Ask the Pharmacist Archive, Tuesday August 12, 2008

During this chat Stephanie A. Dunbar, MPH, RD, ADA Director of Nutrition and Clinical Affairs, discussed and answered questions on any aspect of nutrition and eating related to diabetes as well as discussing the new ADA eTool: My Food Advisor.

The "Ask the Nutritionist" series is brought to you by an unrestricted educational grant from V8 Vegetable Juice

ADA_Moderator: Welcome to ADA Live. Today our guest is Stephanie A. Dunbar, MPH, RD, ADA Director of Nutrition and Clinical Affairs.
ADA_Moderator: Stephanie is here today to answer some of the submitted questions involving nutrition and to answer so of the many questions we have received on MyFoodAdvisor. For those of you unfamiliar with it, MyFoodAdvisor provides food information to people with diabetes, heart disease, kidney disease and those looking to lose weight. This interactive tool compares foods by 22 different nutrients, suggests healthy alternatives, and analyzes what you currently eat. Portion sizes are standardized, based on the American Diabetes Association and American Dietetic Association exchange lists so all carbohydrate-containing foods are shown in servings of about 15 grams of carbohydrate.
ADA_Moderator: It is great to have you hear today, Stephanie.
Stephanie: Thanks, It is a pleasure to be here.
Amy_155: What is MyFoodAdvisorâ„¢?
Stephanie: MyFoodAdvisor (www.diabetes.org/myfoodadvisor) is the American Diabetes Association’s new online nutrition tool that serves as a personal food assistant to people with diabetes, their families, and anyone who wants to eat healthy. The tool is designed to help people with diabetes make healthy food choices and make meal planning easy.
Tadd_skiing: What makes MyFoodAdvisor unique?
Stephanie: The food categories are based on the 2007 version of the American Diabetes Association and American Dietetic Association Exchange Lists for Diabetes. Foods in each category are based on the same amount of carbohydrate and protein (15 grams). Thus, serving sizes that come up under starches and grains (for example) will be different from what you see on the nutrition facts label.
Ren-33-33: Why did the American Diabetes Association create MyFoodAdvisor?
Stephanie: The American Diabetes Association knows that understanding information about calories, carbohydrates, fat, sodium and other nutrients can be overwhelming – especially for people with diabetes. Realizing that there is a gap in free consumer-friendly online tools to help people really understand more about nutrition and food choices, our experts worked to develop a comprehensive and user-friendly tool. MyFoodAdvisor provides people with an easy way to look up a food and say, "wow this has 30 grams of carb and 5 grams of fat." But how does it all work together? How can I make healthier choices? This is what is missing from other online tools and makes MyFoodAdvisor unique.
Calypso: How will MyFoodAdvisor help those who have diabetes?
Stephanie: One of the biggest challenges in managing diabetes is eating healthy. Healthful food is key to managing diabetes. MyFoodAdvisor has several features that allow you to decide what to eat and identify what is right for you in managing your diabetes.
Stephanie: Managing carbohydrate is the cornerstone of glycemic control. All foods listed in the MyFoodAdvisor database have consistent amounts of carbohydrate and protein. This allows you easily compare and choose healthy foods.
Stephanie: Because MyFoodAdvisor allows you to view equivalent amounts of carbohydrate and protein in foods, you can focus your time on picking foods with the healthiest type of fat or foods that are lower in sodium.
Robert: What is in the MyFoodAdvisor database?
Stephanie: MyFoodAdvisor is based on a database of approximately 5,000 foods ranging from basic recipe ingredients like flour to fresh and frozen food to restaurant food. In addition, the tool has hundreds of recipes for you to explore.
James: What are the features of MyFoodAdvisor?
