 hello everyone today we are going to talk about what should i eat for diabetes okay now i'm going to summarize exactly what we are going to talk about and you decide if you want to watch the entire video or not i'm dr. ahmet ergin i'm the founder of sugar mds.com and today you are going to get a very nice comprehensive review of diet and diabetes now we are going to talk about why diet is so important for diabetes right and we are going to give you some secrets about losing weight how to lose weight with diabetes we are going to talk about carbohydrate consistency why it is so important to be consistent with carbohydrates we are going to talk about carbohydrate counting if you want to be precise with carbohydrate counting especially if you're on multiple daily insulin injections sometimes you have to be and we will talk about how to count carbs precisely we are going to talk about the serving size carbohydrates fats proteins how much you should eat how do you calculate and at the end of the video we are going to talk about what should i eat and with that let's move on before we jump into the details i want to explain to you what diabetes is so if you're a new diabetic most of the time people do not really understand why they became diabetic of course genetic factors contribute to it but the bottom line especially for type 2 diabetics right so what happens is in time our body become insulin resistant so insulin is the hormone that allows your body to utilize the glucose which is the primary energy source so if your body is not able to get that glucose within the cells then you're not going to feel good your blood sugars will stay high it's like you have million dollars locked in the bank but you cannot pull your money that's that's miserable right so the most of the time that's how patients with type 2 diabetes feel they're tired and they keep gaining weight also the reason for gaining weight again the problem with type 2 diabetes is not necessarily totally deficiency of insulin they do not respond normal or even high levels of insulin so most patients with type 2 diabetes actually have high insulin levels not too low but they are unfortunately insulin resistant and that is a problem especially every time they eat a carbohydrate containing food their blood sugar tend to rise quickly because the insulin they have in their system is not working properly okay let's talk about why diabetes is so important now when we treat anybody with diabetes we have something called abc of diabetes right so a is your a1c so if you do not know what a1c means or you may have a little idea but not not too much you can definitely go to our website we have an entire article about that at sugarmds.com forward slash diabetes dash education so or just go to our website and go to diabetes education tab and you will find our article about that now a is the a1c right and then b is the blood pressure and c is the cholesterol so if you bring your a1c down but do not control your blood pressure or your cholesterol then you will still have problems as we discussed in our previous videos two-thirds of patients with diabetes die from heart attacks or strokes and these happen not just because of a high blood sugar but they also have accompanying blood pressure and cholesterol problems and every time your blood sugar is high your blood pressure and cholesterol goal is even normal than a normal individual so you may get hit with a blood pressure of 150 over 90 with diabetes way faster than somebody who does not have diabetes cholesterol is the same way a normal cholesterol does not necessarily mean normal for a patient with diabetes their upper level is much lower when you have diabetes so for example the LDL cholesterol the bad cholesterol should be less than 100 for every diabetic although the upper limit of normal can go up to 160 when you run a blood test it may look okay in a regular for a regular person but when you have diabetes your goal of LDL is much lower because in the environment of high glucose the cholesterol makes a bigger impact to block your arteries and cause a heart attack so as a result when we talk about diet for diabetes we are not only targeting your blood sugar but we are also targeting your blood pressure and then your cholesterol as well of course the key to improve your abc for diabetes is losing weight so how do we really lose weight then right so i'm going to give you a quick formula in terms of how much calories you should eat right so that's a common question that i get from my diabetic patients is doctor how much should i eat now of course counting calories and counting carbs is going to be extremely useful but if you don't know what you're counting to then that's not really going to help you right so you can count your calories but if you're counting your 5000 calories every day of course there's too much everybody would know that but if you don't know your personal goal then you will never achieve the weight loss goals which will improve your abc your blood pressure and your cholesterol now how do you determine how much you should eat to lose weight so first you determine what is your basal uh caloric needs right so or overall needs for any individual who's an active let's say talk about an active man and men and women are different age makes a difference sometimes but let's talk about an