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Ask the Nutritionist Archive, Tuesday, March 4, 2008
Our guest was Elizabeth Pivonka, Ph.D., R.D., and President & CEO of the Produce for Better Health Foundation. March is National Nutrition Month and Elizabeth's main topic will be "Fruits and Veggies: More Matters." ADA_Moderator: Our guest today is Elizabeth Pivonka, Ph.D., R.D., and President & CEO of the Produce for Better Health Foundation. March is National Nutrition Month and Elizabeth's main topic will be "Fruits and Veggies: More Matters." Welcome Elizabeth, thanks for taking the time to be here with us today. Elizabeth: Thanks, it's a pleasure to be here. Mary: Why should I eat more fruits and vegetables?
Elizabeth: Our mothers were right when they told us to eat our fruits and vegetables. They are full of important vitamins and minerals as well as other substances called phytochemicals that can’t be obtained from other foods. Additionally, they are high in fiber and water, which makes them helpful as part of a weight management program because they are filling. Consuming recommended amounts of fruits and vegetables has been associated with lower risk for some diseases including heart diseases, type 2 diabetes, and some cancers. Most adults, depending on age and activity level, need at least 7 servings a day, up to 13 a day or 3 1/2 to 6 1/2 cups per day. We encourage eating ‘more’ because most people are not meeting current recommendations. For more information about how to include more fruits and vegetables in your diet, visit:
Elizabeth: http://www.fruitsandveggiesmorematters.org John_S_: My doctor told me to eat more fiber. I need to lose about 40 pounds. Will fiber really help with this? Elizabeth: The potential advantage for weight loss of consuming foods that are higher in fiber is that they help to promote satiety, or the feeling of fullness and satisfaction after a meal. Additionally, they may help to delay feelings of hunger between meals. Both of these effects may be helpful as part of a weight control program when managing calorie intake. Fruits and vegetables in particular tend to promote satiety because in addition to containing fiber, they have a high water content. Additionally, they are beneficial as part of a weight loss plan because most are low in calories in relation to the volume consumed due to their high water content. High fiber foods should be included as part of a sensible weight loss plan that includes a well-balanced diet that is low in calories and exercise. Increasing intake of fiber alone, either with food or using supplements, is not likely to be effective for weight loss. You can view a list of fruits and vegetables that are high in fiber at http://www.fruitsandveggiesmorematters.org Elizabeth: as well as some delicious recipes to incorporate them into your weight management plan. Michael_Q_: What fruits and veggies are good for person with diabetes to eat? Elizabeth: All fruits and vegetables can fit into a meal plan for diabetes. Starchy vegetables such as potatoes and peas, and fruits may need to be considered for their carbohydrate content. Additionally, some canned fruits that are packed in syrup and sweetened frozen fruits will have more carbohydrate from the sugar. Unsweetened frozen fruits and canned fruits packed in juice or water are usually better choices for a diet for diabetes. The food label will tell you how much there is per serving. I suggest you discuss meal planning for diabetes with a registered dietitian or certified diabetes educator who can help you with food selection to manage your blood sugar. Peoria: Since carrots have a high glycemic index, I've been avoiding them. Can I start eating them now? Elizabeth: Different factors will influence glycemic response to different foods such as the amount consumed, whether it is eaten alone or with other foods, and what type of foods it is consumed with. Blood sugar responses to foods are very individual. It is fine to include carrots in your diet. You should account for the carbohydrate in the portion consumed, and be aware of your individual blood sugar response to eating carrots, as well as other foods. And just to clarify - carrots have