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Key Menu Strategies for Preventing and Treating
Type 2 Diabetes
- Use healthy types of dietary fats, such as monounsaturated fats and omega three fatty acids.
- Avoid excessive amounts of saturated and hydrogenated fatty acids.
- Incorporate more whole grains, less refined carbohydrates, beans and legumes. Limit the use of refined, starchy non-fibrous carbohydrates.
- Develop meals which are moderate in the amount of calories and appropriate in portion sizes to maintain a healthy body weight or which will reduce body weight in a healthy manner. TOP
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What is Diabetes?
Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, action, or both. Normally insulin helps to get blood sugar or glucose absorbed into the cells so it can be used for energy. Diabetes can be associated with serious complications such as premature death, cardiovascular disease, amputation, blindness, and renal failure.
There are two types of diabetes
Type 1 This type was previously called insulin dependent diabetes mellitus or juvenile onset. Type 1 develops when the body's immune system destroys pancreatic cells which make insulin, the hormone that regulates blood sugar. This form of diabetes usually affects children and young adults. Type 1 may account for 5 to 10% of all diagnosed cases of diabetes. Risk factors for type 1 include autoimmune, genetics, and environmental factors. In order to survive, people with type 1 diabetes must have insulin via injections or a pump.
Type 2 This was previously referred to as non-insulin dependent or adult onset diabetes. Type 2 diabetes accounts for 90 to 95% of all diagnosed cases of diabetes. In type II diabetes, the body loses it's ability to properly use the insulin it produces (insulin resistance). When this occurs, the blood sugar levels rise, thus leading to damaged blood vessels and other complications. Many people with type 2 diabetes can control their blood glucose by following a careful diet and exercise program, losing excess body weight, and taking oral medication.
Symptoms of Diabetes
- Frequent urination
- Excessive thirst
- Unexplained weight loss
- Extreme Hunger
- Sudden vision changes
- Tingling or numbness in the feet
- Feeling excessive fatigue
- Dry skin
- Sores that heal slowly
- More infection than usual TOP
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One Billion Meals Per Week
by Connie Guttersen, RD PhD,
author of the Sonoma Diet
FACT The American public consumes 1 billion commercially prepared meals each week.
FACT 17 million Americans have type 2 diabetes.
FACT Type 2 diabetes has tripled in the last 30 years.
FACT An additional 16 million Americans have an increased risk of developing diabetes.
Do the facts speak for themselves? Is there a correlation between the growing epidemic of diabetes and the decrease in home cooked meals? Many fingers are pointing your way. But the purpose of this article is not to play the blame game. There are a multitude of reasons for America's growing obesity and diabetes epidemics and your menu is just one part of the equation.
But it is important to remember that these facts are much more than statistics—these “facts” are your customers. With 17 million diabetics and 16 million at risk, that's a lot of customers. And every day their doctors, nutritionists, family and friends are telling them that they must change their diets. Your goal should be to make sure that changing what they eat doesn't mean changing where they choose to dine.
So, with that in mind, we offer this primer on diabetes. The good news is that it does not require a special menu. It's more about offering healthy choices—choices that will also appeal to your other diners. And that just makes good business sense.
One Billion Meals Per Week
Restaurants are getting a large 'share of stomach' these days. The frequency of eating away from home has jumped by more than two-thirds over the past twenty years, with Americans now consuming 1 billion commercially prepared meals each week. (1) In fact, research shows that commercially prepared foods account for 34% of an individual's caloric intake. Unfortunately, the excessive consumption of saturated fat and calories from these commercially prepared meals are linked with America's obesity and diabetes epidemics.
The public's growing interest in nutrition, the rise in out-of-home meals, and the leap in obesity and diabetes present a challenge to chefs and food professionals. Nutrition is going to be crucial if restaurants want to stay competitive in the future. Nutrition education empowers chefs to offer a variety of menu choices, thereby helping their customers change their eating habits. Studies have confirmed that customers will accept healthy food only if the food appeals to the senses and tastes good. (3) Flavor is an essential component of healthy eating.
A large number of Americans need these menu options. According to the U.S. Centers for Disease Control and Prevention (CDC), type 2 diabetes or adult onset diabetes, affects 17 million Americans—a figure that's tripled in the last 30 years. This is due largely to the global epidemic of obesity, which is a major risk factor for developing type II diabetes. In addition to those who have been diagnosed, there are a large number of Americans who are unaware that they have the disease, which particularly puts them at risk.
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16 Million Have Pre-Diabetes.
Plus there are those with “pre-diabetes” which is a new term coined by the U.S. Department of Health and Human Resources. Pre-diabetes is a condition in which blood sugar levels are higher than normal, but not yet indicative of diabetes. An additional 16 million Americans have “pre-diabetes”, which means they are at increased risk of developing the disease. In the past, the medical community referred to pre-diabetes as impaired glucose tolerance. Screening for pre-diabetes is important since studies show that most people with this condition develop full blown diabetes within ten years. The most important risk factors are being overweight, middle-aged, high blood pressure and a family history of diabetes.
Recent studies show that positive lifestyle changes and smart diet choices may be just as effective as drugs for treating type 2 diabetes. (4,5,6) Two landmark studies, The Finnish Diabetes Prevention Study and the U.S. Diabetes Prevention Program demonstrated that sustained lifestyle changes with modest weight loss and physical activity resulted in substantial reduction in diabetes among older adults who were at very high risk for diabetes. The Diabetes Prevention Program proved that modest changes in lifestyle can reduce the incidence of type 2 diabetes in people with pre-diabetes by almost 60%.
