INTERMEDIATE CARBOHYDRATE COUNTING

1
Controlling Diabetes During the Holidays
Janine Freeman, RD,LD,CDE UGA Extension Nutrition
Specialist
2
Tis The Season For Temptation

• Out-of-control blood sugars
• Extra pounds

3
Holidays Are A Time To

• Share with family and loved ones
• Become spiritually connected
• Shop, decorate the house, wrap gifts
• Bake and cook
• Eat, eat, eat...

4
Focus On Holiday Activities That Dont Involve
Food

• Decorating for the holidays
• Attending holiday musicals or plays
• Christmas caroling
• Shopping
• Gift-giving

5
Make Time for Physical Activity

• Relieves your stress
• Improves your mood
• Lowers your blood glucose levels
• Helps with weight control

6
Fit Physical Activity Into Your Busy Schedule

• Split your activity into 2 or 3 intervals of
  10-15 minutes each
• Make physical activity a family event
• Walk around the neighborhood after dinner
• Go mall-walking
• Park farther from your destination

7
Stay Active While Travelling

• Wear walking shoes
• Get to airport early and walk concourses
• Take very little carry-on luggage and walk during
  layovers
• Look for hotels with exercise facilities

8
Lighten Up Your Favorite Holiday Foods

• Make changes in recipes to
• lower the carbohydrate
• less effect on blood glucose
• lower the fat or change the type of fat
• healthier for your heart
• fewer calories

9
Holiday Baking

• Desserts can be made with
• sugar
• low-calorie sweeteners

10
Use of Sugar in Diabetes Meal Plan

• Raises blood glucose levels in similar way to
  starches
• Can be used in moderation

11
Use of Sugar in the Meal Plan

• Substitute sweets for other carbohydrate in the
  same meal
• Check effect on your blood glucose after meals

12
Role of Sugar in Baking

• Sugar provides volume, texture, moistness, and
  browning
• Low-calorie sweeteners only provide sweet taste

13
Sugar in Baking

• Sugar is needed in yeast breads to raise
• The quality of many cakes and cookies suffer with
  reduced sugar or no sugar

14
Low-calorie Sweeteners in Baking

• Sucralose (Splenda)
• Aspartame (Equal, NutraSweet)
• Acesulfame-K (Sweet-One)
• Saccharin (Sweet n Low, Sugar-Twin)
• Neotame (recently approved by FDA)

15
Sucralose (Splenda)

• 600 times sweeter than sugar
• Stable at high cooking temperatures
• Recipes available on web site
• www.splenda.com

16
Consider Heat Stability of Sweeteners for Cooking
or Baking

• Unstable at high temperatures
• Aspartame (loses sweetness)
• Saccharin (becomes bitter)
• Stable in cooking and baking
• Sucralose
• Acesulfame-K

17
Increase Stability of Aspartame

• (Equal, NutraSweet, store brands)
• Add to food after cooking
• Combine with more stable sweetener
• Add acidic ingredient

18
Low-calorie Sweeteners

• In general, use when sugar is primarily for sweet
  taste
• Fruit fillings (pies, cobblers)
• Custards
• Puddings
• Beverages
• Frozen desserts
• Sauces and marinades

19
Low-calorie Sweeteners

• Do not work well as the sole sweetener
• in these foods
• Meringues
• Angel food cake
• Pecan pies
• Pound cake

20
Tips for Using Low Calorie Sweeteners in Baking

• Cookies, muffins, quickbreads
• Honey or molasses will add some flavor and
  moistness
• Add baking soda
• Check for doneness early

21
Tips for Using Low Calorie Sweeteners in Baking

• Cakes
• Use molasses or cocoa for browning
• Add 1/2 cup nonfat dry milk and 1/2 tsp baking
  soda for every cup of sugar replaced
• Combine sugar with low calorie sweetener

22
Tips for Using Low Calorie Sweeteners in Baking

• Fruit fillings, sauces, puddings, custards
• Add thickening
• Reduce cooking time

23
Choose A Sweetener for Pumpkin Pie

• What is the purpose of sugar in pumpkin pie?
• Primarily sweet taste
• Which sweeteners could be used?
• Equal, Splenda, Sweet-One, or others

24
Choose a Sweetener for Red Velvet Cake

• What is the purpose of sugar in a red velvet
  cake?
• Volume, texture, tenderness, moistness
• Would you use a sweetener? If so, which one?
• Sugar would work best

