Nutrition

Eat Balanced by Pairing Your Carbs with Protein

By Lisa Keovongsa
Dietetic Intern

There is a common misconception that once a person is diagnosed with diabetes they need to cut out all carbs. This is not the case! Carbohydrates are very important because they serve as the main fuel source for the body and give the brain and muscles the energy needed to carry out daily activities. Carbs, protein, and fat all play essential roles and can be incorporated into your meals and snacks to keep you feeling your best. Also, eating carbs with protein at every meal will help manage your blood sugar and help your body best utilize the nutrients in your food.

Carbohydrate Foods
Many foods with carbohydrates raise blood sugar.  Eating carbohydrate with a protein or fat can keep your blood sugar steady.  Foods with carbohydrates include:

 Starchy vegetables*/legumes:  Pumpkin, squash, all potatoes, yucca, beans, corn

Dairy: Milk, yogurt

Grains: Breads, pastas, tortillas, rice, crackers/snack chips, cereals, quinoa

Fruit: Apples, oranges, pears, bananas, mangoes

*Non-starchy vegetables have fewer carbohydrates.  Examples of non-starchy vegetables include: Carrots, lettuce, broccoli, cabbage, tomatoes, any leafy green, cucumbers

Protein Foods
There are many options when it comes to eating protein. These foods include meats, poultry, eggs, fish, cheese, cottage cheese, nuts, nut butter, and tofu.

Why do we need to eat protein with carbs?
During digestion, the food we eat gets broken down into simple sugars that are delivered to our muscles and liver through the bloodstream.  Insulin is the “key” that “unlocks the gate” for sugar to leave the blood and enter the cells. When someone with diabetes eats large portions of carbohydrate-rich foods, too much sugar is released into the blood stream and, because there’s either not enough insulin or they have insulin resistance, their body is unable to use this sugar for energy effectively.  This can cause high blood sugar, which, if it happens consistently over time, can lead to complications.  Proteins (and fats) take longer to digest than carbs, so eating protein along with the carb slows down digestion in the stomach and absorption in the intestines. This will help slow the rate of sugar entering the bloodstream, keeping blood sugars steady and preventing blood sugar spikes (and crashes).  Check your blood sugars 2 hours after a meal to see the effects.

Snack Ideas
Pair one item from the protein list with an item on the carbs list to make a balanced snack that will keep your blood sugar in check:

Protein                                                 Carbs

Handful of nuts                                 Whole fruit (apple, ½ banana)

1 cup Greek yogurt                           5 Whole wheat crackers

2 Deli turkey slices                           1 whole grain tortilla

1 oz beef jerky                                  1 oz whole wheat pretzels

Hard-boiled egg                                1 cup regular yogurt

½ cup cottage cheese                       ¼ cup granola

1 tbsp Peanut butter                        3 cups popcorn

2 Tbsp Hummus                               ½ cup dried fruit

1 oz cheese                                       1 cup raw vegetables

Post content reviewed by Melanie Pearsall, RD, CDE
Nutrition

Healthy Holidays: Adapting the “Balanced Plate” for Holiday Eating

balanced plateThe Holidays are often filled with rich foods that may not seem to fit into a balanced plate. But, with the proper portions and a few healthy tweaks, you can confidently create a balanced holiday plate without giving up your favorite dishes.

Many traditional holiday foods have a lot of starches and fat, so it’s important to keep in mind the balanced plate when eating during the holidays. Here are some tips to make your holiday eating a breeze!

PROTEIN: 1 palm-sized portion Protein

Make it work: 1 palm-sized portion of white meat turkey, ham, fish, or any other lean protein

Turkey and ham are traditional holiday proteins.  Try to eat more white meat rather than dark meat as this is a leaner source of protein. No matter your choice of holiday protein source, keep your portion to the size of your palm to fulfill your protein needs.

STARCH: 1 fist-sized portion starch

Make it work:  Usually a fist size of starch is recommended, but choosing smaller (½ fist-sized) portions of your favorite starches will allow you to have more options on your plate.  For instance:  ½ fist-sized portion of stuffing AND a ½ a fist-sized portion of mashed potatoes.

Starches can definitely be tricky with all of the options during the holidays. Holiday starches include stuffing, mashed potatoes, sweet potatoes, and dinner rolls.  These tips can help to decrease the carbohydrates and help save room in your balanced plate for some dessert!

Swap 1: Switch out traditional mashed potatoes for mashed cauliflower.  Mashed cauliflower has about 5 times LESS carbohydrates than mashed potatoes. If cauliflower isn’t for you, stick to a small portion size of mashed potatoes and use skim milk instead of cream.

Mashed Cauliflower

Swap 2: Add extra non-starchy vegetables to stuffing to decrease the carbohydrates per serving.

Carrot Mushroom Stuffing

VEGETABLES: 2 fist-sized portions veggies

Make it work: 2 fist-sized portions of non-starchy vegetable side dishes (such as green beans, broccoli, Brussels sprouts, salad, etc.)

