The quantity and  type carbohydrate food is what’s most important.  In general, the less a food has been processed the better.  That advice actually applies to everyone, not just people with diabetes.  Choose whole grains,  fruit and vegetables more often, and limit the highly processed foods as much as possible.  Fresh fruit for example, is a better choice than fruit juice, which has been processed.

Any food with carbohydrate will make blood sugar rise, but the type and amount of carbohydrate you eat makes all the difference.  Too much of a “healthy” carbohydrate can cause a significant rise in blood sugar.  Conversely, a small, controlled portion of a dessert or sweetened food may not have much of an affect on your blood sugar if you are monitoring your diabetes closely.  It all depends on the food you have chosen, the amount consumed, and the state of your blood sugar at the onset.  The bottom line…1) check your blood sugar often, so you know where you are 2) make note of how certain foods affect your blood sugar, and 3) learn what portion size is right for you!

From my own perspective as a nutrition professional and diabetes educator, I would agree that sugar consumption has negative implications for many people.  People with diabetes, who are overweight are well advised to get excess sugar out of their lives.  But, I believe sugar is not the only dietary problem we have, and agree with Dr. David Katz, director of Yale University Prevention Research Center.  He says that focusing on one dietary problem exclusively makes it all to easy to ignore the rest.  While acknowledging that sugar is harmful, Dr. Katz says “It’s not the sugar that’s the poison, but the dose that makes the poison.”

The sad fact is that sugar is found in so many foods, most of us don’t realize the hefty dose of sugar we get on a daily basis.  From soft drinks and desserts, to sauces and ketchup, added sugars in our food is just plain adding up everywhere.  Trying to cut out all sugar from our diets could be a daunting task.  A focus on the differences between added sugar and natural sugar could help you start sorting things out.

My April 5th blog post discussed the differences between naturally occurring sugar found in food,  and sugar that has been added to foods.  Knowing whether sugar is added or is in the food itself,  could help you make better food choices and reduce your overall consumption.  It’s the added sugar in food that usually puts the average American’s sugar intake over the top.

The natural sugar found in fruit, whole grains, milk, and certain vegetables are part of a healthy diet:  we still need to include those foods.  Let’s not forget that portion size also affects the amount of sugar we get on a daily basis.  Too much of even a healthy food could cause us to get more sugar than we need.

In light of all we know about the deleterious effects of too much sugar, cutting down seems to be good advice for everyone.  First, target the foods with added sugars:  soft drinks, fruit juice drinks, desserts, certain cereals and packaged foods.  Then while you’re at it, make sure your portion sizes are in check!

A better way to get extra sugar out of our diet is to learn the difference between those sugars that are added, and those that occur naturally in foods.  Added sugar may come from “natural” sources (such as sugar cane or the now popular agave) and it will provide extra calories and sweet flavor, without adding any other nutritional value. Natural sugar, on the other hand, is found in whole, unprocessed foods, but other things like fiber, protein, fats, vitamins and minerals is also found in these foods.  Fruit, whole grains, milk and even certain vegetables have natural sugar, and there is no way to avoid getting sugar when you eat these whole foods.  Avoiding natural sugars found in the whole foods would mean total elimination of it.  This is unnecessary since everyone (even people with diabetes) benefit from eating a variety of whole foods on a daily basis.

To figure out how much added sugar is in packaged food, you’ll need to check the nutrition facts panel and the ingredient list. Unfortunately simply checking the carbohydrate or sugar count on the nutrition facts does not differentiate between natural and added sugars. The ingredients list can give you an idea of where the extra sugar is coming from.  Here are some added sugars that you might find on the ingredients list:

Dextrose
Lactose
Maltose
High Fructose Corn Syrup
Brown Rice Syrup
Evaporated Cane Juice
Agave Nectar

In ready to eat cereals, for example, the sweetened or sugar coated varieties will have the most added sugar.  All cereals have carbohydrate and as such, will list the grams of carbohydrate;  the grams of sugar listed below carbohydrate can be compared to this total.  If grams of sugar match or are very close to the grams of carbohydrate, then you have a product with plenty of added sugar.

