Just as a fast review, there are two basic types of diabetes. People with Type I diabetes are reliant on injectable insulin. In the past, Type I diabetes was called juvenile diabetes. Individuals with Type II diabetes many times can be treated without insulin, with diet and exercise being important parts of treatment. In the past, Type II diabetes was called adult- onset diabetes. Neither type of diabetes limits itself to a particular age group, and so the more appropriate Type I and Type II terms are used today.
Everybody's cells get their energy from a sugar called glucose. Glucose is obtained from many different types of foods, such as potatoes, fruit, breads, pasta, etc. Glucose is stored in the liver. Your liver releases glucose into the blood when your body needs energy. The organs that needed the energy capture the glucose and use it. Insulin, a substance released by the pancreas helps glucose get inside cells. If you are a Type II diabetic, your pancreas might not be able to release all the insulin it makes. Without insulin, the body doesn't know how to use glucose. When the glucose can't get inside the cells, it accumulates in the blood. Too much glucose in the blood can lead to many medical problems. If necessary, you can help your body use the glucose it needs by taking diabetic medication properly, exercising, and eating properly. It has been found that just a ten-pound weight loss (in people who need to lose weight) helps insulin to work better and that regular exercise also helps your body use insulin.
What to Eat?
In the 1920's, after it was understood that injected insulin alone was not enough to control diabetes and that the way one ate affected one's diabetes, researchers set out to find exactly what type of diet should be recommended to people with diabetes. One theory, in the 1930's, was that people with diabetes knew intuitively what to eat. In other words, researchers thought that your body would tell you what it needed. That didn't work. Eliminating all sugar from the diet didn't either. After much trial and error, it was found that people with diabetes did best when they ate a balanced diet that kept them at their ideal body weight. Based on the balanced diet theory, the American Dietetic Association began to formulate diabetic diets. From observation it was found that the avoidance of certain foods did little to control diabetes, where a diet balanced in protein, fat, and carbohydrates seemed to help the condition. But how do you design balanced menus for all people with diabetes all the time? It couldn't be expected that every diabetic would visit their dietitian regularly to pick up menus. It was also not realistic to expect that people with diabetes could or would adhere strictly to menus for which they gave no input. This is when a great solution was devised - the exchange lists for meal planning.
Back to the Future
The exchange lists for meal planning, with variations on a theme, are what dietitians and healthcare workers have used to calculate diabetic diets for the past four decades. The exchanges are arranged into three groups. The carbohydrate group includes starch, fruit, milk, and vegetable exchanges; the meat group includes very lean, lean, medium-fat, and fat meats, seafood, poultry, and meat substitute exchanges; and the fat group includes saturated and unsaturated fat exchanges. Each exchange is assigned a calorie level; for example, one fat exchange is 45 calories. Each food within the exchange is assigned a portion amount. For example, one slice of bacon, one-eighth of an avocado, and one teaspoon of margarine are all one fat exchange and all worth 45 calories. People who have worked with the exchanges for a while find they can analyze a recipe or a menu in a matter of minutes.
The exchanges give patients and menu planners freedom of choice. Instead of being told that they must have grapefruit juice at breakfast time, a patient is told that they are entitled to one fruit exchange in the morning. This can be translated into the correct portion size of juice, fresh fruit, dried fruit, or canned or frozen unsweetened fruit.
People with diabetes are counseled as to the correct calorie level for maintenance of good health. The exchange lists allow them to select types and amounts of food while maintaining a healthy calorie level. For example, if told they could have 1 fruit exchange, 2 lean meat exchanges, 2 starch exchanges, and 1 fat exchange for breakfast, one person might select cantaloupe wedges, steamed tofu, and 2 slices of toast and margarine, while another individual might select tomato juice, hummus (as the meat exchange), and a toasted bagel. Both meals comply with the exchanges.
Holidays and special meal events can be frustrating times for people with diabetes and the people providing meals for them. While current theory has it that no foods need be excluded from diabetic diets (except for severe cases), daily intake must be balanced and within the person's calorie level. And although an occasional piece of cake might be allowed, holiday meals often have very few options for people with diabetes.
When designing festive menus, consider that everyone, including people with diabetes, can benefit from menu items that are tasty and fun yet lower in fat and concentrated sweets. Rather than having to create separate dishes for people with diabetes, offer lots of dishes that everyone can enjoy, with perhaps a portion variation for some of the more controlled people with diabetes.
Many of your favorite festive menu items already fit the bill, especially entrées (serve the sauces on the side). Instead of cranberry sauce, offer stewed apples with almonds, raisins, and cinnamon. Instead of chocolate sauce, offer fruit coulis made with frozen fruit, flavoring extracts, and fruit juice concentrate. Tofu makes a creamy base for savory or sweet sauces, requiring little sugar for sweetness (make a creamy dessert sauce with silken tofu, puréed strawberries, and orange zest). Poached or stewed fruit or salsas make low-sugar, lowfat accompaniments to roasted tempeh or seitan or other savory entrées. Once you get into this, you will be surprised at how easy it is to convert your party menus into diabetic-friendly meals.
