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Daily meal planning guide
Daily Meal Planning Guide
Managing Your Diabetes
patient education program
Good nutrition is one of the most basic and im-
Think of this plan as only a temporary guide. Keep
portant diabetes care tools. Eating right can help
in mind that every person with diabetes should
control blood sugar. And good control helps pro-
have a customized meal plan that provides more
tect your long-term health. This meal planning
feedom in terms of food choices. Just about any
guide is a great way to begin making smart food
food, inclding your favorites, can be fit into your
meal plan . A Registered Dietitian (RD) can workwith you to develop the plan that best meets your
Whether you are following a calorielevel meal
needs and lifestyle. Ask your doctor, diabetes edu-
plan, counting carbohydrates, using exchanges
cator, hospital, or local diabetes association for
or just trying to improve the overall nutritional
the names diabetes in your area who specialize
value of your current eating patterns, the food
lists on this sheet will give you a solid startingpoint.
Meal Panning Options
Many effectiv meal plans involve tracking what you eat. Two
of the moust popular approaches are counting calories for regu-
Carbohydrate (starch and sugar) is the main nutrient in food
lating weight and counting carbohydrate for blood sugar con-
that raises blood sugar. When you plan meals based on carbo-
trol . Your diabetes heathcare professional will recommend the
hydrate counting , count only the foods that contain carbohy-
drates. Use either the protion sizes shown in the food list, orcalculate the bolded numbers in each food list. label, count the
Calorie Meal Plans
a number of carbohydrate grams for the serving size.
The table below shows sample meal plans, by number of serv-ing, for different calorie levels. To maintain a healthy weight,choose a calorie level close to what you’re eating now. If youneed to gain or lose weight plan to use. Each plan providesabout half of its calories from carbohydrate and less then 30%of calories from fat,based on choosing skim milk and mediumor lower fat meats and cheeses.
Sample Meal Plans
Calories per day
Fruit (15 gram carb servings)* 3 3 3 3 4 4
Milk & yogurt ( 12 gram carb servings)** 2 2 2-3 2-3 2-3 2-3
* There vegetable serving provide the same amount of carbohyrates as on serving of other carbohydrate food groups.
*Teenagers, young adults to age 24, and women who are pregnant or breastfeeding need 1200 mg of calcium each day. That
equals about 4 serving of milk and yogurt. Eating fat- free and nonfat milk keep fat grams and calories lower.
Starches/ Breads with Fat
Each serving from this food group equals: 15
grams of carbohydrate, 3 grams protein, 5grams or more from fat , and 125-150 calories.
Each serving from this food group : 15 grams of
carbohydrate, 3 grams protein, 1 gram fat, and 80
These foods are the cornerstone of every healty
Fresh Fruit Serving Size
eating plan. Most of their calories come from
carbohydrates, a good source of energy . Many
foods from this group also give you needed fiber,
vitamins, and minerls. Prepare and eat starchy foods
with as little added fat as possible by limiting butter,
Each serving from this food group equals:
These are just a few of the many available starchy
5 grams of carbohydrate, 2 grams protein,
foods . Estimate a single serving size for foods that
A serving is 1/2 cup of cooked vegetables,
Cereals/Beans/ Grains/Past Serving Size
1/2 cup of vegetable juice, or 1 cup of raw
*Beans; cooked or canned ( all kinds) 1/3 cup
Cereal; dry (leass then 100 calories pear serving )
calories per serving are listed with Free
Corn meal; uncooked (mesa or matza meal ) 3Tbsp
Mink and Yogurt
Potato; baked’ boild, steamed 1 small ( 3 oz )
Milk and yogurt supply calcium and minerals,
vitamins, protein and carbohydrates. Choose
low- fat and skimmed varieties for health.
They have less fat, calories, and cholesterol
Fat-free and low-fat
grams of carbohydrrate, 8 grams protein, 0-3
(nonfat, plain or artificially sweetened)
Tortilla (1’’ corn or 7’’ flour )
Each serving from this group equals:12 grams
of carbohydrate, 8 grams protein, 5 grams fat,
Each serving from this food group equals:
15 grams of carbohyrate and 60 calories.
minerals and can be a good source of fiber.
grams of carbohydrate, 8 grams protein, 8grams fat, and 150 calories.
