Tag Archives: diabetes dietitian

What Does Your Body Want?

 

The most general, most unspecific, ambiguous word I know is “healthy”.  We know it means “wellness” but, as far as the means to get to healthy, we have so many discrepancies…it’s hard to know what to do.

I kind of wish we’d throw the word out of our vocabulary except we, myself included, would have a hard time with that.

I’m not that sure what works for one works for all.

There are people who eat Paleo diets which consists of foods only our hunter-gatherer ancestors ate like meat, fowl, fish, nuts, fruit and veggies.  And many of them are trim, energetic, and free of disease.

Some of those people might assume that including meat is the best thing for everyone.  Yet, what about those who totally thrive on a vegetarian diet? 

It had never occurred to me until recently, that what is one man’s food is another’s poison.  Did you know they’ve done studies on indigenous people and found that when they strayed from their original and longstanding diets, they suffered health problems and body deformations, including crooked teeth?  Isn’t this what we find amongst ourselves?  That some of us do better with certain foods than others?  So is it in our genes?  Hmm…maybe that’s why two people on the same diet can have very inconsistent results?

Then there is the subject of exercise and what is appropriate for us.  Some people say marathon runners hurt their heart organ and their knees.  But, so many of those extreme athletes live long, active lives.  Maybe some can be marathoners and some can’t?

I’m a naturally good sprinter and was often one of the first placed to bat in softball because even though I could never hit the ball hard, the coach counted on me to steal a base with every pitch.  However, I have never had the cardiovascular endurance for a long distance run (even after many months of trying). 

How come I feel energized after a salad with chicken and blah after a steak?  Over time I’ve come to the conclusion I should use my body to guide me to what is right for me. 

A great tip that works well is to remember that after a meal (assuming blood sugars are in range) we should feel more energy, not less.  We eat food for fuel.  If you are sleepy after lunch, take a look at what you ate and try something different the next day.  Keep experimenting until you hit the right combinations of foods which leave you feeling wonderful after meals.  You shouldn’t feel like you need a siesta.  Unless you ate a big turkey meal or something…  Honestly, this is difficult to do for diabetics, considering post meal blood sugars can make us feel lethargic and therefore unaware of how a certain food makes us feel.  It’s worth a try, though!

I do this with exercise, too.  I never run more than three miles at a time because it doesn’t feel right.  It never did, even before diabetes when I was really young, super thin, and athletic.  I feel great with short bursts of sprinting, dance, yoga, pilates, and weight lifting, though.  When I do run, I jog 2.5 minutes and sprint 2.5 minutes and continue alternating back and forth. 

Here is what I’m thinking to focus on lately when it comes to food and exercise:

I’ll exercise in the way my body will allow me to (meaning taking in consideration various pains) and do what feels good and gives me energy, rather than what takes it away).

I’ll eat as many whole organic foods as possible.  I’ll make sure to eat plenty of veggies (focusing on the green ones more than the sweet ones).  I’ll eat my Ezekial bread because it always makes me feel good.  I’ll eat chicken.  I’ll eat nuts in moderation (a tough one!).  And I’ll have legumes in small portions because even though they make me feel energetic, they are a little trickier to cover with insulin do to their slow moving carbohydrates. 

I’ll try to stick to the above regardless of what weight loss or “health” fads come my way because the above plan is based on pretty good medical evidence that it’s “healthy” and my body confirms it.

What’s your body telling you it wants every day?

