Chapter 16
A Little Planning Goes a Long Way
IN THIS CHAPTER
Understanding what a meal plan is
Seeing why macronutrients matter
Working with a dietitian to plan your meals
Exploring meal-planning methods
If you’ve recently been diagnosed with diabetes, you probably hear the term meal plan a lot from your diabetes care team. If you’re not familiar with the term, don’t worry! We’re here to help. Planning your meals is one of the best ways to set yourself up for success when it comes to eating healthy with diabetes.
It’s a good idea to have a general understanding of macronutrients (carbohydrate, protein, and fat) when you’re developing a diabetes meal plan. Your healthcare provider may have already discussed with you the importance of carbohydrate in diabetes management, but we review the basics of carbohydrate and the other macronutrients — protein and fat — in this chapter. Then we get you started with the first step of effective meal planning: meeting with a dietitian. Finally, we give you an overview of a variety of different meal-planning approaches.
Introducing the Idea of Meal Planning
So, what is a meal plan exactly? For people with diabetes, a meal plan is simply a guide that tells you how much and what kinds of foods to eat at meals to keep your body healthy and keep your blood glucose in check. An effective meal plan should take into account your schedule, eating habits, and food preferences. A meal plan can be very simple or a little more complex, depending on your individual needs and diabetes goals. And a meal plan should change over time to adapt to changes in your weight, medications, physical activity level, and diabetes goals.
Common goals that people set when creating a meal plan include the following:
- Improving blood glucose levels
- Improving blood pressure and cholesterol levels
- Losing or maintaining weight
- Preventing or treating particular diabetes complications
- Maintaining the joy of eating
You may not share all these goals, but it’s important to determine — with the help of your healthcare provider — what diabetes goals you want your meal plan to address. When you understand these goals, it’s time to create your meal plan! (We introduce different types of meal plans at the end of this chapter and go into more details about them in the rest of Part 4.)
Defining Macronutrients
Every meal plan is made up of three main components: carbohydrate, protein, and fat — the macronutrients. All the foods we eat are made up of some combination of these three nutrients; some foods may have only one nutrient, while other foods may have all three.
The human body needs all three of these macronutrients to function properly, so you should try to eat a variety of foods to ensure that you get all these different nutrients.
Your healthcare provider or dietitian may help you plan a certain range of grams of carbohydrate, protein, and/or fat to eat each day as part of the meal planning process.
The following sections explain how each macronutrient affects your body and identify some foods choices that represent each nutrient.
Note: The American Diabetes Association doesn’t have recommendations regarding the amount of carbohydrate, protein, and fat that people with type 2 diabetes should eat each day. Discuss your personal dietary needs with your healthcare provider or dietitian.
Carbohydrate: Converts into glucose
Carbohydrate is an important nutrient for people with diabetes because it’s the nutrient directly responsible for raising your blood glucose levels after eating. During digestion, your body breaks carbohydrate down into glucose, which then enters your bloodstream and causes your blood glucose levels to climb. Therefore, you’ll need to consider how you’re going to choose carbohydrate foods and manage your carbohydrate intake when building your meal plan. But remember, your body needs some carbohydrate; it fuels your body. So, don’t try to remove all carbohydrate from your diet.
Foods that contain carbohydrate include fruits, vegetables, beans, whole grains, breads and crackers, milk and yogurt, and other starchy or sugary foods and drinks. When choosing carbohydrate foods, look for nutrient- and fiber-rich options, and try to limit or avoid processed and sugary sources of carbohydrate such as white breads, white pastas, sugary desserts, and regular sodas.
Protein: Builds strong bodies
Protein is essential for a healthy body. Among other functions, this nutrient helps your body build new tissues and muscles. Foods that are high in protein include poultry, seafood, red meats, dairy products, and even plant-based proteins such as beans, lentils, peas, and soy products. When choosing protein, it’s best to stick to lean poultry, fish, and plant-based proteins for most of your meals. Limit your intake of red meats, and avoid high-fat and highly processed sources of protein, such as bacon and sausage, that are high in saturated fat and sodium and add to your risk of heart disease.
Fat: Healthy types are helpful
Most people think fat is harmful for your body. But, as with carbohydrate and protein, your body actually needs a certain amount of fat to stay healthy. However, the body only needs a small amount of fat to function properly. Many people have way too much fat in their diets. Moderation is important when it comes to fat because certain kinds of fat and eating too much fat can increase your risk for cardiovascular complications such as heart disease, heart attack, and stroke. And overindulging in fat can increase your weight.
Some fats are better than others. Saturated fats and trans fats can raise your blood cholesterol levels, so it’s a good idea to limit these fats in your meal plan. You’ll find these types of harmful fats in butter, stick margarines, cream, cheese, high-fat meats, full-fat dairy products, and certain oils like palm and coconut oils. But there are some healthy fats that can actually have positive effects on your heart health by reducing bad cholesterol levels and preventing clogging in the arteries. These healthy fats — monounsaturated and polyunsaturated fats and omega-3 fatty acids — can be found in avocados, nuts and seeds, many plant oils, and (for omega-3 fatty acids) fish such as albacore tuna, herring, mackerel, rainbow trout, salmon, and sardines. For more information on which foods contain these healthy fats, see Chapter 1.
