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Diabetic help----carbs and fats



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JUSTEATREALFOOD
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9/12/13 8:55 P

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From the ADA's website -

Total prevalence of diabetes

Total: 25.8 million children and adults in the United States—8.3% of the population—have diabetes.

Diagnosed: 18.8 million people

Undiagnosed: 7.0 million people

Prediabetes: 79 million people

www.diabetes.org/diabetes-basics/diabetes-
statistics/



Diabetes is not caused by a metformin deficiency, just as cancer is not caused by a chemotherapy deficiency.

I'll bow out now but if I have made even just one person think about researching this topic further then I am a happy person.

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JERF - Just Eat Real Food


Working on completing my certified Personal Trainer course in the new year!

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
36 years old
2 kids


Keeping my blood sugar levels consistently under 101 mg/dl or 5.6 mmol/L with my LCHF diet.

ontariomountainbikingmama.blogspot.c
a/


 current weight: 125.0 
 
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SLIMMERKIWI
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9/12/13 6:06 P



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I would just like to add one more comment!

JUSTEATREALFOOD - I am really sorry with what is and has happened with your father, but it sounds to me like rather than accepting that everyone is totally individual and reacts differently to different things, you are tending to generalize and applying that generalization to how everyone or most should eat without acknowledging that our bodies are different. Altho' it hasn't been working well for your father, (has he got other medical issues which could be complicating matters?) it DOES work well for most people with Diabetes. That is one of the reasons why it is advised that Diabetics work closely with their qualified health providers to get that personalized input.

Kris

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DIETITIANBECKY
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9/12/13 5:44 P

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There are several points I wish to make and then I think this thread needs to come to a close.

1. I know I am very lucky to be working with a great bunch of physicians and diabetes educators at the small hospital where I am also employed.

This team of experts works together to mesh the diet, exercise, medication---for the best blood sugar control. They also work to include weight loss when needed, hunger control, as well as meeting one's demands of job and lifestyle. I have never seen them give up on a patient/client who required more "tweaking" to bring about better control.
I feel this team approach works best for patient care.

2. From what the original poster provided---her plan is working well. She does not need tweaking. She needs meal planning ideas to fit her "current" plan.

3. Therefore....Sparkpeople members who are following this thread should "not" be trying to force personal opinion on a member who has an eating plan that is working well. This is inappropriate And I ask it to stop!

Thank You.
Becky

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RUSSELL_40
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9/12/13 9:26 A

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The OP is looking to up their carbs per meal, and while I think we need to look more into low carb, that is not what they are asking for.

I still recommend lower glycemic carbs. You get more bang for your buck with green beans, than corn for example, but to eat 225, the OP will have to eat higher carb foods. Beans are great , as well as low glycemic fruit, and lots of veggies, but I think the OP is going to eat potatoes, bread, pasta, and cereal too.

Just read the labels. There are cereals that are low in sugar, and high in fiber, that have less carbs per serving. So a cereal with 27 g of carbs, and 13 in a cup of sugar is 40 g, and that fits right in with what they want to eat. Make sure you are eating some protein with your carbs though OP. So if you have a baked potato ( 26 g ), have it with some lean meat, and a side of vegetables.

You may be able to find some low carb pasta, but otherwise 41 g is a serving, and it would be hard to fit that in.

I will add. I struggled to lose weight, and keep below 7.0 A1C when I was on a 200 g carb diabetic diet. I was usually around 6.7, and had to take 2000 mg Metformin, and 4 g Amaryl to keep my blood sugars that low. Plus I was constantly starving.

My point is, not all diabetics have such a problem. If you are eating 225 g a day, and losing weight, while keeping your A1C at 6.2, at the very least, you are less sensitive to carbs. If however, you increase to 45 g five meals a day, and your blood sugars skyrocket, or you need to increase the dose of your meds, then you need to look for a better solution.

I hope that doesn't come across as too pro-low carb to the OP. I just want you to pay attention to the types of carbs, as well as the amount. Hopefully, you can do okay with 225 grams a day. I just think that living on pills with an A1C that is still not that low, isn't success. You should be able to eat 225 a day though. Not all carbs are bad.



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RLEEGIRL
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9/12/13 9:01 A

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Type 1 diabetitic and I love whole grain cereal,fruit and skim milk for breakfast my sugars stay level and I feel amazing,you need to accomodate your carbs with your insulin it takes work....but thats what diabetes is...




