2005 Oklahoma Cooperative Extension Service 1 Living with Diabetes: Living with Diabetes: Ingredients, Labels, Ingredients, Labels, Recipe Modification & Recipe Modification & Eating Out Eating Out Barbara Brown, Ph.D., Barbara Brown, Ph.D., R.D./L.D. R.D./L.D. Food Specialist Food Specialist Oklahoma Cooperative Oklahoma Cooperative Extension Service Extension Service
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Living with Diabetes: Ingredients, Labels, Recipe Modification & Eating Out
Living with Diabetes: Ingredients, Labels, Recipe Modification & Eating Out. Barbara Brown, Ph.D., R.D./L.D. Food Specialist Oklahoma Cooperative Extension Service. Today we will. Examine features of food labels important for diabetics to read & understand - PowerPoint PPT Presentation
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2005 Oklahoma Cooperative Extension Service 1
Living with Diabetes:Living with Diabetes:Ingredients, Labels, Ingredients, Labels,
Recipe Modification & Recipe Modification & Eating OutEating Out
Barbara Brown, Ph.D., Barbara Brown, Ph.D., R.D./L.D.R.D./L.D.
• Examine features of food labels Examine features of food labels important for diabetics to read & important for diabetics to read & understandunderstand
• Look at functions of ingredients in Look at functions of ingredients in food & available market food & available market substitutionssubstitutions
• Receive tips for recipe modificationReceive tips for recipe modification• Learn suggestions for eating out Learn suggestions for eating out
with diabeteswith diabetes
2005 Oklahoma Cooperative Extension Service 3
Food labels:Food labels:Key points for diabeticsKey points for diabetics
• Bottom footnote with Bottom footnote with Daily Values for 2,000 & Daily Values for 2,000 & 2,500 calorie diets 2,500 calorie diets • Found only on larger Found only on larger
packagespackages• Does not changeDoes not change
2005 Oklahoma Cooperative Extension Service 7
Serving sizeServing size
• Standardized to ease comparison Standardized to ease comparison of similar foodsof similar foods
• Amounts usually eaten at 1 timeAmounts usually eaten at 1 time• Given in household & metric Given in household & metric
measuresmeasures
2005 Oklahoma Cooperative Extension Service 8
Serving size vs. Serving size vs. exchangesexchanges
• Nutrition Facts serving may not equal Nutrition Facts serving may not equal exchange servingexchange serving• ExamplesExamples
• No, only trivial or "physiologically No, only trivial or "physiologically inconsequential" amount of 1 or more inconsequential" amount of 1 or more of:of:• fat, saturated fat, cholesterol, fat, saturated fat, cholesterol,
sodium, sugars, caloriessodium, sugars, calories•"calorie-free" = less than "calorie-free" = less than 5/serving5/serving
•"sugar-free" & "fat-free" = less "sugar-free" & "fat-free" = less than 0.5g/servingthan 0.5g/serving
• Can be used on foods that can be Can be used on foods that can be eaten frequently without eaten frequently without exceeding dietary guidelines for exceeding dietary guidelines for one or more of: one or more of: •Fat, saturated fat, cholesterol, Fat, saturated fat, cholesterol,
sodium, and calories sodium, and calories
2005 Oklahoma Cooperative Extension Service 17
Low: descriptors Low: descriptors • low-fat: 3g or less/serving low-fat: 3g or less/serving • low-saturated fat: 1g or less/serving low-saturated fat: 1g or less/serving • low-sodium: 140mg or less/serving low-sodium: 140mg or less/serving • very low sodium: 35mg or less/serving very low sodium: 35mg or less/serving • low-cholesterol: 20mg or less & 2g or low-cholesterol: 20mg or less & 2g or
less of saturated fat/serving less of saturated fat/serving • low-calorie: 40 calories or less/servinglow-calorie: 40 calories or less/serving
2005 Oklahoma Cooperative Extension Service 18
““Low-carb” labelingLow-carb” labeling
• ““Net carbs,” “effective carbs”Net carbs,” “effective carbs”•No federal regulation definesNo federal regulation defines•Typically used as result when Typically used as result when
fiber & certain sweeteners fiber & certain sweeteners (sugar alcohols & glycerin) are (sugar alcohols & glycerin) are subtracted from total subtracted from total carbohydrate contentcarbohydrate content
2005 Oklahoma Cooperative Extension Service 19
Lean & extra leanLean & extra lean• Can describe fat content of meat, Can describe fat content of meat,
poultry, seafood, & game meatspoultry, seafood, & game meats•Lean:Lean: less than 10g fat, 4.5g or less than 10g fat, 4.5g or
less saturated fat, & less than less saturated fat, & less than 95mg cholesterol/serving & per 95mg cholesterol/serving & per 100g100g
•Extra lean:Extra lean: less than 5g fat, less less than 5g fat, less than 2g saturated fat, & less than 2g saturated fat, & less than 95mg cholesterol/serving & than 95mg cholesterol/serving & per 100g per 100g
2005 Oklahoma Cooperative Extension Service 20
More nutrient content More nutrient content claimsclaims
• High:High: food contains 20% or more food contains 20% or more of %DV for a particular of %DV for a particular nutrient/servingnutrient/serving
• Good source:Good source: food contains 10- food contains 10-19% of %DVfor a particular 19% of %DVfor a particular nutrient/servingnutrient/serving
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ReducedReduced
