Nutrition - Florida International University



Nutrition

Posted December 27, 2007

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Good nutrition is about fueling our bodies with the foods and beverages they need in order to do their best at the functions they're designed to perform. It's about eating "real food"—not processed food products. Good nutrition is not about eating a lot or a little but about the quality of the food.

A good diet plays a crucial role in achieving optimal well-being by promoting physical and mental vitality, helping us maintain a healthful weight, and fortifying our immune systems to prevent disease. A poor diet, on the other hand, can lead to a number of serious health issues that shorten our lives or make them less enjoyable.

Fruits and vegetables, fiber, and unsaturated fats are keys to nutritious eating. Protein is essential, of course, but most Americans get plenty of that. The trick many of us need to learn is how to stop taking in lots of saturated fat along with our protein.

This discussion will include nutrition guidelines, tips on good dietary habits, and lists of foods to choose—and foods to avoid—to reduce the risk of several major diseases.

1. What are the current nutritional guidelines for American adults?

2. Should I take vitamins or other nutritional supplements?

3. What are some tips for good dietary habits?

4. How should I eat to help fight cancer?

5. How should I eat to help fight heart disease?

6. How should I eat to help fight hypertension?

7. How should I eat to help fight diabetes?

 

What are the current nutritional guidelines for American adults?

Every five years, the federal government updates its "Dietary Guidelines for Americans," using recent scientific data to fine-tune its advice. The newest version, issued in 2005, stresses the importance of fiber, fruits and vegetables, and unsaturated fats. Based on these guidelines and the expertise of nutritionists, here are general nutritional recommendations for everyone:

Eat foods rich in fiber. Adequate dietary fiber slows the absorption of dietary sugars, helps maintain intestinal regularity, reduces cholesterol levels, and may help reduce the risk of colon cancer. And because fiber is filling, a high-fiber diet also can facilitate weight loss. Fiber-rich foods are also excellent sources of vitamins, minerals, and antioxidants.

Nutrition experts recommend eating at least 24 to 30 grams of total fiber daily. (Fiber recommendations on nutrition labels are expressed in grams, not ounces. One ounce is equivalent to 28.5 grams.)

Foods rich in fiber include:

• Beans, including lima, black, garbanzo, kidney, and pinto

• Whole-grain breads. Those containing at least 2 grams of fiber per slice are best.

• Leafy green vegetables, such as broccoli, spinach, brussels sprouts, cabbage, and greens

• Higher-fiber cereals. Those containing at least 4 grams of fiber per serving are best.

• Fresh vegetables, such as carrots, eggplant, peppers, peas, and rhubarb

• Dried fruits, including raisins, prunes, figs, dates, and apricots

• Fresh fruits, such as apples, bananas, berries, pears, kiwis, and oranges

• Sweet potatoes and pumpkins

Reduce consumption of foods and beverages high in refined, low-fiber carbohydrates. These include white breads, juices, white pasta, and white rice.

Increase fruit and vegetable intake. Nutrition experts recommend eating five to seven servings of a variety of fruits and vegetables daily. Vegetables retain their beneficial vitamins and nutrients most effectively when they are eaten raw or lightly steamed. Fruits are most healthful when eaten raw.

Specific recommendations include:

• Dark-green vegetables, such as broccoli, spinach, kale, and cabbage, as well as orange fruits and vegetables such as sweet potatoes, carrots, winter squash, and cantaloupe. These provide an array of beneficial vitamins and nutrients, including folic acid, calcium, vitamin K, beta carotene, lutein, vitamin C, and fiber.

• Antioxidant-rich fruits. These include blueberries, strawberries, prunes, raisins, and raspberries. At least one serving per week is recommended.

• Lycopene-rich foods. Cooked tomato sauce, salsa, fresh tomatoes, watermelon, and red grapefruit fall into this category, and nutrition experts recommend eating at least four servings per week.

• Garlic and onions. Both contain diallyl sulfide, a proven tumor suppressor, and both retain more of their healthful ingredients when eaten raw.

