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12
DIET DETAILS
Planning the Diabetic’s Meals
If your doctor, dietician or health educator has helped you plan your diet, you may want to skip this chapter.
On the other hand, if you want to know how a diabetic diet is planned, you may wish to read on. In fact, whether or not you have diabetes, you can use the following steps to find out what you should be eating each day:
1.Figure out your ideal body weight. Your doctor or nurse will likely tell you what your ideal weight is. Tables such as the one on the next page also provide an easy-to-see estimate of your ideal weight. But just in case you wish to calculate your ideal weight yourself, here is a general guideline.
Men: At 5 feet (152cm.) tall = *110 pounds (50 kg.)
Women: At 5 feet (152 cm.) tall = *105 pounds (47 kg.)
For every 1 inch over 5 feet tall, add 5 pounds.
For every 1 inch under 5 feet tall, subtract 5 pounds.
*These figures are for a person with a medium build.
If you have a large bone frame, add
10 percent; if you have a small bone frame, subtract 10-15 percent.
For example, if a woman with a small bone frame is 5 feet 3 inches (160 cm.) tall, you could figure her ideal weight as follows:
A woman of 5 feet should be 105 pounds,
+ 3 inches x 5 pounds (add 15 pounds)
= 105 + 15 = 120
-10 percent for small frame (120 x .10 = 12)
= 120 – 12 = 108
Her ideal weight is approximately 108 pounds (49 kg.).
Desirable Weight for Men
Small Medium Large
Height Frame Frame Frame
Feet-Inches Cm. Pounds Kg. Pounds Kg. Pounds Kg.
5 1 155 126-132 58 129-139 60 136-148 63
5 2 157.5 128-134 59 131-141 61 138-150 65
5 3 160 130-136 60 133-143 62 140-153 66
5 4 162.5 132-138 61 135-145 63 142-156 68
5 5 165 134-140 62 137-148 64 144-160 69
5 6 167.5 136-142 63 139-151 65 146-164 70
5 7 170 138-145 64 142-154 67 149-168 72
5 8 172.5 140-148 65 145-157 68 152-172 73
5 9 175 142-151 67 148-160 70 155-176 74
5 10 177.5 144-154 68 151-163 71 158-180 77
5 11 180 146-157 69 154-166 72 161-184 79
6 0 183 149-160 70 157-170 74 164-188 80
6 1 185.5 152-164 72 160-174 76 168-190 81
6 2 188 155-168 74 164-178 77 172-197 83
Desirable Weight for Women
Small Medium Large
Height Frame Frame Frame
Feet-Inches Cm. Pounds Kg. Pounds Kg. Pounds Kg.
4 10 147.5 102-111 47 109-121 52 118-131 56
4 11 150 103-113 49 111-123 53 120-134 57
5 0 152.5 104-115 50 113-126 54 122-137 58
5 1 155 106-118 51 115-129 55 125-140 60
5 2 157.5 108-121 52 118-132 56 128-143 61
5 3 160 111-124 53 121-135 58 131-147 63
5 4 162.5 114-127 54 124-138 59 134-151 65
5 5 165 117-130 56 127-141 61 137-155 67
5 6 167.5 120-133 57 130-144 62 140-159 68
5 7 170 123-136 59 133-147 63 143-163 69
5 8 172.5 126-139 60 136-150 65 146-167 70
5 9 175 129-142 61 139-153 66 149-170 72
5 10 177.5 132-145 63 142-146 68 152-173 73
5 11 180 135-148 64 145-159 69 155-176 74
2.Determine your level of activity. Decide how active you are in your daily work, whether you have “light activity”, “moderate activity” or “heavy activity”. The following lists may help to give you some idea of where you fit.
Light Activity
75 percent of your time sitting or standing and
only 25 percent moving around
office worker
sales clerk
taxi driver
tailor
most professionals—doctors, lawyers, accountants, architects
some teachers and students
unemployed men
housewives with mechanical appliances
Moderate Activity
25 percent of your time sitting or standing and
75 percent doing some work
hospital nurses
housewives who wash clothes and clean the floors by hand
waiters
carpenters
plumbers
fishermen
most farm workers and gardeners
soldiers not on active service
students who take physical education classes
some teachers
Heavy Activity
40 percent of your time standing or sitting and
60 percent doing some work
New army recruits
some soldiers in active service
some farm workers
unskilled laborers
construction workers
house painters
mine and steel workers
most full-time athletes
3.Figure out how many calories you need each day. After you know your ideal weight and your activity level, you can calculate your daily calorie needs as follows:
Daily Calorie Needs
Multiply your ideal body weight (in pounds) by 10.
Multiply your ideal body weight (in pounds)
by your activity level factor:
Light activity ------ x 3
Moderate activity ------ x 5
Heavy activity ------ x 10
For example, if a man is 5 feet 8 inches tall (173 cm.), his ideal body weight would be 150 pounds (68 kg.). If he is moderately active, you can figure out his daily calorie needs as follows:
Multiply his ideal body weight, 150, times 10:
150 x 10 = 1,500
Then multiply his ideal body weight, 150,
times his activity level factor,
5 (moderately active):
150 x 5 = 750
Add the two figures together for his total
daily calorie needs:
1,500 + 750 = 2,250 calories needed for the day.