On the label shown here, there are 30 grams of carbohydrate and 6 grams of added sugar.  The sugar represents about 20% of the total carbohydrate…not sugar free, but not exceptionally high in sugar for a cereal.  The ingredient list shows 2 types of sugars added to this product, and they are not the predominant ingredients.

So until labels can tell us what is the natural sugar or added sugar in a product, what’s the best thing to do?  Stick with whole, unprocessed versions of foods as much as you can, and check those packages carefully.

Here’s my recipe:

Kasha Stuffed Peppers- Serves 4

3/4 cup buckwheat kasha

1 whole egg

1 Tb. tomato paste

1 1/2 cup low sodium chicken stock

1 Tb. olive oil

1/2 lb. ground white meat chicken

1/2 cup chopped onion

1/4 tsp. oregano

1/4 tsp. ancho pepper (or chili powder)

1/4 tsp pepper

1/4 tsp salt or to taste

4 red peppers, tops and seeds removed

2- 14 oz. diced tomatoes with green chiles (buy low sodium if you can!)

1. Prepare kasha using the dry cook method.  (I explained this method in my February 23rd post so you will want to review this again).  Using the dry cook method prevents the kasha kernels from sticking together.
2. Add low sodium chicken stock and tomato paste to the dry cooked buckwheat.     Quickly bring kasha and stock to a boil, cover, then simmer 7-10 minutes or until the liquid has been absorbed.  Set aside.
3. In a large skillet heat the olive oil, and add the ground chicken and chopped onion.  Cook for approximately 5 minutes.  Add seasoning to the chicken mixture.
4. Combine kasha and chicken.
5. Prepare red peppers by removing tops and all seeds.
6. Add stuffing to each hollowed out pepper.  Place peppers in crock pot.  Add canned diced tomatoes to peppers, spooning some of the diced tomatoes over the top of the peppers.
7. Cover & cook for at least 4 hours or until the peppers are tender.

Per Serving: 306 Cal  27 g Protein; 8 g Tot Fat; 35 g Carb; 6 g Fiber;

Early in January the seed catalogs arrive, and with it, the plans for next gardening season.  A few new vegetable varieties are added, and I always end up having plans for more items than I can possibly fit into my small garden…this year is no exception!

One of my favorite vegetables to grow is the sugar snap pea because it is delicious and it provides a high yield in a small amount of space.  A row or two is planted along the garden fence and when the seedlings come up, they grow right up the fence.

The snap pea is an edible podded pea, lower in calories, yet containing more vitamins and minerals than traditional peas. For people counting carbohydrates, this variety has a low carbohydrate content similar to other green vegetables, and is not a starchy vegetable like regular peas: very diabetes- friendly! Snap peas are delicious raw or cooked, and lend themselves well to steaming or stir frying.

Gardeners sometimes use holidays as a gauge for when to plant certain vegetables.  St. Patrick’s Day is traditionally considered the day to plant peas.  For years I have tried to follow this guideline but to no avail.  Here in the northeast, March 17th is usually cold, damp, and sometimes there’s still snow on the ground. But this year it’s different!  With unseasonably warm weather (70 degrees!) I actually planted snap peas yesterday.  It was t-shirt weather and this was the first time I was able to plant peas on St. Patrick’s Day.

Our peas are usually ready to pick in late June to early July.  Since I’ve had a head start on my planting, maybe the peas will be ready earlier.    Of all the vegetables I have grown in the past, the snap peas have consistently been my biggest success.  We enjoy them most of the summer, and there’s usually enough to freeze for later.   If you have a garden, or decide to try your hand at gardening, give sugar snap peas a try!

A Sunday morning harvest - July 2011

Myth #1: People with diabetes need to cut out all carbohydrates from their diet.

Fact: Foods with carbohydrate will raise your blood sugar, but people with diabetes can safely incorporate carbohydrates into their meal plan. The trick is to make sure your blood glucose is in range, and your portions are appropriate. What should you do about carbohydrates?  Get most of your carbohydrate from vegetables, fresh fruit and whole grain foods.  Save the sweets or desserts for special occasions.

*While we are on the subject of sweets or desserts, it’s important to know that eating foods with sugar does not cause diabetes.  Just because you might have consumed a lot of sugar before you were diagnosed, understand that this was not the reason you developed diabetes.