been retested and actually have a low GI - they are not a high GI food after all! Rebecca: What fruits would be good to put in a fruit basket for a person with diabetes? Elizabeth: Any fruit would be fine to put into a fruit basket for a person with diabetes. All fruits can be included in a diet for diabetes with proper meal planning and by including an appropriate portion. If you are including canned fruits, those that are packed in water or juice are best. Juices should be 100% fruit juice, which will be indicated on the label. JSPAW: Fruits and Veggies HOW MUCH CAN YOU EAT A DAY Elizabeth: With fruits and vegetables, overall more is better for good health. With diabetes, you need to be aware of the carbohydrate that you are taking in - so you need to keep track. Elizabeth: I can't tell you exactly how much you can eat, but it would be very difficult to eat too many non-starchy vegetables that are low in carbohydrate like spinach, brocoli, mushrooms, zucchini, peppers, celery, cabbage, cucumber, lettuce and many others. Elizabeth: As for the other types like starchy vegetables or fruits, use them as part of your carbohydrate allowance. Fruit makes a great dessert and will save you a lot of calories and carbohydrate in the end. Ann: I need to know how much fruits & veggies & meats I can have a day and stay under 2,000 calories recommended for type 2 diabetes I am 72 years old . Please help if you can. Thank You. Elizabeth: Your best bet is to consult a registered dietitian or a certified diabetes educator who can design a meal plan for you based on your individual medical needs and with consideration of medications you may be taking for diabetes. Your physician may be able to recommend someone for you, or you can find a dietitian at http://www.eatright.org. You can also find a diabetes education program near you at http://professional.diabetes.org/erp_list.aspx boo: How many servings of vegetables is in a V8? Elizabeth: A serving of vegetable juice like V8 is 4 ounces or 1/2 cup. Helen_M_: what type of veggies are best for diabetics? can you please advise me of some recipes for breakfast, dinner and supper thanks. Elizabeth: All veggies are appropriate to include in a diet for diabetes. Some veggies have more carbohydrate than others, such as potatoes, peas and corn. Depending on how you are managing your diet, you will need to account for including them in your diet – either the grams of carbohydrate per serving or as a serving of Vegetable or Starch from the Exchange Lists. The American Diabetes Association suggest that as a general rule for meal planning, you start with 45-60 grams of carbohydrate at a meal. You may need more or less, but it is a place to start. For more fine tuning, I'd recommend you try to see a Registered Dietitian or a CDE. I provided links to find them previously. You can find some great recipes for fruits and vegetables at our webstite http://www.fruitsandveggiesmorematters.org under our cooking section. Rae: Are there certain fruits/veggies that are more appropriate at different times of the day for digestion and proper usage/conversion in our bodies to increase the effectiveness of eating them? Elizabeth: There is no magic combination of fruits and vegetables for digestion. The ideal is to eat a variety throughout the day to maximize the phytonutrients that you get from the different types. RichPanda91744: My question for Elizabeth: I have been put on a low-potassium diet for the next six weeks in preparing for a potassium test. Are nectarines, peaches, berries and apples good fruit alternatives? And are steamed veggies instead of raw allowable? Elizabeth: Peaches, nectarines, and some berries will provide potassium. A small peach or nectarine has around 250 milligrams of potassium. One cup of strawberries has 220 milligrams, but 1 cup of blueberries only has 114 milligrams and one small apple has 159. Compare this to other good sources of potassium such as a small banana, which has 362 milligrams, ¼ cup of dried apricots which have 378 milligrams, and ½ cup of cooked broccoli, which has 293 milligrams. Cooking does not affect the potassium content of foods, but since vegetables cook down, there is a smaller volume after