Chapter 4
Learn about Labels
Would you consider going on a cross-country trip without a GPS, directions, or a map to guide you? Of course not! Without this important information to keep you on track, you’d soon be hopelessly lost. Even now, in your journey with type 2 diabetes, you might find yourself feeling a bit bewildered as you navigate among all the food choices available to fit into your diabetes meal plan. Fortunately, as you embrace making your own decisions about food, you have a powerful tool available to you: the nutrition information label on food and beverage packages.
What can the nutrition information on food labels do for you? It can help you . . .
• Make informed food and beverage choices
• Maintain healthy eating practices
More than half of Americans say they check nutrition information labels to get a general idea of the nutrient content of their food. However, because of the overwhelming amount of label information to sift through, people often become confused, and many admit that even when the nutrition information is not healthful, they still buy the food! In this chapter, you will learn to cut through the confusion and focus on the information you need to know to successfully make the best choices for you.
Staking the Claims
The labels on foods and beverages are regulated by the United States Department of Agriculture (USDA) and the Food and Drug Administration (FDA). Most packaged foods are required by law to display nutrition labeling, although it is voluntary on raw foods such as fruits, vegetables, and fish. To learn more about foods that don’t have labels, like bananas or potatoes, you may want to check out a free online database such as Calorie King (www.calorieking.com) or SuperTracker (www.supertracker.usda.gov), use a mobile app, or check out one of many guidebooks, such as The Diabetes Carbohydrate & Fat Gram Guide, 4th Edition by Lea Ann Holzmeister, RD, CDE, published by the American Diabetes Association.
The USDA and the FDA mandate that claims on food products must be truthful to prevent deception, examples of which include ordinary bread being touted as whole wheat or misleading claims on energy drinks.
3 Type of Claims that Manufacturers Can Make on Product Labels
#1: Health Claims
Health claims are food label messages that describe the relationship between a food component and a health-related condition (such as sodium and hypertension or calcium and osteoporosis). At the time of publication, there are a number of authorized health claims, but none related to diabetes.
Health Claim Example: “Diets low in sodium may reduce the risk of high blood pressure, a disease associated with many factors.” Of course, if a food features a specific health claim, it must meet strict nutrient content requirements without being fortified. For example, a food with a low-sodium health claim must meet the requirement for a low-sodium food (140 mg or less of sodium per serving).
#2: Nutrient Content Claims
A nutrient content claim is a word or phrase on a food package that makes a comment (directly or by implication) about the nutritional value of the food using terms such as “free, low, reduced, fewer, high, less, more, lean, extra lean, good source, or light.” Nutrient content claims are strictly defined by regulations and describe the relative amount of a nutrient in a food, without specifying its exact quantity. They give a general idea about the amount of a specific nutrient in a food product. These claims generally appear on the front of food packaging. Nutrition labeling is required for virtually all nutrient content claims.
Nutrient Content Claim Example: “Sugar free” means the food or drink has <0.5 grams of sugar per serving. “Reduced calorie” means the food or drink has at least 25% fewer calories per serving than a comparable regular food or drink.
#3: Structure/Function Claims
Structure or function claims describe the role of a nutrient or dietary ingredient intended to affect the normal structure or function in humans (such as “calcium supports building strong bones”). Under the Dietary Supplement Health and Education Act (DSHEA) of 1994, structure and function claims may be used as long as such statements do not claim to diagnose, mitigate, treat, cure, or prevent disease and are not false or misleading.
Structure/Function Claim Example: “Fiber maintains bowel regularity,” or “Antioxidants maintain cell integrity.”
Check out the FDA website (www.fda.gov) for the most current guidelines and definitions of product label claims.
Are “Natural,” “Organic,” and “Healthy” Products Better For You?
If the package says a food is “natural,” “organic,” “vegan,” “protein rich,” or “kale-infused,” it’s got to be good for you, right? Not so fast. These buzzwords abound on grocery store shelves these days, and often cause confusion. Yes, some of these products are good for you, and some are less so. Consumers often perceive that “natural” and “organic” imply healthy! But that’s not always the case. Take a closer look at the product and the nutrition information.