• Nutritionally altered food Nutritionally altered food contains at least 25% less of a contains at least 25% less of a nutrient or calories than the nutrient or calories than the regular foodregular food•Claim can't be made if regular Claim can't be made if regular
• Food, whether altered or not, Food, whether altered or not, contains 25% less of a nutrient contains 25% less of a nutrient or calories than the regular foodor calories than the regular food
2005 Oklahoma Cooperative Extension Service 23
Meanings of LightMeanings of LightMeanings of LightMeanings of Light
• 1/3 fewer calories or 1/3 fewer calories or 1/2 fat of reference 1/2 fat of reference foodfood
• Sodium content of low-Sodium content of low-calorie, low-fat food calorie, low-fat food lowered 50%lowered 50%
• Can describe texture Can describe texture &/or color&/or color•Label must explain Label must explain
intentintent
2005 Oklahoma Cooperative Extension Service 24
When label says When label says “More”“More”
• 1 serving contains a nutrient 1 serving contains a nutrient that is at least 10% of Daily that is at least 10% of Daily Value more than in reference Value more than in reference foodfood
2005 Oklahoma Cooperative Extension Service 25
Health claimsHealth claims
• Describe how food or Describe how food or food component food component relates to a disease or relates to a disease or health-related health-related conditioncondition
• Wording regulated by Wording regulated by FDAFDA
2005 Oklahoma Cooperative Extension Service 26
3 types of health claims3 types of health claims
1.1. ApprovedApproved
2.2. AuthorizedAuthorized
3.3. Qualified health claimsQualified health claims
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1.1. Approved health Approved health claimsclaims
• 1990 Nutrition Labeling & 1990 Nutrition Labeling & Education Act (NLEA) provides Education Act (NLEA) provides for FDA to issue regulations for FDA to issue regulations authorizing health claims for authorizing health claims for foods & dietary supplements foods & dietary supplements after FDA's careful review of after FDA's careful review of scientific evidence submitted in scientific evidence submitted in petitionspetitions
cariescaries• Soluble fiber from certain foods Soluble fiber from certain foods
& risk of CHD& risk of CHD• Soy protein & risk of CHDSoy protein & risk of CHD• Plant sterol/stanol esters & Plant sterol/stanol esters &
CHD riskCHD risk
2005 Oklahoma Cooperative Extension Service 31
2.2. Authorized health Authorized health claimsclaims
• 1997 FDA Modernization Act 1997 FDA Modernization Act (FDAMA) provides for health (FDAMA) provides for health claims based on an claims based on an authoritative statement of a authoritative statement of a scientific body of the U.S. scientific body of the U.S. government or National government or National Academy of SciencesAcademy of Sciences
• Such claims may be used after Such claims may be used after submission of notification to submission of notification to FDA FDA
2005 Oklahoma Cooperative Extension Service 32
Claims authorized based on Claims authorized based on authoritative statements authoritative statements
by federal scientific bodiesby federal scientific bodies
• Whole grain foods & risk of heart Whole grain foods & risk of heart disease & certain cancersdisease & certain cancers
• Potassium & risk of high blood Potassium & risk of high blood pressure & strokepressure & stroke
2005 Oklahoma Cooperative Extension Service 33
3.3. Qualified health Qualified health claimsclaims
• 2003 FDA 2003 FDA Consumer Health Consumer Health Information for Better Nutrition Information for Better Nutrition InitiativeInitiative provides for qualified provides for qualified health claims where the quality health claims where the quality and strength of scientific evidence and strength of scientific evidence falls below that required to issue falls below that required to issue an authorizing regulationan authorizing regulation
• Claims must be qualified to assure Claims must be qualified to assure accuracy & non-misleading accuracy & non-misleading presentation to consumerspresentation to consumers
2005 Oklahoma Cooperative Extension Service 34
Allowed qualified health Allowed qualified health claimsclaims
Simple carbohydrates—Simple carbohydrates—Sugars or caloric Sugars or caloric
sweetenerssweeteners• Occur naturally in fruits, dairy Occur naturally in fruits, dairy
products, some vegetables, products, some vegetables, honey, molasseshoney, molasses
• Refined sugars used in Refined sugars used in processing & as sweetenerprocessing & as sweetener
• Most high sugar foods have Most high sugar foods have lower nutritional valuelower nutritional value
2005 Oklahoma Cooperative Extension Service 37
Functions of sugar in Functions of sugar in foodsfoods
• SweetenerSweetener• Tenderizer in bakingTenderizer in baking• Caramelize under heatCaramelize under heat• Enhance growth of Enhance growth of
yeastyeast• Control gelling process Control gelling process
in jellies/preservesin jellies/preserves• PreservativePreservative
2005 Oklahoma Cooperative Extension Service 38
Functions of sugar in Functions of sugar in foodsfoods
• Add to smoothness of frozen Add to smoothness of frozen dessertsdesserts