cooking. Visit www.fruitsandveggiesmorematters.org to see other fruits and veggies that are good sources of potassium. Tommy: I would like to know if there are any cooking methods that could alter the glycemic index of a food. I don't want to turn it into a fruit/vegetable that could spike my glucose. example: corn to creamed corn raises the glycemic index of a food. What types of cooking do I need to be aware of so I don't change the composition of a food without knowing it. I've heard that pasta cooked al dente and pasta that has been cooked longer each have a different glycemic index. Does this situation apply to preparation of fruits and vegetables? Elizabeth: Most non-starchy vegetables have so little carbohydrate that they are not tested and do not have a glycemic index (GI). For starchy vegetables, the more you cook them or mash them (similar to pasta) the higher the GI will be. There are different varieties of potatoes and their GI varies as well. The lowest GI starchy vegetables are legumes or beans, corn, sweet potato, taro and yam - all of these have a low GI. Remember also that once you mix the vegetables with other foods, the glycemic response changes. dport: what is the best vegetable to eat? Elizabeth: All vegetables, including beans/legumes, are good for you. Each vegetable has it’s own unique set of vitamins, minerals, and phytochemicals. To get all of the unique benefits that each vegetable has to offer, I encourage eating a wide variety of them, rather than focusing only on a few. As a general rule, most Americans are low in consumption of dark greens like spinach, broccoli, collards, and kale, as well as deep yellow vegetables, such as sweet potatoes, carrots. Also, while color is often an indicator of beneficial phytochemicals, many "colorless" vegetables are also very nutritious with unique beneficial compounds, such as onions, cauliflower, mushrooms, and celery. shelley: My blood sugar level is 82. I have not been diagnosed with diabetes. However, it runs in my family. How do i know if I have diabetes or the early stages of it developing? Can i give you my symptoms? Elizabeth: If you have concerns about having either pre-diabetes or diabetes, please go to see your health provider. Only your doctor can diagnose diabetes. If you have symptoms such as being excessively thirsty, having to urinate more than often, and being very tired -these can by symptoms of diabetes so make an appointment today. James: My sister told me I shouldn't eat fruit because of the sugar. Can diabetics eat fruit? Elizabeth: Since fruit and fruit juices contain carbohydrate, they have the potential to affect blood glucose. However, this does not mean they cannot be eaten by a person who is following a diet for diabetes. The type and amount of carbohydrate-containing foods to include at meals will depend on several factors such as time of the meal, activity, and composition of the meal as well as medication regimen and individual blood glucose responses after eating. With proper meal planning and by including appropriate portions, fruits and other foods that contain carbohydrate can be included in your diet. A certified diabetes educator can help you with your meal plan and how fruit fits into your diet. JSPAW: What fruits and vegetables should be avoided? Elizabeth: There are no fruits and vegetables that need to be completely avoided if you have diabetes. Starchy vegetables like potatoes, peas and corn as well as fruits have about 15 grams of carbohydrate in 1/2 cup of cooked or canned. Like all foods with carbohydrate, you need to count these as part of your meal plan.
Vlady900: I have a hard time eating fruits and veggies; I just don't like them. I do weight watchers, so I've managed to get to the point where I eat about 2 fruits and 2 vegetable servings a day. I've been like this since I was a kid. The nutritionist keeps telling me to "double up" on my vegetable (such as 5 or more servings), but it's hard just to eat one serving. I've noticed that a lot of the people I know who have diabetes or weight issues have the same problem, so logically I know the consequences of not eating vegetables are not good. What can I do to make vegetables more appealing?