(Don’t say “sugar” unless you’re talking about treating a low)

(I know…I was tempted, too)

Portions and Calories Requirements

 

 

 

 

 

Photo courtesy of Savit Keawtavee
Photo courtesy of Savit Keawtavee

 

 

 

 

Today’s post is an article written by Registered Dietitian, Emilia Klapp.  We’ve asked her questions before but, this time I wanted to ask her to refresh our memories on portions and calorie requirements.  Many of us know how to eat healthy.  We’ve got that down.  Unfortunately we can do that all day and if we are eating too much of the good stuff, that too, can damage our health and cause us all sorts of weight gain.  So I hope you’ll read this article along with me so we can adjust our plates :)

For more great health info visit Emilia’s website, The Diabetes Club.  Her book, which centers on the mediterranean diet, is now available in digital format in her store

 

If you are set on a 2,000 daily calorie intake regardless of how tall you are or how much you weigh, you may want to revisit some parameters health authorities have already developed for us. These parameters consider age, weight, and height when it comes to calculating the servings, portions and calories requirements that you need in order to maintain a healthy weight.

Portions in Mediterranean countries

Not too long ago I was with my sister in Madrid, Spain, in a cafeteria. I ordered a bottle of water (my favorite drink) and my sister asked for a coke. I couldn’t help noticing the size of the coke: 8 ounces! I thought my sister would ask for a larger glass, but she didn’t. She seemed to be pretty satisfied with the size of her coke and during the two hours we stayed at the cafeteria, she didn’t order anything else.        
And then, a bothersome thought came to my mind: what do Americans think when traveling in Mediterranean countries and presented with such small sizes of soda? In the United States we are used to be served “supersizes” and we feel we are not getting our money’s worth when presented with anything shorter of that.

The portion factor

Much has been written in the last few years about the benefits of the Mediterranean diet and many of us know that the virtues of the Mediterranean Cuisine reside in the selection of its basic elements: fruits and vegetables, grains, fish and seafood, olive oil and red wine in moderation. But are we aware that a very important element of this diet is also the size of the portions?

How much you eat, it does count

If you have made the decision of eating healthy because you want to lose weight, all the potential health benefits will be lost if your portions are double of what they should be. Why? Because portions such as the ones we are used to in the United States lead to obesity.

So, how do you know what a “normal” portion is?

The USDA (United States Department of Agriculture) has developed food guidelines to help all of us in this area. I am showing you here a brief sample of servings for different food groups. To get a detail of servings classified by gender and age you can go Go to MyPyramid.gov. You will find here a complete list of different servings and portions for meats, grains, fruits and vegetables, fat, etc. that are adequate for you and your family.

Remember that there is a difference between servings with portions. A serving is a unit of measure. In general, portions count as more than one serving. The number of servings you require to maintain weight depends on how many calories you need and it is based on your age, height, and weight.

For example, the Pyramid suggests 6 to 11 servings of grain products each day. An individual consuming 1600 calories would need 6 servings of grains while an individual consuming 2800 calories would need 11 servings of grains.

 

A Guide to the Serving Sizes Established by the USDA

 

Food Group

Food Item

Serving size

Portions (Total servings)

 Fruit

 Whole fruit – individual pieces

 1 medium

2 – 4

 

Orange juice

¾ cup

 

 

Dry fruit such as raisins, dates, etc

¼ cup

 

 

Fresh fruit cut in cubes

½ cup

 

 

 

 

 

Vegetables

Raw leafy vegetables

1 cup

3 – 5

 

Cooked vegetables

½ cup

 

 

Raw vegetables (no leafy)

1 cup

 

 

Tomato juice

½ cup

 

 

 

 

 

Meat

Beef steak, ham, fish, chicken, seafood

1 ounce

5 – 7

 

 

 

 

Dairy Products

Milk

8 fluid ounces – 1 cup of milk

2 – 3

 

Cheddar cheese

1/3 cup shredded

 

 

Swiss cheese

2 slices, ¾ ounce each

 

 

 

 

 

Grains

Pasta, rice, cooked cereal

½ cup

6 – 11

 

Cold cereal

1 ounce

 

 

Bread

1 slice

 

 

 

 

 

Dry Beans

Cooked dry beans, lentils, garbanzos

½ cup

2

 

 

 

 

Nuts

Almonds, cashews, walnuts, etc.