These guidelines are suitable for the average adult. Children and teenagers are usually more active, and so their calorie requirements must be adapted to their individual needs. Likewise, in their older years people often slow down, so calorie requirements are likely to become less with advancing age.
Women who are pregnant or who are breastfeeding also have special needs. There are certain dangers in the old belief that a pregnant or nursing woman is “eating for two”. And yet she really does need more nutrition in order to meet the needs of a growing baby.
During pregnancy, a woman should take an additional 300 calories each day. After deliver, if she is breastfeeding her baby, she should take 500 calories more than her usual daily requirement. These extra calories should be in the form of good, nutritious food, and should be balanced according to the recommended percentages of carbohydrates, proteins and fats.
If a woman is overweight and has been trying to lose weight, during pregnancy is not the time for dieting. She should eat the recommended number of calories during pregnancy and lactation, then go back onto her weight-reduction program after she stops breastfeeding her baby.
4.Calculate the amounts of carbohydrates, proteins and fats needed for one day. The table below summarizes the diabetic’s requirements of the various food types.
Percent of Calories
From Different Sources
Carbohydrates 55-60%
Proteins 15-20%
Fats *25-30%
*Many doctors recommend using a lower percentage of fats
and a higher percentage of carbohydrates.
From this, we can figure out how many calories the diabetic would need to get from kind of food.
Let us look at the example of a 55-year-old diabetic man who is 5 feet 6 inches tall (168 cm.), and who is unemployed and very inactive. Ideally his weight should be about 140 pounds (63.5 kg.), and he should be eating about 1,800 calories per day. Here’s how he should divide up his calories:
Carbohydrate:
60% of 1,800 calories = .60 x 1,800 = 1,080 calories
Protein:
15% of 1,800 calories = .15 x 1,800 = 270 calories
Fat:
25% of 1,800 calories = .25 x 1,800 = 450 calories
___________
Total 1,800 calories
If we wanted to know the weight of carbohydrate foods we could eat in a day, we would divide our carbohydrate calories by four because one gram of carbohydrate gives four calories. One gram of protein gives four calories, so we would divide the protein calorie limit by four to get our daily grams of protein. And since fat is high in calories, with nine calories for every gram, we would divide out fat calorie limit by nine.
Using the same man as our example again, we can calculate as follows:
Carbohydrates:
1,080 divided by 4 = 270 grams per day
Proteins
270 divided by 4 = 65-70 grams per day
Fats
450 divided by 9 = 50 grams per day
5.… Wait a minute! By now you’re probably thinking that this whole process is too much to cope with. This all sounds unbelievably complicated! How can a person ever figure out what to eat?
Certainly it is much too confusing and complicated to weigh every little bit of food you eat and then figure out how much of what foods you should eat. To simplify matters, the American Diabetes Association and other diabetes organizations have developed lists or groupings of “food exchanges” or “food portions”. Diet manuals are available from most diabetes associations showing lists and/or photographs of food exchanges or portions in a simplified manner.
Each list contains foods which are of a similar type and provide about the same number of calories. Any food in a certain list can be exchanged, or substituted, for the specified amount of any other food in the same list. You may notice that the serving sizes vary from one food to the next. This is because foods are so different that they are measured or weighed to ensure that there is the same amount of carbohydrate, protein fat and calories in each food chosen.
5.(Let’s try again!) With a book of exchanges or portions in hand, figure out how many exchanges or portions of carbohydrate and protein you need for one day. Generally speaking, one carbohydrate exchange contains 10 grams of carbohydrates, and one protein exchange contains approximately six grams of protein.
This means that the man we’ve been using as our example, who should have about 270 grams of carbohydrate per day, should have 27 carbohydrate “exchanges” or portions”: (270 grams of carbohydrate needed per day divided by 10 grams per exchange = 27 exchanges). Since he needs 65-70 grams of protein per day, we divide that by six grams per exchange, and we see that he needs about 11-12 protein exchanges in a day.
What about his fat requirement of 50 grams per day? Some doctors do not consider fat in exchanges, especially for type II diabetes, because most people who have type II diabetes actually need to lose weight. The guideline for them is “Avoid free fat, such as butter, margarine, ghee, and other added fats.” The amount of fat your body actually needs is easily supplied by the natural fat in your foods and in the small amount of oil used for cooking. In fact, anyone who is overweight should eat less fried foods, and should steam, boil, or bake foods instead of frying them.
6.Plan how to distribute your carbohydrate and protein exchanges over the whole day’s meals and snacks. Using your exchange or portion lists, simply begin to plan your menu, including any snacks you may need. Just make sure that your daily total for carbohydrate and protein exchanges add up to your recommended amount.
You will soon learn to recognize portion or exchange sizes of all the foods you usually eat. Once you have mastered that, it will be relatively easy for you to quickly estimate how much you should take of each food—whether you are at home or whether you go out to eat.
7.Enjoy your meals! Dining diabetically—or even dining on a diet—can still be delicious and delightful.