Elizabeth: Given that there are literally hundreds of varieties of fruits and vegetables that can be prepared in thousands of different ways, I'm thinking that you just haven’t found those that you like. A simple cooking technique can make vegetables taste much different – so try them grilled, baked in the oven, steamed in the microwave, or raw. You can find some recipe ideas at fruitsandveggiesmorematters.org. It can take several exposures to a food before you learn to like it, both because of familiarity (people like things that they are familiar with) and because taste buds change as you get older. Some people taste vegetables more bitterly than others, but as your taste buds age and aren’t as sensitive, you might like vegetables better. Just because you didn’t like it as a child, try different fruits/vegetables at various times throughout your life and in different recipes or preparation techniques and I'll bet you'll find some that you like now that you didn’t like before. The important thing is to not give up! Nicky: I recently read about a raw diet to cure diabetes? Although I doubt the "cure" part, is there anything to eating all raw fruits and vegetables? Elizabeth: It really doesn't matter if you consume your vegetables or fruits raw or cooked; it’s just important that you eat them instead of less nutritious or "empty calorie" foods. In fact, if you only eat them raw, you’ll miss out on some foods like asparagus, green beans, eggplant, winter squash, sweet potatoes, mushrooms, tomatoes and many others that are often consumed cooked! One of the things that can help control or prevent Type 2 Diabetes is weight loss, and fruits and vegetables can be very helpful in weight loss because they are generally low in calories. This applies whether they are cooked or raw. Geri: What are the best sources of iron? Elizabeth: The best sources of iron in food are meats, poultry, some fish, beans and lentils, fortified cereals and grains, spinach, lima beans, soy beans, prune juice and tomatoes. Fruits and vegetables high in vitamin C can help you absorb more of the iron in vegetables and grain foods like cereal. So have a 1/2 grapefruit with your cereal or tomatoes with your pasta to absorb the most iron to boost how much iron your body absorbs. linda: We have encouraged whole foods vs blended, juiced fruits specially for diabetics, how does blended vegetable differ? Elizabeth: The main difference between whole foods and blended juiced fruit or vegetables is the fiber content. Juice typically lacks the fiber of the whole food, unless you’ve used a juicer that uses the all of the fruit/vegetable with nothing remaining. The main difference between fruit vs. vegetable juice is that fruit juice is generally a bit higher in calories per unit of volume than vegetable juice due to their naturally higher sugar content. Juice blends that combine both fruit juice and vegetable juice are a way of diluting the fruit juice calories, while sweetening up the vegetable juice. Any person with diabetes will need to count the number of carbohydrates provided by whole or juiced fruits or vegetables.
Donna: I went to a class that was run by a registered dietitian a few weeks ago. She told us that we should be eating 5 servings of veggies a day, and 5 servings of fruit a day. My problem with that, is that so many vegetables and fruits have a lot of carbs in them. The only fruit that I seem to be able to eat is berries, and a banana cut in half to equal 4 oz, as to not go over the 15 carbs. What are some other fruits that are good to eat without getting to many carbs?
Elizabeth: For optimal health, eating 10 servings of fruits and vegetables is a goal. If you find that eating 5 servings of fruit is too much carbohydrate for your meal plan, then I would suggest that you increase your non-starchy vegetables. Remember, they all count including those that are low enough in carbohydate to be considered free foods like salad greens. Other vegetables that are the lowest in carbohyrate among the vegetables still count toward your total are: mushrooms, zucchini, watercress, turnip greens, fresh spinach, endive, eggplant, all types of lettuce, cabbage, celery, cauliflower, and green and hot peppers. To answer your question about fruits - berries are an excellent choice because the serving size for 15 grams of carbohydrate is larger than for either canned fruit or a banana. For example, 1 1/2 cup of strawberries, 1 cup of raspberries, 3/4 cup blackberries or blueberries. Melons also have a larger portion size for 15 grams of carbohydrate than other fruit: 1 1/4 cup for watermelon and 1 cup for cantaloupe or honeydew. Donna: Also that seemed like a lot of fruits and vegetables to incorporate into a meal plan. Was she correct in the amount of fruits and vegetables that we should eat a day? Elizabeth: The amount she suggested of 10 servings total is consistent with the US Dietary Guidelines that recommend between 7 and 13 servings depending on your calorie level. It is ideal for optimal health and preventing heart disease and certain types of cancer to eat as many fruits and vegetables as possible. There is no upper limit! Donna: She also told us that we should be eating them raw, one because they are better for you that way because of fiber, and two, because than we would get a more accurate amount of measurement that we should be eating daily. For example 1/2 cup of raw broccoli, compared to 1/2 cooked broccoli. To be perfectly frank, I have problems eating certain fruits and vegetables raw because of my dentures. So I would like to know how much of a problem this is?