active man when i say active man somebody who's always out at work who works out and and and those people generally require 15 calories per pound so if you are 200 pound individual that means that you're really you know muscular and fit you're gonna need around 15 times 200 that is around 3000 calories that is to maintain your weight so if you're a sedentary man if you're a woman uh then you're probably or an active woman i would say an active woman woman uh and sedentary men will need 13 calories per pound why am i putting the sedentary man an active woman just in the same bucket just because overall men burn more energy more calories they are more muscular their bone mass is bigger it's just a natural thing that the men burn more calories at the same uh weight so as a result 13 calories is if you're sedentary and if you're women active women we are looking around 13 calories per pound to maintain your weight okay now the next next class would be sedentary women or women who's uh after menopausal or after in their 40s uh generally they need 10 calories per pound to maintain their weight again these are both part figures you may have a high metabolism or lower metabolism but that's not going to be like 50 to 60 difference if you are an individual with low metabolism maybe you will have a 20 less needs than a person with a high metabolism the common problem we see all the time is um uh under estimation of calories uh if the studies show that when men and women estimate that they are eating 1500 calories they are typically eating around 2000 but they underestimate down to 1500 and that's because of the calculation problems but also psychologically we tend to underestimate um that so if you're pregnant women that would be around 15 to 17 uh calories per pound so once you determine that how much you need you need to subtract 500 to 1000 calories from that number in order to lose one to two pounds of um weight a week and that is the healthy amount of weight that you can lose so let's say a sedentary man uh or or let's say sedentary women uh age of 42 and she is 150 pounds so her needs are 1500 calories right so for her to lose one pound a week she should go down to 1000 calories and when I say 1000 calories I mean it that means that you have to calculate and be serious about you know when you're counting your carbs and now we're going to move on to you know how to count carbohydrates and consistency and so forth and that's going to give you a very good idea okay let's start with carbohydrate consistency and carbohydrate counting the reason we emphasize carbohydrate consistency in a lot of individuals is if you know what is coming in then your medications can be adjusted a lot easier right so so if you are on uh let's say a gliposide or a gliboride or glimoporide uh when the doctors give you that medication your insulin levels go up so if you are not providing a steady amount of uh glucose to your system uh then your blood sugars will drop now doctors will give you a dose based on what they estimate your needs are and let's say you're taking 5 milligram of gliposide right and then you are eating 60 grams of carbohydrates per meal and that is helping you out great uh you're not gaining weight you're not losing weight that is perfect uh if you are gaining weight that means that we have to cut down on your calories including your carbohydrates so sometimes we tell them to eat 45 grams but that comes with the reduction in the medication dose as well so i always tell my patients do not change your diet drastically without telling me because the medications you're on is based on what your needs are at that time if your needs change your medications needs to change as well and when you are not an expert in this area when you try to manage yourself and you doctor yourself most of the time you will get put yourself into trouble so please do not do that so carbohydrate consistency is also important for people as we said taking oral medications but for patients who are taking insulin as well if they're not willing to count carbs as we discussed in our previous video where i talk about how to take insulin safely uh we get into detail about this uh but here i'm going to explain briefly that if you are consistent with your carbohydrates per meal then your insulin is also consistent then they are going to match and you should not have any problem right so we are going to talk about how to really estimate because you cannot always look at the label sometimes you just have to estimate and to estimate we look at the um the hand our hand is the best guide so a fist will equal to a one cup of carbohydrates so if you just make a small fist look at the food look at your fist you can estimate that that would be a one cup of uh that carbohydrate uh if your palm could be equal to three ounces again the thickness of your palm and the the width of your palm would determine uh three ounces of uh food typically we use ounces for the protein your thumb uh will be around one ounce of uh food so these are just general guidelines to help you uh now with carbohydrate counting if you want to get more education and training and want to be more into it and adjust your insulin as you go because some people are not very regular they just they're younger maybe or their lifestyle is different they eat outside and so forth uh they may not