Diabetes and Your Diet

This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Hello and welcome to the show. You are listening to Weekly Dose of Wellness, brought to you by MemorialCare Health System. I'm Deborah Howell and today our guest is Jamie Mok, a registered dietitian nutritionist at Long Beach Memorial, specializing in nutrition therapy for cancer, surgical and cardiac patients. She holds a Bachelor of Science in Nutrition from Cal Poly State University, San Luis Obispo, and a Master of Science in Applied Physiology and Nutrition from Teacher College, Columbia University. Today's topic is diabetes and your diet. Ooh, sounds ominous. Welcome, Jamie.

Jamie Mok, MS: Hi, good morning.

Deborah Howell (Host): All right, let's dive in. When someone is diagnosed with diabetes, do they need to follow a special diet plan?

Jamie Mok, MS: Well, Deborah, while there's no single diet for diabetes, individuals with diabetes should follow a meal plan to keep their blood sugars in control. So a diabetic meal plan is generally a healthy diet that consists of fiber-rich fruits and vegetables, whole grains, nuts, beans, lean protein, and healthy fats. So a diabetic meal plan should be tailored to an individual, you know, considering their age, gender, physical activity, whether they're on medication or insulin, and also considering their weight goals.

Deborah Howell (Host): So are there any foods that are absolutely completely off-limits for people with diabetes, like maybe waffles with syrup and butter and bacon on top?

Jamie Mok, MS: No, no, no. There actually is no food that is off-limits per se. The key is portion control. So as long as food fits within an individual's meal plan, then it can definitely be worked in. However, not all carbohydrates specifically when we're looking at meal plans are created equal. So it's better to choose the complex carbohydrates rather than the simple carbohydrates because they're slower to raise blood sugars. So, for example, you know, if a meal plan for one meal is allowed 60 grams of carbohydrates, you know, technically that could equal two cups of fruit juice. Or you can have, you know, a turkey sandwich on, you know, whole grain bread with your veggies and your mustard and light mayo. And you can also eat, you know, a cup of yogurt and even a small apple. And all those three foods are equal up to 60 carbs.

Deborah Howell (Host): Wow, that's pretty incredible.

Jamie Mok, MS: You know, they both contain the same amount. It's about how wisely you choose to, you know, quote-unquote spend them.

Deborah Howell (Host): Right. It's almost like you wish each food just had the amount of carbs, you know, notated on it before you eat it.

Jamie Mok, MS: Right. That would be helpful. Maybe someone will develop that someday.

Deborah Howell (Host): Now, if someone is overweight, does that mean they will automatically develop type 2 diabetes?

Jamie Mok, MS: Well, although being overweight does not mean you will automatically develop type 2 diabetes, chances are greater because being overweight or obese is a risk factor for diabetes along with family history or age and ethnicity. So 80% of people with type 2 diabetes are overweight or obese.

Deborah Howell (Host): When you say overweight, are you talking 20 pounds? 25?

Jamie Mok, MS: When I'm referring to overweight or obese, I'm actually referring to the BMI scale.

Deborah Howell (Host): Okay.

Jamie Mok, MS: Yeah. So, with using a BMI, if one is categorized as overweight or obese, approximately 80% of type 2 diabetics fall into that range. And considering that in the United States, about two-thirds of U.S. adults are either overweight or obese.

Deborah Howell (Host): Two-thirds?

Jamie Mok, MS: Two-thirds of U.S. adults, yeah.

Deborah Howell (Host): That just makes me want to cry. You know, it's so sad. And so much of it is portioned. If you look at even, I mean, let's just talk about, you know, it's not the best for you, but the 1950s portion of a McDonald's hamburger, they're just tiny compared to today's quarter pounders, you know, with double meat, etc., etc., etc. So I guess that's pervasive throughout restaurants as well. And then, of course, there's the all-you-can-eat buffet. Which is a big danger.

Jamie Mok, MS: Absolutely.

Deborah Howell (Host): Yeah. Now, does eating too much sugar cause diabetes or is that a myth?

Jamie Mok, MS: So, that's one of the oldest myths in the book. So, just to clarify, in terms of type 1 diabetes, the cause is genetic. So, the amount of sugar that one eats has no relationship to the cause of the development of type 1. However, you know, as we talked about before, being overweight or obese increases one's risk for developing type 2. So, you know, generally a high caloric intake will cause weight gain and therefore increase one's risk for type 2. But there is research to show, there has been a lot of research actually on the consumption of sugary drinks and the development of type 2 and so they've definitely found a link which, you know, in general but, you know, that's just one portion of the whole bigger picture of just excessive calorie intake and poor diet and you know excessive weight as well.

