Amanda Wilde (Host): Balanced nutrition, it can help you take charge of your diabetes and live a fuller, healthier life. We're getting details from Lizzy Katz. She's Diabetes Program Coordinator at UM Capital Region Health. Welcome to the live Greater podcast series, information for a healthier you from the University of Maryland Medical System. I'm your host, Amanda Wilde. Lizzy, it's so great to have you here.

Lizzy Katz, RD, CDCES: Thank you for having me. I'm so excited.

Host: As a certified diabetes care and education specialist, could you start by explaining in simple terms what diabetes is and who is at risk?

Lizzy Katz, RD, CDCES: Yes, definitely. That is a loaded question, but to put it simply, diabetes is a disease where the pancreas doesn't make enough insulin or the insulin that it is making is not working properly. And, insulin acts as a key that allows the body to use energy from the sugar that it intakes. So a lot of risk factors including, family history, being overweight or obese, physical inactivity, smoking.

 It increases with age. The prevalence increases with age and, certain ethnic backgrounds put you at higher risk. In the United States, about 11.5% of people are diagnosed with diabetes. This is about 38.4 million people, as of 2021 per the CDC. So it's no small disease. It's pretty common in the United States.

Host: Now along with being a diabetes care specialist, you are also a registered dietician, so you can speak to this really well. What are the common misperceptions about nutrition with diabetes, and where do those beliefs come from?

Lizzy Katz, RD, CDCES: I hear a lot of different things. Some of them are eliminating carbohydrates completely. I hear that if you eat a lot of sugar, you will get diabetes or that there's a specific diabetes diet. Most of this comes from social media, the internet, you know, there's so many websites, there's so many people out there who claim to be professionals or experts in the area.

So I do hear a lot. So I try to really educate my patients about the ADA, the American Diabetes Association and about research studies that give out real data. I also encourage patients to reach out to me as a resource whenever they're shopping or, they're online or they're in the grocery store and they want to try something new and they heard something on TikTok and they want me to tell them if this is a good idea or not so good, or there's research behind it.

So it can be difficult out there, but you really do have to find your expert in the field.

Host: But it does sound like despite social media, you have some powerful tools to dispel some of these misconceptions. And one of them you mentioned was people can call you and ask you when they're shopping. What is the importance of reading food labels? For those with diabetes, what aspect of the label should people pay most attention to?

Lizzy Katz, RD, CDCES: Yeah, so reading food labels is a really great strategy to really help people with diabetes, see how much sugar is in the product. It helps with meal planning and it really helps to make informative decisions about what they're consuming. It's really good for people, especially who are on insulin and who need to do carb counting to see how much carbohydrates or sugar are in the food that they're consuming.

So it can be very overwhelming looking at a food label. So I really try to keep it simple. Start at the top. You want to look at the serving size because the serving size is going to really correlate to all the numbers below it. So if you eat double the serving size, then you have to double all those numbers.

If you eat half of it, then you half them all. So serving size is a really great place to start. And the second thing I tell patients to look at is actually the total carbohydrates in grams. Many people tell me that they look at the sugars or the added sugars, which is fine, but it's important to know that total carbohydrate actually encompasses all of that.

So you are already getting the added sugars, the total sugars, and all carbohydrates turn to sugar. So you don't need to look at those separately. You just want to look at the total carbohydrate, and then you can really make a better informed decision because those carbs are gonna turn to sugar anyway.

Host: Sometimes when I'm shopping and I just look at the label and see the list of ingredients, that's a turnoff in itself. And sometimes I put that thing back. But also when you're grocery shopping, another tip people give is focusing on the outer perimeter, that that's the most strategic choice for nutritious foods.

For those with diabetes, is there another trick like that to making your way around the grocery store?

Lizzy Katz, RD, CDCES: That's a great place to really shop. Honestly, for most people, we know that processed foods aren't the best option for really anybody. But especially people with diabetes. So, proteins such as meat, fresh produce and vegetables, they tend to affect the blood sugar very minimally.