Chefs can play an important part in this equation by educating consumers on the variety and preparation of healthy foods as well as providing these foods on menus for both dining in and taking-out. Below are some tips for approaching your menus.
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Choose Healthy Fats When Designing Recipes
Scientific evidence finds that specific types of dietary fat are important for preventing type 2 diabetes. Monounsaturated fats, like those found in olives, nuts and canola oil, are beneficial for maintaining blood glucose control and improving the cells response or sensitivity to insulin.
A ground breaking study by the Harvard School of Public Health reported that women who ate one ounce of peanuts or other nuts, five or more times a week, reduced their risk of developing type 2 diabetes by 30%.
Omega three fatty acids, often referred to as fish oil, also play an important protective role against type II diabetes. Further analysis of the Nurses Health Study by Harvard researchers found that eating fish regularly reduced the risk of heart disease in women with diabetes by as much as 64%. This reduction was most evident when the fish was consumed five or more times per week. It is well known that omega three fatty acids reduce the risk of irregular heartbeats, decrease blood triglyceride levels, improve the function of blood vessels and reduce blood clot formation. All of these beneficial effects are important for reducing the risk of heart disease among individuals with type 2 diabetes. The researchers of this study also concluded that the association between the higher fish consumption in diabetic women and better health can also be extended to diabetic men.
It is well documented that the incidence of type 2 diabetes in the Mediterranean, especially in Greece, is much lower than in the Westernized countries. Some of the mainstays of Mediterranean cuisine include fish, olives and olive oil. The flavor and variety of this cuisine is widely appealing to Americans and can replace many traditional meals, which focus on saturated fat or hydrogenated fats, primarily fattier cuts of beef and fried foods.
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Incorporate More Whole Grains and High Fiber
Scientific literature is emphasizing that what is important for preventing and managing type 2 diabetes is not just the total amount of carbohydrate but the type of carbohydrate we eat. What does this mean? It means we do better when we reach for the whole grain versus one that is highly refined. For people who have relied on white bread and potatoes to meet the food guide pyramid's recommendation of 6-11 servings of bread, cereal, rice, and pasta per day, this may be a challenging issue.
 A six year study of 65,000 women conducted by the Harvard School Public Health found that in those women whose diets were high in carbohydrates from white bread, potatoes, white rice, and pasta had two and a half times the risk for type 2 diabetes of those who ate a diet rich in high fiber foods like whole wheat breads and other whole grain items. (12) This conclusion, that a high carbohydrate diet that is low in dietary fiber contributes to type II diabetes, was independent of the women's body weight, exercise level, or family history of disease.
Walter Willet, a co-author of this study explains that low fiber carbohydrates, such as white bread, are digested by the body much like sugar is. The sugar from these starchy, low fiber foods are also absorbed rapidly, resulting in a quick rise in blood sugar (glucose). On the other hand, high fiber carbohydrates, such as whole wheat bread, are digested more slowly by the body. Blood sugars will therefore rise gradually. This reduced rate of absorption is a result of the dietary fiber present in the food. There are also other nutrients, such as magnesium, present in whole grains, which also contribute to this metabolic effect.
Whole grains offer a powerful defense again chronic disease. Unfortunately, many of these protective nutrients are lost during the refining process. Refining removes the bran and the germ from the grain, taking key nutrients at the same time. While some of these nutrients are added back through the enrichment process (thiamin, riboflavin, niacin, and iron), there are approximately 15 nutrients which are lost in the refinement process. These nutrients have been found to be protective against heart disease and cancer. They act as antioxidants, detoxifying agents, vitamins, and minerals. So the next time you choose your carbohydrates, opt for the more fibrous ones.
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| Protective Nutrients Present in Fibrous Complex Carbohydrates |
| Vitamin E |
Selenium |
| Phytochemicals |
Folic Acid |
| Fiber |
Magnesium |
| Vitamin B6 |
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Here are some ideas to incorporate the better choices of carbohydrates. Many of these grains such as kamut, spelt, and quinoa are combined with different lentils chickpeas, and beans in the form of grain medleys, inspired by the flavors of the Mediterranean, Latin America, and Asia.
Weight Loss With Moderate Fat Diets
Researchers at Harvard School of Public Health and Brigham and Women's Hospital in Boston (13) have found that three times as many people were able to follow a moderate-fat weight loss plan—one similar to the amount of dietary fat in the Mediterranean diet—than those following a conventional low fat diet. Furthermore, these individuals were able to maintain their weight loss for over 18 months, consumed more healthy foods such as vegetables and reported feeling more satiated after meals, despite the smaller portions of food. The types of dietary fats consumed by the moderate fat intake group consisted primarily of monounsaturated fats, such as nuts, peanut butter, olives and olive oil. Often times, a low fat high carbohydrate diet is recommended for improving health. It is now well known that for a significant part of the population, this diet may actually have a negative impact on the risk factors associated with type 2 diabetes, primarily for the insulin resistance and pre-diabetes stages. A good start to healthy meal planning for these high risk individuals is a calorie controlled plan consisting of the total calorie distribution of 15% protein, 5-10% saturated fat, 30-35% monounsaturated and polyunsaturated fat, and 45% carbohydrate. Since obesity is the biggest risk factor for type 2 diabetes, even small gradual weight loss can make a difference, especially when the weight loss comes from around the waistline.
Many consumers associate weight loss plans with deprivation, primarily from past experiences of low fat diets. Chefs can make a difference in the quality and flavor of the meals so that weight loss can be achieved without sacrificing the joy of eating.
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