1. UNIT 3, LESSON 7 The Diabetes Food Pyramid

2. Objectives At the end of the lesson, participants should be able to: 1. Explain the Diabetes Food Pyramid 2. State food groups and appropriate serving sizes 3. Make wise food choices using the Diabetes Food Pyramid 4. Describe their feelings and experiences of eating with diabetes 5. Set a goal that relates to making healthier food choices 6. Identify ways to modify everyday recipes to fit into the diabetes meal plan

3. L-esson

4. Myths about Diabetes Too much sugar gives you diabetes People with diabetes are not supposed to eat sugar What do you think?

5. Truth about Diabetes Eating healthy is the same for people with and without diabetes. It is a matter of eating a wide variety of foods and a balanced amount of carbohydrates, proteins, and fats. It doesn’t mean you have to give up all sugars or special treats. You must account for the carbohydrate, fat, and calories in your total meal plan for the day. Source: American Diabetes Association

6. Different Food Guide Pyramids USDA Food Guide Pyramid Diabetes Food Pyramid Both pyramids are divided into six sections of varying sizes

7. Differences USDA Food Guide Pyramid Food are grouped according to their classification as a food Starchy vegetables are placed under the vegetable groups Cheese is placed in the milk group Diabetes Food Pyramid Foods are grouped according to their carbohydrate and protein content Starchy vegetables are under the bread, grains, and other starches group Cheese is placed in the meat and other group

8. Benefits of the Diabetes Food Pyramid Can be used as a guide for choosing a healthy diet Used as a diabetes meal plan Introduces variety in the diet Shows the food groups that a person should increase or decrease

9. Diabetes Food Pyramid There are six groups

10. Diabetes Food Pyramid Fats, oils and sweets Keep servings small Milk 2-3 servings Vegetables (non-starchy vegetables) 3-5 servings Meats and others 4-6 ounces Fruits 2-4 servings Grains, beans, and starchy vegetables 6-11 servings

11. Number of Starches based on Number of Calories CaloriesNumber of starches 1,200 to 1,600 6 starches 1,600 to 2,0008 starches 2,000 to 2,40010 starches Source: National Diabetes Information Clearinghouse

12. Examples If you eat: 6 servings of grains, beans, and starchy vegetables 3 servings of vegetables 4-6 ounces of meat and meat substitutes 2 servings of fruits 2 servings of milk Up to 3 servings of fats then you would have eaten about 1,200 to 1,600 calories.

13. Differences for Women and Men Most women would eat at the lower end of the range Many men would eat in the middle to high end of the range Both men and women would consume at the higher end of the range if they are active

14. Know Portion Size Portion sizes today have become larger One of the most important aspects of meal planning is to know the correct portion size Controlling your diabetes means knowing what makes one portion for each group on the Diabetes Pyramid

15. Grains, Beans, and Starchy Vegetables Eat six to 11 servings each day Good source of fiber What is one serving or one portion in this group? 1 slice of bread (whole wheat is best) ¼ of a bagel (1 ounce) ½ of an English muffin or pita bread 1 6-inch tortilla 4 to 6 crackers ¾ cup of dry cereal ½ cup of cooked cereal ½ cup potato or yam ½ cup peas or corn ½ cup cooked beans 1 cup winter squash 1/3 cup of rice 1/3 cup of pasta

16. Grains, Beans and Starchy Vegetables Choose whole-grain foods, such as: Whole-grain bread Whole-grain crackers Tortillas Bran cereal Brown rice Bulgur Whole-grain foods are nutritious and high in fiber Beans are also high in fiber

17. Grains, Beans and Starchy Vegetables Use whole wheat or other whole-grain flours in cooking and baking Eat low-fat breads, such as: Bagels Tortillas English muffins Pita bread For snacks, try pretzels or popcorn without butter

18. Vegetables Eat three to five servings each day Good source of vitamins, minerals, and fiber What is one serving or one portion for this group? 1 cup raw vegetables ½ cup cooked vegetables Vegetables can be used to fill a person up without adding too much carbohydrate

19. Vegetables

20. Non-Starchy Vegetables

21. Fruit Eat two to four servings each day Good source of vitamins, minerals and fiber What is one serving size or one portion in this group? ½ cup canned fruit, unsweetened or in its own juice 1 small fresh fruit 2 tablespoons dried fruit 1 cup melon or raspberries 1 and ¼ cup whole strawberries Fruit also contains carbohydrates

22. Fruit What are some of your favorite fruit? Choose fresh fruits instead of fruit juices. Fresh fruit contains more fiber. Choose unsweetened fruit juices.

