January 16, 2012

Eating Well For You and Baby

My friend, Jen T. over at Many Blessings, Busy Life requested some information on how I manage my diabetes and pregnancy.  It has taken me far too long to get to it.  But here it is.

My Story

When I was diagnosed with diabetes, at a very young age, I was caught quite off guard.  I knew I was at  risk because of my family history.  However, I was well below the average age of the typical person who develops diabetes.  I exercised faithfully.  I ate well.  I maintained a healthy weight.  My doctor and I agreed I was one of the healthiest people we knew.  But here it was.

Being diagnosed so much earlier, was both a blessing and a curse.  The longer one has diabetes, the more likely you are to develop side effects.  However, on the positive side, because I was diagnosed early, I had a lot of opportunity to control the outcome.

I learned everything I could about the disease and decided, if you have to have something, this was a good thing to have.  Unlike many chronic illnesses, diseases and disorders, we can have a lot of control over diabetes.  Exercise and diet have a huge impact on the rise and fall of high levels of blood glucose that can cause the harmful effects of diabetes.  I like knowing that I can do something.

My studying really paid off.  Except during pregnancy, when I am insulin dependent, I have been able to completely control my blood sugar drug free for more than six years.  And it really isn't very difficult.  Nor do I ever feel I have been deprived of something.

What is that you say?  You aren't diabetic.  Well before you stop reading, let me share what I learned in my training classes.  If all Americans stuck to a diabetic diet we would see much less obesity and sickness.  That's right.  A diabetic lifestyle is good for everyone and it is your best prevention for developing the disease to begin with.

I am going to focus mostly on pregnancy and blood glucose control because Jen is looking to control her weight and keep baby a healthy size for a safer delivery.  However, once again, there is very little difference in what is healthy for expecting mamas and the rest of us.

Exercise, An Important Role

I would like to talk just briefly about exercise because while it plays a vital role, it really is quite a simple thing to understand.  We all need to get up and get moving.  But it doesn't need to be a big ordeal.  It doesn't need to be complicated.  We don't even need to put on exercise clothes.  While I have been an avid exerciser for most of my life, in conjunction with diabetes I found a simple 10 minute walk following each meal was all it took to reduce my blood sugar to safe levels and therefor reduce the amount of medication and injections needed.  I can not over stress this enough.  Just get up from the table and take a ten minute stroll.  Or if you prefer, pop in a video.  Pull out the old weights and do a few curls.  Or hop on a bike, stationary or the good old fashioned kind.  Or the tread mill.  Put in a CD and dance with the kids for 3 or 4 songs.  The weather is no good?  No room for exercise equipment?  Walk up and the down the stairs for ten minutes.  The impact just ten minutes of moving has on your blood glucose and energy levels is phenomenal.  If I can fit three ten minute sessions in my day, anyone can, so you have no excuse not to do it.  And you will be shocked at the difference it makes.  Commit to it for just one week and then email me and tell me how much better you feel.  If you are going for blood glucose control it is important that this follow your three meals.

Keys to a Good Diet
An important key to keeping blood glucose in check is protein.  This was initially very hard for me not being someone who regularly ate meat.

Another key (to prevent hypoglycemia and to make sure baby is getting enough nutrition) is eating every three hours throughout the day (and often during the night, too.)  I don't typically eat so often or so much during the day so I literally have to set a timer to go off every three hours to remind me to eat. The large increase in calories means big gains at the scale (about 60 pounds a pregnancy) which is tough and frustrating because I know I will have to work it back off. However, I have had 3 successful pregnancies and deliveries since I was diagnosed with diabetes so I will gladly do it all. Most people would not need to stick to the every three hours but you will likely find you feel better if you do.

One more important  key is to know how to count carbohydrate servings and balancing your meals accordingly. Each carb serving is made up of 15 carbohydrates.  Each meal and snack should contain 2 carbohydrate servings for a total of 30 carbs.  For example, an apple is 15 carbs or 1 carb serving.  A slice of whole grain bread is 15 carbs or one carb serving.  Add some peanut butter and you have a great breakfast with 30 carbs and some protein.

Many people have no idea what a carb is so let me simplify it. Milk, grains (oatmeal, grits, wheat, pasta, bread, cous cous...) fruit and starchy veggies (winter squash, potatoes, sweet potatoes) dry beans and legumes, sugars (including honey, molasses, syrup) and of course ice cream, sodas, other sweetened drinks (sweet tea, lemonade, energy drinks) desserts and other sweets.