• Increase consumption of nutrient-Increase consumption of nutrient-rich foods that would probably rich foods that would probably not be eatennot be eaten•Examples: oatmeal, grapefruit, Examples: oatmeal, grapefruit,
cranberriescranberries• Incorporate air into shortening Incorporate air into shortening
during creamingduring creaming
2005 Oklahoma Cooperative Extension Service 39
Functions of sugar in Functions of sugar in foodsfoods
• Stabilize egg foamsStabilize egg foams• Delay coagulation of egg Delay coagulation of egg
proteins in custardsproteins in custards• Improve appearance & Improve appearance &
tenderness of canned fruitstenderness of canned fruits• Help retain color & flavor of Help retain color & flavor of
frozen fruitsfrozen fruits• Enable wide variety of candies Enable wide variety of candies
through varying degrees of through varying degrees of recrystallizationrecrystallization
• Table sugar is most commonTable sugar is most common•Contains glucose + fructoseContains glucose + fructose• Includes light & dark brown Includes light & dark brown
sugarsugar• Other high sugar ingredientsOther high sugar ingredients•HoneyHoney•Molasses Molasses •Corn syrupCorn syrup•Maple syrupMaple syrup
2005 Oklahoma Cooperative Extension Service 41
Ingredient label words Ingredient label words meaning sugarmeaning sugar
• LactoseLactose• MaltoseMaltose• Other “ose” Other “ose”
wordswords
2005 Oklahoma Cooperative Extension Service 42
More label termsMore label terms
• ““Naturally occurring sugars”Naturally occurring sugars”•Those in food/beverages that Those in food/beverages that
come from ingredients come from ingredients themselvesthemselves•Fruits, vegetables, milkFruits, vegetables, milk
• ““Added sugars”Added sugars”•Added during manufacturing, Added during manufacturing,
cooking, at tablecooking, at table•Sucrose, corn syrup, HFCS, Sucrose, corn syrup, HFCS, honey, molasses, etc.honey, molasses, etc.
2005 Oklahoma Cooperative Extension Service 43
““No sugar added”No sugar added”
• No form of sugar added during No form of sugar added during processingprocessing
• No high-sugar ingredientsNo high-sugar ingredients• May still be high in carbohydrateMay still be high in carbohydrate• Read Nutrition Facts panelRead Nutrition Facts panel
2005 Oklahoma Cooperative Extension Service 44
Food Categories% of total added sugars consumed
Regular soft drinks 33.0
Sugars and candy 16.1
Cakes, cookies, pies 12.9
Fruit drinks 9.7
Dairy desserts & sweetened milk foods
8.6
Other grains 5.8
Major sources of addedsugars in U.S. diet
Source: Dietary Guidelines for Americans 2005
2005 Oklahoma Cooperative Extension Service 45
FructoseFructose• A monosaccharideA monosaccharide• Added to foods in liquid or Added to foods in liquid or
crystalline formcrystalline form•Crystalline form made from Crystalline form made from
corn starchcorn starch
2005 Oklahoma Cooperative Extension Service 46
Liquid form: High fructose Liquid form: High fructose corn syrup (HFCS)corn syrup (HFCS)
• Glucose + fructoseGlucose + fructose• Made from corn syrupMade from corn syrup• Examples: Examples: •HFCS 42 used in baking (42% HFCS 42 used in baking (42%
fructose)fructose)•HFCS 55 used in beverages HFCS 55 used in beverages
(55% fructose)(55% fructose)
2005 Oklahoma Cooperative Extension Service 47
HFCS & foodsHFCS & foods• Amount eaten has risen in parallel Amount eaten has risen in parallel
with increasing obesitywith increasing obesity•Does not prove HFCS causes Does not prove HFCS causes
obesityobesity•Proportion of total sugar in diet Proportion of total sugar in diet
has remained constant since 1970 has remained constant since 1970 (15-16%)(15-16%)•Table sugar has gone downTable sugar has gone down
• Total caloric intake rose from 3300 Total caloric intake rose from 3300 to 3900/person from 1970-2000to 3900/person from 1970-2000•Based on availability dataBased on availability data
• Don’t affect blood sugar levelsDon’t affect blood sugar levels• Some foods containing artificial Some foods containing artificial
sweeteners can still affect blood sweeteners can still affect blood sugar because of other sugar because of other carbohydrates or proteins in the carbohydrates or proteins in the foodsfoods
• Foods containing artificial Foods containing artificial sweeteners may be sugar-free but sweeteners may be sugar-free but may not be carbohydrate-freemay not be carbohydrate-free
• Compare carb content of sugar-Compare carb content of sugar-free with standard foodfree with standard food•Big difference—may be reason Big difference—may be reason
to buy sugar-freeto buy sugar-free•Little difference—base choice Little difference—base choice
on taste, coston taste, cost
2005 Oklahoma Cooperative Extension Service 50
Potential benefits to Potential benefits to diabeticsdiabetics
• Offer way to control caloric intakeOffer way to control caloric intake• Help with weight control & weight Help with weight control & weight
lossloss•Help reduce calorie intake & Help reduce calorie intake &
therefore help lose weighttherefore help lose weight• Provide greater variety of low Provide greater variety of low
calorie foods & beveragescalorie foods & beverages•Easy to incorporated into dietEasy to incorporated into diet
2005 Oklahoma Cooperative Extension Service 51
ProductCalories
withSugar
With Low-Cal. Sweeten
er
Cal.Save
d
Soft drink (12 oz.)