Go for the "healthy fats." Fats are essential for the proper functioning of cells, the synthesis of beneficial hormonelike substances called prostaglandins, and the absorption of fat-soluble nutrients such as vitamins A, D, E, and K. And an adequate intake of "healthy fats" makes it easier to lose and sustain weight. Omega-3 fats, a type of polyunsaturated fats, have an anti-inflammatory and blood-thinning effect. You should:

• Eat at least five servings a week of nutritious fats, including nuts and nut butters, omega-3 seeds (pumpkin, sesame, and sunflower), and seed butters such as tahini, which is made from sesame and is a main ingredient in hummus.

• Eat 15 ounces a week of fish high in omega-3 fats such as salmon, sardines, herring, and mackerel. (Larger and predatory fish, such as swordfish and golden snapper, are also high in omega-3 fats but have higher levels of contamination by mercury.) For vegetarians and others who don't eat fish, foods that contain as much omega-3 fats as a 3-ounce serving of salmon include: 1½ tablespoons of walnuts, 2 teaspoons of flaxseeds, ½ teaspoon of flax oil, or 1 tablespoon of soybean or canola oil.

• Reduce foods high in saturated fats—including cheese, butter, ice cream, whole milk, red meat, and processed foods—to less than 15 grams daily. Studies suggest that saturated fats may increase low-density lipoproteins ("bad" cholesterol) and promote the inflammatory response.

• Use butter and saturated fat in moderation, and replace it when possible with sunflower, safflower, canola (a form of rapeseed), or extra virgin olive oils, which contain monounsaturated fats known to lower the levels of LDL cholesterol and to maintain the levels of high-density lipoproteins ("good" or HDL cholesterol).

• Avoid foods high in trans fats (a type of hydrogenated oil), such as hard margarine, fried potato and tortilla chips, french fries, store-bought baked goods, commercial cookies, and most commercially fried foods. Trans fats increase LDL cholesterol and lower HDL cholesterol levels.

Get your protein while minimizing saturated fat intake. Do this by reducing consumption of red meat and choosing low-fat sources of protein such as chicken or turkey breast, fish, egg whites, beans, nuts, soy foods (such as tofu, tempeh, and veggie burgers), and low-fat forms of dairy products such as yogurt, cottage cheese, and milk.

Eat nuts and seeds. Because nuts and seeds contain many heart-healthy nutrients as well as being a good source of protein, eating one handful-size serving per day can be beneficial. Opt for unsalted varieties when possible.

Add yogurt to your diet. Eating low-fat forms of dairy or soy yogurt that contain live cultures can help maintain the beneficial bacteria that live in the human digestive tract.

Greatly reduce consumption of foods and beverages high in empty-calorie carbohydrates. These include soft drinks, pastries, cakes, candy, cookies, and ice cream.

Limit consumption of cured and smoked meats to two to three servings per week. Foods such as hot dogs, sausage, deli meats, pepperoni, and beef jerky typically contain nitrates and/or nitrates, preservatives that can lead to cancer-causing compounds forming in the stomach.

Avoid excessive amounts of caffeine. Varying levels of caffeine are found in drinks such as coffee, tea, cocoa, and cola, as well as in chocolate and some medications. Experts recommend that adults consume no more than about 300 mg of caffeine per day, the amount found in two to three small cups of brewed coffee.

Excess caffeine stimulates the central nervous system and can cause insomnia, nervousness, gastric irritation, dehydration, nausea, and vomiting. It also can shorten the stress response, increase heart rate and blood pressure, and quicken the respiratory rate.

Limit alcohol intake. Excessive alcohol consumption increases the risk of all-cause mortality, alcohol dependence, malnutrition, liver cirrhosis, obesity, a number of cancers, ischemic stroke, and hypertension.

