As I mentioned in my last recap post, Bonnie, a reader of this blog, mentioned the Diabetic Exchange Diet to me in a couple of comments on an early January post about my dieting efforts.
I was intrigued, but I felt that I had too much going on at the time (with New Year's resolutions!) to undergo a new type of diet as well.
My dad and his dad both have/had diabetes. My grandfather controlled his with his diet (or rather, didn't control his with his diet as I remember my grandmother scolding him for eating the Polish food that she put on the table!) but my dad has to give himself daily insulin injections and check his blood sugar throughout the day. He also has Hashimoto's disease, a hypothyroidism condition that is hereditary and many heart problems. He's had a quadruple bypass a few years back. My stepmom was a dietician but my dad is a bon vivant who cheated on his diet behind her back so despite her best efforts, he couldn't avoid diabetes.
With all those antecedents, I still refuse to go see a doctor so I have no idea whether I am pre-diabetic or what. I probably am as I'm in the "obese" category when it comes to BMI. I'm not anti-science at all, I'm anti going to the doctor's for myself. I don't want to be pumped up with drugs. I do recognize that there are very serious consequences to having diabetes (blindness and high risk if amputation of the lower limbs being a couple of them) and hypothyroidism, but before I have to be on drugs, I want to try to do my best to improve my health on my own. After all, even if I were on drugs, I'd still have to make the changes that I have undertaken this week.
We all know that being healthy generally means (aside from inherited or genetic conditions) that:
- You need to eat healthy foods in moderation
- You need to exercise or be active, every day
- You shouldn't smoke, drink, do drugs
- You should avoid stress
- You should keep hydrated
- You should get plenty of sleep
I'm sure I'm missing some bullet points, but those are the ones that jump out at me.
Well, I don't smoke, rarely drink, and I don't do drugs so I'm already ahead of the game a little!
Last week, when I ate cereal for breakfast, and then had a Wendy's meal (fried chicken sandwich, large fries) for lunch, followed by 2 donuts, I felt like crap in the afternoon. I oftentimes find myself feeling tired in the afternoons even though I don't lead a particularly strenuous life, but this was something else: I couldn't keep my eyes open and I had to take a nap. It probably was more like a short coma!
When I woke up, I knew that something had to change and I knew right away that my fatigue had been due to eating too many carbs and too much sugar. I had been meaning to look up the information that Bonnie had shared with me back in January and did so that evening.
DIABETIC EXCHANGE DIET
Back in January, I had found this handout from the University of Arkansas Cooperative Extension Service titled "Exchange List System For Diabetic Meal Planning" and asked her if that was the diet program she had told me about. She confirmed, and added:
"Yes that is it...however, there is also a chart which shows how much you should have from each group.. for the # of calories that you are planning on for a day. For 1200 calories:Breakfast is: 1 starch, 1 fruit, 1/2 milk and 1 fat. Lunch is: 1 starch, 1 vegetable, 1 fruit, 2 meat and 1 fatAfternoon snack: is 1 starchDinner: 2 starch, 1 vegetable, 1 fruit, 2 meat and 1 fatBedtime snack of 1 serving milk
1500 adds another starch at breakfast, another at lunch and 1 for a bedtime snack. For approx 1400 you could only add 2 more starches and not 3. The trickiest past about 1 starch is checking the packages to be sure that your 1 starch is only 15 carbs... Cereal is an important one to watch often A serving size on the pack is like 45 carbs so you want to only have 1/3 of what they say. As far as snacks... for your starch as long as it is 15 carbs you are good...so you could have another fruit or nuts etc..."
Basically, the Diabetic Exchange Meal works on the premise that foods are divided into 6 groups and you are allowed to eat so many "exchanges" from each group of food every day, depending on how many calories you should consume. It's more involved than that and you probably should read up on it more, but that's the basic premise. The six groups are:
- Starches/Carbohydrates (I found these terms to be used interchangeably from one source to the next)
- Non Starchy Vegetables
Make sure to read the University of Arkansas handout to understand what foods go into what category. For instance, some foods that I would count, traditionally, as dairy, actually count as a meat (cheese), or milk (yogurt) with this diet. Some foods might be a combination of several groups.