Stephanie: MyFoodAdvisor is a tool that has many features that make it unique compared to other tools you’ll find online. It is a database from which you can look up food information. But the greatest feature of this tool is in how you can access the information and what you can do with that information. Here is a brief overview:
Stephanie: 1. You can search for a food by setting criteria. For example: if your doctor says, "Eat more fiber," you can search the database of foods by setting criteria for all foods with more than 3 grams of fiber. You can also search the database by setting criteria for sodium, carbohydrate, saturated fat and calories.
Stephanie: 2. In the MyFoodAdvisor database, all of the serving sizes for carbohydrate-containing foods are based on about 15 grams of carbohydrate. So the information provided to you through MyFoodAdvisor is different than what you will find on a Nutrition Facts panel on a food label. This is a good thing because if you have diabetes, it is easier to compare foods and plan meals if the carbohydrate is consistent for all food choices.
Stephanie: 3. The food display includes 22 nutrients including potassium and phosphorus. These nutrients are difficult to find on traditional labels or other online tools available yet information about these nutrients are critical for people with kidney disease.
Stephanie: 4. Comparing foods is a breeze because MyFoodAdvisor allows you to compare foods by viewing the foods on the same screen. If the carbohydrate is similar for two foods, you can quickly turn your focus to compare other important information about fat, fiber and sodium or any of the other nutrients.
Stephanie: 5. Looking for other food ideas? MyFoodAdvisor allows you to get suggestions from our "Healthier Alternatives" option so making new, healthy food choices is easier.
Bethany: How do I search for a food in MyFoodAdvisor?
Stephanie: There are 3 main ways to search for a food using the MyFoodAdvisor database. From the Explore Foods Page:
Stephanie: 1. Type the name of a food in the Enter Food box. Click search. For example, if you enter "chicken" as your search, your results will give you all the foods in the database with chicken in the name.
Stephanie: 2. Type a number in the small boxes below the Enter Food box. Click search. For example, if you enter 100 in the calories box, the search will pull up every food in the database with less than 100 calories per serving.
Stephanie: 3. Select a food category under Browse for a food. Your result will reflect all the foods that are classified in that food group. For example, if you select Starch and Grains, your search will take you to the breads, cereals, crackers, and starchy vegetables food groups.
StevenB: Can I use MyFoodAdvisor search for foods that are low in carbohydrate or calories?
Stephanie: Yes. On the Explore Foods page of the MyFoodAdvisor tool, you can enter a specific number of grams of carbohydrate or a specific number of calories to find all the food that matches your criteria. You can also do this for sodium, saturated fat and fiber.
MichelleS: What does browse for a food mean?
Stephanie: All of the foods in the MyFoodAdvisor database are divided into food categories. When you select a food category such as "fruit" all the foods in that grouping will appear.
Shelly: Why are the food serving sizes different than what I see on the Nutrition Facts food label?
Stephanie: For people with diabetes, carbohydrate affects blood glucose levels more than any other nutrient. The food serving sizes in MyFoodAdvisor (with the exception of restaurant foods and frozen dinners) are based on the Exchange Lists for Meal Planning developed by the American Diabetes Association and the American Dietetic Association.
Stephanie: For carbohydrate-containing foods, the serving size is based on how much of the food contains 15 grams of carbohydrate instead of the weight of the food. On most food products, the Nutrition Facts label uses a serving size that is much larger than what you see in this tool. For example, a pasta or rice Nutrition Facts label often displays a serving with 40-45 grams of carbohydrate.
Stephanie: By having consistent carbohydrate, protein, and fat content for all of the serving sizes, it is easier to plan meals. You can swap one carbohydrate containing food for another without having to recalculate serving sizes on your own. MyFoodAdvisor has done it for you!
Jackie: I can’t go back to the previous page. Am I doing something wrong?
Stephanie: There currently is not a "back" feature for MyFoodAdvisor. This is something we will be adding when we launch improvements to the tool. For now, if you need to go back to the search page, click on the Explore Foods tab across the top.
