Archive | November, 2012

Just S’more Politics Folks!

8 Nov

Check this out: http://www.healthy-eating-politics.com/american-diabetes-association.html

Carb Counting Basics

5 Nov

Be prepared for information overload in this post…

I am a huge sucker for health documentaries, even though almost all of them start out with the same shocking statistic: 1/3 of all children born in the year 2000 are expected to develop diabetes during their lifetime.  For minority children, the estimate is as high as 1/2!  UnitedHealth group concluded a study with the prediction that 1 out of every 2 Americans will be pre-diabetic or diabetic by the year 2020.  According to the 2011 National Diabetes Fact Sheet, ~8.3% of Americans have diabetes with 7 million undiagnosed.  I’d be shocked if you didn’t know at least 1 person with diabetes.

Only 5% of diabetics have Type 1 diabetes.  This type is often diagnosed in childhood and is the result of a faulty pancreas that does not have the ability to make insulin.  Therefore, Type 1 diabetics are dependent on insulin injections to maintain their blood sugar levels.

Type 2 diabetes is far more common and stems from 2 possible factors: not enough insulin produced or the body cells becoming resistant to insulin’s effects.  A person with Type 2 diabetes may/may not need to receive insulin injections.  Sometimes, a medication is prescribed that helps with insulin resistance.  I believe Metformin is the most commonly prescribed.

Whereas diet and exercise can alleviate and even reverse Type II diabetes, a person with Type 1 diabetes must be careful to coordinate their meals and exercise with their insulin injections.  Too many carbs and not enough insulin = hyperglycemia.  Too much exercise, too much insulin/not enough carbs = hypoglycemia.

Hyperglycemia is when the body has more sugar than it can handle.  Neuropathy (nerve damage) and nephropathy (kidney damage) are common consequences.  In some parts of the world, diabetes is the most common cause of blindness and kidney failure.   Serious business folks!

Hypoglycemia is when the brain does not receive enough glucose (which it REQUIRES to function).  Mild hypoglycemia can generally be treated at home with sugar pills or a glass of orange juice.  More severe cases can result in coma or even death.  Even more serious business folks!

For the entire month of November, I am on my version of a “diabetic diet”.  The day after Thanksgiving, I will be starting my mini-Paleo experiment (Good timing, eh? ;-))  as there will be exactly 1 week left of November starting on Black Friday.

My cat was recently diagnosed with diabetes 😦  which has prompted some early research into the matter as well as the acquisition of some useful tools including a blood sugar monitor.  Everyone with diabetes is different in terms of how often they need to check their blood sugar.  Those with Type 1 diabetes and Type 2 diabetics who are insulin dependent, should check their blood sugar more often.  Holy crap is it expensive!!!  I bought a box of 25 test strips, and it cost me about $25.  That’s $1.00 per strip!  Not to mention the other costs: insulin: $120 per 10ml vial, flimsy syringes & lancets designed to be used only 1 time, lancet pen, blood sugar monitor, etc.  And here’s the real kicker: some of the glucose monitors are more sensitive than others.  If you don’t do it perfectly, you’ll receive an error message and need to use another $1.00 strip to get a different reading.  YIKES!!!

Originally, I had planned on taking my blood sugar at least once a day.  I wanted to see what it felt like to have to prick myself multiple times per day just to keep tabs on my homeostasis.  Unfortunately, I can’t afford to take my blood sugar everyday in the name of science, so now I’m just planning to test my blood sugar at least a few times during the month.

In my dietetics courses, we were taught the exchange system.  The exchange system is based on keeping track of your macronutrient intakes.  Macronutrients consists of carbohydrates, protein, and fat.  The premise of the program is to make sure you are getting the desired percentage of each.  For example, if you wanted to limit your carbohydrate content to 50%, your protein content to 20%, and your fat content to 30%, there is a method one can adopt in attempting to do so.  However, following the exchange system can be a bit overwhelming, especially for the newly diagnosed.  For those who are less interested in dietary perfectionism and more interested in following a less strict but highly effective method, I would encourage carb counting.  Once you’ve got a handle on it, this is a much simpler approach that more people may be comfortable introducing into their daily lives.

Here is how carb counting works:

The first step is identifying caloric needs based on resting metabolic rate and activity level.  From there, a person must choose how many carbohydrates they wish to consume in a day.  According to the USDA, 45-65% of calories should come from carbohydrates.  I strongly disagree.  This is way too many carbs, especially for a person with diabetes.  I am more comfortable with a range of 30-50%.  Many of us (myself obviously included) are carb addicts, so a higher percentage may be appropriate in certain people who do not like the idea of “low carb” or wish to follow a plant-based diet.  However, my personal and professional opinion is that a lower carb diet is more appropriate for most people with diabetes.  For my experiment, I am aiming for no more than 50% of calories coming from carbs.  We can use my numbers as an example:

I need about 1492 calories per day (based on my height, weight, and activity level).  50% of 1492 = 746.  This means that 746 of my calories will be coming from carbs.  Then, divide that number (746) by 4, because there are 4 calories per gram of carbohydrate.  This leaves us with 186.5 grams of carbs per day.

