Ask the Dietitian

As a National Program Sponsor of the American Diabetes Association, The V8 brand is committed to health and wellness; specifically by helping to address the overweight/obesity issue which is the biggest risk factor in developing type 2 diabetes. The V8 brand also supports the diabetes community by providing educational resources to help consumers better understand the importance of vegetable nutrition as it relates to diabetes prevention and management.

Please review the list of most recently asked questions below and if your area of concern is not addressed, we encourage you to submit a question to our expert – be sure to check back in two weeks to see the answer.

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Top 10 Questions & Answers

1. Does what you eat affect your diabetes?
   
2. Why should I worry about my cholesterol levels?
3. I have type 2 and my doctor said to cut back on fat and carbohydrate. What is left to eat?
   
4. What are easy – and healthy – dinner and snack ideas? Sometimes I am too weak and sluggish to cook.
5. Please explain "net carbs." I get confused on this.
6. Can my son eat a cupcake during class parties? Or should he stick with crackers?
7. What types of vegetables are best for someone with diabetes?
8. Are there cooking methods that could alter the glycemic index of fruits or vegetables?
9. What afternoon snacks can I have that won’t result in a high glucose reading before dinner?
10. Low-sodium foods are expensive. Any ideas to cut back the sodium without breaking the bank?

Does what you eat affect your diabetes?

Absolutely. What you eat is key for managing diabetes. There are a lot of things to balance with your diet - monitoring carbohydrate and cutting back on "bad fats" to lower your risk of heart disease at the same time. To keep blood glucose levels in check, you have to have a balance between the carbohydrates that you eat, how much exercise you do and any medications you take that lower blood glucose levels. But that is not all you need to worry about. The most common complication of diabetes is heart attack and stroke. Most people think it is eye or kidney problems - but that isn't true. So you always want to do what you can to reduce your risk factors for heart disease. This includes eating a healthy diet, exercising daily, and trying to lose weight if you need to. Top

Why should I worry about my cholesterol levels?

People with diabetes are at very high risk for heart attacks and strokes because of their diabetes. Some researchers say that just having diabetes is like having had a heart attack! That is how serious heart disease is for people with diabetes. High LDL cholesterol and triglyceride levels and low HDL levels are risk factors for heart disease. This mix of cholesterol problems is very common in people with diabetes. But there are things you can do to lower your risk. Following a diet that is low in saturated and trans fat as well as high in fiber will help to lower your risk. Daily exercise is also very important. At least 30 minutes of exercise like walking will help to lower your risk. Top

I have type 2 and my doctor said to cut back on fat and carbohydrate. What is left to eat?

First thing I would recommend is calling 1-800-342-2383 (1-800-DIABETES - the American Diabetes Association National Call Center) and request a free copy of "What Can I eat? The Diabetes Guide to Healthy Food Choices." It has 28 pages of advice for choosing foods and different meal planning tips. And it's free! Until then, remember that cutting back on carbohydrates and fat doesn't mean not eating any. When you go to the store and you are looking at rice, or pasta, or bread - choose the ones that are whole grain. This will be brown rice, whole wheat pasta and 100% whole wheat bread. When you eat them, keep your portion small - no more than 1/4 of your plate at any meal. Load up your cart with vegetables especially the non-starchy ones like broccoli, spinach, and peppers. They can be fresh, frozen or canned. The non-starchy vegetables should be 1/2 your plate at your meals. For the last quarter of your plate, add about 3 ounces of lean meat, chicken, or fish. You can add a piece of fresh fruit or 1/2 cup of fruit salad for dessert, or even a "light" yogurt. Light yogurt is about 100 calories per 6 oz container - to help you find them. Stay away from highly processed carbohydrates like cakes, cookies, sugared cereals and sweetened drinks like soda. You can cook with the "healthy fats" like vegetable oils - you want to be cutting back on the bad fats like butter, cream, shortening and those found in full-fat dairy products and meat. Start reading labels to get familiar with the serving sizes listed and the amount of calories and grams of carbohydrate in the foods you eat. When picking between foods, look for those that are lower in carbohydrate and saturated and trans fat. And don't forget to call the American Diabetes Association for the free booklet. It has most of the information you need to get your eating plan on track. Top

What are easy – and healthy – dinner and snack ideas? Sometimes I am too weak and sluggish to cook.

If you're having a hard time wanting to cook, think about convenience items that you might be able to use to help with meal preparation. For example: use pre-washed salad and add canned tuna or chicken (rinse to remove salt) and other veggies. Or bring home a rotisserie chicken and microwave frozen vegetables. Even frozen dinners can work in a pinch if you are too tired to cook. For snacks, try an ounce (small handful) of nuts, a piece of fruit, a small tortilla with salsa and melted reduced-fat cheese. Also, if you are feeling sluggish all the time, you should probably make an appointment with your health care provider to make sure everything is okay. High blood glucose levels can make you feel very tired. Top

Please explain "net carbs". I get confused on this.