According to the FDA, by definition:
• “Natural” means the product does not contain synthetic or artificial ingredients.
• “Organic” foods must meet the standards set by the U.S. Department of Agriculture (USDA). Organic food differs from conventionally produced food in the way it is grown or produced. Overall, organic operations must demonstrate that they protect natural resources, use only approved substances, and conserve biodiversity. But the USDA makes no claims that organically produced food is safer or more nutritious than conventionally produced food.
• “Healthy” means the product must meet certain criteria that limit the amount of fat, saturated fat, cholesterol, and sodium, and the product must contain specific minimum amounts of vitamins, minerals, or other beneficial nutrients.
Just because a food is “natural” or “organic” does not necessarily mean that it’s “healthy.” Some food for thought:
• Although “natural” potato chips might be made with “all-natural” ingredients, they may still be too high in carbohydrate, fat, or sodium to be “healthy” for you.
• Although a premium vanilla ice cream could be “natural” or “organic,” it’s still high in sugar, fat, and saturated fat, so would not meet the above criteria for “healthy.”
Are “Diabetic” Foods Better for You?
When it comes to “diabetic” foods, proceed with your eyes wide open. Many sugar-free, fat-free, or reduced-fat products that are perceived as “diabetes friendly” are in fact made with ingredients that contain carbohydrate (meaning they can raise your blood glucose). So, even if a product is touted as “sugar free” or “diabetes-friendly,” you’ll still want to check the label closely for the total carbohydrate content.
Case in point, revisiting ice cream again—a name-brand “low-fat, no-sugar-added” vanilla ice cream sandwich has 29 grams of carbohydrate. The regular “low-fat” version has 30 grams of carbohydrate. Which one would you choose? Your taste buds may tell you to go with the regular low-fat version (which generally will cost less than the “sugar-free” version too). In this case, follow your taste buds and go with the regular low-fat version over the sugar-free version.
Gluten-Free Guidance
“What is gluten?” you may wonder. Gluten is a protein in barley, rye, and wheat. Gluten is also found in crossbred hybrid grains such as triticale, which is a cross between wheat and rye. People who don’t eat gluten also need to be cautious with oats; while they do not innately have gluten, they may come into contact with gluten during processing. If gluten is a concern for you do not eat oats unless they are labeled gluten free!
Knowing about gluten is of utmost importance for those living with celiac disease. An estimated three million people in the U.S. have celiac disease. In fact, you may have heard of the higher prevalence of celiac disease among those living with type 1 diabetes in particular.
For those with celiac disease, eating gluten triggers the production of antibodies that attack and damage the lining of the small intestine, leading to an array of uncomfortable symptoms. Such damage limits the ability of the small intestine to absorb nutrients and increases the risk for other serious health problems, including nutritional deficiencies (such as vitamin D deficiency), osteoporosis, growth retardation, infertility, miscarriages, short stature, and intestinal cancers.
The only way to manage celiac disease is to completely avoid all foods that contain gluten. Following a gluten-free lifestyle helps prevent permanent damage to the body and helps those with celiac disease feel better.
There are many people who are told they are gluten intolerant. These people also experience uncomfortable symptoms when consuming items with gluten; however, they test negative for celiac disease and actual damage to their intestine does not occur. Avoiding foods with gluten also helps relieve symptoms for those who are gluten intolerant. As for others who choose gluten-free food as a lifestyle choice, experts say there is no evidence that it’s a healthier option for people not suffering from gluten intolerance or celiac disease.
If you cannot eat gluten, always read product labels carefully. Labeling standards are in place to ensure that items labeled “gluten-free” meet a standard for gluten content, thus instilling confidence that “gluten-free” items are safe for consumption.
Defining “Gluten-Free”
By definition, according to the FDA, foods labeled “gluten-free” must contain <20 parts per million (ppm) gluten. The standard definition for “gluten-free” is as follows:
• Foods are inherently gluten-free.
• Foods must not contain an ingredient that is:
+ a gluten-containing grain (such as spelt wheat);
+ derived from a gluten-containing grain that has not been processed to remove gluten (such as wheat flour); OR
+ derived from a gluten-containing grain that has been processed to remove gluten (such as wheat starch), if the use of that ingredient results in the presence of 20 ppm or more gluten in the food.