To reduce your intake of cholesterol and satu-
rated fat, limit or avoid foods in this group.
Each serving from this group equals: 7 grams
protein, 8 grams fat, and 100 calories.
Sugars and Sweets
Each serving from this group equals: 15 grams
carbohydrate, or 1 Starch, or 1 Fruit, or 1Milk,
Each serving from this food group equal : 5
Suger can be included in your meals without
losing blood suger control if them are counted
Fast add flovor and moisture to food but have
few vitamins and minerals. Serving sizes of all
Seasonings csn be used as desired. If you are
guidelines for keeping the amonts of sweets
fast are small. Choose mono-and polyunsatu-
on a low-sodium diet, read labels to avoid
and Fats in your overall ditet small compared
rated fast more often then saturated fast for
seasonings that contain sodium or salt.
to more nutrionally valuable foods. Portion
better hert health and to lower blood Choles-
sizes of foods high in refinbed suger are often
Flavoring extracts (vanilla, etc.) Garlic or
Fats Serving Size
Ice cream (fat-free, no suger added) 1/2 cup
Jam or jelly (regular, suger-free ); made with
Meat and meat Substitutes
Small serving of meat and meat substiutes
Warshw, Hope S. Diabbetes Meal Planning Made Easy,2nd Edition, Alexandri, VA: American Diabetes
provide enough protein to meet most people’s
daily needs. For better health, cheese more
aften then meadium- and high-fat types.Very Lean Meat
Each serving from this group equals: 7 gramsprotein, 0-1 grams fat, 35 calorise.
Cottage cheese (non-fat)
Fish; fresh, frozen or canned in water (cod,flounder, tuna)
Shellfish (clams, mussels, scallops) 1 ozLean Meats
Each free food or drink contains fewer then 20
Each serving from this group: 7 grams protein,
calories per serving. Eat as you want of the
free foods that list no serving size. Eat up to 3
Cheese (low-fat American, low-fat Cheddar)
serving size listed. For better blood suger
control, spread your serving of these extra
Each serving from this group this wqual : 7
grams protin, 5 grams fat, and 75 calories.
Pork (& Canadian bacon, loin chop) 1 oz
Spreadable fruit (100% fruit)
The Diabetes Food Pyramid
Grains, Beans & Starchy Vegetables
6 or more Servings
The Diabetes Food Pyramid
The Diabetes Food Pyramid is a little different then the USDA Food Guide Pyramid
because it groups foods based on thire carbohydrate and protein contrin intead of their
classification as a food. To have about the same carbohydrate content in each serving, the
protion sizes are a little different too. The Diabetes Pyramid gives a range of servings. If
you floow the minimum number of serving in each group, you would eat about 1600
calorise and if you eat upper end of the range, it would be about 2800 calories. The exact
number of serving you need depends on your diabetes goals, calorie and nutrition needs,
your lifestyle, and foods you like to eat. If yiu are using the pyramid, discuss with your
healthcare provider the number of recommended for your particular needs.
http://www.diabetes.org/nutrition-and-recipes/nutrition.jsp.Accessed 6/14/06.Try your hand at these guidelines for estimating protion sizes:
Personal Meal Plan
Goal: Distribute the total number of carbohydrate choices throughot the day in meals and snacks.
Carbohydrate- # of choices:
Protein (oz) :
# CHO choices:
# CHO choices:
Daytime or Evening
(Snack (If part of daily plan)
Dietitian Phone: ( )
Key : CHO=
in the Fast Lane
It is an eatablished fact that a propear diet plays a major role in your good health. Eating healthy is
important for everyoune. especially for those living with diabetes. Making wise food choices canhelp you manage your blood sugar level , lower your blood cholesterol, and help you lose weight.
Diabetes is a lifelong condition,so being able to select healthy food choices in a variety, of situa-
tions is a skill you will need for the rest of your life. As an educational serice for pepole withdiabetes, Eli Lilly and Company has publised thiw condensed edition of Nutrition in Fast Lane
tohelp you make healthy food choices on the go.
You know that following basic nutrition guidelines makes good sense. You should follow these
guidelines whenever buying groceries and preparing meals. That way you can be sure of gettingfood that not only tastes good but helps you manage your diabetes. When you are in charge, youcantrol what is put on the table-and for people with diabetes, this kind of control is very important.