Still with me?

Next, divide by 15, because 1 choice in carb counting is about 15 grams of carbohydrate.  This gives me 12.4 total choices per day.  If I divide this up into 3 meals, I am allowed 4 choices per meal.  Phew!  I hope that all makes sense.  If not, don’t worry.  That’s what dietitians are for. 😉

I have an official “Choose Your Foods: Exchange Lists for Diabetes” reference guide that divides each category of food up into different categories.  As a general rule, 1 serving of starch = 1 choice(15 grams of carb); 1 serving of fruit also = 1 choice(15 grams of carb); milk = a tad more than 3/4 of choice(12 grams of carb).  It’s important to note that all dairy products are not considered equal.  Some hard cheeses are pure protein and therefore, do not contain any carbohydrate.  This is where the reference guide and/or a background knowledge in nutrition comes in handy!  A guide is best for those just starting out, but 1 can branch out by learning and internalizing the general rules of carb counting.

This is the label from a can of black beans.  You’ll notice that it has 20 grams of total carbohydrate & 7.5 grams of fiber.  From this information, we can figure out net carbs.  Don’t worry!  This is much simpler than the hooplah found above. 😉  To get net carbs, we just subtract the grams of fiber from total carbs.  In this case: 20-7.5 = 12.5.  Since fiber is indigestible by definition, we do not have to include it in our carb counting choices.  Therefore, 1/2 cup of black beans has 12.5 grams of carbohydrate.  Using the rules mentioned above, we know that a serving of black beans would = ~3/4 choice since 1 choice = 15 grams of carb.

Here’s another example:

I can have up to 4 carb choices at breakfast.  As stated above, each choice = 15 grams of carbohydrate.

Let’s say I want to have a bowl of oatmeal.  My reference guide tells me that 1/2 cup of cooked oatmeal = 1 choice.  If I eat 1 cup of oatmeal, this will = 2 choices.  To this, I will add 3/4 cup of blueberries (1 choice) and an extra small banana cut into slices (1 choice).  At this point, I have reached my 4 allowed carb choices for breakfast.  I could also add some butter or shredded coconut, but since these are mostly fat, they wouldn’t factor into my allowed carb choices.

I could exchange 1 TBSP of sugar for the banana, as that would also represent 1 carb choice.  A common misperception among people is that a person with diabetes can not have any sugar.  This is not true.  An argument for choosing a slice of whole grain bread over 1 TBSP sugar for nutritional purposes can certainly be made.  However, the fact of the matter is that both will raise blood sugar.  So a sugar really is a sugar is a sugar (& this includes “healthy” starches).  It is often shocking to people that 2 slices of whole wheat bread can spike blood sugar more than a TBSP sugar, but that’s what brainwashing will do to a nation.

Is that enough brain stretching for 1 day?  Let’s wrap it up with my November 1st menu.

What I ate my first day on my diabetic diet:

Breakfast: Smoothie made with 1 cup of soymilk, 1/2 cup of blueberries, 1 banana, collard green leaf, romain lettuce leaves, and cinnamon.  Approximate CHO (carbohydrate) count: 3 choices

Lunch: Brown rice tortilla with 1 oz pepperjack cheese, spinach, lettuce, & red pepper + a handful of almonds

Approximate CHO count: 2 choices

Snack: 1 fun-sized Kit Kat bar & 1 Reese’s peanut butter cup (Soy lecithin!  How I missed you!)

Approximate CHO count: 1 1/2 choices

Supper: Spaghetti with buckwheat noodles, tomato sauce with chopped collard greens, kale, and red pepper, & 4 meatballs; salad with lettuce, spinach, carrots, strawberries, olive oil, and balsamic vinegar

Approximate CHO count: 4

I only used10 1/2 total carb choices on this day rather than the allowed maximum of 12.  My appetite was still quelled from my carb binge the day before (see previous post: “Soyless Joyless Halloween” – What I ate my last day with a soy and egg allergy).  By the way, you can’t eat meat all day and then splurge on 6 frosted cupcakes (the equivalent of 12 carb choices) at the end of the day.  You need to space your carb choices out!