There are also "free" foods, although I've only found out about those on other sources. Obviously, those should only be used sparingly. For instance, "sugar free non dairy creamer" is a free food and so is Romaine lettuce.
The plan is based on "exchanges" not because you can exchange a meat for a fruit, but because you can substitute foods within the same group. So let's say a meal that you looked up includes Brussels sprouts but you don't like Brussel sprouts, you can substitute another non starchy vegetable from the list for it (but you need to make sure that the quantity is correct).
The University of Arkansas Exchange List is a start, but of course is doesn't cover all the kinds of different foods that are out there. Sadly, I haven't found any resource that is truly comprehensible yet. It might be because that method of dieting has kind of fallen out of favor compared to counting net carbs or other diets like keto, paleo, etc. However, the free, online My Food Advisor tool from the American Diabetes Association is a good start. It's very imperfect but it's also been helpful.
You don't need to create an account to use it. I haven't created one. By clicking on their "Explore Foods" section, you can search for foods with just their name, or by certain criteria, including by category.
|Note that under Fats and Others, there is a "free foods" category that you can bring up.|
For instance, here I searched for "pasta". You can see that the results are very limited, only 13 results. That is the downside of the tool, their database is very incomplete.
The screen above tells you that "pasta, cooked" is a starch, but doesn't tell you how much of the pasta equals how many starches, right? To get that, you need to click on "pasta, cooked".
So above you can see that the serving size is 1/3 of a cup, you see the nutritional information for that serving size and that it corresponds to 1 starch. Hence, if you wanted to eat 1 cup of cooked pasta, it would be 3 starches.
Similarly, 1 oz of cooked meat = 1 meat. So if you decide you want to eat 4 oz of any meat or fish, it's going to equal 4 meats. At 1,400 calories I'm only allowed 5 meats per day (and remember, "meat" includes cheeses!) so I learned on that first day that I couldn't indulge on eating such a "large" portion of protein in one sitting unless I didn't mind not having cheese or eggs during the day! Yikes. Also, not all meats are equal, obviously the advice is to use lean meats instead of the fattier (and more unhealthy) ones. I should add that I have found that if I cook 3 oz of raw 73% lean ground beef, I end up with 2 oz of cooked ground beef. Again, the meat exchange is calculated for the cooked meat that you consumed. Meat loses weight when you cook it. So be careful with this. It's probably safer to invest in a kitchen scale. I've had this one since 2013 and I really like it.
Another helpful resource I found, is a book that I borrowed from my library system entitled "The American Diabetes Association Month of Meals Diabetes Meal Planner". I'll probably buy a used copy on Amazon. It's also available as a Kindle book.
It contains several hundreds of suggestions for breakfasts, lunches, dinners, and snacks. Each category of ideas correspond to specific amounts of exchanges, but there is a range of caloric choices in each category.
For instances all 167 breakfast ideas correspond to:
- 2 starch exchanges
- 1 fruit exchange
- 1 fat free milk exchange
- and 1 fat exchange
yet the ideas presented range from 266 to 446 calories. So not all breakfasts are equal in terms of calories.
Same principle with lunches, dinners, and snacks. So with that book, you kind of have to follow the plan they propose of "x amount of calories for breakfast, x amount for lunch, and x amount for dinner". But if you're willing to follow that, the book has tons of suggestions for each meal, including some actual recipes too.
It's also worth noting that they do explain how to adapt their plan if you're vegetarian.
MY APPROACH TO THE PLAN
I wanted a little more flexibility so I decided not to just limit myself to eating the proper amount of each exchanges in a day. I also didn't want to limit myself to the exchanges as presented by Bonnie in her initial comment. For instance, I'd rather have eggs for breakfast as I find protein early in the morning really helps me feel full up until lunch. But I still wasn't sure of the amount of calories that I should consume in order to lose weight.
So I decided to track what I ate in My Fitness Pal (you can create a free account and use their website and/or download their free app to your phone), as it would not only tell me how many calories I should consume according to my age, weight, weight loss goal, and exercise level, but also give me an account of the calories, nutrients, sodium, etc. that I was consuming.