While one alcoholic beverage per day has been proved to reduce heart disease risk, and red wine contains cancer-fighting antioxidants called polyphenols, women should consume no more than one alcoholic drink per day, and men should limit their daily consumption to two drinks.

One alcoholic beverage typically is defined as 12 ounces of beer, 6 ounces of wine, or 1¼ ounces of distilled spirits.

Drink plenty of water. Because our bodies are composed largely of water, staying hydrated keeps bodily functions running smoothly. It also reduces the incidence of kidney stone and gallstone formation, and facilitates waste elimination.

Experts recommend that people consume at least 64 ounces of water each day, whether it's from drinking water, drinks other than water, or the water found in fruits and vegetables. Increase water intake if you are exercising, in a dry climate, dehydrated from illness, pregnant, or breastfeeding.

Personalizing your diet

To help plan your diet, the U.S. Agriculture Department has created an individualized Food Guidance System that gives people choices within various food groups and allows them to consider their own age, weight, height, and level of activity when calculating how much to eat of which foods.)

Should I take vitamins or other nutritional supplements?

Nutrition experts say that healthy American adults who regularly eat healthful, well-balanced meals typically do not need vitamin and nutritional supplements. Those who do choose to take a daily multivitamin should be mindful that such supplements do not replace the nutritional benefits of eating a healthful diet.

Populations who may benefit from vitamins or nutritional supplements include:

• People 50 and older: a daily multivitamin and/or additional calcium

• People who have or are at risk for osteoporosis: additional calcium

• Pregnant women: additional folic acid

• People who suffer from neuropathy: vitamin B-12

• People with anemia: iron

• Vegetarians: vitamin B-12

If you are considering taking vitamins or other nutritional supplements, speak with your physician or nutritionist.

What are some tips for good dietary habits?

• Eat mindfully and only when you're hungry.

• Scientific evidence indicates that a plant-based diet—one primarily made up of fruits, vegetables, and grains—is the most healthful way of eating.

• Take care with foods labeled "low fat." They often are high in calories.

• Moderation is key—modest portion sizes and a variety of foods, with not too much of any one type.

• Eating at home means more control over food ingredients and preparation methods.

• While many of today's foods focus on ease and simplicity, prepared foods also tend to contain excessive salt, fat, and calories.

• All dietary recommendations must be tailored to the individual and his or her overall health, level of activity, and lifestyle.

• People's nutritional needs and metabolism can change dramatically at different points in their lives.

• Teens, young adults, and others unlikely to eat regular healthful meals should be attentive to calorie distribution throughout the day and try to avoid fast food as much as possible.

• While eating habits can be very difficult to change, it's never too late for your body to benefit from good nutrition.

• Consider seeing a dietitian to assess your diet and get your nutrition on track.

How should I eat to help fight cancer?

Scientific evidence increasingly suggests that eating a nutritious diet is one of the most effective things people can do to keep cancer at bay. Your diet is significant in two ways—how it affects your weight and whether you choose foods that raise or lower the risk of cancer. The National Cancer Institute estimates that one third of all cancer deaths can be attributed to poor diet and obesity.

Watch your weight

Excess weight raises one's risk for many types of cancer. And even after a cancer diagnosis, a person's body weight—determined largely by diet and exercise—can influence the course of the disease. According to the American Cancer Society:

• An overweight woman has a 60 percent greater risk for contracting endometrial cancer than a person of normal weight; that risk jumps to 152 percent for an obese woman.

• Being overweight increases the risk of breast cancer by 12 percent, and cancers of the kidney and gallbladder by 78 percent.

And scientists at Duke University have conducted research indicating that obese men are at greater risk for more-aggressive prostate cancer.

One way to keep weight in check is to adopt good dietary habits. A diet of primarily healthful foods leaves less room for the types of foods that may increase calories—and your waistline—without adding nutritional value. The American Institute for Cancer Research recommends that adults maintain a weight no heavier than 11 pounds more than they were at age 18; the rule applies even to those who were overweight at that time.

