Beyond The Basics - Canadian Diabetes Association
Beyond The Basics - Canadian Diabetes Association
Beyond The Basics - Canadian Diabetes Association
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<strong>Beyond</strong> the <strong>Basics</strong>: Meal Planning for<br />
Healthy Eating, <strong>Diabetes</strong> Prevention<br />
and Management<br />
Eleeta Armit RD, CDE<br />
October 20, 2005
GHEG Review<br />
Subcommittee<br />
Eleeta Armit (Chair), MB<br />
Barbara Allan, BC<br />
Kathryn Arcudi, QC<br />
Holly Brown, ON<br />
Anne Garrett, ON<br />
Kathy Harrigan, QC<br />
Wendy Levin, ON<br />
Vanessa Nardelli, AB<br />
Linda Ross Stringer, ON<br />
Judy Somers, NS<br />
Sharon Zeiler, ON
Outline<br />
• Objectives<br />
• Survey results & other feedback<br />
• Features of <strong>Beyond</strong> the <strong>Basics</strong><br />
• Samples of individualized meal plans<br />
• Facilitated open discussion<br />
• News on the extended resource<br />
• Question & answer period
BTB on-line on line
Objectives<br />
• Understand the revisions to the tool and the rationale<br />
• Appreciate how the design of this tool lends itself to use<br />
with a variety of people affected with diabetes & to meet<br />
their diverse needs<br />
• Share practice ideas through open discussion<br />
• Be aware of the summer 2005 evaluation results<br />
• Be aware of the work on the accompanying resource<br />
manual and associated timelines
Survey Results<br />
• CPG logo<br />
• Popularity of 15g CHO portions<br />
• Consistency re measures/units<br />
• Readability grade 6-7 SMOG<br />
• Pictures vs words<br />
• Fats group: amber vs green boxes
Vegetables<br />
• <strong>Canadian</strong>s need to eat more!… so encourage the<br />
use of vegetables<br />
• Most are considered “free”<br />
• Individualize advice using your judgment, which<br />
ones, how much & how often
Comparison<br />
Food Groups<br />
Grains &<br />
Starches<br />
GHEG BTB<br />
CHO (g) Pro (g) Fat (g) CHO (g) Pro (g) Fat (g)<br />
15 2 0 15 3 0<br />
Fruits 10 1 0 15<br />
Milk &<br />
Alternatives<br />
1 0<br />
6 4 0-4 15 8 varies<br />
Other Choices 10 15<br />
varies varies
Comparison (Cont’d)<br />
Food Groups<br />
GHEG BTB<br />
CHO (g) Pro (g) Fat (g) CHO (g) Pro<br />
(g)<br />
7 3-5<br />
Fats 0 0 5 0 0 5<br />
Fat (g)<br />
Vegetables 10 1 0
<strong>Beyond</strong> the <strong>Basics</strong> Poster
Scenario #1 : Pregnant Woman<br />
Gestational <strong>Diabetes</strong>; 2100 calories<br />
TIME B AM L PM S HS NOTES<br />
CARBOHYDRATES<br />
(grams/choices) 3 2 4 2 3 3<br />
GRAINS & STARCHES 2 2 2 2 Fibre rich<br />
FRUITS 2 1 2 Variety<br />
1 1 1 1 Skim as is<br />
MILK&<br />
ALTERNATIVES<br />
OTHER CHOICES - - - - - - Use sparingly<br />
VEGETABLES 1 2 Variety<br />
1 2 4 1 Lean<br />
MEAT&<br />
ALTERNATIVES<br />
FATS 2 2 1 1 Healthy sources
Scenario #2: #2:<br />
Obese Man eating reasonable<br />
breakfasts and snacks but…. but<br />
TIME B AM L PM S HS Day’s Totals<br />
CARBOHYDRATES<br />
(grams/choices)<br />
GRAINS & STARCHES<br />
FRUITS<br />
MILK&<br />
ALTERNATIVES<br />
OTHER CHOICES<br />
VEGETABLES<br />
MEAT&<br />
ALTERNATIVES<br />
FATS<br />
As is 4 2 4 2 Max 16<br />
As is 2 3 1 Limit to 8 total/day<br />
1 2 1 Aim 3/day<br />
1 Aim 3/day<br />
- - - - - 2-(3)<br />
lite<br />
beer<br />
At least 1 if<br />
desired<br />
Aim 2-3 cups if<br />
desired<br />
�------------------As is---------------------------� Lean<br />
Try to avoid adding fats! Try low fat products or<br />
lemon juice!<br />
Lots! No limit<br />
Only where you really<br />
like it!