23. Milk and Dairy Eat or drink two to four servings each day. Milk products contain protein and calcium, as well as other vitamins and minerals.

24. Milk and Dairy What is one serving or one portion size for this group? 1 cup fat-free or low-fat milk 2/3 cup yogurt (plain or flavored with artificial sweetener) Choose non fat or low-fat dairy products for the great taste and nutrition without the saturated fat

25. Meat and Meat Substitutes and other Proteins Eat 4 to 6 ounces each day Meat and meat substitutes contain protein and calcium, and other vitamins and minerals

26. Meat and Meat Substitutes What are examples in this group? Meat: beef, pork Poultry: chicken, turkey, eggs Fish: salmon, tuna, catfish, tilapia Peanut butter Tofu Cheese Limit cheese, hotdogs, processed sandwich meats, bacon, and sausage Keep portion sizes small– two to three ounces

27. Meat and Meat Substitutes 1 ounce of meat equals: ¼ cup low-fat cottage cheese 1 oz cheese (3 grams of fat or less per oz) 1 egg 1 tablespoon of peanut butter ½ cup of tofu 1 oz fish 1 oz pork

28. Fats, Oils, and Sweets Foods in this group contain a lot of fat and sugar They aren’t as nutritious as the other groups Keep your servings small and save them for a special occasion

29. Fats and Oils Serving Sizes FoodServing Size Nuts- almonds or cashews Peanuts Pecan 6 10 4 halves Olives- Black, large Green with pimentos, large 8 10 Avocado2 tablespoons 1 ounce Margarine or mayonnaise, reduced fat regular margarine or mayonnaise 1 tablespoon 1 teaspoon Cream, reduced fat regular 1 ½ tablespoons 1 tablespoon Sour cream, reduced fat regular 3 tablespoons 2 tablespoons Oils- canola, olive, vegetable1 teaspoon

30. Sweets Serving Sizes FoodServing Size Beverages- hot chocolate, lemonade, sport drink 1 cup or 8 ounces CakeOne 2-inch square CookiesOne 3-inch Pie1/6 of 8-inch pie Pudding½ cup Ice cream½ cup Candy3 pieces hard, 5 pieces chocolate KISSES Syrup, light Syrup, regular 2 tablespoons 1 tablespoon

31. Alcohol The American Diabetes Association recommends: Two drinks or less a day for men and One drink or less per day for women. One serving of alcohol equals: 12 ounces of regular beer 12 ounces of light beer 5 ounces of wine 1.5 ounce of hard liquor

32. Putting It All Together What did you learn from the information that was covered today?

33. E-mpowerment Diabetes Education Series: The Diabetes Food Pyramid

34. Diabetes Education Series Describe your experiences and feelings about eating related to your diabetes. What was most difficult for you? What are ways that you could overcome some of these difficulties?

35. A-ction Did you accomplish the goal you set last week? Set a goal related to healthy eating using the Diabetes Food Pyramid.

36. R-eal-Life Problem Solving Leah’s Story

38. Questions about Leah’s Story What is Leah’s Problem? What is the first step that Leah needs to take in this situation? What are some other things that Leah needs to in this situation? (List as many suggestions as possible.) List two things that Leah could do right away to deal with this problem. Why?

39. Questions about Leah’s Story Please find the Real-Life Problem Solving handout for this lesson in your folder These questions will help with your understanding of Leah’s story

40. N-utrition Menu Baked Swiss Steak Fresh Spinach Salad Pumpkin Squares

41. See you next week! Topic for the next week: Carbohydrate Counting

42. Date: References: Margaret E. Cook-Newell, Ph.D., R.D., L.D., CDE Irene Hong-McAtee, MD, MCR Adrienne Glodt, B.S., Graduate Student Laura Hieronymus, MSEd, APRN, BC-ADM, CDE Cheryl Case, M.S., Harrison County Ann Hollon, M.A., Wolfe County Hazel Forsythe, Ph.D., R.D., L.D., CFCS Stephen D. Perry, M.S., R.D., L.D. Pam Sigler, M.S. Lynn Blankenship, M.S., Metcalfe County Theresa Scott, M.A., Floyd County Tamara Thomas, M.S., Franklin County Rusty Manseau, B.A., Graphic Artist Author: Ingrid Adams, Ph.D., Assistant Professor, Nutrition and Food Science, University of Kentucky Other Contributors