Melanie Cole, MS (Host): Welcome to Bryan Health Podcast. I'm Melanie Cole and joining us today to speak about healthy eating to manage diabetes is Teresa Gerbeling. She's a Registered Dietitian, Nutritionist, and an Outpatient Diabetes Educator for Bryan Diabetes Center at Complete Endocrinology. Teresa, thank you so much for joining us.

I'd like you to start by telling the listeners how diet impacts diabetes management and or prevention. Tell us a little bit about this connection between our diet, food and diabetes.

Teresa Gerbeling, MS, RD, LMNT: Hi, Melanie. Thank you so much for having me. I am delighted to be here today to talk about the connection between diet and diabetes. So the way that we plan our meals can really affect blood glucose levels. Healthy eating allows us to get adequate amounts of nutrients that are required for our body to be fueled and well and healthy. We know that carbohydrate is the substance in food that affects our glucose levels the most, and so oftentimes we hear that carbohydrate is bad for us. When it comes to diabetes, balancing the carbohydrate intake on a balanced plate with protein and fat is really the ideal way to plan our meals to best treat our glucose levels.

Host: Well, thank you for that. So I'd like to discuss carbohydrates for a minute, because as we're going to be talking about what this healthy meal looks like, and if someone is told they're pre-diabetic or they have full blown diabetes; I'd like you to talk about diet and food, but carbohydrates is a real buzz word and not all of them are created equal. Can you please speak to the myth that all carbohydrates are bad for you? When we think of things like a tomato and a carrot, those are carbohydrates as well.

Teresa Gerbeling, MS, RD, LMNT: You're right. Not all carbohydrates are created equally. And when we're thinking about diabetes and a healthful diet for diabetes, we want to focus on those healthful carbohydrates that are complex carbohydrates that we find in whole grains and fruit and vegetables and in dairy products. When we consume carbohydrates from these food groups, we're also getting vitamins and minerals essential to our health. So really focusing on those complex carbohydrates that come from fibrous foods and whole grains, rather than the simple sugars, the added sugars, corn syrup, even honey. Even though we think of honey as being natural, it is still an added sugar that's oftentimes added to food to make it sweet. And it affects our blood sugar similarly as high fructose corn syrup.

So when we think about healthy eating, we really want to balance half of our plate with non-starchy vegetables. Things like carrots, broccoli, celery, cucumbers, eggplant, salads, peppers. Because those foods are high in fiber and they slow the absorption of carbohydrate from other foods. We want to balance those non-starchy vegetables with a nice portion of protein, three to four ounces of protein of a lean meat, beef, chicken, or fish. And then also the other fourth of our plate should be carbohydrates and starches because our body does need carbohydrate and starch for fuel.

All of the trillions of cells in our body rely on glucose for energy, and we get that glucose from carbohydrate foods. So we need those carbohydrate foods to fuel our cells so that they can do their job.

Host: When we think of that plate that you're describing, what's the difference between portion size and serving size? And while we're looking at that, are you someone that advocates, if we're trying to eat healthy, and we are trying to control our blood sugar levels; are you someone who advocates that we should eat a little bit of a larger portion of these foods that are non damaging, healthy foods, all the vegetables, or a smaller portion of foods that maybe we've craved or that are maybe not quite as good for us?

Teresa Gerbeling, MS, RD, LMNT: Absolutely. I think there's a time and a place for each of those ideas. So when we think about serving size, that is the amount of food that is recommended to be consumed, or kind of the typical amount, and that is the amount that you see when you look at the nutrition facts label on the food. So generally, a half of a cup of fruit or small piece of fresh fruit, grains, it's a half of a cup, proteins is three ounces.

Portion size is the amount that we actually eat at a setting. So I know for me, my cereal serving does not match the serving size listed on the box. I typically have a larger portion of cereal and for some things and at some times that is okay. And when we're having those cravings or when we're at that celebration and there's birthday cake or cookies; we can indulge ourselves and have a small piece and enjoy the celebration and enjoy that food. And I encourage people to really be mindful when they're enjoying those sweet foods, to take a small bite and really savor and taste and enjoy it. If we don't indulge our cravings, then we are going to continue to crave that food and likely overeat in the long run.

Host: That's really good advice and it certainly is true for most of us. If we deny ourselves these things, then we crave them even more. So as we're talking about meal planning, it's so important. I'm an exercise physiologist, Teresa, so when I talk to my clients about meal planning, a lot of people don't want to think about the week ahead. But it's really an important part of managing diabetes and really, if someone is trying to watch their weight in general. Can you give us your best advice as a registered dietitian nutritionist for meal planning and meal prep, maybe on a Sunday, so that it is easier to keep track of what we're eating?