25
Choose a Sweetener for Christmas Cookies

• What is the purpose of sugar in cookies?
• Texture, tenderness, browning, moistness, taste,
  volume
• What sweetener would you use?
• Sugar alone or sugar with Splenda, Equal,
  Sweet-One

26
Sugar vs Low-calorie Sweetener

• Pumpkin pie with sugar
• 38 grams carb

• Pumpkin pie with low-calorie sweetener
• 20 grams carb

27
Sugar vs Low-calorie Sweetener

• 12 ounces Iced Tea with Sugar
• 33 grams carb

• 12 ounces Iced Tea with Low Calorie Sweetener
• 0 grams carb

28
Reduce Fat in Recipes

• Non-baked foods
• Substitute fat with non-fat or low-fat
  ingredients
• Reduce the fat

29
Reduce Fat in Recipes

• In baking
• Some fat needed for flavor, moisture, and
  tenderness

30
Reduce Fat in Recipes

• In baking
• Use low-fat yogurt or sour cream in place of
  regular sour cream in cookies and muffins
• Replace fat with 1/2 amount of fruit puree or
  applesauce
• 1/2 cup prune or banana
• puree in place of 1 cup
• margarine

31
Traditional vs Healthy Pumpkin Pie
32
Holiday Meals
33
Holiday Meal Tips

• Identify carbohydrate foods
• (carbohydrates raise the blood glucose the most)

Starches bread and rolls, stuffing, potatoes,
sweet potatoes, corn, peas, butter
beans Sugars fruit, candy, desserts, milk,
sodas, sweet tea, eggnog
34
Holiday Meal Tips

• Eat usual daily amount of carbohydrate
• Space out carbohydrate based on timing of holiday
  meal
• Adjust insulin based on carbohydrate if youve
  been trained
• Check blood glucose regularly

35
Holiday Meal Tips

• Fill up on low-calorie salads and vegetables
• Avoid second helpings
• Use high-fat condiments sparingly
• Small portion of dessert can be eaten in place of
  other carbohydrate foods

36
Estimating Portion Sizes

• 1 cup pasta womans clenched fist
• ½ cup vegs ½ tennis ball
• 1 fruit serving 1 tennis ball
• 3 ounces meat deck of cards
• 1 teaspoon thumb-tip
• 1 tablespoon 2 thumbs pressed together

37
Make Smart Food Choices

• 63 grams carb
• 1 piece pecan pie
• (1/8 of pie)

• 58 grams carb
• 1/2 cup mashed potatoes
• 1/2 cup stuffing
• 1 roll
• 1/2 cup green beans
• 3 ounces turkey
• 2 Tbs. gravy
• Tossed salad with Italian dressing

38
Holiday Meal

• 3 ounces turkey
• 1/2 cup stuffing (20 grams carb)
• 2 Tbs. gravy
• 1/2 cup green beans (5 grams carb)
• Tossed salad with Italian dressing
• 1 slice pumpkin pie (38 g carb - sugar)
• (20 g carb with sweetener)

Total carb 63 grams (45 grams)
39
Traditional Holiday Dinner

• Traditional
• Waldorf Salad
• Roast Turkey/gravy
• Green Bean Casserole
• Mashed Potatoes/Gravy
• Sausage Stuffing/gravy
• Cranberry Sauce
• Dinner rolls with butter
• Pecan Pie

• Alternative
• Low-fat mayonnaise
• Without gravy
• Plain beans or ff soup
• Eliminate gravy
• Avoid sausage
• SF cranberry relish
• Eliminate butter
• Pumpkin Pie

40
Attending Holiday Parties

• Plan ahead what you will eat
• Offer to bring a healthy dish
• Eat something light at home to curb your appetite

41
Attending Holiday Parties

• Skip second helpings
• Avoid lingering near buffet table
• Mingle with guests - youll eat less

42
Limit Alcoholic Beverages

• Reduces willpower
• Adds extra pounds
• Can cause hypoglycemia if taking insulin
• Always eat something when drinking

43
Holiday Entertaining

• Reduce stress by planning ahead
• Ask people to bring a dish
• Dont try to be a Martha Stewart
• Get enough sleep

44
Reduce Your Stress

• Plan ahead
• Make a shopping list
• Take a vacation day to do your shopping or
  holiday baking
• Schedule physical activity

45
Enjoy Your Holidays

• Dont set your expectations too high
• Enjoy your holiday festivities

46
Happy Holidays!
47
Practical Non-food Gifts to Give or Receive

• Pedometer
• Exercise video
• Walking shoes
• Exercise clothes
• Fitness class
• Gift certificate to spa
• Healthy cookbook