After I input my details into My Fitness Pal, it told me that I was allowed to eat 1,400 calories per day.
However, the "Month of Meals Diabetes Meal Planner" doesn't have a plan for 1,400 calories. It only has information for 1,200; 1,500; 1,800; and 2,100 calorie plans, and it wouldn't help me with the specific number of exchanges I could eat from each group as well :(
I did, however, find a 1,400 calorie Diet Exchange Plan online! It states that I can have, per day:
- 7 starches
- 3 fruit
- 3 non-starchy vegetables
- 5 meats
- 2 milk
- 3 fat
Incidentally, I also found a 1,200 calorie Diet Exchange Plan and a 1,800 calorie Diet Exchange Plan, which I printed so I have them if I ever have to eat that amount of calories (as I lose weight and as, later on, I'm on maintenance).
Using My Fitness Pal to track my calories and nutrients is great, but it doesn't help me tracking my exchanges and I couldn't find an app or even a printout that would. So I made my own food journal for 1,400 calories in Excel. I'm sorry to say that you can't download it to print it since Blogger doesn't let you post pdf documents but I can email it to you if you want. Just contact me at the email address listed under "Contact Me" and mention the 1,400 calorie Diabetic Exchange Food Journal in the title.
|I used circles divided into quarters for the exchanges since some food serving size might correspond|
only to 1/4 or 1/2 an exchange.
I made myself a binder where I keep my journal printouts, Exchange Plans, the hand out from the University of Arkansas and other printouts. I use a blank journal every morning to plan my food intake for the whole day.
Under "Notes", I jot down what I plan on cooking for Greg and the kids for dinner that day (I don't cook lunch or breakfast for them). I try to eat mostly about the same thing as what they're eating although with some changes. So I start by writing down my dinner. For instance, tonight I made Portobello Mushroom Stroganoff. So I wrote down each ingredient under "dinner" and looked up the exchanges for each ingredient's and the serving size.
After that, I plan my breakfast. I want to have protein, as I mentioned, so I am careful to keep 1 meat at least. I have found that an "omelet" made with 2 egg whites, 1/4 cup of thinly sliced zucchini and a stick of light string cheese (omelet cooked in EVOO spray in a non-stick pan) and a piece of fruit is a filling breakfast for me. It uses 2 meats, 1/2 a non starchy vegetable and 1 fruit.
From there, I finish filling up my daily journal, making sure that I used up most of the exchanges, if not all. Then I input the whole thing in My Fitness Pal to make sure that I'm OK as far as the calories are concerned.
I put a goal of 8 cups of liquids on the food journal, but I have been drinking more than that.
I have decided that I would not eat my exercise calories so I don't log my exercise in My Fitness Pal. I do write down what I did and the caloric value in "Exercise Notes" in MFP and I also write it on my Diabetic Exchange Food Journal. Not eating my exercise calories allows me not to think "oooh, I still have 300 calories to eat!", which usually leads me to eat unhealthy foods. I really want to try to follow the diabetic exchange plan for the level of calories I should be eating. So far, so good.
For instance, my food intake for today was as follows:
- Omelet made with:
- spray of EVOO in my Misto sprayer (free as far as I'm concerned)
- 2 egg whites (1 meat)
- 1 piece of light string cheese (1 meat)
- 1/2 cup slices zucchini (1/2 non starchy vegetable)
- 2 clementines (1 fruit)
Morning Snack: (I actually ate it with my lunch)
- Shake made with:
- 1 cup 2% milk (actually 1/2 cup whole milk and 1/2 cup water) (1 milk)
- 1.25 cup fresh strawberries (1 fruit)
- A little bit of stevia (free)
- Mixed in the blender
- Turkey roll-ups made with:
- Whole wheat tortilla, 8" (2 starches)
- 1 tbsp light mayonnaise (1 fat)
- 2 oz oven roasted turkey lunch meat (2 meats)
- 2 Romaine leaves (free)
- 1 apple (1 fruit)
- 8 saltines (2 starches)
- 1 tbsp Weight Watchers Black Bean Dip (free) Note: I halved the recipe and it still gave me over a cup of it. So far it's kept in the fridge for 4 days without turning.
