Monday, July 18, 2005

Bowling Ball Revisited

As I mentioned in "Insights from the Bowling Ball" the diet given to me by my doctor has some serious issues in it, besides the lack of calories for my activity level.

It's tricky doing nutrition for someone who is pregnant, working out (with heart rate limits) four times a week, may or may not have gestational diabetes OR may or may not be hypogycemic. But there were some very obvious issues with the diet provided. I realize they have to aim for the lowest common denominator and hope they can get someone to follow most of it, but the diet was very misleading as I found out when talking to a dietician who specializes in meal plans for diabetics.

BEST THING: Check with a dietician and get a plan that is right for you. This is the plan they gave me compared to the adjustments a professional dietician made to correct the plan:

Their Suggested Breakfast:
8 oz skim milk
3/4 cup cereal
1 slice toast
2 tsp margarine

What are the problems here?
1. the cereal needs to be a WHOLEGRAIN and unsweetened
2. toast should also be WHOLEGRAIN. Whole grains contain fiber and are much better for you. Fiber is VERY important for pregnant women as the digestive system slows down. Hey, the hemorrhoids will come with labor, why get them early?
3. Margarine is a trans fat and very bad for you pregnant or not
4. No protein included. Protein helps balance the carb load here carbs=blood sugar especially simple sugars from white breads. Ah, you say, but what about the milk? Yes, milk does have protein, but also has lactose, a sugar, and it counts as a carb. Go figure.

My Alternate and Healthier Version:
1 slice wholegrain bread
*2 tbs. natural peanut butter
8 oz. skim milk
* Regular peanut butter contains both trans fats and sugar. Both are bad for you. Natural peanut butter is just peanuts. Check with your dietician about how much fat you can have. All plans should be customized for YOU.

Moving on ... the key with keeping your sugars balanced is to keep them at a steady level, so small meals and snacks are the way to go.

Their Snack 1:
1 small banana

What's the problem? You got it, no protein. To make this an acceptable snack, add a serving of cheese, 1 oz, or cottage cheese (which counts as protein) 1/4 cup, or another protein equivalent.

My Snack:
1 small banana
1/4 cup cottage cheese

Their Lunch:
2 slices bread
3 oz turkey
2 tsp mayo
1 small apple
8 oz skim milk

1. You got it, WHOLE GRAIN bread not just any bread.
2. Mayo? Not a great choice. Mustard has no saturated or trans fats and is sugar free (unless you are cheating with the honey mustard ... check the label for sugars and other fats you don't want).
3. Where's the vegetables? This diet had NO vegetables in it until the evening meal. You get three servings of vegetable to equal one carb in a day. That's quality and quantity.

Here's my alternate lunch:
1/3 cup brown rice
1 small fruit (half an apple cut up on salad is good)
1 cup salad greens, spinach is extra good
8 oz. milk
3 oz meat
1-2 tsp. olive oil plus vinegar for salad dressing
*1/4 cup walnuts

Olive Oil is good fat, all fats should be good fats if possible. Good fats also contain Omega-3 fatty acids which are very important for the growing baby.
*I was allowed 1/4 cup nuts as a snack. Nuts don't raise your blood sugar and are very good for you. Walnuts are high in Omega-3s. I combined the spinach, 3 oz cooked chicken breast, walnuts, apple and dressing for a nice salad.

Their Afternoon Snack:
1 small orange
5 crackers or 3/4 oz. pretzels

Make the crackers whole wheat. The house brand of whole wheat crackers (look like Triscuits) at Whole Foods has only two ingredients: whole wheat and salt. Need a protein added here as well.

My Snack:
4 whole wheat crackers OR 1 small fruit
1 oz cheese

Their dinner:
1 medium potato
3 oz meat
1 cup veggies
2 tbsp vinegar and oil
8 oz skim milk
1 small fruit

Wow. Suddenly a ton of food. What size is "medium" anyway?
1. Margarine, again trans fats are bad.
2. Oil needs to be walnut or olive or another oil high in Omega-3
3. On their plan, there are only 2 servings of vegetable in a day
4. Salad, how much salad, what toppings?

My dinner:
3 oz lean meat
1 small sweet potato (actually raises your sugars less than a white potato plus has vitamin A and beta carotene)
1 tsp butter
1 cup salad greens (no iceberg, dark green leafies only)
2 tsp vinegar and oil
1 cup cooked vegetables (tomatoes, asparagus, broccoli, all good)
8 oz skim milk

Their Snack:
8 oz skim milk
3/4 oz cereal OR 3 small graham crackers

1. 3/4 oz? They made a typo, it should be 3/4 cup, WHOLE GRAIN, unsweetened cereal
2. No protein, need to add one

My Snack:
1/2 cup wholegrain, unsweetened cereal
1 cup skim milk
2 tbs. peanut butter

Surprisingly, this is a LOT of food in a day. Much more than I thought.

Again, talk to your dietician if you have gestational diabetes, find out the right plan for you. But this all goes to show how much a difference a small choice can make, like choosing a whole grain versus a simple carb. I never felt better on any diet before. It was almost more food than I could eat in a day (I had dietician-approved extra carbs for workouts that are not included here) and it was all healthy and fresh. Nothing processed. My blood sugar numbers were all excellent and I felt good. I did not have swelling in my feet until right before labor. I gained only baby weight. Most importantly, my baby was healthy and strong. If I ever get pregnant again, I will go right back on the same diet even if I can pass the glucose test.

Talk to your doctor, and a dietician. Ask, be involved. Research. Take an active part in your health decisions. Food matters.

Here is a good link:
American Diabetes Association
They have information and recipes and resources. For anyone who is living with diabetes, or even gestational diabetes, my heart goes out to you. It is hard, seems like our whole nation is against you as you struggle to eat well. It is so much easier to find bad food cheap than it is to find healthy alternatives. Even going to a friend's house for dinner is a complicated balancing act. Good luck and the best of health to you.

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