150 0 150
Coffee (1 cup) 35 5 30
Strawberry yogurt(1 cup)
230 100 130
Vanilla ice cream(1/2 cup)
170 90 80
Gelatin dessert(1/2 cup)
70 10 60
Chocolate pudding(1/2 cup)
160 80 80
2005 Oklahoma Cooperative Extension Service 52
Low-calorie sweetenersLow-calorie sweeteners
• Sweet taste with few or no Sweet taste with few or no caloriescalories
• Undergo extensive safety testingUndergo extensive safety testing• All FDA-approved meet same All FDA-approved meet same
safety standardsafety standard• Will not perform most of sugar’s Will not perform most of sugar’s
functions in recipesfunctions in recipes
2005 Oklahoma Cooperative Extension Service 53
Currently approved low-Currently approved low-calorie sweetenerscalorie sweeteners
SweeteneSweetenerr
Brand namesBrand names Times sweeter Times sweeter than sucrosethan sucrose
• Incompletely metabolized & Incompletely metabolized & absorbed so body gets fewer absorbed so body gets fewer caloriescalories•1.5 to 3 calories/gram1.5 to 3 calories/gram
• Often combined with low-calorie Often combined with low-calorie sweetenerssweeteners
2005 Oklahoma Cooperative Extension Service 58
Occurrence of sugar Occurrence of sugar alcoholsalcohols
• Naturally in fruits & vegetablesNaturally in fruits & vegetables• Commercially produced from Commercially produced from
sucrose, glucose, starchsucrose, glucose, starch
2005 Oklahoma Cooperative Extension Service 59
Functions in foodFunctions in food
• Add bulk & textureAdd bulk & texture•Replace sugar 1:1Replace sugar 1:1•Also used to replace fatAlso used to replace fat
• Provide cooling effect or tasteProvide cooling effect or taste• Inhibit browning that occurs Inhibit browning that occurs
during heatingduring heating• Retain moisture in foodRetain moisture in food• Lower calories in foodLower calories in food
ErythritolErythritol 0.20.2 60-80%60-80%Bulk sweetener Bulk sweetener in low calorie in low calorie foodsfoods
HydrogenatHydrogenated starch ed starch hydrolysatehydrolysates (HSH)s (HSH)
3.03.0 25-30%25-30%
Bulk sweetener Bulk sweetener in low calorie in low calorie foods, provide foods, provide sweetness, sweetness, texture & bulk to texture & bulk to variety of variety of sugarless foodssugarless foods
• Must include names on ingredient Must include names on ingredient list list
• Nutrition FactsNutrition Facts•Company may declare Company may declare voluntarilyvoluntarily
the number of grams/serving the number of grams/serving •If more than 1 in food, must If more than 1 in food, must use phrase “sugar alcohol”use phrase “sugar alcohol”
•RequiredRequired if “sugar-free” or “no if “sugar-free” or “no sugar added” claim is madesugar added” claim is made
2005 Oklahoma Cooperative Extension Service 64
Modifying sugar in Modifying sugar in recipesrecipes
• Identify ingredient(s) to changeIdentify ingredient(s) to change•Sugar, brown sugar, honey, Sugar, brown sugar, honey,
molasses, corn syrup, maple molasses, corn syrup, maple syrupsyrup
• Consider function in recipeConsider function in recipe• Options Options
1.1.Leave it aloneLeave it alone2.2.Reduce amountReduce amount3.3.Replace with other sweetenerReplace with other sweetener4.4.Leave it outLeave it out
2005 Oklahoma Cooperative Extension Service 65
General suggestionsGeneral suggestions• Baked goods & desserts: cut by 1/4-Baked goods & desserts: cut by 1/4-
1/21/2• In quick bread, cookies, pie In quick bread, cookies, pie
fillings, custard, puddings, & fruit fillings, custard, puddings, & fruit crispscrisps
•Less desirable for some cakesLess desirable for some cakes•Don’t decrease sugar in plain Don’t decrease sugar in plain
yeast breadsyeast breads• Increase sweet spices, vanillaIncrease sweet spices, vanilla•Raises impression of sweetnessRaises impression of sweetness
2005 Oklahoma Cooperative Extension Service 66
General suggestionsGeneral suggestions
• Decrease or Decrease or eliminate sugar eliminate sugar when canning &/or when canning &/or freezing fruits freezing fruits
• Use unsweetened Use unsweetened frozen fruit or frozen fruit or fruit canned in fruit canned in juice or waterjuice or water
2005 Oklahoma Cooperative Extension Service 67
Complex carbohydratesComplex carbohydrates
• StarchStarch• Primary part of:Primary part of:•Grains (bread, rice, Grains (bread, rice,
Reducing carbohydrates in Reducing carbohydrates in traditional foodstraditional foods
• Has been done Has been done in breads, pasta, in breads, pasta, cereals, cookies, cereals, cookies, cakes, juice, soft cakes, juice, soft drinks, candydrinks, candy