Sources:

http://www.diabetes.org/diabetes-basics/diabetes-statistics/?cr=redcpcggfreediabetesstatistics&gclid=CM7QuumfuLMCFcKPPAodzV4Aaw

http://www.nlm.nih.gov/medlineplus/magazine/issues/summer08/articles/summer08pg14-15.html

http://phys.org/news/2010-11-americans-diabetic-pre-diabetic.html

http://reboot.fcc.gov/parents/media-and-childhood-obesity

http://www.renalinfo.com/uk/how_kidneys_work_and_fail/kidney_failure/causes_of_kidney_failure/diabetes_mellitus.html

 

Soyless Joyless Halloween

2 Nov

Just 2 months left of structured eating! I really do apologize for the lack of information regarding the most recent diets.  Again, laziness is my sin.  However, I reiterate that the information in my book will be far more complete! 😀  Here’s a quick overview of soy and egg allergies:

Soy allergies: Similar to dairy, soy allergies generally develop in infants & are often outgrown.  Almost half of all babies with an allergy to cow’s milk develop soy allergies when fed soy-based formulas.  Breastfeeding (when possible) is one of the best ways to avoid soy allergies. Some common symptoms involve skin reactions such as eczema, acne, canker sores, & hives along with possible rhinitis, asthma, & gastrointestinal disturbances.  Soy is a rare cause of anaphylaxis.  Similar to peanut oil, pure soy oil should not theoretically cause an allergic reaction.  However, due to the possibility of contamination with soy protein, it’s best to avoid soy oil.

Egg allergies: The proteins in egg whites cause most of the allergic reactions, but people can have reactions to the yolks as well.  Egg allergies are  again, common in children and generally outgrown but can be very serious while active.  Some vaccines contain egg proteins and must be avoided by those with egg allergies.

As previously mentioned, I followed a soy free & egg free diet for the final 2 weeks of October.  Translation: soyless joyless Halloween.  Soy lecithin is a food additive that serves as an emulsifier.  It’s found in virtually EVERY Halloween candy I encountered (except for Smarties, Dum Dums, and other fruity candies that I could care less about!)  If we are talking about the most sought after Halloween candy, such as Snickers bars and Reese’s peanut butter cups, these were a no go.  Luckily, I did discover the most amazing dark chocolate that I have ever tasted in my life at my favorite health food store.  Made with stone-ground Mexican chocolate and free of soy, it was the lifesaver I needed to rescue me (and those around me) from my pouty I want Halloween candy too! phase.  I ate waaayy too much of it though.  The consequences included spending a ridiculous amount of money (one bar costs ~$5.50, because it’s QUALITY stuff) and not sleeping well for a couple of days (Hello caffeine!)

What I ate my last day with a dairy & tree nuts allergy (October 15th)

Breakfast: bacon wrapped cucumber slices + homemade hashbrowns fried in olive oil & bacon grease with shredded carrot, zucchini, homemade tomato sauce, spinach, & nutritional yeast flakes (remember that cheesy vegan stuff?); 1/2 cup blueberries & strawberries

Lunch: smoothy made with banana, coconut milk, and baby romaine leaves; more hashbrowns & 1 slice of bacon

Supper: turkey salad with baby romaine, romaine hearts, tomato, cucumber, bean sprouts, 1 dehydrated tomato slice, & grated radish

What I ate my first day with an egg & soy allergy (October 16th)

Breakfast: hashbrowns + 2 pieces of bacon; glass of coconut milk + a few bites of coconut cream [FAT!!!];  1/2 cup strawberries & blueberries

Lunch: curried turkey soup (with butternut & delicata squash)

Supper: more curried turkey squash soup + baba ghanoush with dehydrated tomato “chips”, carrots, & cucumber slices

After work/before bed: tomato “chips” with baba ghanoush, 1/2 banana with coconut cream & several spoonfuls of coconut cream; MORE curried turkey squash soup (Why not?)

So I need to reign in my love of food fat a lot a little.  Freudian slips? 😉 No need to point this out to me!  This experiment has taught me just as much about my disordered eating habits (and the disordered eating habits of others) as about food sensitivities.

What I ate my last day with an egg & soy allergy (October 31st) – [Also my last opportunity to binge on carbs before starting my diabetes diet mind you!]

Breakfast: Cheerios with almond milk, coconut flakes, banana slices, blueberries, almonds, & cinnamon

Snack: strawberries & almonds

Lunch: whole wheat cheddar potato pot pie; smoothie made with romaine hearts, raspberries, banana slices, & strawberries; spelt flaxseed pita chips with hummus

Dinner: spelt flaxseed pita chips with hummus + brown rice tortilla with pepperjack cheese, green onions (green parts only), spinach, & lettuce

Sins to confess:

There’s a lot, so brace yourself!