Deborah Howell (Host): If somebody is diagnosed and then they just quit the sugary drinks, is there a way to reverse type 2 diabetes?

Jamie Mok, MS: Well not necessarily. Once you have been diagnosed with type 2 diabetes, you know, you've been diagnosed. But that's not to say that you cannot now, if you start to take oral medication, not have to rely on that and get off your oral medications, if you make these lifestyle modifications and if you control your blood sugars, you can definitely bring your, you know, your blood sugars back into control. So, and cutting out, especially if, you know, these sugary drinks, you know, if you're used to drinking large amounts of soda a day and that's a big habit and you cut all that out, that can make a huge difference and impact on your blood sugars.

Deborah Howell (Host): Okay. You partially managed to answer this a little bit earlier. If someone has diabetes, are they allowed to consume carbohydrates? You were talking about, you know, the wheat bread and, you know, so are all carbohydrates bad?

Jamie Mok, MS: Yeah, yeah, we were talking about this earlier. Yeah, so not all carbohydrates are created equal. I always like to say that carbs often get a bad rap and because when we hear about and think about, you know, carbohydrates, we think of like the unhealthy processed refined foods, anything made with, you know, refined white flour, sugar, all the snacks, fried food and often that is eaten in excess and you know we know that too much of anything is not good. So when it comes to carbs, it's about quality too and so you know the healthful carbs like from the fruits and vegetables, grains, beans, legumes, even like the low-fat and non-fat dairy foods, they're all key components to a healthy diet because you know once we can. And you know, I mentioned that these are the complex carbohydrates because they contain the fiber and they retain the vitamins and minerals and antioxidants that are you know good for our health.

Deborah Howell (Host): Right okay. Now, here's the biggie – alcohol. Because you can be really good about your food diet and then whoops, oh, let's just have three glasses of wine.

Jamie Mok, MS: Absolutely. That's a reason it doesn't … the rules don't apply sometimes but they actually do. We'd like to think they don't, but alcohol definitely does have an impact on our blood sugars. And it can cause low blood sugars soon after, in a diabetic, soon after drinking and up to 24 hours later. So it's really important for a diabetic to check their blood sugars before, while, and that 24-hour period after drinking. You know, symptoms of hypoglycemia can mimic the signs of being drunk. So, you know, sleepiness, dizzy, you know, disorientation. So really moderation is key.

Deborah Howell (Host): Yeah, you know I have a friend who was recently diagnosed with diabetes and she's completely cut sugar out of her diet because she wasn't, she's not going to give up her one glass of wine. Good idea and not such a good idea?

Jamie Mok, MS: Well with her, a good idea to give up sugar, I mean you know the processed stuff, but in terms of giving up that glass, like one glass of wine is fine, but she should never drink on an empty stomach. So your, you know, alcoholic beverage should never replace the meal, especially for diabetics because they're at risk for, you know, going low on their blood sugars. So definitely tell her to keep that same meal plan and then just monitor, you know, her blood sugars a little bit more carefully when she's drinking.

Deborah Howell (Host): Okay. So how can people make time to prepare meals and manage their diet with such a busy schedule. You know, holidays are coming up. It's crazy for some people. It's like one more thing they have to add to their day to figure out what to eat and how many carbs and blah blah blah.

Jamie Mok, MS: Yes, yes. Well, the key is, I mean, everyone leads, you know, a busy schedule. We all have a lot of things going on. So, the best way to, you know, get a hold of this is planning and getting into a routine. That's going to be key. So, for a diabetic scheduling regular meal times and snacks and trying to prepare them ahead of time. So going grocery shopping at the very beginning of the week, having a set list of your go-to's and I say just at the beginning of the week if you can prepare multiple meals at once, kill a few birds with one stone and then dividing them into the separate containers and that way you don't have to prepare a new meal every day, but that helps you get into a routine and I think that a routine is key.

Deborah Howell (Host): And then lastly, where can people go to find more tips like this on diabetes management?

Jamie Mok, MS: Well we actually here at Long Beach Memorial, we have a great diabetes program and so we say that the diabetes program offers a monthly support group and also an education program where you can meet with a dietician. And so there's more information, I can give you the website. If you go to memorialcare.org/diabetes, that's the department page for our diabetes program.

Deborah Howell (Host): Wonderful. Thank you so much, Jamie Mok, for spending time with us this afternoon. It's been so great to have you. I learned a lot.

Jamie Mok, MS: Thank you so much.

Deborah Howell (Host): Okay, to listen to the podcast or for more info, as Jamie said, please visit memorialcare.org. That's MemorialCare.org/diabetes. I'm Deborah Howell. Join us again next time as we explore another weekly dose of wellness brought to you by MemorialCare Health System. Have a fantastic day.