The Great Sugar Shake Up (Powerpoint)
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Transcript The Great Sugar Shake Up (Powerpoint)
The Great Sugar Shake Up
Nutrition Guidelines
For Managing Diabetes
Sugar Shake Up
Babs Carlson, PhD, RD, CDE
Coordinator, DSMEP
Lifestyle Center
Chesapeake Regional Medical Center
Retired
Diabetes
24 million Americans have Diabetes –
8% of the population (1 in 12)
57 million Americans have pre-diabetes20% of the population
By 2020, 20% of the population will have
Diabetes
34% of babies born after the year 2000
will develop Diabetes in their lifetime
Diabetes
Diabetes cost the nation $174 billion in
2008
1 in every 8 dollars spent on healthcare
is attributed to Diabetes (12%)
Diabetes
50% of Black and Hispanic Americans
over age 50 have Diabetes or
Prediabetes
40% of white/ Caucasian Americans
over age 50 have Diabetes or
Prediabetes
Obesity
66% Americans are Overweight
34% Americans are Obese: BMI>30
50 years ago, 20% of Americans were
overweight. Some experts predict that
by the year 2099, 99% of Americans will
be overweight
Obesity
Why the Increase in Obesity?
Why the increase in Visceral Obesity
ie Insulin Resistance
ie Beta Cell Failure
Obesity
Consumption of calories as Fat has remained
steady since 1980s
Consumption of calories as Sugar has
increased from 129 pounds per person in 1980
to 148 pounds per person in 2005
Sugar consumption now as high fructose corn
syrup contributes to Diabetes and triglycerides
Sugar Shake Up
Why Sugar? Sugar does not cause
Diabetes.
ADA: “substituting sucrose containing
foods for isocaloric amounts of other
carbohydrates will have similar blood
glucose effects”
Sugar Shake Up
Sugar does deliver excess calories with
no satiety value
ADA: “People with diabetes should avoid
intake of sugar-sweetened beverages to
reduce the risk for weight gain and
worsening cardiometabolic risk profile.”
Sugar Shake Up
Dietary Guidelines: Reduce added
sugars intake to 4 – 10 teaspoons per
day
Sedentary females: 4 teaspoons
Active males:
10 teaspoons
1 teaspoon = 4 grams of sugars
Sugar Beverages – 12 ounces
Apple juice –
7 teaspoons
Energy Drink
10.5 teaspoons
Orange juice
7 teaspoons
Pepsi
11 teaspoons
Coke
9 teaspoons
Gingerale
9 teaspoons
Vitamin Water
5 teaspoons
Sugar Beverages
7-11 Slurpee
6 teaspoons (ice)
Big Gulp
12 teaspoons
Sweet tea
6 teaspoons
Latte
7 teaspoons
Tazo Chai Frappuccino 14 teaspoons
Tropical Smoothie
12 teaspoons
Gatorade
6 teaspoons
Powerade
8 teaspoons
Sugar Foods
Instant oatmeal
4 teaspoons
Blueberry muffin
5 teaspoons
Chocolate chip cookies
2 teaspoons
Glazed donut
5.5 teaspoons
Sherbet
5 teaspoons
Fruit Yogurt
7 teaspoons
Mars bar
7 teaspoons
Sugar Calorie Sources
Top calorie sources for Adults
Grain-based desserts
Yeast breads
Soda/ energy drinks
Dairy desserts
Sugar Shake Up
If not Sugar, then WHAT?
Follow the A, B, C’s
HbA1c = Average Blood Glucose: 6.5
Blood Pressure: 130/80
Cholesterol
Tchol
Trig
HDL
LDL
<200mg/dl
< 150mg/dl
> 40 >50mg/dl
< 70mg/dl
Nutrition Guidelines
Eat Breakfast every day
Breakfast should be eaten within 60
minutes after getting out of bed
Breakfast should be eaten before
exercise
Breakfast should include Protein
Last meal should be eaten prior to 2
hours before going to bed
Nutrition Guidelines
Carbohydrates – greatest impact on post
prandial blood glucose
Protein – building block for insulin,
provides satiety, necessary in each meal
Fat – delays gastric emptying, plant
sources necessary daily
Salt as sodium – 1500 - 2300 mg daily
Nutrition Guidelines
Carbohydrates should provide 45-60% of
calories per meal, per day
1500 calories:
1800 calories:
2400 calories:
185 grams
225 grams
300 grams
Minimum daily recommendation is 135
grams distributed among 3 meals, snacks if
necessary
Nutrition Guidelines
Carbohydrate sources
Vegetables: 4-5 servings daily
Fruits: 2-3 servings unless triglycerides
elevated. Fruit not juice
Whole grains should provide 2-3 grams fiber
per serving
Cereals should provide 3 grams fiber per
serving
Fiber total: 25 grams daily
Nutrition Guidelines
Protein should provide 12-20% of
calories per meal, per day
1500 calories:
1800 calories:
2400 calories:
55 grams
70 grams
90 grams
Daily protein recommendation is 1 gram to
1.5 grams per kilo body weight
Nutrition Guidelines
Include low fat animal sources or plant
protein sources in each meal. Include at
least 10 grams protein in each meal
Portion size: 3 ounce portion, the “deck
of cards” is 21 grams protein
Nutrition Guidelines
Fats should provide 27-27% of calories
per meal, per day
1500 calories:
1800 calories:
2400 calories:
55 grams fat
63 grams fat
90 grams fat
Nutrition Guidelines
Monounsaturated fats improve lipid
profile, reduce cardiovascular risk.
Choose olive oil, canola oil, peanut oil
Fish oils, Omega-3 oils, reduce
cardiovascular risk, reduce inflammation.
Choose fatty fish: salmon, mackeral,
sardines; also walnuts.
Nutrition Guidelines
Pattern Management
Breakfast should provide ¼ daily calories
Second meal: 4-5 hours after breakfast
Third meal: 5-6 hours after second meal
Snacks are optional, not required
A “meal” must include carbohydrate,
protein, fat. Two “meals” should include
vegetables.
Nutrition Guidelines
Supplements. There is no scientific
evidence to support routine use of
nutrient supplements.
Long term use of Metformin destroys
Vitamin B12. Many persons with
Diabetes are deficient in Vitamin D
Dinner
Resources
www.DietaryGuidelines.gov
• Policy Document
• Advisory Committee Report
• Public Comments Database
www.NutritionEvidenceLibrary.gov