1 ounce

1

 

 

 

 

You want to get your money’s worth when eating out

 Restaurants want your money and the way to get it is to serve you very large plates with a lot of food and a “supersize” soft drink. And to add insult to injury, sometimes the meal even includes a “supersize” refill. Getting all this food may make you happy since for a reasonable amount of money you are getting a substantial amount of food and you feel you are getting your money’s worth.          
Unfortunately, what is happening here is that the restaurant is getting your business and you are getting the calories; definitely, not a win-win situation. In fact, many studies show that the more often people eats out, the more body fat they have.

So, what can you do when at the restaurant or at the fast food place?

  1. When presented with a too large portion, before even getting your teeth into that tasty food, ask the waiter to take half of it and save it for you in a doggy bag (in the refrigerator, of course) until you leave.
  2. Share your meal with your fellow diners.
  3. Do not order supersize soft drinks. It is true that large sizes only cost a few cents more, but you get a lot of unwanted calories (A 12 ounce can of soda has the equivalent of 11 teaspoons of sugar and 150 calories. You can do the math for a 32 ounce soft drink). Instead, order water. According to Odilia Bermudez, Ph.D., of Tufts University, soft drinks and other sugar-added beverages have overtaken white bread and are now the main source of calories in the average American’s diet.

And how about calories?

If you control your portions, chances are you will get your calories about right, unless you eat too many times during the day. Many people follow a 2,000 calorie a day diet, but the amount of calories you need may vary greatly based on your current weight and whether or not you are physically active.

Finding out the calories you need may get a little complicated at times but if you click on My Pyramid.org you will find a table that will guide you on the calories needed.

However, if you enjoy math, here is one equation, the Harris-Benedict, you can use to calculate your daily calorie requirements. Here is how it works.

An equation to calculate calories

Formula for Females 655.1 + (9.6 x kilos) + (1.9 x inches high) – (4.7 x age) =

Formula for Males 66.5 + (13.8 x kilos) + (5.0 x inches high) – (6.8 x age) =

To calculate kilos divide your weight in lbs ÷ 2.2; to calculate inches: 5 feet = 60 inches

Example:

A 23 year-old female with a body weight of 64 kg (141 lb), 5’3” tall (63 inches)

665.1 + (9.6 x 64) + (1.9 x 63 inches) – (4.7 x 23)

(665.1 + 614.4 + 119.70) – 108.1 = 1291.1

Next step: multiply the resulting amount of calories by the activity factor.

Activity factor = Low activity 1.3; average activity 1.5 – 1.75; highly active 2.0

If you are average active: 1291.1 x 1.5= 1936.65

As you can see, it takes a little time to figure out all this. You may prefer to stick to the tables developed by the USDA.

Putting it all together

 

Sample of Servings for Three Different Energy Levels

 

Food Group- Servings

About 1600 Calories

About 2200 Calories

About 2800 calories

Bread

6

9

11

Vegetables

3

4

5

Fruit

2

3

4

Milk

2-3

2-3

2-3

Meat

5

6

7

Dry beans

2

2

2

Nuts

1

1

1

Total fat grams

53

73

93

 

Final words

Remember that all these equations and tables are just estimates, but they can be a good guide when it comes to serving the food at the table for you and your family. Eating adequate portions and calories, along with adequate exercise, could be the best recipe to maintain a healthy weight in a healthy individual.

To your health!

Emilia Klapp, R.D., B.S.

 

I don’t know about you all but, I really needed this info!  (Somehow it seems my portions get larger in the winter…and thus so do I)

Thanks so much Emilia!

Interview with Registered Dietitian, Emilia Klapp

Emilia Knapp
Emilia Klapp

 Emilia Klapp is a Registered Dietitian and author.  She wrote the book called, Your Heart Needs the Mediterranean Diet.  She also has a website dedicated to helping diabetics improve their health through good lifestyle habits.  Go to The Diabetes Club to check it out. 