be very consistent they may not uh meal prep or they may not be home or whatever it may be uh those people need more flexibility for those patients um especially if you're on insulin uh for them to be able to adjust their insulin let's say one day at lunch they are taking five units next day they are taking 10 units next day they are taking eight units they can do that as long as they know what is their insulin the carb ratio is which means that if they know how much insulin they need for a certain amount of carbs let's say if let's say they need one unit for 15 grams of carbs then they know that if they're eating 45 grams of carbs then they are getting three units of insulin or if it is one unit for 10 grams of carbs then if they are eating 45 grams then they're gonna get four to five units of insulin so we are going to jump into now how to actually estimate how to do a plate method where we actually especially if you're a new diabetic we explain to you you know how you how to create a plate let's move on to that right now okay this is how a plate should look like for pretty much any healthy individual but also patients with diabetes so basically you should have one fourth of your plate consisting of carbs and this carbs should be right around the size of a small computer mouse does it look like a mouse yes it does now your meats also should be one fourth of your plate and that should be at least three ounces but depending on your body size and protein requirement you can definitely eat more protein the key here is to eat a lean protein that could be a lean chicken or fish fish fatty fish is okay because it's healthy fat but for example a red meat has a lot of unhealthy saturated fat so we are avoiding that however non fatty lean meats are okay and if you are big and if you're working out trying to build muscle it is okay to have more meat unless you have special contraindications now the grains are okay to have as much as possible at least half of your plate one cup of uncooked vegetables is only five grams so you don't have to count that you only start counting these green vegetables if you are eating more than three cups which is more than 15 grams of carbohydrates since we talked about the plate method now i want to talk to about the exchange system now once you determine that you want to have three servings of carbs for example in the one fourth of your plate then then you have to write to change now but you have to really know how much of rice is how much of a pasta one serving of a pasta versus one serving of a potato versus one serving of a rice one serving of a bread so as long as you understand that exchange concept then then i can tell you that for example eat three servings of carbs then that three servings could be three different carbs if you're having a one serving of each or you can have two servings of one carb and one serving of another type of carb then that also will fit the bill so we talked about dividing our plate we talked about having one third of one fourth of the plate as carbs and one fourth as protein and one half as raw vegetables salads etc now how do we really estimate and how we really come up with a quick determination so basically if you're having pasta one third of a cup would be your your your 15 grams of carbs which is one serving for rice that is also one third of a cup for potato boiled potato it is half of a cup for bread it's one slice for corn it is half of a cup again the computer mouse can give you a size estimation in terms of your pasta rice potato as far as one starch choice as 15 grams and if you have the whole cup of pasta or whole cup of rice that means that you are having three choice which is total of 45 grams since one choice is around 15 grams again you can change you don't have to eat the same things you just have to be consistent in terms of total carbohydrates you eat in most cases or if you're counting carbs you can take a very variable amount of insulin depending on how much carbs you're eating but if your doctor prescribed you a fixed amount of insulin per meal and it prescribed you a certain amount of carbs and if that is easier for you to do so rather than just keep counting carbs then you can just estimate how much carbs you are eating trying to stick to your bold part figure around 45 to 60 or whatever is recommended for you and you can exchange pasta to rice rice the potato bread the corn whatever you feel like eating you all you have to know is how much of that food is equal to one exchange which is 15 grams of carbs when it comes to your protein this is your size size of a deck of a card cards that is basically is telling you that's around three ounces you can use your palm as we discussed so that is another way of doing it so palm of your hand is around three ounces or you can just imagine size of a deck of cards so you can this could be this could be chicken this could be fish or beef whatever it may be for those people for those people who actually want to precise the con carbs it takes time and effort yes you know sitting down with the educator helps but the educator is not going to infuse the information to your brain and lock it in so now i'm going to show you a table where you can actually see commonly eat and carbs they're commonly chosen carbs by many of us and once you practice it once you understand what you're