But what if you are like the millions of other Americans who regularly eat out? Say you’re away
from home most of the day and usually eat lunch in a restaurant or grill. If you have diabetes, it’s allright to eat at these pleces, just watch what you eat on the go-to make sure it fits with your mealplan.
In recent year, doctors have identified key parts of the diet for staying healthy. Experts in nutrition
have used this information to look at the food value of the menu items listed on the following pages.
This booklet should be a useful tool for anyone who regularly eats out, eapecially for people withdiabetes, Keep in mind that every person with diabetes should have a personal meal plan . A regis-tered dietitian (RD)can work with you to develop the plan that best meets your needs.
for the Fast Lane
These three basic guidelines of good nutrition apply to everyone : 1) ear a balanced diet; 2) choose
foods low in fat, especially saturated fat, trans fat and cholesterol ; and 3) avoid high levels ofsodium.
Often pepole think that eating fast -food means you have to settle for food loaded with calories
and fat, buty little food value. That thinking can be misleading.
Fast -food can be part of a healthy diet if you choose wisely. In addition , fast-food can provide somevery good choices, but lick other foods it can also be loaded with calories, fat, cholestreol andsodium.
How to Use This Booklet
This booklet gives you facts about over 1,500 menu items offered by 39 of the most popular nationaland regional fast food chains. Restrurants are listed in alphabetical order . At the top of each restau-rant page are guides to nutrition facts on the labels of goods you buy at the supermaket.
The numbers below the column guides break down the nuteition value of each menu item in calories,calories from fat, total fat, saturated fat , trans fat, cholesterol, sodium, carbohydrete, dietary fiber,saugar and protein. They also give you the total carb exchange (for those counting carbohydrates ),as well as suggested exchange values for each itam as recommended by the American DieteticAssociation and the American Diabetes Association.
An example of a losting in this booklet looks like this :
To keep this simple , it might be helpful to review the meaning of the column guides.
The bigger your body , the harder it must work , the more calories you will
need . Additionally, gender, age and activity level all play an important part in your daily require-
ments. But if you regularly eat more calories then you need, you will put on too much weight. For
body’s ability to keep blood suger in a normal range. For a more in-depth look into FDA suggested
daily food requirements for specific caloric intake see the My. Pyramid. gov
chart on page 5. For
your own calorie requirements , consultation with a Registered Dietitian is highly recommended.
TOTAL FAT, SATURATED FAT & TRANS FATS -
Fat supplies energy, insulates the body, and cushions and protects internal organs. Too much fat,
however, contributes to obesity, some types of cancer and heart disese. Fat many come from such
sources as vegetable fats ( found in cooking oil ) and animal fats ( found in meat and dairy prod-
ucts). Total fat refers to polyunsaturated fats, monounsatruratrd fats and saturated fats.
Most saturated fatis from animals, but some vvegetable oils, such as coconut oil and palm oil ,are
also high in saturated fat. The presence of trans fat is due largely to the use of dehydrogenated
cooking oils during preparation. Both of these are major cause of high cholesterol levels, which
can lead to cardiovascular problems. Since people with diabetes are increased rick for cardiovas-
cular problems, it is especially important to limit the amount of fat in your diet
The Food Guide Pyramid graphically illustrates not only the equql importance of the five major food groups, but the need forexercise as well ( 30-60 minutes of physical activity per day to stay fit and prevent weight gain ). when creating your meal planchoosing more fish , beans,peas, nuts and seeds.
Following are the suggested amounts of food to consume daily from the basic food groups, sub-groups and oils for each of 12 different calorie levels. The final column “DCA” (DiscretionaryCalorie Allowance ) is the number of calories remainig if you have been selecting nutrient-densefoods, such as dark -green or orange vegetables or very lean meats. These calories many be eitherdisarded or may be used to add food itams, increase the use ofe oil, fats and sugars, or to consumealcohol.
FOR MORE SPECIFIC GUIDLINES
VISIT My Pyramid. gov ON THE WORLD- WIDE WEB
and replace the saturated fats with monounsatruated fats, like olive, peanut, and canola oils. Nutri-tionists tell us that total fat should be 30% or less of the total calories we eat. Saturated fat shouldmake up less then 10% of total calories with trans fat consumption kept as low as possible.