Emilia works daily with diabetics helping them to learn the basics of nutrition and teaches them about the wonders of the Mediterranean Diet.  She follows this diet herself and was kind enough to answer all of my curious questions.  I think you’ll enjoy her honesty and openness (and bonus recipe!). 

1. Emilia, tells us a bit about yourself.

I was born and raised in Madrid, Spain. I really have wonderful memories from my childhood and teenager years. I always remember how our family, my parents, my sister and I, we all reunited at lunch and dinner time and had our meals together. Since we had no TV set at the time, we spent our evenings conversing with each other, sharing the experiences we had through the day. I also spent a lot of time with my friends. We didn’t have too many toys but we had a lot of fun playing outside.

Early in my life I developed a fear of growing older and being at the mercy of doctors, so although I was an accountant at the time, I started reading every book I could find on the subject of natural health to see how I could protect myself from ending up at the doctor’s office. This led me into my career as a Dietitian. Now, I have my own consulting business where I teach people how to eat to lose weight, prevent or manage diabetes type 2, and lower high blood pressure and high cholesterol.

Mediterranean
2. You’re a strong proponent of the Mediterranean Diet and even wrote a book on the subject.  Will you tell us about the book and how you arrived to this recommendation?

Being born and raised in Spain made me a firm believer of the Mediterranean Diet. Spain, along with Italy and Greece, has always been a poor country and I’ll never be able to thank Providence enough for this fact. Living in a relatively poor country forced us to eat what the land produced. There was very little red meat, so we grew up with fish, dry beans, fruit, vegetables, and the best extra virgin olive oil in the world. All this, plus a fair amount of walking, is what has made Mediterraneans some of the healthiest people in the world, so I felt the need to tell the world.

I wrote the book as a dialogue format where patient Al and registered dietitian Emi embark on a journey into good health. Diagnosed with high blood pressure and high levels of cholesterol and triglycerides, Al is at risk for heart disease. Chapter by chapter, he learns about the Mediterranean diet where better health comes from eating the right foods and enjoying a lifestyle enriched by family, friends, and physical activity.

Al discovers ways to avoid harmful foods like saturated fats and processed foods and how to cook with healthy foods such as garlic, tomatoes, and olive oil, and Emi shares healthy and delicious recipes that are easy to prepare. Al learns how to introduce more physical activity into his busy schedule. Walking, dancing, and other activities help strengthen his heart and improve his body chemistry.

Al also begins to discover how to improve relationships with his family, friends, and coworkers. As the sessions progress, he decreases his risk of heart disease, spends more time with his family, and reduces stress at work. Al realizes he is becoming happier and healthier by following the Mediterranean diet.

3. Is this diet for everyone?

Yes, it is. However, people with diabetes need to be careful with the amount of fruit and starchy vegetables they eat.

vegetables_3
4. For those who may be interested, are there ways to eat a low carb version of the Mediterranean Diet?

Yes, because the foundation of the Mediterranean diet is legumes such as dry beans, lentils, and garbanzo beans, whole cereals, whole grain breads, fruits and vegetables, olive oil and fish. Legumes for example, are very rich in fiber; fiber prevents a high raise in blood sugar.

But again, diabetics need to pay attention to the amount of fruit servings. In Mediterranean countries we eat a lot of fruit, but a person with diabetes should not eat more than 3 servings of fruit per day. Starchy vegetables also need to be limited. As for pasta, it should always be whole wheat or durum semolina pasta and cooked “al dente”, meaning cooked for just only 5 or 6 minutes.

 
5. I think your website, The Diabetes Club, is a great resource for diabetics.  Why did you begin the site?  What kind of information do visitors get at The Diabetes Club?