doing what you're eating commonly then it's going to the repetition is the key you know once you understand how much how much of a rice you're eating and how much of a carb is that or how much of a bread you're eating and how much of a carb is that then you get the hang of it then you don't have to necessarily open a book or google things or you know or go to your app to necessarily find out so once you know you know that that becomes an essential information for you but i think that is the key understanding so let's go to commonly consumed carbohydrates and we'll take it from there so i am going to give you this table here to give you an idea you can take a screenshot if you want to basically this gives you a serving size or portion for common foods that we typically eat and like and enjoy right so let's go over a few of this the bread part that where most of my patients love for example bagel i test my patients for example how much one bagel contain how much carbs one bagel contain and they will most of the time not know they will make estimations but half the time or more than half the time they're wrong and i think an educated patient is the best patient in my opinion you do not have to be smart you don't have to be rich you don't have to be tax savvy all you have to know is your carbohydrates and educated patient is the best patient in my eyes because that will help you in the long run and in the short run to determine the best way of managing your diabetes as this is the fundamental of diabetes care where we most of the time fold short now one bagel will be around 60 grams why because one fourth of the bagel is around 15 grams right so that is our one serving is only one fourth of a bagel so if you're eating the whole bagel you're eating 60 grams right so one serving is 15 grams that the whole bagel will be 60 grams if you look at bread if it is a very reduced calorie which is hard to find but if you do you can have two slices of those more like a typical bread if you look at the label if the if the one serving is 15 grams and it's 15 grams if the one serving is 10 grams is 10 grams you just need to know how much it is per slice English muffin typically is 30 grams the total thing so half of that will be only one serving which is your 15 grams I wouldn't I don't want to call it one serving because you do not just have to have just 15 grams which is too little actually so most of us will eat 45 60 or 75 depending on your activity level so as a result as long as you know that half of an English muffin is your 15 gram exchange then when you know that you're eating two English muffins you're pretty much having 60 grams of total carbohydrates or four servings of total carbohydrates your pancake is around one your pita six inches it grows is if you're having half of that pita that would be 15 grams one plain roll would be one serving a taco shell of five inches across will be two serving which is 30 grams a tortilla is one a waffle is one if it is four by four again your cereals your couscous your granola grits pasta you can find all these here for your information I'm not gonna go word because that is really a long list here again your fruits a lot of people ask me you know what should they eat we have a separate video in terms of the fruits and how much fruits can be eaten and their serving size etc but if you look at here for example banana is a lot of people's favorite a half a banana around four ounces will be your 15 grams so if you are having a sizable banana a full banana then that would be around 30 grams of carbs on the other hand apple one small apple will be 15 grams cherries 12 of them will be 15 grams three dates would be 15 grams and so forth again the fruits have different glycemic indexes so you need to pay attention to that as well my favorite fruits are blueberries blackberries and let's see orange is good in terms of the glycemic index being low strawberries are good raspberries are good watermelon is not that good so you have to pay attention to that grapes are not that great honeydew is not good these these ones when I say not good I mean it's going to spot your blood sugar due to glycemic index but bottom line this is a good list and you can definitely google anything if you just google and say okay you know whatever that could be just write it down let's say an apple and just put a space and carbs google will pull up from millions of websites exactly what you're looking for and will pop up onto your face and that is as easy as that for people with smartphones that's great for our less tech savvy patients or older patients I recommend them to carry a carbohydrate book which is not that difficult it is a small book and as I said before if you continue to practice that you will be a pro you'll be an expert you will not have to look at carbohydrate content in an apple every day if you're eating apple every day right so you will be able to remember that and that that will make your life easier in time okay finally we are going to talk about reading labels so basically if you are shopping and you have diabetes or not I recommend everybody to know how to read labels that is going to give you an idea what you're putting to your system you could be an athlete you could be a regular guy like just like me or you could be a patient with diabetes regardless of the fact that you