Scenario #3: Overweight dyslipidemia;<br />
dyslipidemia;<br />
reasonable glucose control frustrated that<br />
cannot lose weight and ….<br />
TIME B AM L PM S HS TOTAL<br />
CARBOHYDRATES<br />
(grams/choices)<br />
GRAINS & STARCHES<br />
FRUITS<br />
MILK&<br />
ALTERNATIVES<br />
OTHER CHOICES<br />
VEGETABLES<br />
MEAT&<br />
ALTERNATIVES<br />
FATS<br />
2.5<br />
to<br />
3<br />
3 to<br />
3.5<br />
1 4 to 5<br />
max<br />
�-----------------As is-------------------------------�<br />
1 12 to 14<br />
�-----------------As is-------------------------------� Lite<br />
cheese<br />
as is<br />
�-----------------As is-------------------------------� Avocados!
Scenario #4: Child with<br />
type 2 diabetes
Scenario #5: Child with<br />
type 1 diabetes
Scenario #6: 1 st Visit; 30 something<br />
insulin resistant, overweight male<br />
TIME-negotiate 8:30 12:30 5:00 7:30 11:30<br />
CARBOHYDRATES<br />
(grams/choices)<br />
GRAINS & STARCHES<br />
FRUITS<br />
MILK& ALTERNATIVES<br />
OTHER CHOICES<br />
VEGETABLES<br />
MEAT&<br />
ALTERNATIVES<br />
FATS<br />
Choose green box carb foods more<br />
often than amber<br />
Aim for one at a meal
2 nd Visit; 2 weeks later doing better with<br />
regular meals; fiancée concerned about<br />
large meat portions<br />
TIME 8:30 12:30 5:00 7:30 11:30<br />
CARBOHYDRATES<br />
(grams/choices)<br />
GRAINS & STARCHES<br />
FRUITS<br />
MILK&<br />
ALTERNATIVES<br />
OTHER CHOICES<br />
VEGETABLES<br />
MEAT&<br />
ALTERNATIVES<br />
FATS<br />
Choose green box carb foods more<br />
often than amber<br />
Aim for one at a meal<br />
1 palm 2<br />
palms
1 month later – “What’s all this carb<br />
counting stuff about?”<br />
TIME 8:30 12:30 5:00 7:30 11:30<br />
CARBOHYDRATES<br />
(grams/choices)<br />
GRAINS & STARCHES<br />
FRUITS<br />
MILK&<br />
ALTERNATIVES<br />
OTHER CHOICES<br />
VEGETABLES<br />
MEAT&<br />
ALTERNATIVES<br />
FATS<br />
4 choices 3-4<br />
choices<br />
½<br />
palm<br />
1 choice 4<br />
choices<br />
Aim for one at a meal<br />
1 palm 1 1/2<br />
palms<br />
Choose less fat each day<br />
2 choices
TIME<br />
Scenario #7: Shift work<br />
CARBOHYDRATES<br />
(grams/choices)<br />
GRAINS & STARCHES<br />
FRUITS<br />
MILK &<br />
ALTERNATIVES<br />
OTHER CHOICES<br />
Shift one 8-4 Shift two 4-12<br />
7 12 5:30 10 2 5 8 1-2 hrs<br />
before<br />
bed<br />
45 45-<br />
60<br />
6/day<br />
3<br />
3<br />
60 45 45 30 30 15<br />
VEGETABLES At least 5 per<br />
day a a a a<br />
MEAT &<br />
ALTERNATIVES a a a a a<br />
FATS Moderation
Scenario #8: Shift work – 40<br />
something type 2 lady; permanent<br />
nightshift; wants to lose weight<br />
TIME 8AM (1PM) Time<br />
for your<br />
walk<br />
CARBOHYDRATES<br />
(grams/choices)<br />
GRAINS & STARCHES<br />
FRUITS<br />
MILK&<br />
ALTERNATIVES<br />
OTHER CHOICES<br />
VEGETABLES<br />
MEAT&<br />
ALTERNATIVES<br />
FATS<br />
10 choices each day Lunch days off�--------------------------------�Lunch at work<br />
2<br />
choices<br />
3<br />
choices<br />
6PM 10PM (2AM)<br />
3<br />
choices<br />
2<br />
choices<br />
Scenario #9: Type 1 label with excellent<br />
eating habits; pumps insulin<br />
TIME<br />
CARBOHYDRATES<br />
(grams/choices)<br />
GRAINS & STARCHES<br />
FRUITS<br />
MILK&<br />
ALTERNATIVES<br />
OTHER CHOICES<br />
VEGETABLES<br />
MEAT&<br />
ALTERNATIVES<br />
FATS
Open Discussion<br />
Tell us how you have been<br />
using the resource
What’s Next?<br />
• Revised longer lists available on-line Nov 2005<br />
• 3 rd revised printing Sept, 2005<br />
• 75,000 sold to date
Resource Manual<br />
• Extended food lists for each group<br />
• Suggestions accepted for tips and other content<br />
• Volunteers still needed<br />
• Phase 1 will be ready for June, 2006<br />
• Phase 2 will be ready 1 year later
Question & Answer Period
Contact Sharon Zeiler at<br />
1-800-BANTING x7086<br />
sharon.zeiler@diabetes.ca
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