Restaurants and other establishments making a gluten-free claim on their menus should be consistent with the FDA’s definition.
If celiac disease or gluten intolerance is a concern for you, talk with your registered dietitian/registered dietitian nutritionist (RD/RDN) or doctor for further guidance on gluten-free eating.
What Do You Really Need to Know to Make Good Food Choices?
If you’ve occasionally (or maybe frequently) taken a look at nutrition information labels over the years, you’ve probably noticed that a lot has changed since these labels made their debut over 20 years ago! Although it may be interesting and nice to see health claims and the exact details for each nutrient on a label, you don’t have to memorize the FDA/USDA regulations to make the best choices for your diabetes meal plan!
If you find yourself standing in the supermarket aisle trying to decide which loaf of bread to buy, at first glance, the information on the label may seem overwhelming. Rather than throwing your hands up in frustration and randomly choosing a bread to toss in your shopping basket, take another moment to check out the label. What you really need to know is how to compare the nutrient numbers and claims of the different breads.
To provide a point of reference and get you started on your quest to make good-for-you choices, there are some quick tips in Table 4.1 about the nutrients on nutrition information labels that have the most impact on your diabetes.
Ultimately, the goal is to build awareness of what you eat and become empowered to make the choices that are best for you. After all, not all healthful-sounding products are created equal.
Top 10 Label Features That Deserve Your Attention
At the time this book was published, FDA food labeling regulations were in flux and the nutrition information label format was in the process of being redesigned. But regardless of how the final refreshed label design, its content, or labeling regulations turn out, there are 10 core pieces of information—or “features”—on the nutrition information label that you can use to make the best food choices for you:
Feature #1: Ingredient List
First things first: Peruse the ingredient list to check out what is in your food or beverage. When you look at the list of ingredients on a label, remember that they are listed in descending order by weight. This means that the first ingredient is the main (heaviest) ingredient, followed by ingredients used in lesser amounts.
Take, for example, the following ingredient lists from two different steam-in-the-bag broccoli products:
• Frozen steam-in-the-bag broccoli florets have one ingredient: broccoli.
• Frozen steam-in-the-bag broccoli with cheese sauce contains broccoli plus nearly 20 other ingredients.
Also pay attention to whether the food product has healthier ingredients (such as whole-wheat flour or canola oil) or not-so-healthy ingredients (such as hydrogenated or partially hydrogenated oils).
Takeaway: Know what you’re eating. If you don’t recognize multiple ingredients in the item, maybe it’s best put back on the shelf. You can make healthier choices just by choosing items that have healthier ingredients listed first in the ingredient list.
Feature #2: Serving Size and Servings Per Container
Size up the serving size and the number of servings in the package/container. The serving size on a food or beverage label is a standardized amount used for comparing similar foods/beverages. It may be different from the portion you usually eat/drink or the serving sizes in your meal plan. As you learned in Chapter 3, portion size matters! Once you’ve determined the serving size of a food, you’re on the way to knowing the exact amounts of nutrients you’ll be getting from that food.
Let’s use popcorn as an example. If you pop up some light microwave popcorn, do you eat a 3-cup serving? Or the 6.5-cup serving listed on the bag? Or the entire bag?
Take a look at the selected nutrition information below, which is from a box of light microwave popcorn:
• Serving size: about 6.5 cups popped
• Servings per bag: about 2
• Calories per serving: 120
• Total carbohydrate: 25 grams
Takeaway: As you can see, the serving size for this light microwave popcorn is 6.5 cups popped, which has 120 calories and 25 grams of carbohydrate. However, the number of servings per container is two. So, if you eat the entire bag of popcorn (even though it is “light”), you’ll be munching down 50 grams of carbohydrate—nearly enough carbohydrate for a meal! That extra carbohydrate can make quite a difference in your blood glucose, particularly if excess consumption like this happens several times a day!