I am allergic to milk so it is not part of my meal plan.  However, if you are a milk drinker, you could add it to your meal plan in exchange for another carbohydrate serving.  8 ounces of milk is 15 carbs or 1 carb serving. Learning to read the packages is the way to go so you can plan your meals accordingly.

I rarely consume simple sugars and when I am pregnant it is even rarer. It is just too hard on me and baby. However, there is no reason you can not eat anything you desire, as long as you count the carbs and stick to the carb limit.

Resources
A good set of measuring cups and spoons and an electronic scale will go a long way in helping you to do this.

I like the website Calorie King to look up carb counts to help plan my meals at home.  I find it helpful to plan ahead when we will be dining out.  Calorie King has a huge database of restaurant meals.

I also keep the exchange list for diabetics) in my kitchen. This is also available at Amazon. It is only a few dollars but a great investment if you are working towards better health.

When I calculate a recipe I write down the carb count and serving size for 30 carbs right on the recipe card or in my cook book so I have it readily available next time. It is quite simple to calculate the carbs in your favorite recipe and you might be surprised at what you come up with.  This is an excellent exercise for those home school moms out there.

One cook book I really like is Fix-it and Forget-it diabetic cookbook. I find I prefer to eat what I like and limit the serving to my carb intake. I truly am never hungry and when I stick to my carb limit I feel fabulous.

Most Americans eat too much food in general and specifically too many carbs for their health sake. I do not in any way advocate a low carb or carb free diet. These are unhealthy and down right dangerous. But the enormous amount of carbs consumed by the average American is killing them. And looking around at the amount of illness caused by poor eating and obesity, I am sure you don't need me to tell you that.

My Meal Plan
To give you an idea of how my meal plan works, here is my simple pregnancy meals.

The biggest change from my regular meal plan is breakfast.  As a general rule I typically eat fruit for breakfast. But when I am pregnant my sugar can not handle it. Keep in mind that these are just suggestions from what I like to eat.  You can easily mix and match from any meal.  The key is to keep to those 30 carbs/6 times a day/every 3 hours or if you aren't pregnant and would prefer you can divide 180 carbs over 3 meals.

Breakfast is typically one of the following: oatmeal with nuts, a peanut butter sandwich on whole wheat bread, 2 slices of whole wheat toast with butter,  2 Whole grain waffles with butter, a whole wheat english muffin, half a whole grain bagel with cream cheese, 1/3 cup home made granola (30 carbs worth).  If I am not having another source of protein (peanut butter and nuts) I also include an egg white that has been hard boiled or fried.  I am allergic to the yolk but it is a good source of fat if you desire to eat it.

For my 9 am snack I typically have 30 carbs of fruit with a spoonful of peanut butter or a handful of nuts for the protein to stabilize my glucose. Alternately, I would have anything from the list above.

At lunch, I am a big fan of tuna salad on two slices of rye bread and will eat it almost every day when I am expecting. I like to have a pile of raw veggies or a nice big salad with this.

 My 3 pm snack is usually 30 carbs of fruit with an ounce of cheese or some peanut butter.  I love to slice a granny smith apple thin and slice some cheese and use the apple in place of crackers.

At 6 I eat dinner from whatever I prepared for the family with lots of veggies or a nice salad.

At 9 pm I have a tuna sandwich, peanut butter sandwich or 30 carbs of fruit with a big spoon of peanut butter.

Jen, as I said in my email, I am sorry this took so long to get to you.  I hope it is helpful to you, yet.  I appreciate you spurring me on to do it.  This has been on my mind to blog about for a long while but somehow something else always comes up.  Wishing you and baby the best for these last few weeks.  We can hardly wait to meet your new blessing.

Hugs,

Kat

11 comments :

  1. What a great post! Just so I read it the correct way on the carbs at each meal. You eat 30 carbs per meal? Does this include your snacks? So that would be 90 carbs a day without snacks, even when expecting? Do you increase your carbs when expecting?

    Pamela

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  2. i do not have diabetes ,however i do need to lose weight...then what do you drink in your coffee since you are allergic to milk,and also we shouldn't count milk as a dairy? about how many calories do you eat in a day? thanks Kat :)

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  3. Hi, Gaby.

