Tomorrow marks the last day of National Nutrition Month, but like so many things, nutrition is something everyone should think about year-round. In light of this, I reached out to Patti Geil, MS, RD, FADA, CDE and Tami Ross, RD, LD, CDE, the authors of a book called What Do I Eat Now? A Step-by-step Guide to Eating Right with Type 2 Diabetes that I wish I’d had when I first started nutrition education – even though I don’t have type 2 diabetes. It is a four-week program that would be helpful for anyone trying to understand what it means to maintain a healthy meal plan.
Let’s start at the beginning – why did you write this book?
Tami: What Do I Eat Now? was inspired by our patients who over the years have so often said, “I have diabetes…what do I eat now?”- or “Just tell me what to eat!” The concept for this book was years in the making. Our goal is to share how in just four weeks people with diabetes can eat better, improve their diabetes management and live a healthier lifestyle. I’ve had many readers tell me it is their “playbook” or “guide book” for healthier eating.
Patti: Managing diabetes can feel overwhelming at times, particularly in the area of nutrition – there is so much confusing, conflicting and incorrect information bombarding us all! Each chapter in our book clearly outlines food options and menus, along with a key healthy eating concept and a simple, wholesome recipe. As our readers progress through the book, the lessons they learn will lead them to make the right food decisions in real-life situations from eating out, to surviving the holidays, to enjoying favorite family recipes.
So tell me, what’s your favorite food?
Tami: While I certainly appreciate and enjoy fine cuisine, it is nachos – fully loaded and with extra jalapenos – that are a favorite! As I tell my own patients, food is meant to be a pleasurable part of life, and it’s all about moderation, how much you eat and how often you eat it. So when I do order nachos out, I share them with my family or get a to-go box to bring some home to enjoy again the next day. And when I make nachos at home, I’m sure to use ground round or ground sirloin, fat-free refried beans and light sour cream…a few switches that lower the fat content and that I don’t mind at all taste-wise. I also have been known to pile on lots of extra lettuce, tomato, fresh salsa…and jalapenos! Crunchier and more filling, so I find I eat less chips.
Patti: Early in my career, I worked in the area of fiber and nutrition research. One of our studies showed that eating ½ cup of cooked legumes (such as kidney, pinto, or black beans) every day would lower your total cholesterol by 19% over 6 weeks. Since then, I’ve become a great fan of beans in every shape and form, even to the point of writing a cookbook called “Magic Beans.” My favorites are vegetarian chili (simply made in a slow cooker), a tex-mex chili bean salad (which can also be served in pita bread for a main dish sandwich) and the Hoppin’John recipe in “What Do I Eat Now?”
And in the spirit of full disclosure, I have a slight obsession with stale Marshmallow Peeps– whether they’re shaped like Easter bunnies, Halloween pumpkins or holiday snowmen!
Nice! Well, I’m not much of a marshmallow fan myself, but everyone needs a treat now and then. What are your favorite tips or tricks when it comes to healthy nutrition?
Tami: Plan at least five meals each week. Winston Churchill once said, “Let our advance worrying become advance thinking and planning.” You can change that anxiety about what to eat into action, by planning meals. Planning five meals truly only takes about five minutes, and leads to healthier food choices that meet your diabetes needs. That five minute upfront investment enables you to shop from a list, shop more efficiently, avoid extra trips to the store for forgotten items, and take advantage of specials and coupons.
Patti: Remember that “free” doesn’t always mean free- It’s so important for people with diabetes to read food labels closely. Some sugar-free foods such as diet soda are truly sugar-free, but others contain carbohydrate from sweeteners such as sugar alcohols (such as malitol, mannitol, and sorbitol) which can affect blood glucose. Fat free foods may have extra starch and carbohydrate added to provide flavor and texture. Focus on the amount of Total Carbohydrate on the Nutrition Facts label to learn exactly what a food contains.
Tami: Be wise of portion size. You can incorporate just about any food or beverage into your diabetes eating plan – the portion size may just need to be tweaked to meet your carbohydrate and nutrition goals. I find using my hand helpful to estimate portion sizes, given that the average fist is about 1-1-/2 cups, the palm of the hand equal to about 3-5 ounces or meat, and the thumb equal to a tablespoon.
Also, stick close to Mother Nature. Choose whole foods as close to their natural state as possible. For fruits and vegetables, that doesn’t mean you have to buy only fresh. Frozen fruits and vegetables (without added sauces or sugars) are generally as nutritious as the fresh variety. If using canned beans or vegetables and concerned about sodium, you can rinse them in a colander under running water to remove about 40% of the sodium.
Patti: Spend less, eat healthfully– Many of our patients have shared with us the challenges they face in trying to eat healthfully on a lean budget. Without a doubt, diabetes is an expensive disease, so Tami and I wrote Diabetes Meals on $7 a Day – or Less! to dispel the “I can’t afford to eat healthy foods” myth and share some of our favorite economical recipes and tips. Here’s one of mine: 100 calorie portion packs of snack foods can help you control carbohydrate and calories, but they’re also quite expensive. Why not do it yourself?
Fish Shaped Snack Crackers
100-calorie portion pack: $0.60 per packet
Do-It-Yourself version (39 crackers): $0.20
Teddy Bear Shaped Cookies
100-calorie portion pack: $0.48 per packet
Do-It-Yourself version (18 cookies): $0.24
So people pay twice as much for the cute teddy bear cookie shape? Who would’ve thought! You’ve obviously both put a lot of time and work into this. What has inspired you along the way?
Patti: People who live with diabetes inspire me. Diabetes is unlike any other medical condition in one important way: people with diabetes manage their own condition 95% of the time. Because of this, people with diabetes are always learning, adjusting and searching for the individualized healthy living plan that works best for them. I’ve heard it said “Experience is a hard teacher. She gives the test first, then the lesson afterward.” I am grateful that as a registered dietitian and certified diabetes educator I have the opportunity to share my diabetes and nutrition knowledge and coach people along their pathway to success.
Tami: Several years ago a friend shared with me the wise words, “Progress, not perfection”, which I have since embraced in my personal life and in my practice. While I am very much a perfectionist, I’ve come to realize that any progress in a situation is usually beneficial. For instance, maybe the goal is to walk 150 minutes a week. If an individual can go from not exercising at all to walking 10 minutes a day, or 70 minutes a week, that’s definitely progress. Or, if breakfast carbohydrate is reduced from an average 90 grams (from the large bagel and cup of juice) to 75 grams (in the bowl of high fiber cereal with skim milk and half a banana) – that’s progress.
If you could say one thing about diabetes, what would it be?
Tami: Diabetes is not a death sentence. So often patients come into my office terrified because they’ve had a friend or family member experience complications from diabetes and they are fearful that diabetes means the same for them. Studies clearly show that getting blood glucose levels as close to normal as is safely possible and keeping them there, lowers the risk of complications and death related to diabetes. My philosophy about life is to truly live in the moment and try to enjoy every day for what it is!
Patti: Diabetes is a marathon, not a sprint. There’s a huge difference between making healthy choices most of the time and occasionally eating something that isn’t the best for your body. If you’ve eaten a cupcake or skipped a workout, don’t beat yourself up with negative self-talk. Learn from your slip-up and move on! Don’t let an unhealthy choice be an excuse to give up on your self-management plan.
Thanks to Patti and Tami for taking the time to share some of their expertise with us. If you’d like to learn more about their books and other diabetes-related information, you can find it at shopdiabetes.org.