Health Insights: Diabetes and Diet | HealthiNation

Uploaded by HealthiNation on 12.04.2012

DR. HOLLY ATKINSON: Welcome to HealthiNation, I'm Doctor Holly Atkinson. As a diabetic person,
you know it can be difficult to make the right food choices but there is help out there.
I spoke with Doctor Derek LeRoith, Chief of the Endocrinology, Diabetes and Bone Disease
Department at the Mt. Sinai School of Medicine about the importance of working with a nutritionist.
DOCTOR DEREK LeROITH: What's very important is for the nutritionist to work with each
individual patient so what they do is they ask the patient what are your favorite foods?
What do you generally eat? And they learn about the patient's ability, whether it's
socioeconomic, whether it's ethnic, and they vary the diets for the weight loss aspect
according to what's available to the patient, they also then help the patient understand
what's important in terms of what happens to the glucose after you've eaten 'cause a
lot of the post-meal rise in sugars cause a lot of the complications. So they can work
with the patient and design diets that would be appropriate for that individual patient,
both for weight loss, but also for controlling their sugars. The consensus is that a Mediterranean
type diet, with lots of fresh fruit and vegetables, is the best way to go. And again, the nutritionist
would help them work with how much of the fresh fruit and vegetables to include in the
diet, the cereals and what type of meats, fish and carbohydrates they should be eating;
but the more fresh fruit and vegetables, the healthier the diet's gonna be.
DR. HOLLY ATKINSON: What about the "no-nos?" What are the bad foods?
DOCTOR DEREK LeROITH: I think it's all a question of quantity, so, if a patient could not live
without ice cream, I would say, well, try and reduce the times that you eat ice cream
to perhaps once a week, twice a week, just to reward yourself. So, there are no no-nos
but quantity is what's very important, cutting down on theÉ the high-fat diets, the uh the
simple sugar diets, et cetera, try to increase the complex carbohydrates, all of those are
relevant in everyone's diet and a mixture of some fat, carbohydrate and protein, which
the nutritionist will help them with.
DR. HOLLY ATKINSON: Just quickly give me some examples of complex carbohydrates.
DOCTOR DEREK LeROITH: So, rice, starch like bread, those are complex carbohydrates, requiring
some breakdown of the complex carbohydrate down to a simple sugar as opposed to uhm,
when you have sugar in variousÉ uh, where it's sodas, for example; the real "no-no"
perhaps is a soda which has 180Êcalories in general; the sugar goes right into the
body; that's a simple sugar. Two slices of bread is about the same as a soda but it's
a complex carbohydrate. What's very important is to try and lose weight because five pounds,
ten pounds weight loss will reduce a diabetic's blood sugar much easier to control the blood
sugar, much more sensitive to the medications; it will drop their blood pressure and make
them require less anti-hypertensive and blood pressure medication and it will drop their
cholesterol as well. So, just a few pounds is enough, in terms of weight loss, to actually
improve many of those factors that cause the long-term complications.
DR. HOLLY ATKINSON: Is there a consensus in the medical community about the most effective
way that diabetics can go about losing weight?
DOCTOR DEREK LeROITH: The general consensus is that if you reduce your caloric in-take,
you will lose weight if you reduce your caloric in-take and you exercise, you will lose weight
and you can maintain the weight loss by exercising. The problem is that there's so many different
diets that are available most of the "fad diets" help you lose weight immediately but
they don't help you keep the weight off. What's important is sustaining it and takes a lot.
DR. HOLLY ATKINSON: So, here's the insight: nutritionists are a great resource in helping
you learn about how food affects your blood sugar levels. They'll help you personalize
your diet, making sure you're getting lots of fresh fruits and vegetables and eating
the right amount of fat, protein and complex carbohydrate if you must have some of your
favorite treats, remember: everything in moderation. And losing just a little weight can really
help you control your diabetes.