2005 Oklahoma Cooperative Extension Service 69
Methods to reduce Methods to reduce carbohydratescarbohydrates
• Increase amount of animal or Increase amount of animal or vegetable proteinvegetable protein•Replacing wheat or corn flour Replacing wheat or corn flour
with soy flourwith soy flour•Examples: soy-based chips, Examples: soy-based chips,
pasta, breadspasta, breads
2005 Oklahoma Cooperative Extension Service 70
Methods to reduce Methods to reduce carbohydratescarbohydrates
• Increasing fiberIncreasing fiber•Example: fiber such as Example: fiber such as
cellulose replaces digestible cellulose replaces digestible form of carbohydrateform of carbohydrate
•Used in candy, cereals, bread, Used in candy, cereals, bread, pastapasta
2005 Oklahoma Cooperative Extension Service 71
Methods to reduce Methods to reduce carbohydratescarbohydrates
• Sugar substitutes or Sugar substitutes or sugar alcohols (polyols) sugar alcohols (polyols) used in place of used in place of traditional sweetenerstraditional sweeteners•Used in soft drinks, Used in soft drinks,
fruit drinks, baked fruit drinks, baked goods, frozen dessertsgoods, frozen desserts
2005 Oklahoma Cooperative Extension Service 72
Methods to reduce Methods to reduce carbohydratescarbohydrates
• Smaller portionsSmaller portions•Used for baked goodsUsed for baked goods•Bread—thinner Bread—thinner slicesslices
•Desserts—smaller Desserts—smaller pieces or pieces or less/single serving less/single serving containercontainer
2005 Oklahoma Cooperative Extension Service 73
Dietary fiberDietary fiber
• Excellent source contains five Excellent source contains five grams or more/servinggrams or more/serving
• A good source contains 2.5—4.9 A good source contains 2.5—4.9 grams/servinggrams/serving
2005 Oklahoma Cooperative Extension Service 74
Ingredients that indicate Ingredients that indicate fiberfiber
• Fruits & vegetables, especially Fruits & vegetables, especially those with edible skin (apples, those with edible skin (apples, beans) & those with edible seeds beans) & those with edible seeds (berries, summer squash)(berries, summer squash)•Fresh, frozen, canned, driedFresh, frozen, canned, dried
2005 Oklahoma Cooperative Extension Service 75
Terms & ingredients that Terms & ingredients that indicate fiber in grainsindicate fiber in grains
• Keep peel on fruits & vegetablesKeep peel on fruits & vegetables• Add extra produce to casseroles, Add extra produce to casseroles,
soups, salads & other dishessoups, salads & other dishes• Add produce to muffins, Add produce to muffins,
pancakes & dessertspancakes & desserts• Substitute whole-wheat flour for Substitute whole-wheat flour for
1/2 of all-purpose flour in making 1/2 of all-purpose flour in making breads, muffins, pancakes, other breads, muffins, pancakes, other grain productsgrain products
Replacing fats: Replacing fats: Systems approachSystems approach
• May require more than one May require more than one ingredientingredient
• Synergistic components used to Synergistic components used to reach functional & sensory reach functional & sensory characteristics of full-fat versioncharacteristics of full-fat version
• Micropaticulated protein: Micropaticulated protein: SimplesseSimplesse•From whey, milk or egg proteinFrom whey, milk or egg protein•Digested as proteinDigested as protein
• Modified whey protein Modified whey protein concentrate: Dairy-Loconcentrate: Dairy-Lo•Heat denatured proteinHeat denatured protein
• Other: K-Blazer, Ultra-Bake, Other: K-Blazer, Ultra-Bake, Ultra-Freeze, LitaUltra-Freeze, Lita•Use different process or base Use different process or base
• Cellulose: purified & ground to Cellulose: purified & ground to microparticles that form network microparticles that form network with mouthfeel & flow of fatwith mouthfeel & flow of fat
•Passes through body Passes through body undigestedundigested
•Stable under high heat Stable under high heat •Approved in salty snacks & Approved in salty snacks & crackerscrackers
2005 Oklahoma Cooperative Extension Service 92
OlestraOlestra
• May reduce absorption of fat May reduce absorption of fat soluble vitamin & carotenoids soluble vitamin & carotenoids eaten at same time as olestra eaten at same time as olestra containing foodcontaining food
• Label cautions:Label cautions:•Some people may experience Some people may experience
temporary digestive effectstemporary digestive effects•Vitamins A, D, E, K have been Vitamins A, D, E, K have been