Food Lists
If you use the Academy of Nutrition and Dietetics/American Diabetes Association booklet Choose Your Foods: Food Lists for Diabetes for meal planning purposes, remember that each food list groups foods together because they have similar nutrient content and serving sizes. Each serving on a food list has about the same amount of calories, carbohydrate, protein, and fat as the other foods on that same list. Be prepared to do a little math to translate the serving size on the label to the serving size called for in your meal plan. There are many mobile apps and free, online food databases that enable you to adjust the serving size of the food of interest in order to see the associated nutrient content information. Or you can pull out a good old calculator or smartphone calculator to get the job done.
Again, at the time this book was published, the FDA was in the process of redesigning and updating nutrition information labels. Serving sizes—one of the label features undergoing change—are predicted to begin to look more realistic; they will be based on the portions people usually consume in one sitting, rather than what they “should” be eating.
Feature #3: Percent Daily Value
What is Percent Daily Value?
The percent daily value (% DV) information on the label may initially bring some confusion. The Dietary Guidelines for Americans (www.health.gov/dietaryguidelines) recommends specific amounts of certain nutrients each day for optimum health. While nutrition and calorie needs may vary from person to person, the % DV on food and beverage packages are based on an average 2,000-calorie-per-day meal plan to provide a point of comparison.
What Does % DV Mean for You?
1. Glancing at % DV can help you see what and how much you’re getting from what you’re eating in the context of average needs for a day. These values can help you understand whether a food/beverage contributes a little or a lot of a particular nutrient to your total daily diet.
A quick guide to % DV: 5% or less is low, 20% or more is high.
Take sodium, for example:
+ 5% DV (120 mg) or less of sodium per serving is low
+ 20% DV (480 mg) or more of sodium per serving is high
2. Percent daily value can help you to track and raise or lower your intake of particular nutrients as needed.
Your meal plan might not be based on 2,000 calories per day, but the % DV is still a good frame of reference. At your next visit with your RD/RDN or certified diabetes educator, you may want to take a few minutes to calculate your own personal daily values for key nutrients and keep those numbers handy. You’ll then be able to judge how far the amount of fat or fiber, for example, in a food goes toward meeting your individual nutrition goals.
Take fiber and vitamin D, for instance:
Let’s say on the nutrition information label for a food, the amount of dietary fiber is 35% DV, which makes this food an excellent source of fiber; however, if vitamin D is 0% DV, this item is not a good source of vitamin D. You might decide to either eat or forgo this food based on how much of these particular nutrients you need.
3. You can also use % DV to compare similar foods and determine which is best for you.
For example, what if you’re trying to eat heart- healthy and reduce your saturated fat, trans fat, and cholesterol intake, but you love a little cheese now and then? Let’s compare the % DV of these nutrients in two kinds of cheese to determine which will better meet your nutrition goal.
Takeaway: Between the two cheeses, the light cheddar would be the better choice because the % DV for saturated fat and cholesterol are lower than those for the regular cheddar cheese.
Some nutrients, such as trans fat, sugars, and protein, don’t have a % DV listing. This is because no daily reference value has been established for these nutrients. However, you can still use the amount per serving to make comparisons between products before you buy.
Feature #4: Calories
While you may hone your focus in on carbohydrate to help achieve blood glucose control, calories do still matter. The number of calories per serving is especially important to maintain a healthy weight. (See Chapter 1 for additional guidance.) Look at the number of calories per serving on each food. How many of those servings do you plan to eat? Two? If you double the serving, then double the calories.
Checking out calories can provide perspective in the context of your daily calorie goal.
Take pistachios, for instance:
1/2 cup pistachios equals 350 calories. If you’re trying to lose weight and hold your calories around 1,500 per day, that 1/2 cup of nuts uses up nearly one-quarter of your day’s calories!
Are There “Free” Foods?
A serving of a food/beverage with <20 calories and <5 grams of carbohydrate may be counted as a “free” food. Limit yourself to three servings or fewer of the “free” food per day and spread these servings out throughout the day; otherwise, the carbohydrate in the item may raise your blood glucose. So “free” doesn’t mean “unlimited free.”