Myth #2: Carrots are bad for diabetes because they have too much sugar.

Fact: There is sugar in carrots, which is digested quickly compared with other foods. That’s why carrots have what is called a “high glycemic index”. Yet carrots actually have a very small amount of sugar; a whole pound of boiled carrots contains only about 3 teaspoons of sugar.  Rather than using glycemic index as a way to choose what foods to eat, consider the “glycemic load” of a food.  Glycemic load takes into account the actual quantity of sugar in a food, well as the speed in which it is digested.  Guess what? Carrots happen to have a low glycemic load.  The bottom line: carrots provide a rich source of fiber, beta-carotene and are low in calories.  Enjoy them raw or cooked!

Myth #3:  Type 2 diabetes is not as serious as type 1 diabetes.

Fact: Type 2 diabetes is often treated initially with healthy diet and exercise, while Type 1 diabetes is always treated with insulin. Some people interpret this to mean that type 2 is a less serious form of diabetes so they can let things ride. A complacent attitude towards type 2 diabetes may result in progression of the disease.  Not taking care of type 2 diabetes is serious and has the potential for development of complications. So, even if the diabetes can be successfully treated with diet and exercise right now, it’s important to maintain a careful watch on your condition.

Need help with sorting out diabetes information?  Find a Certified Diabetes Educator to help answer your questions and work with you.

Dealing with diabetes or pre-diabetes can be overwhelming,  as it means a major lifestyle change for most individuals. To help cope with the disease and to learn how to properly handle or even prevent diabetes, certain measures can be taken. One of the best ways is to get help from those who are well trained in the field of diabetes,  which may include Registered Dietitians, especially those who are also Certified Diabetes Educators. While dietitians have the training and knowledge to help with food and nutrition, those who are Certified Diabetes Educators  have credentials that demonstrates they are a certified health care professional with distinct and specialized knowledge in diabetes self-management education. These individuals can help lessen the strain of diabetes, by their ability to educate you more fully and help set up healthy eating regimens to better control diabetes. If you are one of the 25.8 million individuals who deal with some type of diabetes, why not get in contact with a local registered dietitian or C.D.E.,  and see how they can better help you cope with and successfully manage your diabetes.

To find a registered dietitian in your area, go to the Academy of Nutrition and Dietetics and click on “find a registered dietitian” in the upper right hand corner.

The American Association of Diabetes Educators maintains a national list of Certified Diabetes Educators.

Special thanks to guest blogger Stephanie Arellano, a Dietetics senior at the University of Wyoming.  Stephanie is a member of ADA and of the UW’s Student Dietetic Association. Stephanie hopes  to become a Registered Dietitian and a Certified Diabetes Educator, so she can  work with  people who have diabetes.

Kasha Pilaf with Vegetables – Serves 6

For this recipe you will need:

1 cup Kasha

1 egg or 2 egg whites

2 cups low sodium chicken or vegetable stock

2-3 cups chopped fresh or frozen vegetables

Add  dry kasha to 1 beaten egg (or egg whites).

Heat a nonstick skillet or saucepan  (no oil needed) and “dry cook”  the egg-coated buckwheat mixture.    Cook over high heat for 2-3 minutes until egg has dried and kasha kernels are separate.  This step is necessary to assure that the kernels do not stick together and you get a nice, fluffy product.

Add  2 cups low sodium chicken or vegetable stock .   Quickly bring kasha and stock to a boil, cover, then simmer 7-10 minutes or until the liquid has been absorbed. You can also use water if you don’t have stock.

**A tip when buying ready made stocks:   I recommend that you look carefully at the labels.  Regular stock is very high in sodium.  The low sodium versions have a great deal of variability. I found that the store brand low sodium chicken broth had almost 500 mg. sodium per serving, where the organic version I used in this recipe had just 140 mg. per serving  That’s quite a difference!

While the kasha is cooking, prepare vegetables that will be added to the kasha.  Today I used :  1/2 medium onion chopped, 1 red pepper,  chopped and about 2 cups of frozen broccoli florets sauteéd in 1/2 Tb. olive oil for 2- 3 minutes.  You don’t have to sauté the vegetables; a mixture of  lightly steamed frozen or fresh vegetables will work just as well.  The vegetables should be tender crisp.  Add the vegetables, toss lightly with the kasha and serve.