should understand what you're eating in terms of total carbohydrates fat trans fat saturated fat protein what you're eating makes your body and changes your health so as a result if you're diabetes of course you have to be more meticulous about this but I'm going to go over right now how to read labels and you will be a pro with practice okay we will talk about reading the nutrition labels very very important if you make it a habit of reading the nutrition labels you are gonna be a pro before you know it so I do that I don't have diabetes but I'm a diabetes expert and I feel like I have to know what I'm doing before I teach anyone else and I think anyone who is fit and who's into health and fitness always look at the nutrition facts regardless of if they have diabetes or not so when you have diabetes that's an extra incentive that is not an obligation that is not the you know that's not a torture for you that is something you should seriously be doing anyways so let's look at how you read the nutrition facts now number one you have to look at how many servings in that container so they put this calories big here 230 but that is per serving so you're looking for eight times 230 so if you are looking to eat this whole package good luck with that you are going to get around 1700 or more calories just from this this packaged food right so basically you look at the serving size next that is two thirds of a cup so that means that everything that is listed here that is total fat your total carbohydrates and protein are within the two third of a cup of this food that is one serving size so if you are thinking to eat one cup then you have to think accordingly for example if there is 37 grams of total carbohydrates in this food per serving and that is two third of a cup you can make the math and you can say okay well one third then would be think about this if this 37 gram is two third then what would be the one third of a cup that would be pretty much half of this right so if the two third of a cup is 37 then one third of a cup would be half of this so that would be around 18 grams so if you are looking for the whole cup that would be 18 times 3 which is 54 grams so basically if you are looking to eat one cup of this which is more than one serving then you can adjust your total carbohydrates being 54 so you can make your calculations accordingly so if you are eating a fixed amount of carbs per meal let's say you're trying to stick to 60 grams of carbs that 54 grams almost puts you to your target and then you can look into how much protein you are getting so if you have a protein goal you know as we discussed an average sedentary man that eats around 50 to 60 grams of carbs but if you are more into sports you're more active and you're working out lifting weights you may definitely need more than that as much as twice or even more than that if you are burning it out and if you're building muscle on the other hand you also have to look at your total fat the next thing you need to look at is saturated fat you want to keep the saturated fat less than 10% in our diet so so basically what you're looking here is is 5% of that food is saturated fat so that is that not necessarily a bad thing because it is less than 10% so anything you eat should have less than 10% saturated fat trans fat is zero which is great that's something we try to avoid we do not want to have trans fat in our diet process foods most processed foods have trans fats margarine's hydrogenated oils especially those cookies pastries they all have a lot of trans fat so that is your biggest enemy so you need to totally avoid that saturated fats are okay up to 10% as we said you pay attention to big time to your total carbohydrates again you even when you buy rice or you buy bread most things are in packages nowadays and you just have to have a quick glimpse to see how much carbs they have per serving and then you will figure it out and then again you know if you're buying same things again and again and eating again and again which most people do and we all do then you do not have to look at that because you have something called memory right you will have memorizes next time unless you are buying something totally different then you will have to look at their nutrition facts but if it is something that you already know then then that is that becomes easier and easier as you go along as you pay attention to your nutrition labels okay the striking question finally what should I really eat right so most people um know what they're eating but they don't know necessarily if it is good or not so let's make a general statement here where you can pick what you want to eat from these choices so in terms of carbohydrates as you all know lots of fruits and vegetables legumes food with high fiber content right low fat low fat dairy there is okay as well so carbohydrate wise you can eat carbohydrates how much carbs you should eat that is based on your needs some people will need as low as 30 grams of carbs per meal with some snacks in between maybe 15 grams of snacks some people will need up to 60 75 grams or more carbohydrates if they are very active individuals so as we discussed about the caloric needs so once you determine your caloric needs around 40 to 50 percent of that can be carbohydrates so as long as you're burning these carbohydrates and not