Consider salsa:
Want to use 1/4 cup fresh salsa to top grilled chicken? A 1/4-cup portion of salsa is a “free” food. However, if you want to use 1 cup of salsa to slather over a bean burrito, the larger portion of salsa is not “free” and must be counted.
Feature #5: Fat
As we’ll discuss later in Chapter 8 the type of fat eaten is more important than the total amount of fat. With the goal in mind to choose foods that are limited in saturated fat and cholesterol with zero trans fat, and those that are rich in heart-healthy polyunsaturated and monounsaturated fat, turn to the nutrition information label. The label shares with you the amounts of the following fats in the item:
• Total fat
• Saturated fat
• Trans fat
• Polyunsaturated fat
• Monounsaturated fat
Let’s take a look at real mayonnaise—a food in which nearly all of the calories come from fat—in comparison to a couple of other creamy sandwich spread options. When it comes to fat, by comparison, which of these spreads would you choose?
Takeaway: Choose guacamole for the healthiest fat profile, followed by the mayo made with extra-virgin olive oil (as opposed to regular mayo).
Feature #6: Total Carbohydrate
When it comes to carbohydrate, know your numbers. (See Chapter 1 and Chapter 2 for detailed guidance related to carbohydrate.) Check the grams of “Total Carbohydrate” per serving on the nutrition information label. The number of total carbohydrate does include the grams of dietary fiber and sugars, so you do not need to count those separately or add them to the Total Carbohydrate. Total carbohydrate is “one-stop shopping” when it comes to counting carbohydrates; that’s the number to use in your carbohydrate count. (As an aside, take care NOT to interpret the gram weight of the serving—as denoted alongside the serving size on the label—as the grams of carbohydrate. We’ve found in practice over the years that some of our patients confuse the two.)
Compare total carbohydrate amounts among items to see what best fits your nutrition needs. We compare two types of cereal—bran flake cereal and frosted flake cereal—below to see how this works.
Takeaway: The carbohydrate content of these two flake cereals is close, although the Total Carbohydrate in the bran flake cereal is 3 grams less than that of the frosted flake cereal. And the fiber of the bran flakes is 10 times more! That’s a big plus! Which would you choose?
Feature #7: Added Sugars
While the total carbohydrate count (See “Feature #6”) is your overarching focus for blood glucose control, the “Added Sugars” information is particularly eye-opening. The goal of this information is to help you distinguish between sugars that are naturally found in foods/beverages (such as those in fruit/natural fruit juice) and the refined sugars added by food manufacturers. On average Americans get 16% of their daily calories from sugars added during food production. That’s too much. Foods and beverages with added sugars can decrease your intake of nutrient-rich foods while increasing calorie intake. Furthermore, there’s solid evidence linking excessive sugar consumption to an increased risk for heart disease and other illnesses.
The grams of added sugar are encompassed in the “Total Carbohydrate” value on nutrition information labels, so they do not need to be accounted for separately in terms of carbohydrate count. However, added sugars provide no added nutrition, and thus are often referred to as “empty calories.”
You can easily spot added sugars as you peruse the ingredient list. Words that mean “added sugar” include the following:
• Added sugars (brown, cane, confectioner’s, date, invert, powdered, turbinado)
• Agave nectar
• Dextrose
• Fructose
• Honey
• Maltose
• Molasses
• Polydextrose
• Sucrose
• Syrup (corn, maple, agave)
Every 4 grams of sugar is equal to 1 teaspoon of sugar! Choose items without added sugars among the first three ingredients. Compare brands of similar products and choose those with the least amount of added sugars.
Take canned sliced peaches as an example:
Peaches canned in 100% juice have no added sugars, while those canned in heavy syrup generally have two or more types of added sugars, resulting in a total carbohydrate count over 1 1/2 times that of the peaches without added sugar!
Takeaway: To conserve carbohydrate and consume less added sugar, choose fruit canned in juice over that canned in syrup.
Your palate may benefit from less sugar as you begin to appreciate the natural sweetness of many foods. (See Chapter 2 and Chapter 8 for additional guidance on added sweeteners.)