• Cream, whole milk: evaporated fat-Cream, whole milk: evaporated fat-free milk or chicken broth thickened free milk or chicken broth thickened with cornstarch or flourwith cornstarch or flour
• Butter: soft tub margarineButter: soft tub margarine• Cheese: non-fat or low fat cheeses Cheese: non-fat or low fat cheeses
or 1/2 original cheese & ½ low fat or or 1/2 original cheese & ½ low fat or replace with reduced amount of replace with reduced amount of sharper cheesesharper cheese
• Meat: use lower fat cut or meat, or Meat: use lower fat cut or meat, or replace with soy-based substitutereplace with soy-based substitute
• Ice cream: lowfat or fat-free Ice cream: lowfat or fat-free versionsversions
• Whole eggs: 2 egg whites for each Whole eggs: 2 egg whites for each whole egg or egg substituteswhole egg or egg substitutes
• Sour cream: mix nonfat yogurt Sour cream: mix nonfat yogurt with light sour cream, or nonfat with light sour cream, or nonfat sour cream or plain lowfat or sour cream or plain lowfat or nonfat yogurtnonfat yogurt
• Whipped cream: nonfat or lowfat Whipped cream: nonfat or lowfat versions of commercial productsversions of commercial products
2005 Oklahoma Cooperative Extension Service 95
Low fat guidelines for Low fat guidelines for recipesrecipes
• For recipe to be low fat, 1 serving should For recipe to be low fat, 1 serving should have 10g fat or less for main dish, & 5g have 10g fat or less for main dish, & 5g or less for dessert, side dish, snack or less for dessert, side dish, snack
• 1 teaspoon fat = 5g so look at total oil or 1 teaspoon fat = 5g so look at total oil or margarine in recipe & number of servingsmargarine in recipe & number of servings• 1 cup of oil = 48 teaspoons1 cup of oil = 48 teaspoons• To be “low fat” recipe with 1 cup oil To be “low fat” recipe with 1 cup oil
needs to serve 48 as side dish, 24 as needs to serve 48 as side dish, 24 as main dishmain dish
2005 Oklahoma Cooperative Extension Service 96
Low fat guidelines for Low fat guidelines for recipesrecipes
• Recipes with more than 1/2 cup Recipes with more than 1/2 cup fat are probably too high in fat fat are probably too high in fat to bother trying to modifyto bother trying to modify
• Take recipe with 1/2 cup or less Take recipe with 1/2 cup or less & cut fat by half& cut fat by half•May need additional liquidMay need additional liquid•Use skim milk, water, fruit Use skim milk, water, fruit juices as appropriatejuices as appropriate
2005 Oklahoma Cooperative Extension Service 97
Low fat guidelines for Low fat guidelines for recipesrecipes
• If cutting fat in 1/2 worked well, If cutting fat in 1/2 worked well, next time cut fat a little more, next time cut fat a little more, until product has right amount of until product has right amount of fat per serving & still tastes fat per serving & still tastes good good
• Replace only 1 source of fat at a Replace only 1 source of fat at a timetime
• Reduce fat slowly to level where Reduce fat slowly to level where changes are unacceptablechanges are unacceptable
• Choices if changes are Choices if changes are unsatisfactoryunsatisfactory•Have favorite recipe less oftenHave favorite recipe less often•Cut down on serving sizeCut down on serving size•Serve dish with lowfat foodsServe dish with lowfat foods
from the Center for Science in the Public from the Center for Science in the Public InterestInterest
• Health trends caused byHealth trends caused by•Pressure to sell healthPressure to sell health•Obesity, trans fat, whole grainsObesity, trans fat, whole grains
•Replacing carbsReplacing carbs•FDA allows more health claims FDA allows more health claims
on foodson foods•““scientific evidence scientific evidence suggests…”suggests…”
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1. More whole grains1. More whole grains
• General Mills: All GM Cereals are General Mills: All GM Cereals are made with WHOLE GRAIN!made with WHOLE GRAIN!•Example: TrixExample: Trix
• Means some, not all flour, flour Means some, not all flour, flour is whole grainis whole grain•Still high in sugarStill high in sugar
2005 Oklahoma Cooperative Extension Service 101
2. Less sugar2. Less sugar• Sugar-free Milanos, Sugar-free Milanos, SnackWell’s SnackWell’s
Sugar-Free Fudge BrownieSugar-Free Fudge Brownie & & oatmeal cookies label: “not for oatmeal cookies label: “not for weight control”weight control”
• Ask: Ask: • Is it lower in calories?Is it lower in calories?•Has the serving size changed?Has the serving size changed?•Does it use only Splenda?Does it use only Splenda?• Is it nutrient dense?Is it nutrient dense?