letting the blood sugar go high and you're maintaining your weight or even losing weight then even if you're eating 60 to 75 grams of carbs per meal is not going to really be a problem like personally I eat around 75 grams of carbs per meal but I work out a lot as a result I do not gain weight if I was a patient with diabetes I would have taken enough insulin to cover my carbohydrates so I make sure that these sugars are going to my muscles and then I burn that sugar later with the exercise and for my daily activities of course so as a result as long as you maintain your your your weight carbohydrate depends on your needs now as we discussed in discussing our article in our website again in the sugarmds.com under diabetes education which diet is best for diabetics there I talk about in detail but my favorite is a Mediterranean diet I'm a Mediterranean I'm from Turkey but I mean that's that's that is one of the reasons that I prefer Mediterranean but that's the only diet actually has been proven to reduce the mortality which is dying from heart attacks on strokes it has been proven to reduce the number of medications we give to patients so as a result Mediterranean diet is your best friend of course you can do low fat diet low carb diet low salt diet whatever it may be as long as we are keeping your calories low and you are eating the right foods you are still okay so when you're on a low fat diet for example that doesn't mean that you can go eat all the other carbs out there you still have to choose the right right amount of carbs when you are on a low carbohydrate diet some people for example follow these ketogenic diets and so forth but they end up eating so much saturated fat that their cholesterol go up and that's not our goal right so we have to make sure we control A, B and C you're A1C your cholesterol and your your blood pressure at the same time so we are looking to have high potassium which comes from your veggies and fruits that reduces your blood pressure that's right and then you choose the right carbohydrates which is a low glycemic index carbohydrates carbohydrates with high fiber that will help and of course when you are eating in a Mediterranean diet for example you eat carbohydrates proteins and fat when you choose fat you need to choose fat with very low saturated fat so it is recommended to have less than 10 saturated fat in your diet because saturated fats are commonly found in animal fat so if you can avoid animal fat like steaks or red meat if you're eating red meat it has to be really really lean but if you're eating chicken for example taking the skin off or trying to stick with the chicken breast or turkey will be really beneficial that way you are getting the lean protein without the saturated fat in your diet one thing that you have to totally avoid is trans fat trans fat recommendation for a person's diet for any individual is zero so trans fat never helps you that is the basic source of heart attacks and strokes so hydrogenated oils commonly used in processed foods and commonly used in bakery that's why we always tell patients avoid avoid avoid unfortunately the biggest the biggest fall for our diabetic patients are bakery you know of course everybody likes bakery you just need to limit it to as low as possible so if you're if you like cookies if you like to have cookies once a day every day instead of having three four cookies just have one take a walk after that it limited and I think you will still be you'll still be winning but if you can totally avoid it that's gonna give you the best health ever now now we talked about the carbohydrates we talked about the fat content you are looking for polyunsaturated fat which are found in sunflower oil canola oil and olive oil right nuts are extremely important you know when you are having nuts actually that not only satisfies your hunger but also gives a good amount of fat so we do not necessarily tell patients avoid fat totally but you can have healthy fats such as olive oil and nuts canola oil are all fine we do not recommend frying things just because it increases your overall calories remember when you're on a diet you always have to keep your total calories in mind as we discussed in our previous in our in the beginning of the video you have to always keep in mind how much calories you are getting and when things are fried you know their calorie count goes sky high no matter how healthy the fat is the over consumption will still make you gain weight and when you gain weight you become insulin resistant your cholesterol goes high anyways so as a result we have to keep our calories down eat healthy fat eat the right amount of carbohydrates and the right carbohydrates and when it comes to the carbohydrates as we discussed it needs to be low glycemic index try to keep your glycemic index below 60 in most of the carbohydrates you eat try to eat fiber in your diet around 25 to 30 grams of fiber is recommended in a person's diet that includes patients with diabetes and when you count your carbohydrates it is okay to take the fiber off so if you're having 45 grams of carbs but there's 10 grams of fiber in that it is okay to count as 35 we call that net carbs so i hope that video was helpful to you and if it is please give a thumbs up and subscribe to our channel for many more videos to come so you don't miss anything