 The following is a production of New Mexico State University. Welcome to another episode of Long Live La Familia, the nutrition soap opera series that speaks not only to our hearts, but also to our appetites. I'm Keri Bachman. If you've been with us before, you'll remember the Sierra family, the focus of our series. Today's episode is called La Viabetes, a matter of balance, and so we're looking at the issue of diabetes. What featured in the episode today are Lisa and her brother, Samuel. Samuel has just been diagnosed with diabetes, and Lisa's boyfriend has the illness, and it's interesting to see the contrast between how the two of them deal with diabetes. Now, you'll remember that our episodes are a mixture of English and Spanish, but don't worry if you don't speak any Spanish at all. With just English, you'll be able to understand all of the concepts perfectly well. We have our episode broken up into three segments, and that means it'll give us some time to get back together and talk about what we've seen and relate it also to our own lives. We always make a recipe with our episode, and so today I'm going to go ahead and wash my hands and explain to you all while I'm doing that a little bit about diabetes. Diabetes is an illness that used to be considered just something that older people got, and more and more we're seeing it in younger people and even in children. Diabetes is caused when the body is unable to process carbohydrates that we eat, and carbohydrates are important because they give us energy. When we eat them, they turn into glucose or blood sugar, and when that blood sugar or glucose doesn't get into the cells that use it for energy, it stays in the blood stream, and it can cause all kinds of problems. Now the body produces a substance called insulin, which is the key that lets the carbohydrate or the glucose into the cells. With people who have diabetes, the insulin isn't functioning properly, and so they're not able to get enough carbohydrate or glucose into their cells. That makes it really challenging for them because then their bodies are starved for carbohydrate. All of the glucose that is in their blood then can cause some complications, just such as kidney disease, kidney failure, and also problems with circulation in your limbs such as feet, which can lead to amputations, and also blindness too because your blood is not circulated, your blood has too much glucose in it. So there are many reasons to be concerned if you have diabetes, but luckily there's a lot of things that can be done related to diet to help people deal with their diabetes. Now in our first segment as we watch it here, take a look and see what the stresses are that Samuel is feeling as he's trying to deal with the thought that he has diabetes. Let's go ahead and watch. Oh, cre, que puedes, cuñado. Normally you're early. I lo siento cuando llegué a tiempo. I was closing a deal and it took a little longer than I expected. Nothing's wrong at home, is it? No, todo está bien. Meno so, yo y este dieta. Samuel, are you still struggling with what you eat? How's the day of the cuñado? That is what I wanted to tell you. She's pregnant. Marisana, felicitadas. You must all be so excited. The thing is, I'm worried. I want to live to see this baby grow up. ¿Por qué te preocupa que te vayas a morir? Pues ya sabes que tengo diabetes. Forget it. I have diabetes too. Pero aun cuando divetes, yo pienso vivir muchos años más. I'm going to live to see my kids have kids. No entiendes, cre. I can't control what I eat. En el trabajo, sin darme cuenta, me como una caja entera de donas. I keep a hidden stash of junk food. Puede cambiar todo tan rápido. It takes time to change. Yo no tengo que cambiar. What is something that happened to me? ¿Quién va a cuidar mis hijos y me enfermo? Calma, te mano. It can't be that bad. ¿Tienes shock, cre? Ah, sí, por favor. Siempre habido la misma cosa. This is the only place in town I can get papales. ¿Tallet cook? Normalmente los hombres no toman refrescos. ¿Aquí vienes usted helado? Thank you. Are you ready for your... Al menos yo estoy lista. I'll have the red chicken enchilada plate. Don't fry the tortillas, please. Y solo un poquitito de queso. And then I want a side order of frijoles de la olla. Oh, beans with a little bit of green chile. That's all. You're sure taking a long time with that menu, Miguel? Como nunca he venido a ti, no conozco el menu. ¿Cómo están tan bien a ti? Ah, they make the best green chiles too. Lo preparan con muchas verduras. Entonces el talio, por favor. That's your beach you haven't seen before. ¿Por qué te preocupas por los carbohidratos? ¿Tienes diabetes? ¿Te ves tan sano? Did you notice how stressed out some well is with his diagnosis of diabetes? It's interesting to compare him with his brother-in-law, Craig, who also has diabetes, and with Lisa's boyfriend, Miguel. One thing that came out in that last segment was that when you're eating and you have diabetes, a healthy diet for people with diabetes is not so different from a healthy diet for people who don't have diabetes. And that comes in really handy, actually, because when you're in a family where some people have diabetes and others don't, you want to make sure that the person who has the illness doesn't feel left out. And all of you can make some healthy changes to your diet that will