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JUSTEATREALFOOD
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9/12/13 8:24 A

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I'm really not trying to be a pain the a** here Becky it's just that this is something I feel very strongly about.

My Dad has been eating that kind of meal for the last 15 years as per his diabeties educator and it hasn't helped him in the slightest, infact it's killing him. I watch him eat a meal like that and take a handful of pills then a few hours later he's starving and grumpy from low blood sugar. His next step is insulin because his meds are no longer working for him. My Grandpa died from complications from his diabetes.

I will not let that happen to me. I have done a ton of research on the subject. Bought myself a glucometer and started testing to see how I react to the foods I eat. It was enlightening. Most amazing is the higher the fat in my meal the steadier my blood sugar is. I no longer have hypoglycaemic episodes which are horrible. Grains and sugars raise and lower my blood sugar the most so I try to avoid them now.

To the OP please reseach this further, it's your life on the line.

The ADA has a huge conflict of interest as some of it's major sponsors are Coca Cola, Pepsi, General Mills, Kellogs, Mars and Hershey.

Nuts contain carbs.

JERF - Just Eat Real Food


Working on completing my certified Personal Trainer course in the new year!

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
36 years old
2 kids


Keeping my blood sugar levels consistently under 101 mg/dl or 5.6 mmol/L with my LCHF diet.

ontariomountainbikingmama.blogspot.c
a/


 current weight: 125.0 
 
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DIETITIANBECKY
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9/12/13 7:42 A

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TAZZYWOMAN--
There are many with diabetes who would experience poor blood sugar control on 70 grams of carbohydrate a day. I am glad to hear you are working with health professionals several times a year to assure good blood sugar control. Tweaking a general program to meet your individualized needs is important. I could tell by your post that you had received education, knew about testing and carb counting. You may want to get additional meal planning options at your next visit with your certified diabetes educator.

All my best
Becky



SLIMMERKIWI
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9/12/13 3:31 A



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What Becky suggested re the cereal is actually good for a quick, healthy meal. I just had a look at this morning's breakfast:
Fish Oil Capsules - 2 caps, 2 serving
Banana, fresh, 60 grams
Brown Sugar, 3 grams
So Good Lite Soy Milk, 0.5 cup
Rolled Oats, 23 gram(s)
Bran Flakes (Baker's type), 6 gram(s)

That worked out to:
7g Fat
38 Carb's
9g Protein
7g Fibre

To the OP - perhaps you could make some small meals that are as per your food 'prescription' re nutrients, and have them frozen in single serve containers. Then on the days you are going to work longer hours, grab from the freezer and go. Just heat it at work.

Kris

Edited by: SLIMMERKIWI at: 9/12/2013 (03:33)
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TAZZYWOMAN
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9/11/13 9:28 P

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Becky I also sent you a private message. To the person who is doing low carb GOOD for you. Not good for me. I start getting signs of low sugar at around 70. No thanks to what happens to me at that point. I work with a dietitian a couple of times a year (all my insurance will cover) and low carb is not recommended for me.

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DIETITIANBECKY
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9/11/13 8:57 P

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I provided the cereal, milk, fruit as an example for it sounded like the original poster had some experience with carb counting for diabetes management (food portions, etc)

To help explain more:

a serving of whole grain, high fiber cereal or oatmeal would be 15 grams of carb (1 carb choice)
topped with about 1/2 cup of fruit would be 15 grams of carb (1 carb choice) (depends on type of fruit selected)
topped with about 1/2 cup of skim milk would be 7 grams of carb. (1/2 carb choice)
The person could even add about 1 tablespoon of nuts for more protein. (no carbs)

This would provide:
37 grams of carbs and the original poster said that the meals were to be around 45 grams.
about 10 grams of protein.
healthy fat, and
3-6 grams of fiber.

It would make a quick, easy healthy mini-meal. It would be within the poster's carb plan, also provide protein and fiber.

Becky

Edited by: DIETITIANBECKY at: 9/11/2013 (21:17)


JUSTEATREALFOOD
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9/11/13 5:47 P

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Cereal, milk and fruit!! For a diabetic? That's messed up.

JERF - Just Eat Real Food


Working on completing my certified Personal Trainer course in the new year!

