Wednesday, October 19, 2011

Diabetes diet , a low tech idea for a low tech problem


This discussion is about an idea that may help with some of the problems of food management and glucose control


Controlling portion size and maintaining consistent daily carbohydrate intake is a major obstacle for many of us and is a big contributor to blood glucose control problems. Todays discussion is about combining two well know ideas ( Lilly's handy guide to portion size and the Mediterranean diet )into one useful tool . This discussion is not about weight loss however weight loss may be a desirable side effect.


I have spent over 30 years looking for a high tech solution to a low tech multiple variable problem ( our food intake). The low tech problem is maintaining consistent carbohydrate intake and controlling portion size . I teased our dietitians by telling them that I was going to find a high tech inexpensive handheld gadget to replace them. I have bought a lot of gadgets over the years and I am happy to report that all of my dietitian friends are still working. I do use one iPhone app , "Carb Master" , occasionally .

I have finally given up on my pursuit of the easy perfect gadget and realize that a low tech solution for a low tech problem may be in the palm of my hand.


The "Handy " guide to portion size found in the Lilly Diabetes -My Carbohydrate guide. combined with some of the ideas found in the Mediterranean diet may help overcome some the problems of controlling portion size and consistent carbohydrate intake.


You could point out that using our hands as a measuring tool is not accurate because we all have different size hands . I think this is actually a plus because smaller people have smaller hands and need smaller a portion sizes than bigger people. Remember we are looking for "Handy " available tool to help us control portion size and maintain a more consistent carbohydrate intake.


I have looked at Lilly's "Handy" guide many times in the past and never really use it until I read an article about applying the Mediterranean to our daily lives. Unfortunately I copied this article and missed the name of the author and the source. I believe it was in webMD . I apologize for my mistake and beg for your permission to use your article.


Two things in this article caught my eye ; nuts: a handful each day and vegetables 2 cups /day reminded me of the Lilly Handy guide to portion size .


The idea that my fist is about the size of a cup ,and my thumb is about the size of a table spoon is fairly easy to remember.


Finding a way to work vegetables into my diet has been difficult for me. Remembering to eat a , 1 fist size serving of legumes , 2 fist size serving of other vegetable a day may just work. I have found that eating a handful of mixed nuts each day may be the easiest part of the Mediterranean diet. It is also easier to measure and spread a thumb size portion of peanut butter on a knife than it is to actually use a tablespoon.You can point out that a serving size is 15 Grams of carbohydrate and the portion size will be different for different vegetables and grains. I cup ( 1 fist size ) is about 30 grams of carbohydrate . Remember we are talking about a guide for help in maintaing a more consistent intake of carbohydrates and and a way of adding some of Mediterranean diet ideas to our diet.

Read the article below and focus on " What you can Eat Section " . Simplifying our approach to food intake may just be the low tech idea that works.


I have attached the Mediterranean diet article and Lilly's Handy guide to portion size below.----------------------------------------------------------------------------------------------------












Try your hand at these guidelines for estimating portion sizes*:

page2image22192.pngA fist is about 1 cup or about 30 grams of carb for foods such as 1 cup ice cream or

1 cup cooked cereal.



page2image20624.pngYour thumb is about
1 tablespoon or 1 serving of regular salad dressing, reduced-fat mayonnaise or reduced-fat margarine.




page2image21216.pngYour thumb tip is about 1 teaspoon or 1 serving of margarine, mayonnaise or other fats such as oils.

These portion estimates are based on a woman’s hand size. Hand sizes vary. Measuring or weighing foods is the most accurate way to figure out a portion size.





page2image19760.pngYour palm, not including fingers and thumb, is about 3 ounces of cooked and boneless meat.



*Adapted from: Warshaw, H.S., Kulkarni, K. Complete Guide to Carb Counting 2nd Edition. Alexandria, VA: American Diabetes Association, 2004; and Wondering How Much to Eat? Do the Hand Jive! Diabetes Spectrum 1999; 12:177-178.



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he Mediterranean Diet: What It Is

Some experts consider the "Mediterranean diet" -- rich in plant foods and monounsaturated fats -- to be one of the healthiest in the world. The Mediterranean diet has long been associated with heart health and longevity. Beyond that, it can also be an excellent weight loss plan, as long as you eat in moderation.

The Mediterranean coastal region stretches across Europe from Spain to the Middle East. Fifty years ago, scientists noticed that people living in this region tended to be healthy and live long lives, primarily because of their diet and lifestyle. Mediterranean cuisine varies by region, but is largely based on vegetables, fruits, olives, beans, whole grains, olive oil, and fish, along with a little dairy and wine. Additionally, the Mediterranean lifestyle includes leisurely dining and regular physical activity.

Studies show that calorie-controlled diets rich in plant foods, healthy fats, and lean protein -- like the Mediterranean diet -- are a nutritious formula for weight loss. A study in the New England Journal of Medicine found that a Mediterranean diet was as effective as a low-fat diet for losing weight and also offered some metabolic benefits.

"Research continues to demonstrate that being physically active and eating a nutritious diet of primarily whole foods that are filling and satisfying can enable people to control weight," says cardiologist Arthur Agatston, MD, creator of the South Beach Diet, which is based on the Mediterranean diet model.

Some other perks of living the Mediterranean lifestyle include a reduced risk of chronic diseases such as diabetes, cancer, Alzheimer's and heart disease, says cardiologist Robert Eckel, MD, past president of the American Heart Association.

Mediterranean Diet: What You Can Eat

There is not a single "Mediterranean diet." Instead, it's a dietary pattern of plant foods, monounsaturated fats (mainly olive oil), fish, and limited amounts of animal products.

The basic Mediterranean diet pattern is as follows:

  • Legumes: Eat daily.
  • Fruit: 2.5 cups daily.
  • Vegetables: 2 cups daily.
  • Fish: More than twice weekly.
  • Nuts: A handful daily.
  • Meat/poultry: Less than 4 ounces daily.
  • Dairy products: 2 cups of a low-fat variety daily.
  • Wine: 1 daily serving for women, two for men.
  • Fats: Use primarily monounsaturated fats.
  • Eggs: Less than 4 per week.

Some tips for embracing the Mediterranean style of eating:

  • Select whole grains for your breads, cereals, and other starches.
  • Choose nuts, seeds, legumes, fish, low-fat dairy, and poultry to satisfy your protein needs (you can include lean meat on occasion as well).
  • Most importantly, reduce the amount of saturated and trans fats in your diet. Use olive or canola oil instead of butter or margarine.
  • If you choose to drink alcohol, enjoy it as a glass of wine with lunch and/or dinner.

"It's almost too good to be true -- a steaming pasta dish with tomato sauce and herbs, or a grilled piece of snapper drizzled with olive oil and fresh cracked pepper, or a great salad of greens, tomatoes, a crumble of Parmesan, and a drizzle of olive oil and lemon," says K. Dun Gifford, Oldways Preservation Trust president. "Scientists report these dishes are as healthy as it gets."


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What do you think about the above idea. ? Do you think it will work ?


Next discussions . How to talk to a dietitian. Have fun , Read food labels . Dr. Calder


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Your comments and questions are appreciated. David Calder,MD