2005 Oklahoma Cooperative Extension Service 102
3. No 3. No transtrans fat fat• Hershey’s Chocolate Dipped Hershey’s Chocolate Dipped
cookies have no trans fat but 5g cookies have no trans fat but 5g saturated fat/servingsaturated fat/serving
• Ask:Ask:•Did it ever have any?Did it ever have any?• Is it high in saturate fat?Is it high in saturate fat?• Is it really trans-free?Is it really trans-free?•““free” = 0.5g or lessfree” = 0.5g or less•If 0.49/serving x 3 = 1.47gIf 0.49/serving x 3 = 1.47g
2005 Oklahoma Cooperative Extension Service 103
4. More functional fiber4. More functional fiber
• Fiber in Dannon yogurt fiber Fiber in Dannon yogurt fiber from maltodextrin—3g/1/2 cupfrom maltodextrin—3g/1/2 cup
• Breyer’s CarbSmart ice cream Breyer’s CarbSmart ice cream fiber from polydextrosefiber from polydextrose
• Many breads raise fiber with Many breads raise fiber with cellulose from oat hull fiber, cellulose from oat hull fiber, wheat fiber, pea fiber, soy fiber, wheat fiber, pea fiber, soy fiber, cottonseed fiber, wood pulpcottonseed fiber, wood pulp
• Most are low in phyotchemicalsMost are low in phyotchemicals
2005 Oklahoma Cooperative Extension Service 104
4. Functional fiber4. Functional fiber
• AskAsk•How much fiber?How much fiber?• Is it naturally occurring fiber?Is it naturally occurring fiber?•Studies on benefits generally Studies on benefits generally use dietary, not functionaluse dietary, not functional
•Could it cause cramps or Could it cause cramps or diarrhea?diarrhea?•Sugar alcohols maySugar alcohols may
2005 Oklahoma Cooperative Extension Service 105
5. Weaker claims5. Weaker claims
• FDA allows qualified claims FDA allows qualified claims “scientific evidence suggests,” not “scientific evidence suggests,” not “proves”“proves”•Claims based on weaker evidenceClaims based on weaker evidence•Example: Example: Kashi Heart to HeartKashi Heart to Heart
• Added to pasta from ground Added to pasta from ground flaxseedflaxseed•Example: Barilla Plus pastaExample: Barilla Plus pasta
• Also found in margarine spreads, Also found in margarine spreads, breads, eggs, barsbreads, eggs, bars
• Other ALA sources include Other ALA sources include walnuts, canola & soy oilswalnuts, canola & soy oils
2005 Oklahoma Cooperative Extension Service 107
6. More omega-3 fats6. More omega-3 fats
• Problem: flaxseed high in alpha-Problem: flaxseed high in alpha-linolenic (ALA) acid not a longer-linolenic (ALA) acid not a longer-chain omega-3’s chain omega-3’s eicosapentaenoic acid (EPA) & eicosapentaenoic acid (EPA) & docosahexaenoic acid (DHA)docosahexaenoic acid (DHA)•Not clear if ALA lowers sudden Not clear if ALA lowers sudden
death heart attack risk like death heart attack risk like EPA, DHAEPA, DHA
2005 Oklahoma Cooperative Extension Service 108
7. Self-styled symbols7. Self-styled symbols
• Companies highlight healthier Companies highlight healthier productsproducts•Example: Life cerealExample: Life cereal•““Smart Choices Made Easy” logoSmart Choices Made Easy” logo•Kraft products may have “Sensible Kraft products may have “Sensible
program has 5 logosprogram has 5 logos• Problem: companies develop own Problem: companies develop own
criteria for healthy foodscriteria for healthy foods
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8. More phytosterols8. More phytosterols
• Natural compounds in small Natural compounds in small amounts in fruits, vegetables, nuts amounts in fruits, vegetables, nuts & beans& beans•At high levels can lower LDL At high levels can lower LDL
cholesterol about 10%cholesterol about 10%• Example: YoplaitExample: Yoplait• Ask: Ask: •How much per serving? (at least How much per serving? (at least
0.8g)0.8g)•Over 3/day, no increased effectOver 3/day, no increased effect
• Added liberally to cereals, Added liberally to cereals, breakfast barsbreakfast bars
• Example: Kellogg’s Smart StartExample: Kellogg’s Smart Start• Ask:Ask:•Do you need it?Do you need it?•Are you getting too much?Are you getting too much?• Is it nutrient dense?Is it nutrient dense?