Per Serving: 155 Cal ; 8 g Protein; 4 g Tot Fat; 25 g Carb; 5 g Fiber;  286 mg Sodium; 35 mg Cholesterol

Buckwheat flour is commonly added to commercial pancake mix, and this is how most people even know of its existence.  However, buckwheat is much more than just an addition to a breakfast pancakes.  In its lesser known forms, there are a lot health and nutritional benefits that could make buckwheat a wonderful addition to a “whole foods” diet.

Contrary to its name, buckwheat is not a form of wheat at all.  Although it is sometimes referred to as a whole grain, it is, in fact a fruit seed that is related to rhubarb.

Whole buckwheat is a very nutritious food. The protein in buckwheat contains the eight essential amino acids. Buckwheat is also rich in many B vitamins as well as phosphorus, magnesium, iron, zinc, copper and manganese, and has Alpha-Linolenic Acid, which is one of the two essential fatty acids we must have in our diets.

In addition to its nutritional value, there are some a few health benefits that make this food worth your consideration:

• Buckwheat is a high fiber food. 1 cup of cooked buckwheat groats contains over 4 grams of dietary fiber.
• Because it is high in fiber and has a low glycemic load, it is a good carbohydrate choice for diabetes.
• Diets that contain buckwheat have been linked to lowered risk of developing high cholesterol and high blood pressure.
• Buckwheat is is a gluten-free alternative to grains, which makes it a healthful grain alternative for people with celiac disease or wheat sensitivity.

I find buckwheat products in the health food aisle of the grocery store, so you won’t need to search far to find it.   Here’s a quick primer on the various forms of buckwheat readily available:

Buckwheat Groats: hulled grains of buckwheat, triangular in shape and resembles other grains. Buckwheat groats are used whole in hot cereals and soups. The seeds from buckwheat can be used to make flour after being removed from the husk.

Buckwheat Groats

Buckwheat Kasha:   kasha, or roasted hulled buckwheat kernels, may be sold whole or cracked.  You may find it ground into coarse, medium, or fine consistencies. The variety you use will depend on the consistency you need for the dish you are preparing.

Buckwheat groats and the roasted version, kasha are usually cooked in a manner similar to cooking rice. Either can be used to make hot cereal, added to soups or casseroles, or used as a side dish.

Buckwheat Kasha

Buckwheat Flour:  buckwheat flour can be used alone or mixed with other types of flours to make pancakes, breads, and muffins. 

Buckwheat Soba:  thin noodles made from buckwheat flour and typically served with a sauce.

So on your next trip to the grocery store, I hope you will look for buckwheat and give it a try.  The Birkett Mills is the World’s largest manufacturer of buckwheat products, and their products are what I find in the grocery store. They are located in New York in the heart of the Finger Lakes. Next time, I’ll give you some recipe ideas for this wonderful food!

I’ve noticed that many people rely on the 100 Calorie packs of crackers, cookies or salty snacks.    The prepackaged snacks may be useful for calorie control: that is, if you stick to one pack!  In many cases what you are getting is a refined flour product that’s short on nutrition or satisfaction. 

A better plan might be to make your own snack.  Here’s a few easy ideas:

4 oz. carrots with 2 Tb. hummus = 95 calories

A medium apple and low fat cheese stick = 120 calories

Two clementines = 80 calories

You get the idea.  If you are looking for a crunchy snack like the 100 calorie packs, trying making your own, using a variety of whole grain cereal, dried fruit and nuts. Experiment with different combinations until you find a mix that you like. Here’s a high fiber  snack mix that’s only 145 calories per 1/2 cup. Ten minutes of your time and you have 9 portions ready to go!

Cereal Snack Mix: Makes 9 servings

1 cup Fiber One- Original
1 cup Kashi Go Lean – Original
1 cup Cheerios – Original
1/2 cup dried cranberries
1/2 cup dry roasted unsalted peanuts
1/2 cup semi-sweet chocolate chips

Mix well and measure 1/2 cup portions into sandwich bags.

145 Calories, 4 gm Protein, 22 gm Carbohydrate, 4 gm Fiber