Mark: I am trying to create a recipe for Chicken Burgundy that uses 1 1/2 cups of beef stock. I can't seem to find beef, chicken or fish stock in any of the ingredient lists. Can you tell me where to find the item or how to enter the item if I get the information off the can? I have found a number of stews that us either beef, chicken or fish stock that are beneficial for diabetes if in the correct portions. Being able to enter an ingredient using the label on the item would be helpful in creating recipes.
Stephanie: Try searching for "broth." There are quite a few types in the database. When we make our next update, we'll add the word "stock" to these entries so that these foods will pop up under both search terms.
Stephanie: Try searching for "broth." There are quite a few types in the database. When we make our next update, we'll add the word "stock" to these entries so that these foods will pop up under both search terms. In terms of being able to add your own food based on the label is a great suggestion. I will look into this for our first update.
Stephanie: In terms of being able to add your own food based on the label is a great suggestion. I will look into this for our first update.
cbryant: Are yellow peppers really better for me than red peppers? Based on the healthier alternatives ranking of fresh vegetables, this is true.
Stephanie: All vegetables, and fruits for that matter, are great sources of vitamins and minerals. Choosing a mix of different colored fruits and vegetables is a way to make sure you are getting a variety of the nutrients these two food groups offer.
Stephanie: So enjoy all of your favorites and don’t worry about the ranking for the fruit and vegetable food groups. The only things to stay away from are the fruits and vegetables with added sugar, sodium or fat.
HeatherOakley: I want to use Create a Dish to analyze a recipe, but I don’t see the correct amounts of the ingredients. How many servings of flour is 1 cup? How about sugar?
Stephanie: Because all the serving sizes are based on 15 grams of carbohydrate, a serving of flour is 3 tablespoons and a serving of sugar is 1 tablespoon. If you want to use MyFoodAdvisor to analyze a recipe, you will need to use a few conversions that are listed below:
Stephanie: Flour
Stephanie: 1 Cup of flour is 5.3 servings
Stephanie: ¾ cup of four is 4 servings
Stephanie: ½ cup of flour is 2.6 servings
Stephanie: ¼ cup of flour is 1.3 servings
Stephanie: 1 tablespoon of flour is 0.3 servings
Stephanie: Sugar
Stephanie: 1 cup of sugar is 16 servings
Stephanie: ¾ cup of sugar is 12 servings
Stephanie: ½ cup of sugar is 8 servings
Stephanie: ¼ cup of sugar is 4 servings
Stephanie: 1 tsp of sugar is 0.3 servings
jules: how many carbs can i have a day
Stephanie: How many grams of carbohydrate you can eat depends on many things. Are you physically active? Do you take any medications that lower blood glucose level? How many calories do you eat each day? What are you eating now? How are your blood glucose levels? Do you have type 1 or type 2 diabetes? How much carbohydrate you should eat, depends on the answers to these questions as well as others. As a first step, you can try eating about 45 grams of carbohydrate at a meal and see how this works for you. You may need more or less carbohydrate, but if you keep track for a few days of what you eat,any exercise you do and any blood glucose check results, you can see if any patterns develop. Share this information at your next office visit to help your doctor, nurse, dietitian make changes to get your blood glucose levels on track.
biobuff: Will you have a paper form of this tool for those who do not use computers?
Stephanie: We do not have plans for a paper version of the tool. There are many print resources already available with some of the information. ADA sells a couple of calorie and carbohydrate counter-type books such as "The Diabetes Carb and Fat Gram Guide." You can find that book and others like it at www.store.diabetes.org
Hector: I was recently diagnosed with type 2, my doctor stated that if i loose weight I may be able to get off the diabetes meds is that possible
Stephanie: This may be true, but there is no guarantee. Many people after losing weight still need some type of medication to manage their diabetes. It depends on many things including how much insulin your body is still producing on its own. It is definately worth a try! Losing some weight can also help decrease blood glucose levels and will also decrease your risk of diabetes complications such as heart disease. So there are benefits regardless of a promise for less medication.
