Using the REACH Diabetes Food Guide Pyramid

A Diabetes Food Guide Pyramid is different than the USDA MyPyramid because the food groups are based on carbohydrate and protein content instead of the type of food. For example, while you might think of potatoes, corn, and winter squash as a vegetable, in a diabetes pyramid you will find these foods in the grains, beans and starchy vegetables group. That is because these starchy vegetables have similar amounts of carbohydrate per serving as rice and pasta. You will also find cheese is in the meat group when you might expect to find it in the dairy section. Cheese is a significant source of protein and fat, but much less so of calcium and carbohydrates. To have about the same carbohydrate content in each serving, the portion sizes for grains, cereals, and fruit juice are generally smaller than those you see listed in MyPyramid or on Nutrition Facts Labels on packaged foods. For example, a serving of rice is 1/3 cup in a Diabetes Food Pyramid and is 1/2 cup in the USDA pyramid.

The REACH Diabetes Food Guide Pyramid gives a range of servings which are consistent with American Diabetes Association nutrition guidelines. If you eat the minimum number of servings in each listed, you will eat about 1600 calories. If you eat the maximum number of servings in each group, you will eat about 2800 calories. Everyone is different and there is no one "diabetes diet." The number of servings consume will depend on your age, gender, activity level, and your blood sugar goals. Regardless of the number of servings in each food group that you consume, remember to spread your meals throughout the day, eating on a schedule, with an emphasis on whole grains, fruit, vegetables, lean meats, and foods that are low in saturated fat.

Bread, cereal, pasta, and grains are found at the bottom of the REACH Diabetes Meal Planning Guides. The nutrient in these foods is mostly carbohydrates, but they may also have varying amounts of protein or fat. Included in this group are potatoes, peas, along with dry, cooked beans such as white, black, red and pinto beans, lentils, and garbanzo beans. Serving sizes in this group are not the same, but each will have a similar amount of carbohydrate per serving.

Choose 6-11 servings per day. If you are like most people, you will probably eat fewer than 11 servings from this group daily. You are not required to eat the maximum serving, but should use this range as a guide for meal planning. Each serving from this food group has about 15 grams of carbohydrate. Six servings of grains provide about 90 grams of carbohydrate. Most people eat 2-4 servings from this group at each meal (or 30-60 grams of carbohydrate).

All types of grains are included in a diabetes meal plan. The 2005 US Dietary Guidelines for Americans recommend that at least half of the grain products consumed daily should be made of whole grains.

Grains and cereals that contain 5 or more grams of fiber per serving are considered to be high in fiber. Subtract the grams of fiber from the total carbohydrate amount to calculate the amount of carbohydrate per serving. The recommended level of fiber for most adults is 25-35 grams per day.

Most of the vegetables in this group are low in fat and calories and a good source of fiber, vitamins, and minerals. The non-starchy vegetable group includes leafy greens such as spinach, mustard and collard greens, broccoli, cabbage, bok choy, peppers, summer squash, cauliflower, carrots, tomatoes, cucumbers, etc. Vegetables in this group have about 5 grams or less of carbohydrate per 1/2 cup serving. This group is considered to be "free" in small servings. If you eat more than a cup of these types of vegetables at a meal, you may need to consider the amount carbohydrates you are adding to your daily intake. The 2005 Dietary Guidelines for Americans recommend that most adults eat 2 to 2-1/2 cups of vegetables daily.

The fruit group is another rich source of carbohydrates and can have a big impact on your blood sugar. Fruits are also a good source of fiber, vitamins, and minerals. The average serving size is 1/2 cup and is equal to about 15 grams of carbohydrate. The 2005 Dietary Guidelines for Americans recommend that most adults eat 1-1/2 to 2 cups of whole fruit daily. People with diabetes should spread their fruit intake throughout the day and limit their intake of juice.

Most milk products are rich in protein, calcium, vitamin D, potassium and other important vitamins and minerals. If you consume dairy products, choose nonfat or lowfat products to reduce your intake of total and saturated fat. Milk has 12 grams of carbohydrate for every 8-ounce serving. While yogurt is often included in this group, it may have over 50 grams of carbohydrates per 8-ounce serving depending on the brand and flavor. Read labels and choose yogurt that has less added sugar to reduce carbohydrates. Many Asian older adults do not drink milk or eat dairy products and are at risk for not getting enough calcium and vitamin D. If you drink soy or rice milk, choose products that have been fortified with calcium and vitamin D. Non-starchy, leafy green vegetable are good sources of calcium and will not significantly impact carbohydrate load and should be included to meet calcium nutrient needs.

The Protein-Rich group includes beef, chicken, fish, turkey, eggs, tofu, cheese, cottage cheese and peanut butter. Meat and meat substitutes made with soy or vegetables are also included in this group and may be a lower fat choice.

These types of food have very little carbohydrate and will not significantly impact blood sugar. But, these foods may contain a lot of fat, especially saturated fat. Select lean cuts of meat and trim visible fat before cooking. Remove the skin from poultry and fish before cooking. Bake, broil, steam, poach, or grill meats to reduce fat. Keep your portion sizes small. Three ounces is about the size of a deck of cards. Most adults only need 5-7 ounces for the whole day.

As you see, dry, cooked beans are in both the protein and the starchy food groups. Dry, cooked beans and legumes are excellent sources of low-fat, high-fiber protein, but also contain approximately 15 grams of carbohydrates per 1/2 cup serving.

People with diabetes may eat sugar and depending on their medication, may drink alcohol in moderation. Individuals should check with their health care provider about medication and alcohol interactions.

Sweets such as pastries, cookies, candy can be substituted in a healthy diet for other carbohydrates on a limited basis. Individuals should plan for a dessert as part of their meal. Although sugar and sweets can be eaten as part of a healthy diet, these foods often have little nutrient value and are usually high in calories and fat.

Healthy fats should be substituted for saturated and trans fats. Healthy fats include olive, canola, peanut, and sesame oils. Avocados, nuts, and seeds are also sources of healthful oils. Oils and fats do not contain carbohydrates and even though these types of food will have little impact on blood sugars, they are high in calories.

The basic guidelines for diabetes meal planning are from the American Diabetes Associations and are as follows:

• Eat meals and snacks at regular times every day.
• Eat about the same amount of food every day.
• Try not to skip meals. If you want to lose weight, cut down on your portion size.
• Eat a variety of foods every day.
• Eat foods rich in fiber such as vegetables, fruit, whole grains, and beans.
• Use less added fat, sugar, and salt.