While on my honeymoon, I was avoiding dairy and tree nuts.  I was careful to inquire about whether or not there was dairy in the bun of my fish sandwich without asking about the fish itself.  I had expected and hoped that the walleye sandwich I ordered was going to be fresh rather than fried.  I don’t order fish at restaurants very often, but I should have known better.  There is a good chance the breading on the fish contained dairy. I felt too guilty when it arrived (after the previous ingredient list scavenger hunts I sent the waitress on) to change my order.

I wasn’t as hardcore towards my allergic diet as I originally intended.  Somewhere into the 2nd week (technically speaking, 6th week of overall allergic dieting), I stopped avoiding packages with warning labels stating: “Processed in a facility that also produces…”.  Different kinds of terminology are used on food packages, and I’m not sure any are more accurate than the others.  However, if I had encountered a label that stated “May contain…”, I wouldn’t have bought and/or consumed it.  Here’s where the experiment becomes even less scientific.  While I was making a conscious effort to avoid these warning labels in the beginning of the allergic diets, I wasn’t bothering to purchase every prepackaged item with allergen free promises on the label.  Companies who use these warning labels are essentially just being nice and/or covering all of their potential lawsuit bases.  There in no law requiring such labeling.  There is, however, a law that any of the top 8 allergens: milk, eggs, fish, shellfish, soy, wheat, peanuts, and/or tree nuts used in the product itself must be clearly stated.  For example, if there is an additive derived from milk, the package must clearly state this in the ingredients list or somewhere else on the label.

Towards the very end of the soy-free, egg-free experiment, I went grocery shopping to buy items to feed myself for the first week of my diabetes diet.  Once again getting my brain in a whirl between what I could have on 1 day and not the next, I ate crackers with soy in the ingredients list!  I noticed this as I was eating them and had a couple more before the guilt sunk in enough to stop me!

Cravings: During my soy & egg allergy phase, I wanted cookie dough ice cream REALLY BAD!  Since eggs are so common in cookie dough, and I wouldn’t settle for anything else, I had to give up the dream. 😦

Lessons learned:  I promised an overview of a honeymoon with dairy and tree nut allergies, so you’re going to get one!

At the first restaurant we went to, there were NO dessert options that did not include dairy: cheesecake, ice cream topped cake, etc. Lesson #1: Life is unfair, & dessert options are far more limited when you cannot have dairy.

As much as Derek and I enjoy each others’ company, we are human with human vices that follow us on vacation.  “I want a cigarette so bad right now you have no idea!”  wined Derek as we sat around our cabin’s fire pit.  I had tried to guilt him into giving up cigarettes before the wedding, because he had always said he would quit by the time he was 30.  (This is based on science by the way.  Much of the damage done to the lungs of young smokers in their 20s will fix itself if smoking is given up early.  After that, all bets are off!)  I don’t know where he got the great idea to try and give up smoking on our honeymoon, because the last thing I wanted was to hang out with Cranky McCrank pants while taking in beautiful Lake Superior.  Utilizing all of the willpower and coping skills of a 3 year old, I offered: “Should we go get cigarettes and ice cream?”

So we did.

I had a heck of a time trying to find something awesome to put in my vanilla Soy Dream “ice cream” at the small town grocery store we happened upon.  Luckily, before deciding that a container of cocoa would have to suffice, I spotted a small allergen friendly section in one of the aisles.  “K-toos!”  K-toos are dairy-,tree-nut-, and gluten-free Oreo type cookies that taste pretty amazing (better than Oreos if you ask me).  Lesson #2: While it’s harder to be picky about dessert when you’ve got multiple food allergies, the food industry has got your back in making sure you can still feed your sugar addiction! 

Update: Derek is still smoking, and I’m still a sugar addict.  Sigh…

Without the threat of death staring you in the face, it’s hard to convince yourself to avoid numerous packaged goods “just to be safe”.  I did some reading, including various allergy discussion forms.  It seems that unless you are feeding a child, paranoid (such as myself), or susceptible to anaphylactic shock, many people with allergies will still purchase products with warning labels concerning cross-contamination.  Company phone calls are another common approach.  However, if you are paranoid (like me), you might not trust what the dispatcher tells you.  Basically, it is the severity of the allergies weighed against the threats and conveniences of the modern food system that may determine how far a person is willing to take his/her allergen-friendly shopping endeavors.

Sources:

Joneja, J. (2003) Dealing with Food Allergies (Pg. 151-159, 181-187)

Larsen, L. (2008) The Everything Food Allergy Cookbook (Pages 11 & 13)