CALORIES FROM FAT -
When watching your diet, knowing the number of calorise coming from
fat can help you to quickly make a healthier choice. A recommended diet would contain no more
then one-third of total calories from fat.
ALL food cholesterol comes from animals. The main sources are egg yolks,
meat, poultry shellfish and dairy products. High blood cholesterol levels contribute to heart attacks
and strokets - and much of the blame fore this gose to saturated and trans fats. Nutritionists recom-
mend keeping dietary cholesterol to 300 milligrams daily . A low-fat, high - fiber diet can help keep
your cholesterol levels low.
Sodium is alredy in some food. In addition, it is addel during cooking and at the table in
the from of salt. Nutritionists tell us that sodiam should be limited to 2,300 milligrams per day.
Sodium can affect blood pressure, so people with high blood pressure may need to eat less.
Carbohydraytes raise blood sugar more then any other food item. Your body
uses carbohydrates for energy. Carbohydrates come from suger and starches. Some sugars are found
naturally in the foods you eat, as in honey and fruits. Other are added during processing, like the
corn syrups used in baked goods. Foods that have the largest amount of carbohydrates include fruit,
milk, sugars and starchy foods such as breads, pasta ands potatoes. Since all carbohydrates are
turned into glucose by your body, even foods lick rice, fruit, or bread can mack your blood sugar
level rice. When using carbohydrate counting for diabetes meal planning, only keep track of foods
that contain carbohydrate. The amomunt of carbohydrate thet’s best for you may be given either as
a number of servings or exchanges, or as a number of grams. Cheak with you dietitian to see the
amount of carbohydrates you need.
DIETARY FIBER -
Fiber in the food you eat helps your digestion run smoother. Also, a high -fiber
, low- fat diet may reduce the risks of some forms of cancer and may lower blood cholestrerol levels.
High figer foods include fruits, vegetables, beans, whole grins, whole-wheat breads and cereals .A
goal of 14 grams of dietary fiber per 1,000 calories consumed is recommended.
All food provides calories. All calories provide energy. But not all calories come with a
full complement of extra benefits such as amino acids, fattry acids, fiber, vitamins and minerals.
Natural sugars in fruits and milk contain these exrtra benefits . However, desserts, candly, syrups
and jellies / jams contain the “empty” calories of added sugar. Since there are no other benefits,try
avoid added sugar as much as possible.
Proteins are the body’s building blocks and are needed for the growth and development
of your body and for keeping muscle and body tissues fit. Meat and dairy products are high in
proten. Beans and nuts are also rich sources.
TOTAL CARB EXCHANGE -
Starch and suger in foods are carbohydretes. Starch is in bread,
cereal, pasta, potatoes, beans, peas and lentils. Natural sugare are in fruits and milk. Desserts, candy,
syrups and jellies / jams all have added sugar. These starches and sugars are in the carbo hydrate
exchange group and can be exchanged for each other. Eating the same amount of carbohydrate daily
at meals and snacks can help you control blood suger levels. Although foods with added sugar can
be substituted in a meal plan, they do not contain the important vitamins and minerals as would a
starch, fruit or milk choice.
SUGGESTED EXCHANGE VALUE-
The exchange systam is a way to plan meals. It was devel-
oped by The American Dieretc Association and The American Diabetes Associatin. It tells you how
to control protion sizes, calories, and the amounts of carbohydrate, protein and fat that are eaten
The exchange lists divide all foods into three main groups: CARBOHYDRATE; MEAT &
MEAT SUBSTiTUTES; and FAT. Foods that are high in these nutrients are placed in those groups.
Foods within a certain group can be traded or “exchanged” for each other .
The CARBOHYDRATE groups includes high carbohydrate food such as Fruits, Starches,
Milk, Vegetables and Other foods that contain high carbohydrate such desserts .
The MEAT &MEAT SUBSTITUTES group includes foods that are high in protein like
meats, cheeses, chicken and fish . These foods are further defined to make it easy to find the lowerfat choices. Meats are grouped as Very Lean Meats (VL), Lean Meats (L), Medium Fat Meats (MF)and High Fat Meats (HF).