- 1 oz oven roasted turkey lunch meat (1 meat)
- Portobello Mushroom Stroganoff serving (I use penne pasta and reserved 1 cup of cooked pasta for myself, then added 1 cup of the mushroom sauce to my plate) made with (my portion only, estimated):
- 1 cup portobello mushroom (1 non starchy vegetable)
- 3 tbsp light sour cream (1 fat) I probably vastly underestimated how much light sour cream went into my portion, though. Good thing I biked for an hour today and didn't eat my exercise calories!
- 1 tsp butter (1 fat)
- broth (free)
- 1/4 cup onion (1/2 non starchy vegetable)
- 1 tbsp flour (1/3 starch)
- 1 cup cooked penne pasta (3 starches)
- Side salad made with:
- Romaine lettuce (free)
- 1/2 cup cucumber (1/2 non starchy vegetable)
- 1/4 cup shredded carrots (1/4 non starchy vegetable)
- 1 Fit & Active nonfat yogurt (1 milk)
All in all, I consumed about 1,318 calories according to My Fitness Pal. It's probably a little more as I didn't input the sugar free non dairy creamer that I added to my morning coffee, or the 1 tbsp of light dressing I used on the salad (which would have been another 1/2 fat, btw).
As far as nutrients are concerned, I'm pleased that my sodium and potassium intake are definitely much better than they used to be. However, I'm still eating too much sugar and not enough iron, according to My Fitness Pal. And I'm also eating more carbs than I should, according to My Fitness Pal! It's kind of maddening but I'm going to keep plugging at it. I did eat 1/3 starches more than I should have and should have eaten another 1/4 non starchy vegetables.
However, I think that on the days when we might eat out, keeping those exercise calories will allow me not to have to worry as much about the exchanges on that day (as again, my goal in using the Diabetic Exchange Diet Plan is to lose weight and be healthier, not avoid a potentially dangerous blood sugar count on a particular day). I spent a lot of time today researching what the best choices might be at fast food places for diabetics. It's not necessarily healthy, but reading the information prepared me for some choices I ought to keep in mind when we go out to eat or when my daughter and I will be on our trip in a few days.
I found a couple of useful resources:
- On the Prevention Magazine website, an article entitled "Rescue Your Fast Food Meal". It doesn't address the exchange aspect of things, but explains what is a better choice at several fast food places.
- Same with the "Diabetic-friendly Fast Food" article from Lifescript.
- The "Restaurant Foods" category of the "Explore Foods" section of My Food Advisor lists over 3.696 dishes/foods but it's not searchable, just an alphabetic listing that sometimes doesn't make sense. On the plus side, it shows the exchanges for those dishes/foods.
- I also ordered a used copy of a book on Amazon, entitled "Eat Out, Eat Well, The Guide to Eating Healthy in Any Restaurant", which was written for the American Diabetes Association. Since we do eat out quite a bit, I figured I should educate myself to be able to make better choices.
So all of this, coupled with making sure that I exercise at least 30 minutes a day (I've been exercising 45 to 60 minutes a day so far, on my recumbent bike) and drink at least 8 cups of liquids a day, constitutes my new diet.
It sure seems to be working. I weighed 230 lbs on Tuesday morning. This morning (Saturday), I was down to 223.4 lbs, a 6.6 lb drop in just 4 days! Of course I went from eating a ton of calories and carbs to eating a reduced amount of calories and carbs, I went from only taking a long walk on Saturdays to exercising every day, and I started drinking 4 to 5 times the amount of liquids that I had been drinking. I'm quite sure subsequent weeks won't see such a steep drop, but it was very encouraging to see immediate results in my weight. I don't have sudden stores of extra energy but I sleep better and I don't wake up tired and I haven't needed to take an afternoon nap as I don't feel tired in the afternoons. I also fall asleep (apart from tonight!) earlier than I have been.
I hope to keep posting positive updates :)