To help watch calories, the American Cancer Society recommends the following portion sizes:

Fruits · 1 medium apple, banana, orange · ½ cup of chopped, cooked, or canned fruit · ¾ cup of 100 percent fruit juice

Vegetables · 1 cup of raw, leafy vegetables · ½ cup of other cooked or raw vegetables, chopped · ¾ cup of 100 percent vegetable juice

Grains · 1 slice of whole-grain bread · 1 ounce of ready-to-eat whole-grain cereal · ½ cup of cooked whole-grain cereal, rice, or pasta

Beans and nuts · ½ cup of cooked dry beans · 2 tablespoons of peanut butter · 1/3 cup nuts

Dairy foods and eggs · 1 cup of milk or yogurt (low-fat, when possible)· 1½ ounces of natural cheese (low-fat, when possible)· 2 ounces of processed cheese (low-fat, when possible)· 1 egg

Meats · 2 to 3 ounces of cooked, lean meat, poultry, or fish

Recommended foods

• Fruits and vegetables. Many colorful vegetables and fruits contain powerful cancer-fighting antioxidants. The National Cancer Institute estimates that raising fruit and vegetable consumption to the recommended level nationwide could cut the incidence of colorectal cancer in half, reduce breast cancer cases by one quarter, and cut the number of cases of cancer of the prostate, endometrium, and gallbladder by 15 percent.

• Experts advise women to eat seven servings of fruits and vegetables a day, and men to eat nine. Research suggests that people who consume these recommended daily amounts have half the cancer risk of those who eat one serving a day or less.

• Cruciferous vegetables, such as broccoli, cabbage, and brussels sprouts, are particularly good, as are tomatoes, berries, beets, beans, flaxseed, and vegetable-rich soups, as well as other foods that are red, orange, or yellow—such as peppers, apples, squash, pumpkin, and sweet potatoes.

• Lean high-protein foods. These include eggs, low-fat dairy products, legumes, nuts, and lean meats. Lean meats include poultry, fish, and lean pork and beef cuts, such as sirloin and loin. Cold-water fatty ocean fishes—such as salmon and mackerel—are preferable to freshwater and/or farm-raised fishes. Legumes include beans, peanuts, soy beans (edamame), and soy products, such as tofu and soy milk.

• Whole grains. Whole grains are complex carbohydrates that are low in fat and high in fiber. They can be found in cereals such as oatmeal, Kashi, and granola, as well as in some breads, bagels, and muffins. If whole-wheat flour is listed first on the label, the product is made primarily from whole grain. Otherwise, the percentage of whole grain may be insignificant.

• High-quality dark chocolate. Research suggests that eating several small squares each day may lower one's overall cancer risk.

Foods to avoid or limit

• Processed meats. Foods that are salted, cured, and smoked—such as bacon, hot dogs, luncheon meats, sausage, ham, pepperoni, and dried snack meats—often are high in nitrates and nitrites, preservatives that have been linked to some types of cancer.

• Red meat. Research indicates that eating 3 ounces of red meat—such as beef, pork, and lamb—a day increases the risk of colorectal cancer by 25 percent.

• Charred foods. Food that has been charred is likely to contain carcinogens that can damage DNA and increase the risk of developing gastrointestinal and other cancers.

• Refined carbohydrates. Found abundantly in candy, sweetened cereals, cookies, cakes, pastries, and soda, refined carbohydrates offer little nutritional value and numerous calories.

• Sugary drinks. Although there is no scientific indication that sugary drinks alone cause cancer, beverages such as soda, fruit juice cocktail, and sweetened coffee and tea add calories, which can increase one's chances of developing obesity-related cancer.

• Diet sodas. While there is no conclusive evidence linking the moderate use of sugar substitutes to cancer in humans, drinking too much diet soda can lead to lower consumption of healthful beverages such as water, pure fruit juices, green tea, and low-fat milk. Try to limit consumption to no more than two 12-ounce diet sodas per day.