The FAT group has foods that are high in fat. These are items like butter, margarine, mayon-
naise, oils and salad dressings. Polyunsatutated, monounsaturated and saturated fats are all part ofthe fat group.
The exchange system helps you because it not only tells you how many calories something
has, it lets you know where those calories are coming from. For example, a food that conatains 120calories could be from either a healthy choice like fruit or it many all be from fat . This way, you canidentify high fat foods and eat those less often.
Some itams are lited as “free’’ in the exchange. A “free’’ food is one that has less then 20
calories or less then 5 grams of carbohydrate per serving. These are good choices to include, but tryto eat no more then 3 servings per day. Even a “free’’ food is not “free’’ if you eat too much of it!
Healthy eating not only means finding good quality in your food, but also serving appropri-
ate portining. How much is eaten is every bit as important as maintaining a healthy balance. The totalnumber of servings you have per from each of food groups depends on your own needs.
A registered dietitian can help you desin a meal plan that will help you reach your personal
goals. This plan could mean cutting back on fat, losing weight, controlling blood glucose levels, orimproving your eating habits. You can find a registered dietian in your area by calling the NutritionHotline of The American Dietetic Association at 1-800-366-1655. Befor you do, check with yourhealth plan to see if these services are covered by your insurance.
For many peoply, life in the fast lane means eating on the run. This often means ordering food
based on convenience rather than health. Sometimes it even means skipped meals. As a person withdiabeters, staying with a healthy diet can be an even greater challenge in today’s fast-pacced life-style. But just taking a moment to think about your food choice, and eating right-even with fast food-can help you manage your blood sugar. Besides gaining control over yourself, too.
Staying healthy isn’t just about eating the right foods and avoiding too much fat, saturated
fat, trans fat, cholesterol, sugar and sodium. You should also remeber to keep a healthy weight,exercise regularly, and take your medication as prescribed by your doctor.
We hope then Nutrition in the Fast Lane will be helpful to you. It should fit conveniently in
you purse, pocket or the glove compartment of your car. Carry it with you and use it often to helpyou manage your doabetes while making the most of your life in the fast lane.
Speedly Snack Ideas
Having healthy snacks available helps you follow your meal plan. Each of these of snacks has about15-20 grams of carbohydrate and 3 grams of fat or less. Enjoy!
10 tortilla chips ( 1 ounce ) with 1/4 cup salsa
4 or 5 whole-grain snack crackers or 6 saltine cracker squares
3/4 cup mix-and-match unsweetened cereals
Nabisco 100 Calorie Packs Honey Maid Cinnamon this crisps
Nabisco 100 Clorie Packs Oreo thin crisps
Nabisco 100 Calorie Packs Chips Ahoy thin crisps
Nabisco 100 Calorie Packs Planters Peanut Butter cookie crisps
3 cup of any combination of baby carrots, broccoli, caulifilower, cherry tomatoes,celery, cucumber, pea pods, bell peppers, redishes, tow fat dip, or 2 Tbsp FAGE Tzatziki
1/2 cup suger-free ice cream or 1 sugar-free ice cream bar
3/4 to 1 cup yogurt (artificially sweetened or plain)
1 Kashi TLC Cherry Dark Chocolate chewy granola bar
15 Kashi TLC crackers ( Ranch, Original 7 Grain, or Honey Sesame )
2 to 4 sugar-free cookies (cheek the label for portion size)
1 silce low calorie bread, 1 romaine lettuce leaf, 1 slice turkey, 1 slice low/non-fatcheesa, 1 tsp mustard
1 slice of reduced calorie bread spread with 1/4 cup non-fat cottage cheese mixed with2 Tablespoons of applesesauce and sprinkled with cinnamon. Especially good warmedin the microwave.