Elizabeth: It is not a problem at all to cook your vegetables. Some nutrients are harmed by heat (like vitamin C) and some are enhanced by heat (like lycopene). Drying will help concentrate the nutrients a bit more since the drying process removes the water. The important thing is to eat more vegetables – whether they are cooked, dried or raw really doesn’t matter. Fiber is not reduced by cooking, so cooking your broccoli is just fine! As far as measurement goes, ½ cup of cooked vs. raw vegetables isn’t really that different other than “leafy greens." Spinach, collard greens, kale and other greens do shrink in volume once cooked. So consider 1/2 cup of cooked greens to be the same as 1 cup of fresh.
Ron: I have heard that it is best to eat veggies and fruits that are "in season." In this modern world, just what is a given veggie or fruit's "season?" Elizabeth: Well that’s a good question since fruits and veggies wouldn’t be in your produce department if they weren’t in season somewhere! But if you want to know what is in season in the U.S., go to http://www.fruitsandveggiesmorematters.org/?page_id=674." “In season" is often recommended because the prices are typically lower at this time. Keep in mind that frozen and canned fruits and veggies are always harvested at their peak of season as well, and are available all year long. LR_Moreno_Valley_CA: Back in the mid 90's, part of the information given at a diabetes education class was that nobody who had diabetes should ever eat more than 3 fruit servings in a day no matter how many calories were eaten as it could elevate triglycerides, thus causing the blood to thicken and run like applesauce through the veins. Does this thinking hold true today? Elizabeth: There is research to show that large amounts of fructose can increase your triglyceride levels - but this is not in the amount you find in fruits. The fructose used as a sweetener in products either as fructose and high fructose corn syrup are more of a problem. They are found in foods in higher concentrations than occur naturally and can affect triglyceride levels. Something to beware of is that fructose is often used as a sweetener in products marketed to people with diabetes - such as bars and snacks - because it has a lower glycemic response than sucrose or table sugar. Eating a lot of these products may affect triglycerides. P_Walker: I think one advantage of FRESH fruits and vegetables, (in addition to probably having a lot more fiber) over canned or frozen is that there are no additives, no sugar, fat or other things which may add extra calories. Do you have any tips on shoppping for, preparing, and serving fresh veggies and fruits? Elizabeth: The fiber isn't really an issue since it doesn't change with cooking. But you are right that you want to limit added sugar, fat and sodium. Shopping for fruits and vegetables that are in season will typically keep costs lower. I referenced our website earlier for more information on what is in season. In terms of preparing fresh produce - the great thing about using fresh is that you can eat it right after washing! For fruits, you can always mix different types together to make a fruit salad or layer berries with a low-fat yogurt to make a great looking dessert. For vegetables, you can eat them raw, steamed, or stirfred with your favorite lean meat and sauce for a quick meal. CMSue: tell me how, if your dealing with frozen or fresh, to measure? other than filling a huge measuring cup with water to 1 cup and adding till you get a 1 1/2 cups if fresh of frozen the weight of the veggie or fruit will have a different weight. Elizabeth: It's a good question and your suggestion would give you an exact amount. Other than that, or using a scale it wouldn't be a 100% exact measurement. Because fruits and veggies are generally low in calories, there is probably not going to be enough of a variation in adding or losing 2 strawberries to make a difference in your diabetes management. ADA_Moderator: Do have any parting words for us today Elizabeth? Elizabeth: More than 90% of the US population does not eat their recommended amount of fruits and vegetables, and it’s so important to do so. Not only because they help prevent long-term diseases, but also because of the more immediate role they play in managing weight. If you have further questions about fruits and veggies, you can submit questions to me or sign up for our biweekly newsletter. ADA_Moderator: That's it for today. Thanks so much for taking the time to be here Elizabeth. Thanks to all of you who joined us by asking great questions or by just tuning in. If you wish to continue any of today's discussions please feel free to visit the ADA Message Boards. Keep up to date with all the ADA Live events and reference the archives here. We hope you found this interesting and informative and that you'll join us again next time here at ADA Live. Our guest will be Rite Aid Pharmacists and diabetes experts, will discuss and answer your questions on all aspects of diabetes at 1:00 p.m. EDT Thursday, March 6, 2008. See you then. Elizabeth: It was a pleasure to be here. |
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