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
36 years old
2 kids


Keeping my blood sugar levels consistently under 101 mg/dl or 5.6 mmol/L with my LCHF diet.

ontariomountainbikingmama.blogspot.c
a/


 current weight: 125.0 
 
135
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DIETITIANBECKY
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9/11/13 3:50 P

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To the original poster...
I am sorry that this thread has turned into a "low carb" debate.
Let's get back to your original question.
You state that you have been directed to eat around 1800 calories daily, 225 grams of carb (which is about 50% of your calories coming from carb). You state that when you are following this plan, you are having weight loss, and good blood sugar control, good A1-C. Yet there are times with your hectic schedule that your eating plan is slightly higher in fat, lower in calories, etc.

My suggestion would be to stick with your given plan, since it is working well for you. You may find it beneficial to come up with some meal plans that are quick and easy, require little prep, you can take to work, and meet your meal plan guidelines.

For example:
yogurt with fruit and granola
cereal, milk, fruit
deli sandwich with veggies
frozen entree with added piece of fruit

even if you get a quick fast food sandwich, add on a salad and piece of fruit.
a piece of thin crust pizza, salad and fruit

Hope this helps with ideas for your situation.

Becky
Your SP Registered Dietitian



MICHELLEXXXX
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9/11/13 9:21 A

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i agree with JustEatRealFood's posts.
Adequate vegetable intake will provide you with micro nutrient rich carbs. All 3 macro nutrients can be broken down to glucose therefore protein and fats are excellent fuel sources because they also maintain steady bs levels.

"For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life." John 3:16


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RUSSELL_40
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9/11/13 7:47 A

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I think that low carb should be being studied a lot more Becky. I have also been off my meds for about 40 months now, and while I do not live in a laboratory while being watched 24/7, there is tons of evidence supporting reducing carbs in general, and more success the lower you take your carb intake ** in most cases **. Sure, there are dangers. I personally had a lot of low blood sugars when I started, until they took me off my meds after a year on low carb. This is not something to just start on your own, which is what I think your point is.

However, it is hard to find a doctor who will work with you to reduce carbs more than the ADA suggests, and at that level, I have never seen anyone get their blood sugars under control, or get steady results. So if someone realizes that having a 7.0 blood sugar while taking pills is probably not a great way to live their life, they are forced to " wing it ".

Over the years, I have learned how to control my blood sugars,both too high, AND too low, but only after a lot of trial and error. We should be exploring a sensible low carb plan for diabetics. This may be 80 grams for some, and 150 grams for others, with lots of fiber, but a slight reduction in carbs is not enough for most diabetics. We got fat eating too many poor carbs, and 225 grams is way to high for most people. This is why they struggle to lose weight. A simple shift to lower carbs reduces hunger, and allows people to eat a proper amount of calories, while not spiking their blood sugars. This allows for weight loss, and has reversed the effects of diabetes for many people.

I agree that the OP shouldn't just run out and start Atkins Induction, but there has to be some middle ground that we can explore, before more people have kidney failure, or blindness from " managing " diabetes.

Recently I have added a slice of high fiber bread to my eggs for breakfast, and upped my carbs to about 30 g a meal, but most of my carbs come from the bread, and vegetables. There are a few simple ideas that diabetics can start with. Eat lower glycemic carbs, limit fruit, split carbs into equal amounts per meal.

If that is not enough though, what should people do? My doctor had no answers, so that is not an option. At that point do people just accept that they will die?

My suggestion to the OP is to talk to your doctor, and get bloodwork done to make sure your kidney function, and everything else is fine. Steady weight loss will be a huge help. If you are still checking blood sugars daily, pay attention to those numbers. You will find that a certain amount per meal will be enough to maintain good levels (80-120). Hopefully this is a sizable amount of carbs. Also focus on better carbs. In the end, with the help of your doctor, you need to find a level that gives you the nutrition you need, and the blood sugar numbers you want.

I eat 90 grams of carbs a day, with 20 coming from fiber. My bloodwork is great, and this works for me. What is most important is that IF you raise your carbs, does your weight loss stop? Does your blood sugar spike? Be truthful with your doctor, and see if they have any advice that works to keep weight loss, and blood sugars improving, while upping carbs. If not, then you have to make some decisions, and what works for ME, may not be the best solution for YOU.