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10. Repackaging10. Repackaging
• Smaller servings of foodsSmaller servings of foods•Pre-portioned packs inside a Pre-portioned packs inside a
large containerlarge container•Example: Oreo Thin CrispsExample: Oreo Thin Crisps
• Ask: Ask: • Is it nutrient dense?Is it nutrient dense?•How much does packaging cost?How much does packaging cost?• Is this environmentally friendly?Is this environmentally friendly?
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11. Low-glycemic foods11. Low-glycemic foods• Next big fad???Next big fad???• Glycemic index measures speed Glycemic index measures speed
carbohydrate is digested & carbohydrate is digested & raised blood sugarraised blood sugar•Refined grains/sugars are highRefined grains/sugars are high•Whole grains are lowWhole grains are low
• New products introducedNew products introduced•2 in 19992 in 1999•175 in 2004175 in 2004
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Eating out with diabetesEating out with diabetes
• Requires planning, wise choicesRequires planning, wise choices• Work with health care team to Work with health care team to
identify goalsidentify goals•Know how to make changes in Know how to make changes in
meal plan if restaurant doesn’t meal plan if restaurant doesn’t have what you wanthave what you want
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How to order at How to order at restaurantsrestaurants
• Phone aheadPhone ahead•Ask to see menu—what fits planAsk to see menu—what fits plan•Are changes possible? Are changes possible?
• Be assertive, ask questions about Be assertive, ask questions about food, ingredients, preparationfood, ingredients, preparation
• Try to eat same portions as at Try to eat same portions as at homehome•Share, to-go container, leave on Share, to-go container, leave on
plateplate
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How to order at How to order at restaurantsrestaurants
• Get meat & fishGet meat & fish•Broiled without added fatBroiled without added fat•No breaded & fried—peel off if No breaded & fried—peel off if
can’t avoidcan’t avoid• Order baked potatoes plain & Order baked potatoes plain &
add:add:•1 tsp. margarine or low-cal 1 tsp. margarine or low-cal
sour cream and/or vegetable sour cream and/or vegetable from salad bar or menufrom salad bar or menu
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How to order at How to order at restaurantsrestaurants
• Ask for no added saltAsk for no added salt• ““On the side”—sauces, On the side”—sauces,
dressings, graviesdressings, gravies• Read menu creativelyRead menu creatively•Fruit cup for appetizerFruit cup for appetizer•Breakfast melon for dessertBreakfast melon for dessert•Combine salad with low fat Combine salad with low fat
appetizer as entréeappetizer as entrée
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How to order at How to order at restaurantsrestaurants
• Substitute or omit: Substitute or omit: double vegetables double vegetables instead of fries or ask instead of fries or ask for no friesfor no fries
• Ask for low fat version Ask for low fat version of dressing, margarine, of dressing, margarine, milkmilk
• Limit alcohol to cut Limit alcohol to cut caloriescalories
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Eat on timeEat on time
• Ask others to eat at Ask others to eat at your regular timeyour regular time
• Plan to avoid Plan to avoid waiting for a tablewaiting for a table
• Be on time for Be on time for reservationreservation
• Do special dishes Do special dishes take extra time?take extra time?
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Eat on timeEat on time
• If late lunch eat If late lunch eat fruit or starch fruit or starch serving from that serving from that meal at usual timemeal at usual time
• For very late dinner For very late dinner eat bedtime snack eat bedtime snack at usual dinner timeat usual dinner time•May need to May need to
adjust insulinadjust insulin
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Fast food in AmericaFast food in America
• 47% of money spent on food will 47% of money spent on food will be spent at restaurants in 2005be spent at restaurants in 2005
• Healthy food is not trend at fast Healthy food is not trend at fast food restaurants—healthy is for food restaurants—healthy is for homehome•““Taste” important to 93.6%Taste” important to 93.6%•““Healthy” important to 69.1%Healthy” important to 69.1%
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Fast food in AmericaFast food in America
• Fried chicken Fried chicken fastest-fastest-growing food growing food category in category in 20042004
• Watch for “big” Watch for “big” words or words or “double”“double”
• Choose buns, Choose buns, bread, English bread, English muffinsmuffins
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Ordering fast foodOrdering fast food
• Choose thin Choose thin crust pizza with crust pizza with veggiesveggies
• Limit dressings Limit dressings on salads & on salads & high-fat salad high-fat salad bar itemsbar items
• Limit cheeseLimit cheese
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Today youToday you
• Examined features of food labels Examined features of food labels important for diabetics to read & important for diabetics to read & understandunderstand
• Looked at functions of ingredients Looked at functions of ingredients in food & substitutions available on in food & substitutions available on the marketthe market
• Received tips for recipe Received tips for recipe modificationmodification
• Learned suggestions for eating out Learned suggestions for eating out with diabeteswith diabetes