Teresa Gerbeling, MS, RD, LMNT: Melanie, you're exactly right. Healthy eating does take time and preparation. And I say that to almost every single one of my clients and all of my friends. If we are going to eat healthfully, it has to be quick and easy. When we get home from work, it's been a long day and we're tired; we are going to go for whatever is easiest.

When I'm running out of the house in the morning on my way to work, I'm going to grab whatever's easiest for breakfast. I'm not going to take the time to make breakfast. So planning and prepping is essential in healthy eating. I like to encourage people to write down three dishes that they want to make during the week and then from there determine what ingredients they need to make those dishes and then go to the grocery store one time a week rather than making multiple trips during the week.

Save yourself some time by planning ahead, making one trip to the grocery store and then on Sunday or whatever day works, spending a couple of hours every week, getting the vegetables ready, getting the fruit ready, and having it ready to go and grab. I like to prep little bags of veggies so every day I can just grab a little ziplock of vegetables and I can have that with my lunch.

There's no way that I would do that every morning before heading out the door, but I do it all together on Sunday. And it's super easy to grab on the way out. So making food ahead of time, but having a plan and knowing what you're going to make before you even go to the grocery store.

Host: Okay, then let's go to the grocery store now and we hear that you're supposed to stay in the perimeter because that's where the healthier options are. Can you tell us a little bit about grocery shopping and what you would do with a patient that you were taking to the grocery store or that advising about because diabetes can be managed and it's so important when we're at the store to look at these things and to read labels.

Teresa Gerbeling, MS, RD, LMNT: Right, fortunately we do have the Nutrition Facts label that is required to be on every food. The contents of the Nutrition Facts label are standardized and required by the FDA to be listed. So when going to the grocery store, I encourage people to go with the list and try to stick to the list as much as they can. Spend some time in the produce area finding what is on sale, what's in season, and experimenting with new fruits and vegetables that maybe you're not as familiar with. And going for whole meat, lean beef, pork, chicken, fish. And then going through the grains aisle and really looking for those that say whole grain on the label. We know that when we consume foods that have whole grain on their label, we're getting more fiber. We're getting more vitamins and minerals and some of the healthy fat is also found in the whole grains that we don't get in the refined grains.

So looking at the front of the box to see if it says whole grains and then flipping it to the side and looking at the nutrition facts and paying attention to the dietary fiber. We know that foods high in fiber, again, slow down the absorption of carbohydrate, and scientists are beginning to learn more and more about fiber all of the time and how important it is and how it's linked to our entire health.

Host: This is so educational. And Teresa, as we wrap up, I'd like you to offer your best advice for eating healthy to manage diabetes. If someone is told they have pre-diabetes or full blown, they are diagnosed with Type 2, what do you tell them every single solitary day about watching their food, watching what they eat, keeping track of it, whether it's a journal or some technology, but keeping track of what they eat so they could monitor how their blood glucose levels are going to react.

Teresa Gerbeling, MS, RD, LMNT: We do know that people that record their food intake tend to eat a little bit less and be more mindful of what they are fueling their bodies with. And I encourage people to think about food as fueling their body and how can they best fuel their body by the foods that they choose. And reminding people also that it is a choice.

We get to choose what we are going to eat and we can choose whether or not we want to have a cookie and how we can fit that into our overall diet. I think that focusing on whole foods, fruits and vegetables and whole grains, lean meats is really the key. So I encourage all of my patients to make a plan even if they're planning one meal a week and to incorporate whole foods, fruits, vegetables, whole grains, and lean meats and make their plate balanced with half of the plate being those non-starchy vegetables. And we have dieticians at Bryan Health that are here to help any patients that have more questions and that want individual tailored nutrition information and nutrition counseling.

We have dieticians ready to help.

Host: That's great, Teresa. Thank you so much for letting us know about that. And you can also get more information at bryanhealth.org.

Melanie Cole, MS (Host): And Bryan offers several physician clinics that provide comprehensive diabetes care for patients. At these clinics, patients receive coordinated care important to diabetes management that includes their provider as well as certified diabetes educators, registered dieticians, social workers, care navigators, and pharmacists.

To learn more, please visit bryanhealth. org slash diabetes. And that concludes this episode of Bryan Health Podcast. please always remember to subscribe, rate, and review Bryan Health Podcast on Apple Podcasts, Spotify, iHeart, and Pandora. I'm Melanie Cole.