Here's a traditional festive meal (and our thoughts on making it diabetic-friendly):
Parties for Everybody
With an eye to individual people with diabetic needs, here are some suggestions for festive foods that can fit into a diabetic pattern.
The following recipes are written in amounts for caterers, or for prepping ahead and freezing or storing for later use.
Red Onion and Basil Salad Dressing
Makes 1 pint or 2 cups
Combine all ingredients in a non-reactive bowl until well mixed. Cover and refrigerate until ready to use.
One portion (1 ounce) = 20 calories, 3 grams carbohydrate, 1 gram fat, and no protein, or approx. 1/3 bread exchange, 1/8 fat exchange
Oatmeal Apricot Bars
Makes fifty 2 x 3-inch bars
Preheat oven to 325 degrees. In a mixer bowl, combine margarine and sugar and beat until well mixed. Add applesauce and concentrate and beat until smooth.
Combine flour, oats, and soda. Add to margarine and mix until just combined. Mixture should be crumbly.
Spread half of mixture evenly on 4-5 ungreased baking sheets. Cover mixture with chopped fruit. Top evenly with remaining mixture. Bake for 35 minutes or until golden brown. Depending upon oven space, you may have to do this in batches.
Cut into bars and serve warm or allow bars to cool. Serve with stewed fruit or yogurt with chopped dried fruit.
Note: Make this recipe ahead of time and either store in airtight containers in the freezer, or in a cool, dark area.
One bar = 245 calories, 46 grams carbohydrate, 8 grams fat, and 3 grams of protein. Approx. 21/2 starch exchanges and 11/2 fat exchanges.
Makes three 9-inch cakes or 25 portions
Preheat oven to 350 degrees. In a mixer bowl, combine margarine, sugar, applesauce, and vanilla and mix until well combined and fluffy. Add tofu and mix until well combined. Add bananas and mix at medium speed for 2 minutes.
Combine flour, powder, and soda. With the mixer at low speed, alternate adding dry ingredients and yogurt. Mix until well combined.
Place batter into 3 greased and floured 9-inch cake pans (if loaf pans are used instead, baking time will have to be increased). Bake at 350 degrees for 25 minutes or until a toothpick inserted in the center of the pan comes out clean.
Cool and then remove from pans. Serve as breakfast bread with fresh fruit or as a dessert, served with sorbet.
One portion = 250 calories, 40 grams carbohydrates, 11 grams fat, and 3 grams protein, or approx. 31/2 bread exchanges, 2 fat exchanges.
Roasted Two-Pepper Soup
Serves 10 (4-ounce or 1/2 cup portions)
Pierce whole peppers and rub with oil. Place on ungreased baking sheet and roast in 375 degree oven until skins are blistered. Remove from oven, place in a plastic bag, and allow to cool (this makes removing the skin easier). Peel, seed, and chop peppers. Set aside.
Lightly sauté garlic and onions in a medium stockpot (use oil or vegetable spray). Add tomatoes and oregano. Sauté until soft. Add stock, white pepper, and chopped peppers and bring to a boil, stirring occasionally. Reduce heat and allow to simmer for 15 minutes.
If desired, purée for a creamy texture. Pair with crudities and crunchy bread for a light supper.
One portion= 96 calories, 15 grams carbohydrate, 3 grams fat, 3 grams protein, or approx. 1 bread exchange, 1/2 fat exchange
Fruit Cobbler with Biscuit Topping
Makes ten 3 x 2-inch portions
Use a combination of unsweetened peaches, apples, pears, cherries, and berries in this cobbler.
Reserve fruit in large mixing bowl. Preheat oven to 425 degrees.
In a small stockpot, heat juice to boiling. Lower heat. Mix sugar, cornstarch, zests, cinnamon, and ginger together and add to juice. Stir to combine. Add water and whisk until thickened.
Place fruit in a 9 x 12-inch casserole or baking dish. Pour thickened juice over fruit.
In a separate bowl, combine biscuit mix and water. Mix until soft dough is formed. Roll biscuit dough on a floured board to a 2-inch thickness. Place rolled dough on top of fruit. Bake at 425 degrees for 25 minutes or until browned.
Serve warm and use for breakfast, or allow to cool and serve as a holiday dessert with flavored whipped topping.
One portion = 195 calories, 30 grams carbohydrate, 8 grams fat, and 1 gram protein or approx. 21/2 starch exchanges, 2 fat exchanges
Excerpted from Vegans Know How to Party
By Chef Nancy Berkoff, EdD, RDB
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