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Fast and Simple DIABETES MENUS
Over 125 Recipes and Meal Plans for Diabetes Plus Complicating Factors
By Betty Wedman-St. Louis The McGraw-Hill Companies, Inc.
Copyright © 2004Betty Wedman-St. Louis
All rights reserved.
ISBN: 978-0-07-142255-0
Excerpt
CHAPTER 1
Diabetes and Complicating Factors
Diabetes and Hyperlipidemia
In a 2002 study of cardiovascular disease and diabetes by the National Diabetes Education Program, over 60 percent of patients surveyed did not consider heart attacks or strokes to be a serious complication of the disease. The older the patients, the less likely they were to rate cardiovascular disease as a serious concern. Those surveyed rated blindness and amputations as more serious than premature death from a heart attack or stroke.
Yet diabetes can damage large and small blood vessels. Scars form inside the blood vessels, making the walls stiff and hard. These scarred places trap cholesterol and may eventually lead to a blocked vessel. When a blood vessel becomes blocked, the heart must work harder to pump blood through the obstructed vessel. Consequences may include heart attacks, strokes, high blood pressure, and poor blood circulation in the arms, legs, and head.
To combat the complications of cardiovascular disease, the National Cholesterol Education Program recommends that individuals limit their intake of foods with high fat content. Foods high in saturated fatty acids and trans fats can be replaced with unsaturated fatty acids from fish, vegetables, legumes, and nuts.
Since high-carbohydrate diets can increase triglycerides and lower high-density lipoprotein (HDL) cholesterol, whole grains and whole fruits are recommended instead of refined-carbohydrate sources.
After years of focusing on low-density lipoprotein (LDL) cholesterol as the "bad" fat in the blood, scientists are finally taking another look at triglycerides. Research shows that high triglycerides alone can raise the risk of cardiovascular disease. Triglycerides are the most common source of fat in the body. Some come from foods you eat. Others are made by the body. Too high a triglyceride level in the blood is called hypertriglyceridemia. New recommended government guidelines set the goal at 150 milligrams per deciliter after a twelve-hour (overnight) fast. If your triglyceride level exceeds this goal, lifestyle changes can help lower elevated triglycerides:
• Lose weight.
• Reduce your consumption of saturated fat and high-cholesterol foods.
• Drink less alcohol.
• Increase physical activity.
• Eat fatty fish (for example, tuna, mackerel, sardines, and salmon).
When most people think of heart disease or cardiovascular disease, they think of cholesterol levels in the blood. The levels of HDL and LDL cholesterol are important to monitor regularly. The National Cholesterol Education Program recommends the following levels:
HDL ("good") cholesterol Greater than 45 mg/dl in men
Greater than 55 mg/dl in women
LDL ("bad") cholesterol Less than 100mg/dl
If detected soon enough, hyperlipidemia, or a high concentration of fats in the blood, can usually be corrected by a healthful diet and exercise. To illustrate how dietary habits can influence hyperlipidemia, the table compares two days of menus. The high-cholesterol, high-fat menu from restaurant meals may be a "vacation treat" menu, but it does not fit the recommendations for a heart-healthy diet.
Diabetes and Hypertension
Hypertension, or high blood pressure, affects about fifty million Americans (one in four adults), and a significant number of them also have diabetes. The following guidelines define normal blood pressure and the levels of hypertension (systolic over diastolic pressure):
Blood Pressure Category Systolic/Diastolic Measurement
Normal
Less than 120/less than 80 mm Hg
Prehypertension 120 to 139/80 to 89 mm Hg
Stage 1 hypertension 140 to 159/90 to 99 mm Hg
Stage 2 hypertension 160 or greater/100 or greater mm Hg
The treatment goal for hypertension is to lower blood pressure to less than 140 mm Hg systolic and less than 90 mm Hg diastolic. For those with diabetes and chronic kidney disease, the goal is stricter: less than 130 mm Hg systolic and less than 80 mm Hg diastolic.
In May 2003, the National Heart, Lung, and Blood Institute (NHLBI) released new guidelines advising Americans to make needed lifestyle changes—losing excess weight, increasing physical activity, following a heart-healthy diet—to reduce the damage caused by high blood pressure. Cutting back on salt and high-sodium foods in the diet may help manage prehypertension and/or reduce the amount of medication needed to control blood pressure.
The average American diet contains greater than 6,000 milligrams of sodium per day. More than 75 percent of that sodium comes from packaged and processed foods. Convenience foods tend to be high in sodium, so meal planning requires a rethinking of food choices.
A healthful diet usually contains 2,500 to 3,000 milligrams of sodium per day. For comparison, consider that one teaspoon of salt has about 2,400 milligrams of sodium. The obvious way to reduce sodium content is to avoid using table salt. Less obvious sources of sodium include the following foods:
• Seasonings and condiments–Soy sauce, garlic salt, onion salt, bouillon, olives, pickles, relishes
• Dairy products–Processed cheese, cheese spreads, buttermilk
• Soups–Bouillon cubes; canned, dried, or frozen soup mixes; canned broths
• Vegetables–Frozen vegetables with prepared sauces, sauerkraut
• Meat and fish–Canned, cured, dried, salted, or smoked meats and fish, bacon, hot dogs, ham, corned beef, luncheon meats, sausage, canned tuna
• Fast foods–Pizza, Chinese foods (unless they are prepared without MSG, soy sauce, oyster sauce, etc.), deluxe hamburgers
• Cereals and breads–Instant mixes such as those for biscuits, muffins, and quick breads
• Convenience items–Packaged sauces, including spaghetti sauce, au jus and gravies, seasoned pasta and rice, stuffing mixes
• Snack foods–Corn chips, potato chips, pretzels, party dips and spreads
Spices and herbs can provide flavor and enhance meal choices. The recipes in Fast and Simple Diabetes Menus feature many commonly available fresh herbs and spices found in the local supermarket. A lower-sodium diet does not have to be bland and tasteless.
Diabetes and Kidney Disease
Diabetes is a leading cause of kidney failure. Over thirteen million people with diabetes are at risk for developing kidney disease. It often goes unrecognized, underdiagnosed, and undertreated until too late. The progression of proteinuria—spilling of protein in the urine—may develop slowly over the years.
Early in the development of kidney disease, the kidneys begin working less efficiently in removing waste products from the blood. Proteins are then lost in the urine instead of being used for cell repair and growth. As the disease progresses, kidneys lose their ability to remove creatinine and urea (waste products) from the blood. Kidney disease is a silent disease complication of diabetes, so each person needs to be familiar with the four stages of the disorder:
• Stage 1– Blood flow through the kidneys remains normal or near normal, but the glomeruli (the "filter paper") begin to show damage. Tears or leaks in the glomeruli allow small amounts of protein, called albumin, to leak into the uri
(Continues...)
Excerpted from Fast and Simple DIABETES MENUS by Betty Wedman-St. Louis. Copyright © 2004 by Betty Wedman-St. Louis. Excerpted by permission of The McGraw-Hill Companies, Inc..
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