At my consulting business I teach patients who are diabetics or who are at risk of developing the disease. However, I felt that because of the nature of my business, I was limited on the amount of people I could reach. So, I decided that a way to “reach the world” would be to have a site where I could literally tell everyone on earth how to prevent or manage diabetes and other health conditions very much related to diabetes such as high blood pressure and high cholesterol. People coming to my site will find articles that will help not only with diabetes but also with their general health. One example is the article I wrote on how to read Nutrition labels. This article can be found at my site, under “Archives”.

6. Being a Registered Dietitian, do you get a different point of view of our society’s state of health?

Because of my profession, I spend most of my days around people who have different health conditions. This means that on a regular day, I see more sick people than healthy ones and if I am not careful and I make sure I put things into the right perspective, I tend to go home in the evenings thinking everybody in this world is sick. Unfortunately, the truth is that this epidemic of obesity we are experiencing, the way we eat, and the lack of physical activity, are causing a large percentage of the population to have at least one chronic health issue. This is a very sad fact, because many of these health conditions can be prevented.
7. What do you think will take for most people to change their eating habits?

Unfortunately people wait until they are sick or overweight to take some action regarding their health. Somehow, they don’t believe in preventing. But part of the reason why people take this position is because they don’t have the facts. People need to be educated on nutrition and the consequences of eating poorly. To give you an example: I haven’t met one single person who has come to my nutrition classes who knows how to read a Nutrition Label. If the person doesn’t know what is inside a box of cereal or a can of juice because they cannot understand the food label, they cannot be selective and make the right choice.

The result is that people keep eating processed foods with a lot of hidden sugar, wrong fats, too much sodium, very little fiber, and so on. There is no doubt that eventually we pay a price with our health for eating this way. At this point, to stop overweight, diabetes, heart disease, high blood pressure, and any other chronic health condition, educating the population in nutrition and exercise seems to be the best course of action.

Mediterranean_1
8. Do you yourself, follow the Mediterranean Diet?  If so, what is your favorite healthy meal?

Yes, I do. I eat a lot of fruits and vegetables. One item that is never missing in my kitchen is a juice extractor and every day I make my own raw vegetable juice. As for protein, I mainly eat fish, some chicken, and dry beans; red meat once in a blue moon. Extra virgin olive oil, nuts, whole grain breads and pasta are also part of my diet.

One of my favorite dishes is a seafood stew. It is very simple to make. Heat three tablespoons of extra virgin olive oil in a pan, medium heat. Add one large yellow onion finely chopped and 3 or 4 garlic cloves, crashed. Sauté for 3 or 4 minutes. Add one pound of calamari rings. Cover, lower the heat, and let it simmer. After ten minutes, add a can of marinara sauce, low sodium, if possible, organic. Let simmer for five minutes and add six cups of water. Add a bay leaf and some aromatic herbs such as parsley, oregano or any other one you like. When the calamari are tender, add two zucchini cut in small cubes and cook for 3 minutes. Add half pound of medium size scallops and half pound of medium size raw shrimp and cook for three minutes. Remove from the heat. Serve hot. It serves about 4 to 6 people.

9. If you had to give only one piece of advice to a client, what would it be?

Cook more at home. Cooking your own meals gives you a better control of what you eat because you can limit the amount of sodium, sugar and bad fats that come with many of the meals we eat outside. If you like hamburgers, no need to deprive yourself of them. Just buy organic, lean beef and make them at home.

 

Ah ha! About that last point Emilia makes…  Since I’ve begun cooking most of what I eat, I’ve been able to reduce my salt/sugar intake, UP my good fat intake, AND eat more food all while staying the same weight! 

Something additional we can take away from this interview that I’d like to point out is how a lifestyle habit such as family dinners without the TV can be so beneficial.  I too grew up with dinner at the dining room table with the family.  This habit makes us pay attention to the food we are eating and the people we love.   

Muchas gracias Emilia for all of the great info and tips!  If you want to check out her site you can find it here: The Diabetes Club and if you want to learn more about her book click here: Your Heart Needs the Meditteranean Diet.