Feature #8: Fiber
When reading nutrition information labels, look for foods rich in “Dietary Fiber.” Foods containing >3 grams of dietary fiber per serving are considered “high in fiber,” according to the Academy of Nutrition and Dietetics and American Diabetes Association booklet Choose Your Foods: Food Lists for Diabetes. A high-fiber food that has at least 5 grams of dietary fiber per serving is considered an excellent source of fiber. (See Chapter 8 for additional detailed guidance on fiber.)
Compare the fiber amounts in these soups, for example:
• 1 cup chicken noodle soup = 0.7 g fiber
• 1 cup black bean soup = 8 g fiber
Takeaway: The black bean soup has over 11 times the fiber of chicken noodle soup and is considered an excellent source of fiber.
Look again at the earlier cereal comparison in “Feature #6: Total Carbohydrate” (page 73) and check out the difference in fiber between bran flake cereal and frosted flake cereal.
Takeaway: The fiber in bran flakes is 10 times that in frosted flakes! So bran flakes would be a much better cereal choice.
Feature #9: Sodium and Potassium
Give sodium and potassium a little extra attention if you’re concerned about high blood pressure. Eating less sodium can help manage blood pressure. And eating more potassium-rich foods may help lower blood pressure and prevent high blood pressure. In general, Americans don’t consume enough potassium. (See Chapter 8 for additional specific guidance.)
When reading a nutrition information label, check out the “Sodium” value and see how the food fits within your daily sodium limits. And choose foods that are high in potassium (unless your health-care team advises you otherwise).
Check out the sodium content in tomatoes, which are rich in potassium, for example:
• 1/2 cup diced fresh = only 5 mg sodium
• 1/2 cup diced canned = 130 mg sodium
Takeaway: To get a potassium boost but manage sodium, go for diced fresh tomatoes instead of diced canned tomatoes (or choose no-salt-added canned tomatoes).
Feature #10: Vitamin D
In general, Americans don’t consume enough vitamin D, which is important for healthy, strong bones, especially for women and older adults. Look for foods and beverages that are rich in vitamin D to get the most nutrition for your calories. At the time this book was published, vitamin D was not listed on nutrition information labels, but it is one of the FDA’s proposed additions to the forthcoming label design. Remember 20% daily value or more is a high percent daily value.
Take the Time to Read Labels
Reading labels can add some time to your grocery shopping routine (at least initially), so you may want to set aside a few moments to study the labels on the foods you often purchase. Compare the labels of your choices side by side. Once you’ve identified the best choices for your grocery staples, your future shopping trips will go much faster. Even after you’ve identified your favorites, periodically do a checkup on their labels to catch any changes in ingredients and numbers. The time you spend now will save you time—and protect your health—for years into the future.
Take One Last Look at the Label
Make a Smart Choice: It’s All About You!
You’ve taken a good look at a nutrition information label to size up your servings and learn more about the specific nutrients in each serving. Now it’s time for you to make a smart choice, keeping your own personal needs and diabetes care in mind. Here are two additional special tips on label reading:
Tip #1: “Sugar Free” Isn’t “Carbohydrate Free”
Technically, if a food is labeled “sugar free,” it has <0.5 grams of sugar per serving. However, sugar-free foods may still contain carbohydrate, especially if sweeteners such as sugar alcohols (also known as polyols) are used in their preparation. (See Chapter 2 for more information about sugar alcohols.) Sugar alcohols may be listed on the nutrition information label. As a reminder, sugar alcohols do contain calories and carbohydrate, which can boost your blood glucose levels, particularly if you eat a large serving of them. Check your blood glucose after eating them to note their effect on you.
Candy Comparison
Comparing the nutrition information labels of a standard product and its sugar-free version you may be surprised to find that there is little difference in the carbohydrate content. Or, that the sugar-free variety is actually higher in carbohydrate than the standard version, as is the scenario with the butterscotch hard candy below. If that is the case, let your taste and your budget guide your choice.
Tip #2: Fat-Free Foods Often Contain Carbs
If you’re counting calories, fat-free foods may seem like a great solution to a dieting dilemma. However, many of today’s fat replacers are carbohydrate based. Although the fat content in a product might be lower, the carbohydrate content can be higher and affect your blood glucose. You’ll find an example on the following page.