    Please be a dear and email me. I looked all over on Saturday and again today and yet I can not seem to find your email address in my database. Although, I know it is there somewhere. ☺

    To answer your questions...

    I drink half and half in my coffee. I can tolerate that since it is mostly fat and because it is such a small amount.

    Milk does count as a dairy and is a carbohydrate. The lactose in milk is a sugar. However, I should mention that a small amount of milk in your coffee is not counted in your carb servings. However, if you were to have, say a latte, which is usually about 8 ounces of milk, would count as a carb serving.

    As for calories? I really don't know how many calories I consume each day. I don't track calories. If I had to make a guess I would say between 1500 and 2000 calories a day. On the average day, probably closer to 1500. During pregnancy and nursing closer to 2000.

    I hope you find this helpful!

    Hugs,

    Kat

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  4. Gaby,

    One more note on calories... I should point out that I am a very small person. Standing at my full height I am only 5 foot 2 inches and I am small boned. So I require much less calories than say my Brianna who is almost 5 foot 10 inches and medium to large boned.

    And there is always the consideration of your activity level. I find I eat much less in the winter, when we are sitting around indoors all the time, than in the summer when I am outside running and walking and swimming and gardening, etc...

    A sedentary woman who is Brianna's height might still require only 1800 or less calories a day.

    Eating for health versus eating for weight loss will bring you far more success any day no matter what your body size.

    Hugs,

    Kat

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  5. Hi, Pamela.

    Glad to see you here this afternoon. I do no more than 30 carbs per meal and at each snack. When I am pregnant this is 30 carbs at each meal and each snack, no more and no less. That is a total of 180 carbs per day, or 12 carb servings. However, when I am not pregnant, I find that I don't usually require the 3 snacks per day. So I do more like 90 or 120 carbs per day. I will sometimes have a snack in the evening before bed, not really because I am hungry, so much as I like popcorn. ☺A diabetic pregnant woman really needs the higher carb count. And because I am insulin dependent, I often become hypoglycemic and require extra carbs to bring my glucose back up to a safe level. I feel like all I do is eat when I am expecting!

    The prescribed carb servings for a non diabetic or a non pregnant diabetic would be 60 grams or 4 carb servings per meal. That would be equivalent to 4 cups of milk or 4 slices of bread or 4 fruit servings. That's a lot of food. A breakfast, for example, might be a fried egg, a sliced apple, a cup of milk, and two slices of whole wheat toast. Or a lunch of 60 carbs would be a sandwich on whole wheat bread with tuna salad, a glass of milk and an orange.

    I hope that helps you out.

    Hugs,

    Kat

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  6. Great post! We control Doug's diabetes by diet and exercise and at 68..almost 69 he takes a low dose medication. Quite impressive for someone his age with diabetes. We keep it in the normal range. Americans really need to re-evaluate their eating. Almost all Americans are likely to end up with diabetes just b/c of the way they eat. Okay, I will get off my soap box before a reader gets too upset with me and I will end by saying...I understand how hard it is to eat correctly b/c I struggle with keeping good eating habits myself. LOVE YOU, andrea

    PS: THANKS for your continued prayers and support. You will NEVER know what it means to me.

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    1. Andrea,

      If we can't pray for our sisters and brothers, what could are we?

      Hugs to you,

      Kat

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  7. Kat, thanks so much for posting this. Not so much for me, 'cause of the email you sent, but I can tell others need the information too. This has already helped me a lot. I have found (like I told you in my email) that when I eat healthier, I don't eat as much. My hubby and I go on dates once a week and I have found I am not able to finish my meal like I used to. I have actually lost weight with this pregnancy, but the baby is still growing (just not too much). I lost 4 lbs just in the last week. I told dh that I've discovered that when you are limited to what you can eat, you don't eat as much! And I also don't miss the things I'm not eating! Oh sure, I would love a chocolate shake or a Cinnabon, but I know that I can have that after the baby is born. It is so worth not eating those things, knowing that the baby will be healthy and the birth will be easier. Thanks, again!

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    1. Hi, Jen.

      It is so encouraging to hear of your success with eating better and maintaining your weight during this pregnancy. I do pray it brings you an easier delivery and recovery.