help the health of everybody. Now, there are a couple of differences in terms of looking at foods when you have diabetes. And in fact, what I want to show you right now is a different version of the food guide pyramid. It's called the diabetes food guide pyramid. And actually, as you'll see, it looks quite a bit like the regular food guide pyramid. The shape is the same. The food groups are pretty much divided up the same way. But there are a couple of very important differences. The first difference that you'll notice is that the bottom level of the pyramid, which is normally the grains group, has some other foods added to it. It includes also beans and starchy vegetables. And that's because those foods are high in carbohydrate, just like grains are. So you want to go ahead and put dry beans down into the grains group, as well as starchy vegetables, like corn. Now, the vegetables group then includes vegetables that are not starchy. The fruits group is pretty much the same. The milk group includes liquid milk and yogurt. But cheese actually is moved over into the meat and others group. That's because cheese itself doesn't have too much carbohydrate in it. And then at the tip, we also have the fat, sweets, and alcohol, as we do in the regular food guide pyramid. Now, when we look at the food guide pyramid, it's important to look at the individual food groups and how they affect blood glucose. Remember that foods that are high in carbohydrate will affect blood glucose more than foods that are lower in carbohydrate. That's why Miguel was looking at the menu so carefully. When you look at the food groups here, we've got them all listed, and you can see that there are some food groups that have a very large effect on blood glucose because they are high in carbohydrate. Those are the groups, the grains, beans, and starchy vegetables, the fruits, and the milk group. Now, groups that have a small effect on carbohydrate or on blood glucose, rather, are the vegetables, the meat and others, and the fats. The sweets group is actually going to have a large effect on blood glucose because it generally contains a fair amount of sweeteners, which are carbohydrate. Now, when you're looking at the food groups, the other thing to keep in mind is portion sizes. And we don't have time to go into that in great detail today. If you'd like more information about portion sizes and also, as well, a copy of the Diabetes Food Guide Pyramid, you can give us a call on the screen, toll free. Now, we're going to go ahead and introduce the recipe that we're making today. And it is for an ambrosia fruit dip. And I've selected it because it's using artificial sweeteners, which we'll talk more about at the next break. First thing I want to discuss with you, though, is that we're using some cream cheese as the basis for our dip. We've used cream cheese before in our recipes. And you can have us, there are many selections. What I've chosen here today is fat-free cream cheese. You can also, if you like, a cream cheese with a little bit more fat and a little different taste, you can choose this Neuf Chateau, which has a third less fat than regular cream cheese. Either one will work just fine. But we'll get back to the recipe in a few minutes. Let's go ahead and watch the next segment of our episode. As you're watching, take a look at how the people in the episode balance their food choices between foods that are higher in carbohydrate and foods that are lower in carbohydrate. It's easier for you to eat, right, Craig? Your family's eating the same foods you are. In your family, the others are still eating the same as before. And you're the only one who's changed? Yes. I can't take it anymore. Especially when everyone else gets into good verduras. And you should see what they feed me for dessert. The rest is like a cake. I'm not a lot, any sugar, any more. And now they're permitting coming out of the sugar? It sounds like Samla's family doesn't really understand how to help him. Before you have a lot of coming to LLV, I see the way to explain how to work well. So they'll be ready soon. I just try to eat right so I can keep my blood sugars in a healthy range. Uh, no es tan diferente de tu manera de comer, Lisa. You mean if you follow the food guide pyramid, like I do, you can help your diabetes? I just have to plan my meals a little more carefully by balancing certain foods. No entiendo. Me estás diciendo que tienes que comer huevos con tus papintas en la mañana? Exactamente. Valencia o la comida que aumenta el azúcar en la sangre, con las que no hablas. You mean some foods raise your blood sugar more than others? Entonces qué hace si vienes a un restaurante y te da de más? I mean, you know, what if they give you too much beans and rice? I just take what's left to go. Me lo llevo para casa para comerme después. Ay, cómo estrando esta comida. Adela piece me like a rabbit. But I promise, Craig, this is the last time I break my diet. Hey, Samuel, no are necessary. ¿Tú creías que es posible viver el resto de la vida sin comer otra sopa pia? You can't just give up everything you love. Pero Craig, necesito dejar de comer todo lo que sea comida grasosa. Y todo, y toda clase de la comida grasosa tiene que ver con la comida grasosa. Y todo, y toda clase de dulce. I don't have a choice. Yes, you do have a choice. It's really just