile diabetes,’ is often diagnosed in childhood and affects only 5% of those with the disease. It is caused when the body does not produce insulin, which regulates blood sugar levels and can be managed through diet and insulin therapy. Type 2 is characterized by ‘insulin resistance,’ which can increase until the body does not produce enough insulin to regulate blood sugar properly. Those who are diagnosed with Type 2 may simply take oral medications to help control their blood sugar, or may need to be on insulin therapy as well.

There is another type of diabetes, gestational diabetes, which is diagnosed around the middle of pregnancy. It does not mean that you had diabetes prior to becoming pregnant, or that you will have diabetes after pregnancy.

Type 2 diabetes can be treated with lifestyle changes (like diet and weight loss), as well as oral medications and insulin therapy. In Type 2, blood sugar accumulates in the blood stream instead of going into our cells, which need to produce energy, and over time can cause damage to your eyes, kidneys, nerves and heart. It’s common for Type 2 diabetes to worsen over time; if you have been managing your disease with diet and activity alone, it’s possible you will need medication or insulin therapy down the road.

So, how does having diabetes affect diet?

For starters, those with diabetes on insulin therapy must match their carbohydrate intake to their insulin. Carbohydrates are found in grains, legumes, dairy, fruits and vegetables. Servings of carbohydrates are measured in 15-gram increments; you can find the amount of carbohydrate in foods on its nutrition label. The amount of carbohydrate servings someone should eat is based on the amount of calories they should eat in one day. Most people should eat 3-4 carbohydrate servings per meal, with a few more as snacks throughout the day.

Additionally, pairing carbohydrates with food sources of protein, fat and fiber is important to keep blood sugar from spiking and promote satiety, or the feeling of fullness. For example, instead of eating just an apple, diabetics (this goes for everyone, actually) should add a cheese stick or some nuts to temper their blood sugar rise and stay fuller longer.

Instead of worrying about the amount of carbohydrate in everything, it’s often easiest to start with becoming familiar with the amount of carbohydrate in the foods you most often eat. For example, if you like cottage cheese, bananas, apples, mashed potatoes and a specific brand of sandwich bread, memorize the amounts of those items that correspond to approximately 15 grams of carbohydrate. For most items, it’s one piece of bread or a small roll, ½ a banana or 1 small piece of fruit, ½ cup of cut-up fruit, 1/3 cup of pasta or rice. If you eat an entire banana, that’s two carbohydrate servings.

Lastly, it’s important to maintain a healthy lifestyle that includes plenty of fruits and vegetables, lean protein, healthy fat and exercise. This goes for everyone, obviously, but even more so for diabetics. Uncontrolled blood sugar levels can lead to hyperglycemia, or high blood sugar, and can be life-threatening if left untreated. If you begin experiencing increased thirst, headaches, blurred vision, frequent urination, fatigue or weight loss, or receive a blood glucose test higher than 180 mg/dL, be sure to see your doctor.   For more information about how to manage diabetes and your diet, talk to a Registered Dietitian or Certified Diabetes Educator (CDE). Go to www.eatrightwnyda.org for a list of local dietitians, or send me an email!

Holly R. Layer is a registered dietitian and a freelance writer. She works as a clinical dietitian at DeGraff Memorial Hospital in North Tonawanda and also provides nutritional counseling at Weigel Health Center at SUNY Buffalo State, as well as teaching fitness classes at the Southtowns Family Branch YMCA. She lives in East Aurora with her husband, Andrew, a village native. She blogs at thehealthypineapple.com and her work appears monthly in the online version of Refresh. Send her nutrition-related questions at refresh@buffnews.com  

Buffalo News Refresh Blog – September 2016


Try Healthier Carb Substitutes

by: Holly R. Layer

I recently received a question about ‘carb substitutes.’ As I couldn’t engage the person directly, I didn’t know if they simply wanted GRAIN substitutes, or better sources of carbohydrates. So, I’ll start from the beginning and address both topics.

I like to tell my patients and clients that the term ‘carbohydrates’ can be equated to sugar, because that’s what they break down into in the body in the form of glucose. This glucose gets turned into energy (to use immediately) or to be stored in the muscles (to use later), and any additional goes to the liver to be stored as fat.

According to the 2010 Dietary Guidelines for Americans, our diets should be approximately 45-60% carbs, 20-35% fat and 10-35% protein. As you can see, carbs make up at least half of our energy intake. I realize that number may seem high, taking into account the recent low-carb craze, but stay with me–carbs are more than just bread and pasta, and we really do need that much for our bodies to function well. (There’s a lot more I can talk about in terms of refined vs. unrefined grains, fiber and starch, simple and complex carbs, but we only have so much room. Keep writing in questions!) For now, I’ll simply discuss food groups and carbohydrates.

Which brings me to our reader’s question about carb ‘substitutes.’ First of all, you cannot substitute protein and fat for carbs, but you CAN choose healthier carbs to eat. Remember that carbohydrates are made up of anything with natural sugars, which includes: grains, dairy, fruit and vegetables. So, when we say that approximately 50% of our calories should come from carbs, that doesn’t mean it should only be coming from bread (or other grain-based products), but from fruits, vegetables and dairy, too. In fact, as a dietitian, I’d rather you reach for fruits and vegetables first before grains and dairy.

So, we finally make it to substitutes for grain products in the carbohydrate category. Vegetables like white and sweet potatoes are packed with carbohydrates (for energy), low in calories, high in fiber and full of vitamins and minerals. Carrots and corn are also high in carbs, as well as fruits like bananas, apples and oranges. Also, beans (all kinds!) are high in carbs, and nuts and seeds have carbohydrates, too. Here’s a sample ‘menu’ for a day that features non-grain carbs to show you how easy it is to find energy in fruits, vegetables and dairy:

Breakfast: 2 eggs, scrambled with veggies, 1 oz cheese and 1 orange

Lunch: 2 C zucchini noodles, 1 C spaghetti sauce & meatballs, green salad

Snack: 1 banana with 1 T almond butter or ¼ C hummus and 1 cup veggies

Dinner: 4 oz steak, 1 roasted sweet potato, sautéed spinach

Dessert: 1 C berries with 1 C lowfat milk

To recap: Carbs give us energy, so they’re very important in our diet. They should make up about half of the calories we eat each day. Remember that carbs come in the form of fruits, vegetables, dairy and grains, and that it’s best to eat a variety of them. I always recommend reaching for fruits and vegetables before grains and dairy products to fulfill your carbohydrate needs.

And instead of your morning bowl of Cheerios, try one of my favorite breakfasts: 1 baked sweet potato topped with 1 tablespoon almond butter, 1 cup plain Greek yogurt and a sprinkle of cinnamon! YUM!


Holly R. Layer is a Registered Dietitian and a freelance writer. She works as a clinical dietitian at DeGraff Memorial Hospital in North Tonawanda and also provides nutritional counseling at Weigel Health Center at Buffalo State College, as well as teaching fitness classes at the Southtowns YMCA. She lives in the village with her husband, Andrew, an East Aurora native. She blogs at www.thehealthypineapple.com and her work appears monthly in the Refresh Buffalo Blog.