Other cancer-fighting tips

Strive for a healthful diet breakdown. In general, approximately two thirds of each plate of food should consist of plant-based foods such as fruits, vegetables, whole grains, seeds, nuts, and soy products. The remaining one third of each plate should consist of lean high-protein foods, such as fish, tofu, beans, or lean meats.

Limit alcohol consumption. Not only is alcohol high in calories, but research also suggests that people who regularly consume more than four drinks per day have nine times the risk of developing cancers of the head, neck, stomach, and colon that teetotalers have—and that even moderate amounts of alcohol can raise women's risk of breast and ovarian cancer.

The American Cancer Society recommends that among people who drink, women should limit their alcohol consumption to one alcoholic beverage per day and men should drink no more than two alcoholic beverages daily.

Use healthful cooking methods. The closer food is to the heat source, the more likely it is to form carcinogenic hydrocarbons. Baking, broiling, microwaving, and poaching are preferable to grilling, frying, and charbroiling. If you enjoy the flavor of foods hot off the grill, try baking or broiling them inside first and then putting them on the grill for just a minute before serving.

Curb the restaurant habit. By cooking at home, you have much more control over the ingredients in your food and how your meals are prepared.

How should I eat to help fight heart disease?

Cardiovascular disease is the No. 1 cause of death in the United States.

A number of factors can raise a person's risk for heart disease—a family or personal history of high blood pressure, cholesterol, obesity, gout, or heart disease, for example, as well as lifestyle factors like smoking, stress, inadequate physical activity, and excessive alcohol consumption. However, cardiovascular disease results primarily from a diet high in saturated fat and cholesterol.

Heart disease is commonly defined as narrowing of the arteries to the extent that blood flow to the heart, and therefore the heart's ability to function, are compromised. This narrowing is caused by the buildup of cholesterol, which is produced by the liver and consumed through the diet.

There are two types of cholesterol:

• Low-density lipoproteins are known as "bad cholesterol" because their molecules tend to cluster together and stick to irregularities on the inner surfaces of blood vessels and arteries. Once these LDL clusters accumulate, blockages can occur.

• High-density lipoproteins, on the other hand, are often called "good cholesterol." Their molecules serve as scavengers that collect particles of LDL cholesterol and return them to the liver for resynthesis or elimination. Exercise can elevate HDL levels.

The saturated fats found in animal products and cholesterol raise LDL and lower HDL. High levels of saturated fat are found in meat (particularly red meat) and in dairy products. They are also found in lard and many oils, including palm, coconut, and cottonseed, and therefore in foods that contain or are cooked with those items. Many processed and prepared foods are high in saturated fats.

Nutritional experts recommend these heart-healthy guidelines:

• Opt for lean animal products. Lean meats include chicken, fish, turkey, and lean pork and beef cuts, such as sirloin and loin. Low-fat dairy products include reduced-fat or skim milk and reduced-fat cheese and ice cream.

• Eat monounsaturated fats when possible. These plant-based fats increase HDL and lower LDL and are found in olives and olive oil, canola (a form of rapeseed) oil, peanut products, and avocados.

• Eat polyunsaturated fats when possible. Known to help lower LDL, these are found in soybeans and soy products, walnuts, flax, and oils such as corn, sesame, sunflower, and safflower. Polyunsaturated fats include omega-3 fatty acids, which have an anti-inflammatory and blood-thinning effect. In addition to soybeans, walnuts, and flax, good sources of omega-3 fats are fish such as salmon, herring, sardines, and mackerel.

• Avoid foods with added or trans fat. Many processed and prepared foods contain trans fats, which are polyunsaturated fats that have been mechanically altered to create the product texture or strength the manufacturer desires. "Partially hydrogenated oils" listed on food labels are trans fats.

• Keep alcohol consumption in check. Because alcohol can increase one's odds of developing heart disease—or exacerbate an existing heart condition—people who have or are at risk for cardiovascular disease should limit their alcohol consumption. Women should drink no more than seven alcoholic beverages per week, while men should limit their weekly intake to 14 drinks.

