It's easy to get answers about health and nutrition! Just send your question by email to email@example.com and Dr. Harlan will respond to selected questions of general interest. Answers will be posted in the Ask Dr. Gourmet newsletter (sign up now!) and archived in the Ask Dr. Gourmet section of the website.
I am a recently diagnosed Type 2 Diabetic. I am a 50 year old African American, overweight woman and when I was diagnosed I had a fasting blood sugar of 247. With Glucophage twice a day it has gone down to 146. I haven't lost any weight yet (it's only been two weeks since I was diagnosed) but I have managed to cut out a lot of refined sugar and a lot of fat especially trans fat (my cholesterol levels are very good).
Do you have any advice on diet...how to lose weight? Stay within dietary limits? What kind of food should I avoid? I eat a lot of fruit especially mango and bananas. Is that okay?
I'd appreciate it if you can steer me to a Web site that would help. Thanks so much.
It sounds like you're on the right track. Bringing your blood sugar in line with medications is key. At the same time you can go a long way to controlling your blood sugar with the types of lifestyle changes you are making. Your first step is a great one -- cleaning up the types of foods that you eat -- cutting out refined sugars and fats.
Following the American Diabetic Diet and using "exchanges" is a great way to learn about eating a moderate diet. It also gives you some guidelines and structure about how much to eat and when to eat that can help you stay within reasonable boundries. The great thing is that this doesn't limit your choices of foods. It guides you about the right amount of foods that you like to eat.
Dr. Gourmet recipes don't have diabetic exchanges as part of the nutrition info, but they generally conform to about a 1500 calorie ADA diet. Starting with a diet that helps you to maintain your weight gives you a chance to get used to a healthier approach. After you have sorted out the exchanges and how they work then begin cutting the calories slowly. The combination of the type of diet that you are pursuing already with slow careful weight loss can be a powerful way to control your blood sugar. A lot of times these sort of changes can lead to less or no medication.
The first information that is needed is your height. This can give you an idea of your ideal body weight. The formula below is not perfect but it is a good guideline:
Calculate (for men) by allowing 106 pounds for the first 5 feet and then 6 pounds for each inch over 5 feet. (For women, it's 105 pounds for the first 5 feet and 5 pounds for every inch over that.) So ideal body weight for a 5'7" man would be 148 pounds [106 + (7 x 6)]. Diabetics appear to do better at or just below ideal body weight. If you multiply your ideal body weight by 10 and add your ideal body weight this will tell you the amount of calories you need to maintain your weight -- not gain or lose any weight. For an ideal body weight of 148, your required calories would be about 1600 [(148 X 10) + 148] = 1628. To lose about a pound a week you need to eat about 500 calories less per day or a diet of 1100 calories.
The main thing for you to remember is that, as a diabetic, this a long term process. There's no rush. Take your time, take it off, keep it off. Of course, you can also exercise. That 500 calories can be 250 calories per day of exercise and eating 250 calories less per day. This is a good approach because the exercise helps to keep your sugar down also.
Fruit can and should be a part of your diet. Following the ADA diet for 1500 calories there are 3 servings per day. A serving is possibly not as much as you are used to, so checking the exchanges lists at every turn is important.
The American Diabetic Association is a great place to start, at www.diabetes.org.
Good luck, and thanks for writing.
Timothy S. Harlan, MD, FACP