Takeaway: After reading the nutrition information label and finding that the fat-free version of ranch salad dressing contains a significant amount of carbohydrate, you may decide to eat a small portion of the “real thing.”
Next Steps
Put your label-reading skills to the test by doing a bit of shelf searching. Find three foods in your pantry that fall into each of the following categories:
• Contains 0–15 grams of carbohydrate per serving
• Contains 16–30 grams of carbohydrate per serving
• Contains 31–45 grams of carbohydrate per serving
Did you note the serving size and number of servings per package on the foods you found?
What Do I Eat for Breakfast?
For 45–60 Grams of Carbohydrate*
Recipe: Lean Green Smoothie or Cherry Berry Smoothie (3/4 cup)
1 scrambled egg or 1/4 cup egg substitute
2 slices whole-grain toast with 2 teaspoons honey
For 60–75 Grams of Carbohydrate*
Recipe: Lean Green Smoothie or Cherry Berry Smoothie (3/4 cup)
1 scrambled egg or 1/4 cup egg substitute
2 slices whole-grain toast with 2 teaspoons honey
1/2 cup cooked oatmeal or cream of wheat with cinnamon
*For most women, 45–60 grams of carbohydrate at a meal is a good starting point; for most men, 60–75 grams of carbohydrate per meal is appropriate. Check with your diabetes health-care team to find the amount of carbohydrate that’s right for you.
Swift, Simple Tips
• Whip up the smoothies while the toast is toasting and the egg is cooking.
• Consider making a double portion of oatmeal or cream of wheat and refrigerating the second portion in a mug to heat up the following morning. Thin with water or low-fat milk.
• Both smoothies can also easily stand alone as a 1–carbohydrate choice snack.
Food for Thought
• Size up your servings.
• Know your numbers. Check the out the labels of the foods you eat, paying special attention to the numbers for the 10 features outlined in this chapter.
• Make smart food choices—it’s all about you.
• Feel overwhelmed by the nutrition information label? Get back to basics and focus on serving size and amount of total carbohydrate.
Lean Green Smoothie
Serves: 4 / Serving Size: 3/4 cup
Preparation Time: 5 minutes / Cooking Time: 0 minutes
Ingredients
1 cup unsweetened vanilla-flavored almond milk
2 cups raw baby spinach
1 cup fat-free plain greek yogurt
1 cup unsweetened frozen diced pineapple
3 large ice cubes
4 dashes ground cinnamon
1. Combine almond milk, spinach, yogurt, pineapple, and ice in a blender. Cover and blend until smooth. Pour into 4 glasses and garnish each serving with a dash of ground cinnamon. Serve immediately.
Choices/Exchanges
1/2 Carbohydrate, 1 Lean Protein
Calories 70
Calories from Fat 10
Total Fat 1.0g
Saturated Fat 0.1g
Trans Fat 0.0g
Cholesterol 0mg
Sodium 90mg
Potassium 330mg
Total Carbohydrate 9g
Dietary Fiber 1g
Sugars 7g
Protein 7g
Phosphorus 100mg
Cherry Berry Smoothie
Serves: 4 / Serving Size: 3/4 cup
Preparation Time: 5 minutes / Cooking Time: 0 minutes
Ingredients
1 1/2 cups unsweetened pitted frozen dark sweet or sour cherries
1 cup unsweetened vanilla-flavored almond milk
1 (6-ounce) carton fat-free blueberry-flavored greek yogurt
1/2 cup fresh or frozen unsweetened blueberries
1 small banana, peeled and chopped into large pieces
1. 1. Combine cherries, almond milk, yogurt, blueberries, and banana in a blender. Cover and blend until smooth. Pour into glasses and serve immediately.
Choices/Exchanges
1 Fruit, 1 Lean Protein
Calories 90
Calories from Fat 15
Total Fat 1.5g
Saturated Fat 0.2g
Trans Fat 0.0g
Cholesterol 5mg
Sodium 60mg
Potassium 265mg
Total Carbohydrate 18g
Dietary Fiber 2g
Sugars 12g
Protein 5g
Phosphorus 65mg