How should I eat to help fight hypertension?

Known as “the silent killer” because it often exhibits no symptoms, hypertension (high blood pressure) affects approximately one third of American adults. Untreated hypertension can lead to serious medical conditions such as heart failure, heart attack, stroke, kidney failure, hardening of the arteries, partial leg amputation, and vision impairment or blindness.

High blood pressure is linked to diet. One of the best ways to fight it is to adopt a diet low in fat and cholesterol but high in nutrients, especially calcium, potassium, and magnesium:

• Lots of fruits, vegetables, low-fat dairy products, whole grains, legumes, and nuts

• Limited amounts of meat (especially red meat), sweets and sugary drinks, and foods high in fat, especially saturated fat

A leading example of this kind of diet is the DASH eating plan, developed by scientists funded by the National Institutes of Health, including researchers at Duke University Medical Center. DASH is an acronym for “dietary approaches to stop hypertension.” Adopting the DASH diet is one of the most effective things that people, particularly African-Americans, can do to lower or maintain their blood pressure. It has been proven in many cases to reduce blood pressure in two weeks.

DASH eating plan

DASH is a diet rich in fruits, vegetables, low-fat dairy products, fiber, potassium, calcium, and magnesium—and low in total and saturated fats, meat (especially red meat), sweets, and beverages with sugar. DASH lowers blood pressure without restricting salt intake or weight loss.

The DASH dietary pattern:

• Results in an average 12-point drop in blood pressure, which is approximately the same average reduction people experience after starting a new medication for hypertension.

• Is consistent with the nutritional recommendations of both the American Heart Association and the American Diabetes Association.

• Promotes weight loss in part because it is high in fiber, which causes people to feel full.

• Is a way of eating that people can adhere to by shopping in an ordinary grocery store.

• Is proven to lower blood pressure in people with pre-hypertension, the population most likely to develop high blood pressure.

Weight loss and exercise

People who are overweight are more likely to have high blood pressure. If you are overweight, try to lose weight. It is not necessary to be at your ideal weight to achieve a reduction in blood pressure. On average, people experience a 5- to 10-point drop in blood pressure for every 10 pounds they lose.

Experts say that if people feel they must choose between losing weight and limiting salt intake—for example, eating small-portioned but high-salt frozen dinners—weight loss is the better way to go.

Increasing your exercise is another good idea. Exercise can help people lose weight but can also lower blood pressure even if no pounds are lost.

A sprinkling of words about salt

While reducing sodium intake can lower blood pressure, many experts believe there is a misplaced emphasis on salt’s role in hypertension. Except for people who adhere to an extremely low-sodium diet—which often is not sustainable over the long run—limiting salt intake reduces blood pressure far less than DASH and weight loss do.

As with most aspects of nutrition, people should be moderate when it comes to salt. Try to add salt minimally to your food, being aware that 85 percent of the salt Americans consume is already in the foods we eat. It’s a good idea to rinse canned vegetables, which tend to be high in sodium, with water. In general, precooked, preserved, and prepared foods are high in salt, while fresh and frozen foods contain much less salt but are more expensive.

Other tips

• Work within your budget and your personal likes and dislikes to develop a good dietary pattern. If you’re trying to lower your blood pressure but don’t want to live without potato chips, for example, include them in your diet but cut back on something else. Sustainable choices are what’s important.

• Because alcohol is known to negatively influence blood pressure, people who have or are at risk for hypertension should limit their alcohol consumption. Women should drink no more than seven alcoholic beverages per week, while men should limit their weekly intake to 14 drinks.

How should I eat to help fight diabetes?

Good nutrition plays a critical role in preventing and treating diabetes. In some cases, diabetes can be controlled so well with nutrition and exercise that patients do not require medication.