I would be interested in more info from you. While eating at this lower carb level have you seen a marked drop in blood sugar? How fast are you losing " steadily "? How do you feel? Are you experiencing low blood sugars? Are you low in essential vitamins/nutrients?

Those are things your doctor will want to know too, and while I believe low carb in general can be a benefit to diabetics, you need to be careful, and discuss this with your doctor, since your situation is unique. If what they suggest fails though, don't continue to do it. Demand that they come up with a new plan. Stable blood sugars are something you should be able to achieve.

Russell - current BMI 28.6
197 - bmi 30 - done
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TAZZYWOMAN
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9/11/13 7:46 A

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sorry I wasn't on here yesterday--I did track my food all day. I'm committed to that, I work two jobs just as I stated in the beginning and I worked over 13 hours yesterday. My fats are coming from grabbing some fast food here and there to supplement when I am not prepared ahead. The amount in say an egg mcmuffin will throw off the fat totals for the rest of the day. I did turn on the suggested meal plan after I was reminded it was there. My yesterday's meal plan was all sandwiches--boring! I ended up just eating 1313 calories. I know I need to eat more! I find I am hoarding calories until dinner which needs to stop since I am busier during the day. BTW I have been diabetic for almost 20 years and under great control until the past couple of years(using pills). Been on a bit of a yoyo with my AIC but my last one was a 6.2 so I'm back on track. Ohh and to answer Becky's Question I was told 225 per day. 45 per meal and then two snacks per day.

Edited by: TAZZYWOMAN at: 9/11/2013 (07:58)
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JUSTEATREALFOOD
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9/10/13 8:19 P

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They asked the question Becky. I'm only giving my opinion.

JERF - Just Eat Real Food


Working on completing my certified Personal Trainer course in the new year!

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
36 years old
2 kids


Keeping my blood sugar levels consistently under 101 mg/dl or 5.6 mmol/L with my LCHF diet.

ontariomountainbikingmama.blogspot.c
a/


 current weight: 125.0 
 
135
132.5
130
127.5
125


DIETITIANBECKY
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9/10/13 7:41 P

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I am sorry to hear about your father and his difficulty in obtaining good blood sugar control.

While there are studies looking at using a low carb approach for blood sugar control--these would be considered preliminary studies (some even rat studies). Once enough evidence is gathered then generalized recommendations are able to be made for the general population and practice guidelines can be implemented. This would be connected to the calorie amount, specific carb amount, protein and fat amount, medication amount, etc, etc. Suggesting to a member to do low carb, low protein, high fat is incomplete, inaccurate and possibly dangerous advice. You do not know this member's medical history.

Since our site provides services to 15 million members--we only use evidence based practice guidelines. For individuals who need more tweaking to their diet prescription---they should be working closely with their medical team which can run lab work, adjust meds, as needed.

Thank you for following our guidelines

Becky
Your SP Registered Dietitian Nutritionist



JUSTEATREALFOOD
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9/10/13 6:52 P

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The ADA's recommendations have been slowly killing my dad for the last 15 years. So you'll have to excuse me for not placing much stock in anything they have to say.

A few studies below. There are many, many more I could cite.

The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus.

www.ncbi.nlm.nih.gov/pubmed/19099589

Improved glucose regulation on a low carbohydrate diet in diabetic rats transplanted with macroencapsulated porcine islets.

www.ncbi.nlm.nih.gov/pubmed/18714676

Low-carbohydrate diet review: shifting the paradigm.

www.ncbi.nlm.nih.gov/pubmed/21586415

In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss.

www.ncbi.nlm.nih.gov/pubmed/22562179

Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes.

www.ncbi.nlm.nih.gov/pubmed/22673594

Low carbohydrate diets for diabetes control.

www.ncbi.nlm.nih.gov/pmc/articles/PMC15707
67/


Edited by: JUSTEATREALFOOD at: 9/10/2013 (18:54)
JERF - Just Eat Real Food


Working on completing my certified Personal Trainer course in the new year!

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
36 years old
2 kids


Keeping my blood sugar levels consistently under 101 mg/dl or 5.6 mmol/L with my LCHF diet.

ontariomountainbikingmama.blogspot.c
a/


 current weight: 125.0 
 
135
132.5
130
127.5
125


DIETITIANBECKY
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9/10/13 3:14 P

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Dear JUSTEATREALFOOD--

This Sparkpeople site follows the nutrition guidelines and research evidence from the American Diabetes Association for our diabetes tools and resources.