Healthy fats still need to be enjoyed in moderation, but you can help protect your heart from the effects of saturated and trans fats by replacing the sources of these unhealthy fats with sources of heathy fats. Work with your healthcare provider or dietitian to come up with a personalized strategy for including healthy fats in your meal plan.
First Things First: Meeting with a Dietitian
Many people are surprised to find out that there is no one meal plan or “diabetes diet” that is recommended for all people with diabetes. Your meal plan should be individualized for you. If you’ve just been diagnosed with diabetes, you’ll want to meet with a registered dietitian (RD) or registered dietitian nutritionist (RDN) to develop your personalized meal plan. If you don’t have a dietitian, your doctor can give you a referral. You might think you can make a meal plan on your own, but the help of an RD or RDN will make the process so much easier. He or she can answer any questions you have about healthy eating with diabetes.
A registered dietitian (RD) or registered dietitian nutritionist (RDN) is a person who is professionally trained to educate people on food, nutrition, and weight management. Some dietitians are also certified diabetes educators (CDEs), which means they’re specifically trained to work with people with diabetes on all topics related to diabetes management. A CDE can be an excellent resource for you as you begin your journey with diabetes. Your dietitian doesn’t have to be a CDE, but finding a dietitian who has experience with diabetes management and nutrition will be helpful.
Your dietitian will work with you to create a meal plan that’s best for you. This means that he or she will help you
- Select a meal planning approach that fits your lifestyle, diabetes goals, and eating habits.
- Determine how many calories and grams or servings of carbohydrate, protein, and fat you should aim to eat each day to meet your diabetes goals.
- Figure out when, how often, and how much you need to eat.
Is eating three square meals a day right for you? Or will you need a snack or two between meals? Will counting calories and carbohydrates be effective for you? Or should you focus more on portion-control techniques? Your dietitian can help you with these questions and many more.
The meal plan you create with your dietitian should also take into account your lifestyle, food preferences, and culture. If you’re a vegetarian or if you can’t eat certain foods for religious reasons, for example, your meal plan needs to reflect that. If you’ll be cooking most of your meals for your family or you work late and don’t usually have time to cook, your dietitian can help you find foods and recipes to meet your needs. Because so many different elements go into creating a meal plan, the input of an RD or RDN is helpful.
When working with your dietitian, take advantage of the wonderful resource at your disposal and ask questions. In addition to helping you develop an individualized meal plan, your dietitian can teach you the basics of diabetes nutrition, give you tips on shopping and eating out, and even help you make some of your favorite recipes healthier. Embrace the process and take the opportunity to learn more about your body and diabetes.
Ultimately, an effective meal plan is all about balance. It should balance the foods you eat with any diabetes medications you take (including insulin) and your physical activity level to keep your blood glucose levels within a normal range. At the same time, it should help you meet your diabetes goals and still allow you to enjoy your food. A dietitian can help you achieve this kind of balance.
More Than One Way to Plan a Meal
When you work with an RD or RDN, he or she may suggest a few different meal-planning methods for you to consider. No one meal-planning approach works for all people with diabetes. Everyone is different, and there are several meal-planning strategies to explore. Understanding the different options can help you decide, with the help of your dietitian, which of these options suits your needs. Here are the most common meal-planning methods:
- Portion control: This meal-planning method focuses on weighing and measuring foods and estimating portion sizes to ensure that you’re eating the correct amount of food. It may be used in conjunction with other meal-planning methods.
- The plate method: This easy meal-planning technique uses a plate divided into sections to teach you the correct types and amounts of foods to enjoy at each meal. It promotes portion control and well-balanced meals. Find out more about this method in Chapter 17.
- Carbohydrate counting: In simplest terms, this meal-planning method refers to tracking the amount of carbohydrate you eat. There is a basic and an advanced version of carbohydrate counting. The version you use will depend on your needs and diabetes goals. Generally speaking, people with diabetes who use insulin practice advanced carbohydrate counting. Chapter 18 gives you more details about carbohydrate counting.
- Diabetes food choices/exchanges: This meal planning system shows the number of food “choices” that people with diabetes should eat at each meal and snack based on the American Diabetes Association and Academy of Nutrition and Dietetics’ publication Choose Your Foods: Food Lists for Diabetes. The food lists in this guide group together foods that have the about the same amount of carbohydrate, protein, fat, and calories. This approach to meal planning makes choosing between food options and navigating serving sizes even easier. Check out Chapter 19 for more about basing your meal plan on food choices/exchanges.
- Diabetes-friendly eating patterns: Even though there is no specific “diabetes diet” that works for everyone with diabetes, several healthy-eating patterns work well for people with type 2 diabetes. These eating patterns include the Mediterranean-style eating plan, the Dietary Approaches to Stop Hypertension (DASH) eating plan, plant-based (vegetarian/vegan) eating patterns, and low-carbohydrate and low-fat eating patterns. These healthy eating patterns focus more on high-quality, nutrient-dense foods than they do on specific nutrients. Chapter 20 goes into more details about these eating patterns.
There is no one perfect meal plan for people with diabetes, and the American Diabetes Association does not recommend a specific distribution of carbohydrate, protein, and fat for everyone with diabetes. An effective meal plan should be tailored to fit your needs and goals. So if you don’t already have a meal plan, familiarize yourself with the planning methods and eating patterns discussed in Chapters 17–20, and then meet with your dietitian to determine which approach is the best fit for you.