A progressive disease of the pancreas that is serious in and of itself, diabetes affects the whole body and is known to be a strong risk factor for a number of other life-threatening conditions, including cardiovascular disease and stroke. Type 1 diabetes—formerly known as juvenile diabetes—affects 5 to 10 percent of diabetics. The vast majority have type 2, also known as adult-onset diabetes. Although most people with type 2 are overweight, it can occur regardless of weight, and many people of healthy weight have type 2 diabetes.

Both forms of diabetes have a genetic component, although it remains unclear exactly how and why some people are born with the disease, why others can develop it decades later, and why some people never develop it.

What is known is that the incidence of the disease among Americans is at an all-time high. What is also known is that proper nutrition can go a long way in reducing that number.

Managing carbohydrates

The key to preventing and treating diabetes is controlling blood glucose, often called blood sugar. That does not mean eliminating sugar and other carbohydrates from your diet. While diabetics do need to monitor their carbohydrate intake, it's critical for them to understand that not all carbohydrates are to be avoided.

Structurally, carbohydrates can be "simple" (sugars) or "complex" (starches). Sugars are more quickly absorbed into the bloodstream, while starches are absorbed more slowly. Our bodies need carbohydrates to function properly, and by making good choices about them, diabetics can avoid potentially dangerous highs and lows in blood sugar levels. The goal is to keep blood glucose levels consistent.

To control carbohydrates, you should:

• Monitor your carbohydrate consumption and spread your daily allowance throughout the day.

• Eat approximately the same amount of carbohydrates at every meal.

• Eat a good balance of foods from each of the four categories of carbohydrates:

• Grains, beans, and starchy vegetables, such as potatoes, corn, dried peas, winter squash, and beans

• Fruit

• Milk and other dairy products

• Sweets, which may be included occasionally as part of a balanced diet

Meats and nonstarchy vegetables such as broccoli, cauliflower, lettuce, tomatoes, summer squash, carrots, and spinach contain minimal amounts of carbohydrates.

Other foods

In addition to being vigilant about managing their carbohydrate intake, patients with diabetes need to eat a good balance of the three macronutrients—carbohydrates, proteins, and fats—at every meal. They should:

• Eat a diet rich in whole grains and fresh fruits and vegetables.

• Eat enough protein. When possible, opt for lean or low-fat meats, or choose meat alternatives, such as tofu, peanut butter, and cheese.

• Limit fried foods and substitute mono- and polyunsaturated fats for saturated and trans fats whenever possible.

• Use artificial sweeteners in moderation. While there is no evidence that artificial sweeteners are harmful, people should treat them as they would sugar, using only as much as necessary to make foods palatable.

• Be mindful of the correct portion sizes. For example, a 3-ounce serving of cooked meat is about the size of a deck of cards. For bananas and grapefruit, a half, not a whole, is one serving. And for fruits like apples, oranges, and kiwis, think small; today's average specimen may constitute 1½ servings.

Helpful habits

Managing diabetes long term means you need to be disciplined, so that you can follow good daily habits, but also flexible, so that you can enjoy special treats on occasion.

• When eating out at a restaurant, ask for things like condiments and sauces on the side. This allows you to better control what and how much you eat.

• Stick to regular meal times. Whether you normally eat eight small meals a day or three big ones, try to eat at approximately the same times each day. And no matter how busy you are, never skip meals.

• Plan ahead for special events. Don't deprive yourself; have that slice of birthday cake. The key is to learn the carbohydrate amount ahead of time and work it into your meal plan.

To successfully manage diabetes, patients must work with members of their healthcare team, who need to know what patients are eating in order to determine their medication needs. People's bodies, lifestyles, and dietary preferences are different, as are the types and levels of severity of their disease. There is no one "right diet."

Patients might consider taking regular refresher courses with their dietitians to stay abreast of new products and ways of navigating changing portion sizes and preparation methods.

There are also a number of tools available for managing nutritional intake, such as nutrition labels for counting carbohydrates, scales and measuring cups for weighing and measuring food, and websites that list the nutritional content of various foods (such as ).

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