a matter of balance, planning ahead to fit in your favorite foods. Hoy puedo comer así y mañana no como nada más que lechuga. Now you can't eat like a pig today and a rabbit tomorrow. La idea es balancear tu comida cada vez que comes. Mira mi plato. It has a little bit of everything. Bueno. Pero mi plato también tiene una variedad de comida, no crees? You can see that when you have diabetes, it's important to try to balance the foods within a meal between foods that are higher in carbohydrate and foods that are lower in carbohydrate. That's what Miguel and Craig were actually trying to do when they're ordering. Now let's take a look at how you can actually bring this into your own life a little bit. There's a method we can use called the 50-50 method. Now if you think of a plate, divide the plate in half. 50% of the plate is going to be for higher carbohydrate foods and 50% of the plate will be for lower carbohydrate foods. Let's look at an example of how that can work. I've got an example here of a meal that is focused around a bean burrito. Now on our high carb side of the plate, which is the left side here, we have a flour tortilla and one half cup of refried beans. So that gives us a total of three servings of high carb foods. On the low carb side of our plate, we have half a cup of diced tomato, half a cup of chopped lettuce, one cup of jicama, which we eat as a snack kind of on the side, and then half a cup of grated cheese. The total here comes to three and a half servings of low carb foods. So you can see that we've actually balanced out the high carb foods with the low carb foods. Now the reason this is a good idea to do is when you balance your plate like this, you'll be assured that you're not eating too many high carb foods in the same meal. That can make it harder for your body to process those carbohydrates and can lead to a larger jump in blood glucose. It's not that the protein foods actually counteract the high carb foods, but the fact that you're eating foods that are higher in protein, fiber, and fat will kind of give you a sense of fullness and then you won't be so inclined to eat very high carb foods at the same time. So you want to try to balance out those two sides of your plate. Now let's go ahead and take a look at our recipe here that we're preparing. I showed you before we've got our cream cheese here in this bowl and we're going to make a dip called ambrosia fruit dip. And a dip for fruit, you might guess, is normally going to be sweet. When you're working with people with diabetes, sugar can be one of the sources of carbohydrate in the diet. It's not the only source and you don't have to get rid of all sugar. But it does come in handy to use artificial sweeteners from time to time. I've got a couple of them here today. There are many more that you can find in the store. Splenda is one of the newer artificial sweeteners that usually uses a food called sucralose, a substance called sucralose that makes it sweet. And another type that you can use, you can find store brands of these now, is an aspartame-based sweetener, which is often called equal or natural taste. This is actually the store brand of that. And the reason I've got these two different versions here is you can see this one here measures just like sugar does, whereas this one is actually much sweeter than sugar. So when you're using this one, make sure that you pay attention to how this can substitute for sugar. In our recipe, what we're going to do today is add about a half a cup of sugar. And what that translates into as a sugar substitute depends on which one of these we're using. So because this one measures just like sugar, you can add half a cup of this one or do the math and add 10 or 12 of these packets. Because each packet here is equal to two teaspoons of sugar in terms of sweetness. So I've already dumped 10 packets into this bowl right here. We're going to go ahead and dump these in here. And what I recommend is putting that in and mixing it with your other ingredients and then at the end tasting to see if you need to add any more sweetener. Now, we'll go ahead and take a look at our next segment as you're watching. Think about the ways that you see in the segment that Samuel can really help deal positively with his diabetes. Do you have diabetes in your family? Um, yes. My brother-in-law has had diabetes for a while and my brother-in-law Samuel has seen diabetes recently. Now, he doesn't have to eat anything that contains sugar. Well, actually, people with diabetes can eat some sugar. There's many myths about diabetes. It's important that from Marseille they take good care of themselves. Miguel, you seem to be very well-informed. Hey, would you be willing to talk to my brother-in-law about diabetes? He's been so depressed. Maybe you can help him. Lisa, are you going to introduce me to your family? I'd be honored to meet your brother. You know, Samuel, you also need to think about your son. If you have to change, it's possible that he also changes his habits. Yeah, I heard that diabetes runs in families. I don't want my son to suffer like me. Why don't you come with me to my support group? In our group, we talk about issues related to diabetes. I don't know. A group of chickens doesn't sound like something for me. Samuel, we're just a bunch of guys who get together to hang out