David M. Rider, MD August 2010. This talk is NOT: A substitute for an individualized plan designed by a nutritionist, dietician or your personal physician.

David M. Rider, MDAugust 2010

This talk is NOT:A substitute for an individualized plan

designed by a nutritionist, dietician or your personal physician

Universally applicable for all people with Diabetes, especially those with “brittle” diabetes

A set of hard and fast rules that you MUST obey

The final say on the subject of diabetes and diet

Who am I?I’m not a nutritionist

I’m not an expert chef

I’m also learning

Who am I?I have many, many diabetic patients

who I have guided to success in controlling their diabetes

One of them had “success” through medicine alone

Most of them exercise a LOTMost of them eat a LOT of saladsNone of them count carbs

The bottom line:

We all want to look good and feel good

The bottom line:

And most diabetics ended up that way because food makes us feel good

The bottom line:

We need to re-define “good food.”

Good food not only feels good to eat but is ALSO protective against diabetes AND makes you look and feel great.

Some universal truths:Americans eat too many calories every day

with not enough exercise

Some universal truths:Not only do we eat too many calories, but the

ones we choose are not the ones we are designed to eat.

How Colorful is your Plate?

Some universal truths:Sorry!

You can’t lose and keep off significant weight/fat without exercise, and lots of it. Sustainable success is not only about burning fat, but about building muscle.

The Meat of This ProgramCarbohydrates:

Simple: table sugar, bleached flour, white rice Turn right into sugar

Complex: Whole Grains, vegetables Take longer to digest

Sugar SubstitutesSucralose / Splenda:- No calories, not recognized

as sugar or carbohydrate but 600 times sweeter than sugar. No aftertaste, very heat stable, ideal for baking.

Aspartane / NutraSweet- No calories, 200 times

sweeter than sugar, does not hold up as well under heating.

Fiber: AKA yummy plant stuff you can’t digestBulky and Absorbs Water Fills you up faster

Slows Down DigestionProlongs satiation

Binds together wasteKeeps you regular

Reduces fat and cholestrol

in your blood Protects your heart

Keeps blood sugar levels steady

avoid post-meal spikes

Helps maintain high energy

Fluctuations wear you out

Full of PhytochemicalsThe REAL vitamins

Delicious

Fillin’ up with Fiber (20-30g/day)1. It’s Whole Wheat or Nuthin’. Period.2. Don’t Peel the Skins!3. Add Wheat Germ or bran to meat loafs,

casseroles, yogurt4. Beans, beans, they’re good for your heart (half

cup with up to 10 grams of fiber!) Add beans to salad, just open up a can!

Chickpeas!

5. White vs Wheat.. Wha? The first ingredient should be “Whole Wheat

Flour”

ProteinAlmost any natural food (vegetables, grains,

nuts, beans) is chock full of proteins. Protein takes a lot of work to break down, so it is digested slowly.

Causes a more gradual rise in sugar levels

Decreases Hunger! (no one knows why, but it seems carbs stimulate it)

What about Fat??Fat is Yummy.It’s true, don’t deny the truth, and don’t deny yourself some FAT.

Fat helps us feel satiated (full). Most people on low-fat diets end up consuming far more calories than they do when they allowed themselves to eat some steak. And most gain the weight back.

Bad Fat, Good Fat

Is it solid at room temperature? Is it from an animal? It’s probably bad in excess.

Unsaturated Fats

Saturated Fats

Is it liquid, from fish, avocado or nuts? It’s probably great for you – Eat up!

Worst Fat

Counting Carbs

Beyond the scope of this talk.

I have approximately zero patients that do this regularly.

But that doesn’t make it okay to NOT think about what you eat.

Instead of Counting What we CANT eat… Eat these a LOT!

Non-starchy Vegetables Beans!(eat 5 a day!)

Nuts! Avocados and Good Fat!

14 Foods to EatGreen Leafies most mealsLean, not Mean protein

(seafood, chicken)Seafood 2-3 x weeklyBeans (at least half a cup a

day)Whole grain or Skip the

grain (eating out? If it’s not whole wheat rice then get double veggies)

Cruciferous Veggies (broccoli, cauliflower, cabbage, turnip, radish, watercress)

Handful of Nuts Every day (lower cholesterol and improve satiety)

BerriesSoy products (chorizo,

facon)Garlic and herbsGreen TeaNon-fat yogurtChocolate and Cacao

(dark, semi-sweet 60-70% cacao. 1st ingredient should not be sugar!)

Fiber…

FIBER!Improves insulin levelsDecreases cardiovascular diseaseFills you upDecreases weight5 cups of vegetables and fruits per dayPlate should be COLORFULThe best food predictor of losing weight is

FIBER

Can I give a shout out to Salad?

… And throw some beans or chickpeas in there!

Serving SizesOur serving sizes are TOO BIG! Two tricks to

limiting size:

1. Don’t go out to dinner, cook at home instead.

Is your food touching itself on your plate?

Too much!

2. Go out to eat and share an entrée.

The bottom line:

We all want to look good and feel good

A (sort of) Simple EquationWant to maintain your weight?

Multiply by 10 and adda) 300 if you are totally sedentaryb) 500 if you are moderate activec) 700 if you are very active

(example: 200 lbs and moderately active = 2500 calories)

A (sort of) Simple Equation

Want to LOSE weight?One pound is 3500 calories.

Half a pound a week is 250 calories less per day

One pound per week is 500 calories less per day

Two pounds per week is 1000 calories less per day

A (sort of) Simple Equation

Want to have some look good and lose weight?One pound of muscle burns 40 calories a day just sitting there.

That’s 40 x 365 = 14,600 calories a year or 4.17

pounds. Just sitting there.

The Nutrition Facts Label

The Percent Daily Value

The % DV is based on 100% of the daily value for each nutrient.

No % Daily Value

Trans Fat

Sugars

Protein

Conclusions

We need to re-define “good food.”

Good food not only feels good to eat but is ALSO protective against diabetes AND makes you look and feel great.

Number One

Conclusions

Eating healthy is important, but it’s not enough. You have to sweat regularly.

Number Two

Focus on what you CAN eat!

Non-starchy Vegetables Beans!(eat 5 a day!)

Nuts! Avocados and Good Fat!

Number ThreeConclusions

Conclusions

Some basic background can allow you to adjust most any decent recipe to one that is SUPER diabetic friendly

Number Four

Questions?