Remember that half of the balanced plate should be filled with non-starchy vegetables. Try to avoid dishes with a lot of cheese, butter, or cream and instead choose roasted, sautéed, or raw vegetables.  There are many recipes online with healthier versions of traditional side dishes such as the Healthy Green Bean Casserole recipe below!

Healthy Green Bean Casserole

Roasted Broccoli with Lemon & Parmesan

FRUIT: 1 cup or 1 small piece of fruit

Make it work: Incorporate fruit in a festive way into your holiday meal. Add in any of your favorite seasonal fruits to make a festive, colorful side dish.

Winter Fruit Salad

Beverages

Stick to water as a beverage and save room for all the other delicious things on the plate! Starting the meal off with some lemon water will help you stay hydrated and able to enjoy the entire meal. Be mindful of alcohol, especially holiday drinks like eggnog! These drinks contain a lot of added sugar and fat.  Try switching to healthier versions or other fun beverages with very little added sugar.

Dessert  

There are many recipes out there for lighter versions of holiday desserts.  If you have a family favorite recipe, try searching online for some easy swaps to make sure you can have your pie, and eat it too!

These simple tips can ensure that holiday eating doesn’t wreak havoc on your progress towards a more healthy life! By making a few changes, you can still have all the traditional holiday foods while following the balanced plate guidelines.

Have a happy & healthy holiday season!

Content reviewed by MGH Department of Nutrition and Food Services
Nutrition, Uncategorized

More Nutrition Myths Debunked

Sydney Bates, Dietetic Intern

There is a lot of conflicting information when it comes to nutrition. It seems that every day there is a new headline that’s at odds with everything we thought we knew. Despite emerging science, many nutrition myths are still prevalent. Here’s the truth about some common nutrition myths.

Myth: Egg yolks are high in cholesterol and should therefore be avoided
Fact: For decades, we were told not to eat eggs too often (and only the whites) if we wanted to be healthier and avoid elevated cholesterol. The latest evidence, however, shows that advice was scrambled. While egg whites are an excellent source of protein, the egg yolks contain most of the major nutrients including iron, folate and vitamins that support eye and brain health. The dietary cholesterol in eggs that was demonized for decades is now largely recognized by the medical community as having little effect on blood cholesterol. Overall, eggs contain a host of valuable nutrients, and focusing on the cholesterol content of eggs as a contributor to disease is not only counter-productive but false. Maintaining a balanced eating pattern with plenty of plant-based proteins and fats with the occasional animal product is the key to keeping those blood lipids at an optimal level.

Myth: Coffee is bad for you
Fact: The majority of studies on coffee have actually shown it provides protective effects against disease. Coffee is loaded with antioxidants, and has also been shown to help reduce the risk of developing diabetes in regular consumers. It’s likely the bad reputation comes from cream and sugar many people add to their drink. Adding sweetener greatly decreases this protective effect. To reap the most benefits, limit the amount of cream, milk, sugar, or artificial flavorings you add to your coffee.

Myth: You can eat as much “healthy” food as you like
Fact: The key to a healthy lifestyle is eating a variety of foods from all the main food groups. What this means is that just because the media touts avocados and kale as healthy “superfoods,” it doesn’t mean more is better; even healthy foods still need to be eaten in moderation. Ever hear of the saying, “too much of a good thing?” It applies to so-called healthy foods too. The body needs a certain amount of nutrients to function, and any excess is either stored as fat or eliminated. Plus, when you eat from only a small selection of foods, you miss opportunities to obtain vital nutrients from other sources. No one food contains all the macro- and micronutrients we need. That’s why it’s so important to view articles that promise things such as “eat as much of these foods as you want and never gain weight” with a critical eye. These headlines are designed to grab your attention using the allure of being able to eat all day long and never gain weight. To maintain health, eat a variety of foods, from all the food groups, in portions that are satisfying but don’t leave you feeling overly full all the time.

Myth: Gluten Free is healthier…and other labeling misconceptions
Fact: The term “health halo” is given to foods with a reputation for being better for you. They may have a special title or brand that is associated with being more nutritious, but this is not always the case. For instance, foods like smoothies, granola, organic snacks, protein shakes or foods labeled “organic” or “gluten free” are often thought of as being better options. The fact of the matter is that this is simply marketing and tailoring to consumer demand. Gluten is a protein found in wheat that has received a lot of attention recently. People with celiac disease or gluten sensitivity need to avoid gluten, but there is no need for the average person to eliminate gluten from their diet. As for organic foods, if you have the resources to purchase the “dirty dozen” (produce known to have high levels of pesticides) organic, wonderful. If not, you will not be losing out on any of the health-giving vitamins and minerals found in fresh produce. Learn more about the “dirty dozen” and “clean fifteen” and make an informed decision about which foods you will purchase organic. Overall, beware of falling for labeling traps and use your best judgement!

If you have questions about nutrition or your meal plan, speak with a Registered Dietitian to shed light on the evidence.