JOCKEY: DO I REALLY NEED TO COUNT CARBS?
Stephanie: No, you do not need to count carbohydrates to effectively manage diabetes. There are many different ways to decide how to eat. If you have type 2 diabetes, you may be more interested in using a simple method such as "create a plate." To do this, fill 1/2 your plate with non-starchy vegeteables like brocoli, green beans, or salad. Use the other half of your plate for both your protein foods and starchy foods. So 1/4 of the plate is for a piece of chicken and 1/4 is for rice, pasta or corn. This is a great way to change to portion sizes that you are eating, without having to do any counting. You can find out more about this type of meal planning at diabetes.org/rateyourplate
l_a: what are the two lifestyle changes a prediabetic can do to prevent or delay the development of type 2 diabetes
Stephanie: The most important thing to do to prevent diabetes is to lose weight. For most people, you need to change how much you eat (portion sizes) and often how you cook things and the foods you eat. Becoming more physically active is most important to help you keep off any weight you lose.
JoeDoe: I don't follow a "Diabetes Diet" like I should, but I take Metformin twice a day at meal time, however. I take occasioanl blood readings and they are almost always within the acceptable range given by my past health professional even when I accidentally skip a pill dosage. Could I try to test myself by skipping the Metformin for awhile to see if I'm okay without it, or is it too dangerous and I am just fooling myself into thinking "I'm getting better?" And I do realize that a healthier diet will help me in many ways above and beyond diabetes, but sticking to a healthy diet doesn't work without will-power (which I lack) and especially when I see readings that seem to indicate I'm okay. -- (57 year-old male. 2-3/4 years with diabetes). Thank you.
Stephanie: You should keep taking your medicine. If you have concerns about your medicine, talk with your doctor at your next appointment. Remember, you want to keep your blood glucose levels in the acceptable range. If your current dose of medicine is achieving that, it means it is working! It does not mean that your diabetes is gone. I would also suggest you try to make some small steps toward improving your lifestyle. You don't have to change everything at once! I find that is what many people are doing when they say they have no will power. Try eating more non-starchy vegetables at dinner or having a piece of fruit for dessert instead of something sweet. Or try taking a 10 minute walk after lunch or dinner, or whenever you can fit it in. From there, you can increase your exercise time. Set yourself up to succeed by making small changes instead of expecting to radically change everything at once. Good luck!
Nia: I have type 2 and am always distressed about what to do/eat, etc. when faced with often high bsl. What SHOULD I do that really works.
Stephanie: The first thing I would recommend is to call 1-800-Diabetes (1-800-342-2383) to get more information. We have a 32 page booklet that we can send to you for free. It has information on 3 different meal planning options for getting started with managing diabetes. It also has information on getting physically active, snack suggestions and two menus to get you started. The booklet is called, "What Can I Eat? The Diabetes Guide to Healthy Food Choices."
tigger305: My father is insulin dependent and I am not how do we combine the two for proper diets for both of us?
Stephanie: The good news is that the same food that is good for your father, is also good for you. So you can eat the same exact foods. The portion sizes may be different but you both can select foods to follow a heart healthy meal plan that will help him manage his diabetes.
ADA_Moderator: That is all the questions we have time for today. Thanks so much for taking the time to be here Stephanie. Thanks to all of you who joined us by asking great questions or by just tuning in. If you wish to continue any of today's discussions please feel free to visit the ADA Message Boards.
ADA_Moderator: If you have any further questions on My Food Advisor, please send them to myfoodadvisor@diabetes.org
ADA_Moderator: Keep up to date with all the ADA Live events and reference the archives here. We hope you found this interesting and informative and that you'll join us again next time here at ADA Live. Our guest will be Rite Aid Pharmacists and diabetes experts, will discuss and answer your questions on all aspects of diabetes at 1:00 p.m. EDT Thursday, September 4, 2008. See you then.