So we really do find that the perimeter is ideal for people with diabetes. So, we suggest that each meal consists of mostly non-starchy vegetables. So going to the produce section is, is always a great place to be. Vegetables have immense vitamin content, very low calories, and they really do not affect your blood sugar very much.

So fresh is always great, but frozen is fine too. So we do really suggest the outside because the inside is where you do find the more processed foods that are packaged or shelved or sitting in salt water. So we do also suggest that.

Host: So really good tips for shopping for yourself, but then when you go out, how can people enjoy eating out while keeping their glucose levels under control? Can you offer some tips on that or choosing the best meal options when you go out?

Lizzy Katz, RD, CDCES: Definitely, I hear this question a lot because we're all human. We all enjoy our nights out to dinner and, it can really pose a challenge for anybody. Anybody concerned about their weight, concerned about their blood sugar or just their overall health. Because we never know exactly how the food is prepared in the restaurant. And the portion sizes tend to be bigger than what we're used to. So some tips when eating out, and I also follow this, is, either splitting a meal or taking half of it home. So if they put down, your big bowl of pasta with grilled chicken and Alfredo sauce, immediately ask for a to-go box. Before you even start eating, put half of it away, out of sight, out of mind. That is a, it works every time because you tend to just finish what's on your plate. And if half of it is gone, you're not really thinking about it. You finish your plate and this way you still have another meal. Also planning ahead, making sure you look at the menu before you go, go in with the plan.

Choosing a meal that's mostly vegetables or where the main portion is protein. And this way, you know, you're getting foods that are not going to affect your blood sugar as much. Choose water and split or skip the dessert. That's always a good one.

Host: Mm-hmm. Those are great tips. And you even touched on portion sizes. Because we're in a super-sized world, so it's hard sometimes to deal with the portion sizes we're given, but I think putting some away is a really, really good idea. Are there any lesser known tips or overlooked habits, additional insights, those who have diabetes might get better nutrition through knowing.

Lizzy Katz, RD, CDCES: Yeah, definitely. There are many. So a big one for me is fiber. So as Americans, we really just don't consume enough fiber by a long shot based on the recommended daily intake, which is about 25 to 30 grams of fiber per day. So there's both insoluble and soluble fiber, and both of them have been shown to improve blood sugar.

And they also increase insulin sensitivity, which is a really good thing. Soluble fiber you're going to find in oats, you're going to find in apples, some beans. And then the insoluble fiber is in like wheat bran, some nuts and seeds and then most of the skin of any raw fruits or vegetables, and so

people with diabetes should even, if possible, aim for more than the recommended daily value because it's got such good benefits. But as you increase fiber, it's important to remember you also have to increase water because it is really good for the GI tract and keeping things going and flowing.

So you definitely need to increase water with that. And speaking of water, drink more water. I tell this to all my patients that water will become your best friend with diabetes. It is like the go-to. So, of course it keeps you hydrated, but it's also really helpful in lowering high blood sugar, as well as helping the kidneys flush out any excess sugar.

Host: So let's summarize our key takeaways from this discussion. Fiber is a focus. Increase water, read food labels, know what you're looking for on those food labels. Increase water again. When you go grocery shopping, do the perimeter, is there anything else you'd like to add?

Lizzy Katz, RD, CDCES: I just think it's so important to know that, it's entirely possible to eat healthy, to eat good, and still manage your blood sugar levels. So you want to choose, like you said, foods that are high in fiber, low in added sugar, and always remember nobody can eat perfectly 100% of the time. It's really just what you do most of the time that counts.

Host: That's right. So forgive yourself if you fall off the wagon and move on.

Lizzy Katz, RD, CDCES: Exactly, exactly.

Host: Lizzy Katz, thank you so much for all this practical useful information about using nutrition to manage diabetes. We really appreciate your time and insights and the work you do for diabetes education and management.

Lizzy Katz, RD, CDCES: Thank you. I appreciate it as well, and I'm happy to help out.

Host: For more information about diabetes education and counseling at UM Capital Region Health, visit the website listed in the show notes and that will allow you also to share on your social media. Find more shows just like this one at umms.org/podcast and on YouTube and your favorite podcast platform.

Thank you for listening to Live Greater, a health and wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again.