1 tsp regular margarine, butter, or vegetable oil1 Tbsp low fat spread1 Tbsp regular salad dressing2 Tbsap reduced-fat salad dressing8 black olives, 10 green stuffed olives6 almonds, cashews, or mixed nuts 10 peanuts4 pecan halves, walnuts, English nuts 1/2 Tbsp peanut butter1Tbsp peanut butter2 Tbsp Half and Half
Serving Sizes & Exchanges
Starch / Bread
Cereals, grains, pasta, bread, crackers, starchy vegetables and cooked beans,
1 Starch / Bread Exchange =
1. 1/2 cup cooked cereal, grain, or starchy vegetable (corn, peas, or potato)2. 3/4 cup unsweetened, cold cereals3. 1/3 cup cooked rice, pasta, or beans4. 1 oz of bread product ( such as 1 slice of bread, 1 small roll)5. 1/2 English Muffin, hamburger or hot dog bun6. 3/4 to 1 oz of most snack foods
1 Fruit Exchange =
1. 1 small fresh fruit (4 oz)2. 1/2 cup canned or fresh fruiy or unsweetened fruit juice3. 1/4 cup dried fruit4. 1 1/4 cup watermelon or strawberries
Try to choose the low-fat or fat-free varietis of Milk products1 Milk Exchange =
1. 1 cup milk of any variety ( includes soy, buttermilk, Goat’s milk, and Kefir)2. 1/2 cup evaporated milk3. 6 oz yogurt
1 Vegetable Exchange =1. 1/2 cup cooked vegetables or juice2. 1 cup raw vegetables
Meat and Meat Substitues
1. oz of meat, fish, poultry , or cheese2. 1/4 cup lov fat cottage cheese3. 1 egg white, 1/4 cup egg substitute, 1 whole egg4. 4 oz tofu
Botanical (Herbal ) Medicines:
Caution should be exercised when botanical medicines (botanicals
) are taken concomitantly with COUMADIN (Warfarin Sodium ). Few adequate, well-controlled
studies exist evaluating the potential for metabolic and/ or pharmacolohic interactions between
botween botanicals and COUMADIN. Due to a lack of manufacturing standardization with botani-
cal medicinal peparation, the amount of active ingredients may very. This could further confound the
ability to assess potential intractions and effects on anticoagulation. It is good practice to monitor
the patient’s response with additional PT/INR determinations when initiating or discontinuing
Specific botanicals reported to affect COUMADIN therpy include the following:
Bromelains, danshen, dong quai (Angelica sinenis), garlic, Ginkgo biloba, ginseng, andcranberry products are associated most aften with an INCREASE in the effects ofCOUMADIN.
Coenzyme Q10 ( ubidecarenone) and St. john’s wort are associated most aften with a DECREASE in the effects of COUMADIN.
Some botanicals may cause bleeding events when taken alone (e.g., garlic and ginkgo biloba) andmay have anticoagulant, antiplatelet, and/or fibrinolytic propertise. These effects would be expectedto be additive to the anticoagulant effects of COUMADIN. Conversely, other botanicals may havecoagulant properties when taken alone or may decrese the effects of COUMADIN.
Some botanicals that may affect coagulation are listed below for reference; however, this list shouldnot be considered all-inclusive. Many botanicals have several common name and scientific names.
The most widely recognized common botanical names are listed.
Botanicals that contain coumarins with potential anticoagulant effects:
Miscellaneous botanicals with anticogulant properties :
Botanicals that contain salicylate and/or have antiplatelet properties :
Botanicals with fibrinolytic properties :
Botanicals with fibrinolytic properties :
1. Contains coumarins and salicylate.
2. Contains coumarins and has fibrinolytic properties.
3. Contains coumarins and has antipatelet properties.
4. Contains salicylate and has coagulant properties.
5. Has antiplatelet and fibrinolytic properties.
Effect on other Drugs:
Coumarins may also affect the of other drugs. Hypoglycemic agents (chlo-
rpropamide and tolbutamide) and anticonvlsants (phenytoin and phenobarbital) may accumulate in
the body as a resuilt if interference with either metabolism or excreton.
FURTHER REVELATIONS by C.Lovell. INTRODUCTION. Most of the information in this paper has not been easy to obtain, and much of it is sensitive. In most casesthe sources of information have been indicated by a code; refer to the last sheet for the bibliography andcodes. All statements have been made in good faith, but it is possible that some of the reference books arenow out of date, or that
• They are more direct and give more and better context than indirect reports from professionals • They commonly describe the impact on people’s lives, which clinicians rarely note • Indirect and direct reports complement each other, generating multicultural knowledge • Knowledge of ADRs and their importance accumulates faster • Patients become active pa