Post content reviewed by Melanie Pearsall, RD, LDN, CDE
Nutrition, recipes

Be Fit Basics: Quinoa Breakfast Cereal

Ingredients:
11/2 cups skim milk
1 cup uncooked quinoa
1/4 teaspoon salt
1/2 teaspoon ground cinnamon, plus more for serving
4 teaspoons honey, agave, or maple syrup
20 walnut halves
1 cup sliced strawberries

Instructions:
In a medium saucepan, combine skim milk, quinoa, salt, and cinnamon and bring to a boil, covered. Reduce heat to low and cook until milk is absorbed and quinoa is tender (about 20 minutes).

Remove pan from heat and let stand for 5 minutes, covered. Fluff with fork.

Divide quinoa evenly among 4 bowls. Top each with 1 teaspoon of honey, agave, or maple syrup, 5 or 6 walnut halves, and 1/4 cup of sliced strawberries. Use additional milk as desired.

Yield: 4 servings

Nutrition Information per Serving:
Calories: 300 • Protein: 10g • Sodium: 190mg • Carbohydrate: 50g • Fiber: 7g • Fat: 8g • Sat Fat: 0.5g

Recipe adapted from epicurious.com
Nutrition

Personalized Nutrition- Is the Future Here Yet?

By Robert Dunn, Dietetic Intern

Is the secret to a perfect diet hidden in your own body?

Personalized nutrition is a modern approach to nutrition that aims to prescribe specific diets based on biomarkers. Biomarkers are substances that provide information on a person’s condition, and can be used to measure disease risk. By assessing their impact on nutrition, medical professionals may be able to precisely determine the best diet for improving a person’s health.

The role of personalized nutrition is evolving quickly. Many researchers are optimistic that it may provide a breakthrough in the treatment of certain diseases. One of the diseases being closely studied is diabetes, a condition that affects over 29 million people in the United States. Additionally, over 80 million people are estimated to have prediabetes, putting them at risk for developing diabetes later in life. Diet and lifestyle have always been important for diabetes management, and personalized nutrition may soon play a key role in this process.

Researchers in Denmark recently published a study on personalized nutrition in diabetes treatment. Their goal was to determine the most effective weight loss diet for people that were diabetic, pre-diabetic, or neither (healthy group). To do so, they divided patients from prior weight loss studies into those groups based on two biomarkers: fasting insulin and fasting blood glucose. Once the patients were assigned groups, the researchers could then compare weight loss data to determine if any diet had a particularly strong effect on any specific group.

After comparing the data, several trends became clear. Patients in the diabetic group lost more weight on a low-carbohydrate diet that was high in plant-based fats like olive oil. Meanwhile, the healthy group was more successful with a low fat, high-carbohydrate diet. Finally, pre-diabetic patients who followed a diet high in fiber (fruits, vegetables, whole grains) lost more weight than those who followed a control diet. Based on these results, the researchers concluded that biomarkers like fasting blood sugar could be helpful in planning diet interventions for patients with either diabetes or pre-diabetes.

The results of this study seem promising, and may offer insight into weight loss strategies for people with diabetes or pre-diabetes. However, personalized nutrition is an emerging area of research and it is important we don’t make conclusions based on limited evidence. The study’s authors stated that next steps include “research to explore additional biomarkers…which may help to more effectively customize the right diet for specific individuals.”

In the meantime, people with diabetes and pre-diabetes should be encouraged to optimize their nutrition and physical activity. Nutrition counseling with qualified professionals has been shown to improve the health of people with these conditions. Anyone interested nutrition for diabetes management should consider meeting with a Registered Dietitian (RD).  Registered Dietitians are nutrition experts who help people of all backgrounds use diet to meet their medical needs.

To schedule an appointment with an RD from Massachusetts General Hospital, contact the Department of Nutrition and Food Services by calling 617-726-2779.

Content reviewed by Melanie Pearsall, RD, LDN, CDE
Nutrition

Low-Calorie Options for Adding Flavor to Water

By Melanie Pearsall RD, LDN, CDE
Sr. Clinical Nutritionist

Water is the healthiest drink for people of all ages. Drinking enough water is an important part of helping your body “detoxify,” and even mild dehydration can cause problems with concentration.  Americans tend to drink a lot of beverages other then water. Many of these drinks have a lot of added sugars and fat’s which are high in calories and cause weight gain. But the one thing these beverages have is flavor!   Many people know it’s important to drink water and stay hydrated but hate to drink “plain” water. Here are some suggestions to help even the pickiest water drinker succeed:

  • Flavor your water with orange or lemon slices, cucumber slices, berries or fresh herbs like mint or basil
  • Try flavored or plain seltzer waters! Sometimes that added fizz is enough to tickle your taste buds.
  • Herbal teas are a great way to flavor water. I often add an herbal tea bag to my cold water bottle and let it steep slowly, flavoring the water. Tea also provides an extra health benefit from anti-oxidants.
  • Add small amounts of sugar free type flavorings like Crystal Light to your water. I suggest people start off with just enough to add some flavor but without making it overly sweet.
  • Buy a water purifier for your home or individual bottle. This can make the water taste clean and refreshing as it removes some of the impurities that cause an aftertaste
  • If you like to drink pre-flavored water just double check the label to make sure it is low calorie (fewer than 10 calories per serving)
Article originally appeared in Summer 2013 DiabetesViews