      One additional note I wanted to make to your comment concerning Cinnabons (ours closed years ago... haven't had one in forever and a day... yum!) and chocolate shakes is that one important point to maintaining health without depriving yourself of what you like to eat, is simple getting into the mindset that you can have a little and be satisfied. You needn't eat and entire cinnabon just because you have it. I love Sees Truffles. And I really love the variety. However, I have found that one bite of a truffle is enough for me to satisfy my craving. I like to make sure that whenever I eat anything, it is in a setting where I am really conscious of my food. I do not eat in the car... ever. (Okay, I do when we are driving down South because it is a days drive and Allen does not stop for meals) I know that it is tempting on errand day to grab a bite as we go but it just isn't a good habit. I'd rather be hungry than deal with the feeling lousy in the long run. Often we eat more than we really need or want simply because we aren't paying attention. You can consume a whole bowl of ice cream while watching a video and not taste a bite. So even though you should really be satiated you are still craving it because your mind doesn't register it. However, if you sit down at the table in a calm setting with a small dish of ice cream and really take time to relish it, you might find that just a few bites and you are no longer craving it. Consider the truffles. My girl friend gave me a box for Christmas this year. I will take a small bite that it roughly 1/4 of a truffle (they aren't small) and then pass the rest to someone else. Having kids helps a lot in this area, because there is always someone who would like the rest. And because I like the different flavors I might sample four with my cup of coffee after dinner. But when I am finished, I have only eaten the equivalent of one truffle. Which still boils down to half a serving of carbohydrate. So really, this long winded paragraph is to point out two habits that can be intertwined. Pay attention when you are eating and if you do, just a small amount may be all you really wanted to begin with.

      I am also sure that everyone has heard this before but there is also the idea of remembering what food is for and how it is going to affect your body and really thinking about that before you start to eat. Looking at a plate that is 1/2 veggies, 1/4 protein and 1/4 starch we think, "this is a meal that is going to nourish my body and help me feel well and give me energy." Looking at an enormous piece of cake we need to think, "this cake is going to give me a headache and make me lethargic tomorrow. Plus, this is going to cause a spike in insulin that is going to make me crave more carbs than I really need tomorrow." Then we can make the decision to eat what will satisfy us instead of what will leave us craving more junk food the next day.

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    2. Another habit that may seem silly or insignificant is applying the principle of putting others before myself. When serving food in my home, I like to make sure everyone else is served before me. Visually, by the time the platter gets around to me there is much less on it and therefor I will take a smaller amount. If it is leftover day, I let everyone else choose first. That way, I am practicing two important things. I am letting others have their preference and putting them before me. The bonus is, by the time I get to the leftover choices (I don't care much for leftovers) there may not be something I care much for so I will eat less. Likewise, our church has a lot of fellowships that involve food. I always try to be near the end of those going through the buffet line. That way I am again practicing the principle of putting others before myself. Secondly, it is much less likely I will be tempted by too many choices. Thirdly, that helps me focus more on what fellowship is about... visiting with the brethren. Apply this practice at any social gathering and it will serve us well. It is also an excellent example to our children.

      Ha, I see this is a long an rambling reply, but I hope it makes some sense. I am going to pop over and put this in the post, too.

      Again, just to let you know, you and the family are in our prayers.

      Hugs,

      Kat

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  8. A friend and reader sent me the following email:

    Hey Kathleen,

    So I was just catching up on your blog and tried leaving a comment, but it wasn't working for some reason. It's probably some temporary issue with blogger or it could be my laptop which is acting a little strange lately.

    Anyways... I really enjoyed your eating healthy for you and your baby post. When I saw a nutritionist back with Ella's pregnancy they recommended me to eat 30 carbs for breakfast, 15 for snack in between breakfast and lunch and before bed, if necessary, and then 45 carbs for lunch and dinner. Apples dipped in peanut butter became one of my favorite snacks! I tried to follow that somewhat with Kenna's pregnancy and now that I'm feeling good and can eat everything again, I'm also trying to stick to that with this pregnancy to help with potential blood sugar problems. So, I've been using the Calorie Counter app for my smart phone and I love it! It's very similar to Calorie King (used that with Ella and Kenna's pregnancies) in that it has alot of restaraunts in the data base. But I love it because I can track my carbs and protein (and calories) all day and see at a glance how I've done throughout the day. So anyways, I thought I'd mention in case you want to check it out.

    Hope you're all having a good week! Is Ellie feeling better?

    Love,
    Susan

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