Net carbs have no "official" definition from FDA who regulates food labeling. So that fact that this appears on food labels is very confusing. Different food manufacturers can use different definitions since it is not standardized. There is also not a standard definition for "low carb" so you need to be careful. Buyer beware applies in these cases. I do not recommend that you rely on "net carbs" or any other version on it. Most manufacturers have subtracted all of the grams of fiber and sugar alcohols and declared that they do not impact blood glucose levels. Unfortunately, that is not always true. Some types of fiber are partially digested and some sugar alcohols cause a rise in blood glucose levels even though it is a smaller rise than sugar. The bottom line is that unless a food has more than 5 grams of fiber or 5 grams of sugar alcohol, you do not need to do anything. Use the amount on the label listed as "total carbohydrate." If a food has more than 5 grams, you can subtract 1/2 the grams of fiber or sugar alcohols from the total grams of carbohydrate. Remember, the calories remain the same as what is listed on the label. Top

Can my son eat a cupcake during class parties? Or should he stick with crackers?

It is absolutely okay for your son to participate in the party - including having a cupcake. If he substitutes equal amounts of carbohydrates in a cupcake for the carbs in crackers, you may not see much of a difference at all in his blood glucose levels. If there is more carbs in the cupcake, his blood glucose levels may be higher. From the parties I've witnessed, there is usually extra activity as well - even if it is just the kids running around and bouncing off the walls! I feel strongly that children with type 1 diabetes should be allowed to have sweets on special occasions and birthday parties definitely qualify. If you find that his blood glucose levels are higher after the cupcake or the serving was larger than you expected, ask your physician or educator how you should adjust his insulin. Check out our website specifically for kids. There is information on how to handle special celebrations. I hope your son enjoys his next party! Top

What types of vegetables are best for someone with diabetes?

All vegetables 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 as either the grams of carbohydrate per serving or as a serving of Vegetable or Starch from the Exchange Lists. The American Diabetes Association suggests 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 finer tuning, I'd recommend you try to see a Registered Dietitian or a CDE. Find an ADA Recognized Education Programs in your area. Also, you can find some great recipes for fruits and vegetables at our website http://www.fruitsandveggiesmorematters.org under our cooking section. Top

Are there cooking methods that could alter the glycemic index of fruits or vegetables?

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. Top

What afternoon snacks can I have that won’t result in a high glucose reading before dinner?

If you are having high blood glucose levels before your evening meal, you may need some type of change in your plan. With many of the newer medications and insulins, you don’t have to eat a snack anymore in the afternoon to prevent hypoglycemia. If you are taking medication, make sure you know when it works to lower blood glucose as to whether you need an afternoon snack. If you want a snack, but want to avoid the typical options that are higher in carbohydrate, you can try having a small handful of nuts, or some raw vegetables with either a tablespoon of salad dressing or hummus for dipping. You can also try a small can of tomato or vegetable juice. All of the above ideas are heart healthy. If you are looking for something sweet without calories or carbohydrate, try a sugar-free popsicles or sugar-free jello. Other foods that contain no more than 5 grams of carbohydrate are 1 cup of popcorn or 2 saltine-type crackers. Top

Low-sodium foods are expensive. Any ideas to cut back the sodium without breaking the bank?

You are right that there are a lot of lower sodium foods on the market, but sometimes they cost more. It's important for everyone to watch their sodium intake, not just people with high blood pressure. ADA recommends that everyone with diabetes - whether they have high blood pressure or not eat <2300 mg of sodium per day. It's easy to find a can of soup that has that much! So you do have to be careful. Fresh fruits and vegetables, meats and unprocessed grains, like rice or whole oats, don't have added sodium. Most other foods do. If you try to generalize it, the more processed a food, the more sodium. Here are a few tips for cutting back on sodium:

• Cut back on processed meats and cheeses. Make sandwiches from meat that you have leftover from dinner.
• Canned foods can be loaded with sodium. If you are using canned vegetables, do not cook them in the water from the can. Dump them out, rinse the vegetables well, and warm them in fresh water. This will significantly reduce the sodium.
• Frozen vegetables are often lower in sodium, but you do have to read the labels. Those vegetables in sauces will usually be higher.
• Watch out for condiments and dressings. These are often high in sodium in well, so use just small amounts.
• And of course, avoid adding salt to foods when you are cooking or at the table. Just 1 teaspoon of salt has 2300 mg of sodium.

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