It could be very dangerous to tell someone with diabetes to not worry about carbohydrate intake and to follow a low carb, low protein, high fat diet. It is also inaccurate to suggest that diabetes is reversible. Yes, one can control diabetes through diet, lifestyle, and medication.

This site respects your right to select the foods as you so desire; but we also ask that members also use evidence based research when giving nutrition suggestions.

Thank you

Becky
Your SP Registered Dietitian

Edited by: DIETITIANBECKY at: 9/10/2013 (15:16)


DIETITIANBECKY
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9/10/13 3:10 P

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The health professional who told you to go up to 1800 calories---did this person provide a minimum carbohydrate amount??

Or is this what your SP program is indicating from the data you have entered??

Becky



JUSTEATREALFOOD
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9/10/13 10:57 A

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I keep my blood sugars steady by eating a diet high in fat and lower in carbs and protein. I wouldn't worry about it since carbohydrates are what caused the problem in the first place. Not only is type two diabetes controllable through diet it is completely reversible if you eat the proper diet.

Best to you

JERF - Just Eat Real Food


Working on completing my certified Personal Trainer course in the new year!

I eat mostly vegetables, fats, meats, some fruit and dark chocolate. Unprocessed and preservative free. And it's changed my life!

5'4"
Goal weight 125lbs
36 years old
2 kids


Keeping my blood sugar levels consistently under 101 mg/dl or 5.6 mmol/L with my LCHF diet.

ontariomountainbikingmama.blogspot.c
a/


 current weight: 125.0 
 
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MISSRUTH
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9/10/13 8:36 A

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I agree with Becky, that it would be easier to make suggestions if your Nutrition Tracker was public.

What struck me was... you said you haven't been meeting your carb goal because you'd been maxing out your fat. So I reckon the first place to look would be, what are you eating that's maxing out the fat grams? Can you make some adjustments there? Like, switch from whole milk to low fat? You don't need to go from whole to skim milk overnight.... 2% doesn't taste that much different, and then after a while you could step it down to 1%. Or lowfat cheese. Or non-fat yogurt. Or reduced fat triscuits, even. Instead of using 2 T. butter (margarine, whatever) can you use 1/2 that and be okay with it? Where are you getting that much fat, and how can you cut it back?

Ruth in Cookeville, TN Central Time Zone


Promise me you'll always remember: You're braver than you believe, and stronger than you seem, and smarter than you think - Christopher Robin to Pooh


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TAZZYWOMAN
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9/9/13 8:38 P

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yes. I was told I could go to 1800


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DIETITIANBECKY
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9/9/13 5:47 P

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A 150 gram intake would be fine; especially when spaced between 3 meals and 1-2 snacks daily.

From the range you share, is your calorie range: 1384-1728???

Becky



TAZZYWOMAN
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9/9/13 4:00 P

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daily goal for carbs is between 173-216 with a reading on my chart saying for low carb diets it should be between 225-250. Usually I am around 150 in that measurement. Over this weekend I didn't hit 100 in my daily goals either day.

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DIETITIANBECKY
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9/9/13 3:37 P

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What has your diabetes educator said is the minimum amount of carbohydrate you are to consume daily? 130 grams??? What amount are you getting daily?

It would be easier to make suggestions if your nutrition tracker was public. Let me know if you need the steps to do this. Are you low in milk/yogurt, fruits, starchy veggies, beans/lentils, whole grains???

Becky
Your SP Registered Dietitian



TAZZYWOMAN
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9/9/13 2:58 P

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I have had a steady weight loss since I have been back but I am curious. I am eating between 1300 and 1600 calories per day and have a goal of burning 2800 (which I do not meet everyday as I have a desk job (actually 2 desk jobs). I haven't been meeting my carbs allotment totals because I have been hitting the fat ones too quickly. Last weekend I went overboard with protein and I have felt a bit rotten ever since. Am I alone in this? Can someone suggest something I can do to help? I do eat lots of fruits and veggies but most are negligible in carbs.

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 Pounds lost: 26.5 
 
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32.5
65
97.5
130


 
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