Meal-planning basics for type 2 diabetes

The more we learn about the influence of diet on long-term health and well-being, the more important it becomes to make wise, conscientious food choices. When you have type 2 diabetes, this is even more crucial.

What is meal planning? As the name implies, it involves thinking ahead of time about what, how much, and even when and where you are going to eat. It may involve working out a “food budget” as well — although in this case you’ll be counting calories as well as dollars and cents.

Meet with a dietitian

The best person to help you develop a healthy eating plan is a registered dietitian (R.D.) with expertise in diabetes. Ideally, he or she is a certified diabetes educator (C.D.E.) as well. Health insurance plans usually cover at least one or two visits to a dietitian. Meal planning usually begins with a visit to a dietitian. Your first meeting with the dietitian will be largely devoted to compiling a nutritional assessment — your “diet history.” This analysis of your eating and lifestyle habits will take about an hour. It may be helpful if you bring to your first visit a diary listing everything you have eaten, with approximate serving sizes, in the previous three days. During this session, you and the dietitian will discuss which types of food you eat, when you eat, and who does the shopping and food preparation in your household. The dietitian will use all this information to help you target a realistic healthy body weight and to devise an eating plan that’s right for you.

Keep a food diary

To get the most complete picture of your food consumption, keep a food diary for one to two weeks. Jot down what you’ve eaten and how much, as soon as you eat it. If you wait until the end of the day, it’s likely you’ll forget some of the things you ate earlier. Then bring the food diary with you to any appointments with the dietitian. A thorough food diary should record such facts as these:

• What you eat and drink. This means every mouthful of food — even tastes, snacks, and sips. Indicate how it was prepared (baked or fried, for instance). Also count oils, butter, sugar, and condiments.
• When you eat. The timing of meals and snacks is valuable information for blood sugar control.
• How much you eat. When you first start recording your food intake, measure your portion sizes with standard measuring utensils. This serves two purposes: It provides more precise information about your food consumption, and it helps you become accustomed to standard serving sizes. You’ll probably be surprised by what a standard 3-ounce serving size of chicken or half a cup of potatoes looks like on your plate. As you grow more familiar with these portions, you can begin to “eyeball” servings more accurately. Or use the guidelines we’ve provided in the table below.
• Physical activity. It’s important to track the timing and intensity of your exercise sessions so you can begin to get a picture of how physical activity interacts with your food and medication schedule.
• Medications taken and blood sugar levels. Bring along any records of blood sugar tests, as this can provide the dietitian with some idea of your average blood sugar levels. Also mention any medications you are taking.

Once all this information is collected, you and your dietitian will begin the planning stage of the assessment. Your dietitian will discuss the general principles of diabetic meal planning and prepare an individualized eating plan that suits your lifestyle, health goals, medical needs, and personal likes and dislikes.

Handy portion guidelines
This chart can help you estimate portion sizes.
This amount of food…	Is the size of this…
3 ounces meat, fish, or poultry	deck of cards, cassette tape, or the palm of your hand
1 ounce cheese	pair of dice, or your thumb
1 cup pasta, potato, or rice	tennis ball, or your fist
1 level teaspoon peanut butter, oil, mayonnaise, etc.	tip of your thumb
This amount of food…	Consists of…
1 ounce nuts	24 almonds, 18 cashews, 28 peanuts, or 14 walnut halves
2 ounces pretzels	40 mini-pretzels