and talk. We have a group of people, and we're always shooting hoops. So, they're the ones who have helped you to lose some weight. You know, I never really liked going to the gym much. Guñado, I can see why you're such a successful car dealer. Let's see if I can join the group. Since when do you work here? I see you here at Las Trancas all the time, as a customer. Well, my grad assistant salary just wasn't enough. I had to pay the bills. Did you notice that Lisa was here? It seems like she's my sister-in-law. Come on over. Gracias, Santiago. La comida estuvo bien deliciosa como siempre. Otra vez, este amigo de Lisa. Is this someone I should know about? Hey, how are you, Lisa? Miguel, ¿cómo estás? We missed you at our last meeting. Guñado, hermano. Miguel, this is my brother-in-law, Craig and my brother Samuel. Don't you like the Samuel? Nice to see you, Craig. Miguel y yo nos conocimos. Somos miembros de la misma grupo de apoyo para los divetes. Ah, Craig was just telling me about your group. I'll see you at the next meeting, Miguel. Ay, qué bueno. El grupo le ayudará a Samuel controlar su diabetes. Now that you met half the family, I'm Santiago. I'm Lisa's younger brother. Alguien me dijo, tú y Lisa son hermanos. It's nice to meet you, Santiago. No nos vimos la otra noche. You two have been out to eat, I think. That was our first date? Our first many hours. Me alegro verte tan feliz, Lisa. Did you pick up a couple of ideas about how Samuel can deal a little healthier with his diabetes? Well, one thing he can do is join the support group that Craig mentioned, and he looks like he's planning to do that. One of the things that was mentioned there, too, was physical activity, and I wanted to stress that that is very important for people who have diabetes. Physical activity helps your body process blood glucose more efficiently so you can actually deal better with the carbohydrates that you're eating. Another thing that will help Samuel is thinking about his son and being a healthy role model for him so that he doesn't end up getting diabetes. Let's go ahead and finish our recipe real quickly here. I've gone ahead and chopped up some fruit here. We've got two different kinds of apples and pears as well, just real colorful. And these are favorites of both adults and kids. We've got eight ounces of cream cheese and our sweetener here. We're going to use a bean masher. And I'm also going to measure in one cup of yogurt. It's plain yogurt. And when you're using yogurt, it's nice to use plain yogurt because you can add your own sweetener, either artificial or a small amount of sugar or honey, and then you don't actually end up having quite as much carbohydrate. So we'll use a cup of this plain yogurt. I'm using low-fat here today. You can use non-fat if you'd like. And then one teaspoon of grated orange rind. You can see I've grated this up ahead of time. It's really pretty. This adds a nice zing to our recipe. When you're grating, just use the small holes on your grater. And once you've grated all of the yellow part of the lemon off, you can use your lemon for juice to put on the apples so that they don't get discolored. Okay, so we've got all of this here now. The one last thing that we need is one teaspoon of vanilla. And then all we're going to do is mix this up with our bean masher. And then we're going to have this, the cream cheese at room temperature, because that will help everything mix together a little bit better. Now let's think as we're mixing here about what a goal could be after having watched this episode. Do you have diabetes? Well, then you might want to set a goal of using the Diabetes Food Guide Pyramid and or the 50-50 method when you're planning your meals for the next week. And one way to do that is using the meals and snacks planner. Again, you can call us if you'd like one of these or make one yourself. Basically, you just list all of the meals and snacks that you have for the day. And then on the left side, put high carbohydrate foods. On the right side, put low carb foods. And it's a kind of a way of using the 50-50 method over the course of a day to make sure that you're getting the right amount of servings of the foods that you need. Now the dip is coming together a little well and I'm sure that can actually work real well too. One thing I'm realizing is I might have wanted to go ahead and mash up the cream cheese before I put in the yogurt so that I didn't have so many lumps. But regardless of lumps, it'll still taste delicious. Now, like I mentioned, we want to go ahead and have a taste of this using a clean spoon each time and see, hmm, sweetness-wise. You can also use this as a topping for cakes or breads and it's a really healthy alternative to some of those cream cheese products that you can get in the grocery store. Okay, well I'm glad that you've been able to join us today for our episode dealing with diabetes and I hope that you've learned some things and will be able to achieve the goal that you've set over the next week. Remember, as you're working with diabetes, eating healthy and physical activity go hand in hand. Long live our families. The preceding was a production of New Mexico State University. The views and opinions in this program are those of the author and do not necessarily represent the views and opinions of the NMSU Board of Regents.