Meal Plan Collection

Five Day Pregnancy Meal Plan

Here's a five-day meal plan to get you started on your healthy eating track. You'll notice the adjustments for the first trimester at the bottom of each menu this is because your body requires fewer calories during the first three months and more during the last six months.

Transform a sound meal plan into a disaster In addition even the most sensible diets ignore the cruc

A suggested meal plan such as the one at the back of this book isn't perfect. You'll need to tinker in order to determine the ideal diet for you. Building a physique takes time, dedication and consistency, and losing or gaining weight should be a gradual process to ensure the right kind of changes. Don't rush it, stay focused and consistent, and you'll move ever closer to physical excellence.

Dietary Interventions That May Alter Risk Factors

Weight can be altered by dietary change, but this appears to be difficult. Trials are often of very short duration and suffer from high drop-out rates, limiting their validity. Several good quality systematic reviews offer insights. A behavioral component improves weight loss in dietary and exercise programs (including very low calorie diets), as do written meal plans, weekly shopping lists, and group (rather than individual) therapy. Weight maintenance strategies (such as support groups) should be integral parts of all weight loss programs.38 There is little strong evidence that the proportion of dietary fat (as distinct from calories eaten) has an effect on body weight.38-40 In terms of managing cardiovascular risk, people with hyperlipidemia should receive dietary lipid lowering advice in addition to weight management advice.41

Early Dietary Advice in the United States

The first half of the twentieth century was a period of enormous growth in nutrition knowledge. The primary goal of nutrition advice at this time was to help people select foods to meet their energy (calorie) needs and prevent nutritional deficiencies. During the Great Depression of the 1930s, food was rationed and people had little money to buy food. They needed to know how to select an adequate diet with few resources, and the USDA produced a set of meal plans that were affordable for families of various incomes. To this day, a food guide for low-income families the Thrifty Food Plan is issued regularly by the USDA and used to determine food stamp allotments. In addition to meal plans, the USDA developed food guides tools to help people select healthful diets. Over the years the food guides changed, based on the current information available.

Electrolytes and Fluids

As the level of protein in the renal diet became more liberalized, potassium control also became an issue for patients receiving maintenance hemodialysis. When routine dialysis increased to two to three times per week, patients began to feel better and their appetite increased. A dietary potassium intake of 2-3 g day was the maximum amount recommended in all meal plans for patients receiving maintenance hemodialysis (29). However, dietitians realized that many patients who were receiving maintenance peritoneal dialysis did not require a potassium restriction and intake could be liberalized based on the patient's serum potassium levels.

Mealplanning approaches

Various meal-planning approaches are used in diabetes management. The meal plan followed prior to conception may need only minor adjustments to account for fetal growth. Women with no previous MNT will need more intensive self-management education. The appropriate meal-planning tool selected depends on the woman's ability and motivation to follow the plan. Meal-planning approaches include menus, plate method, Food Guide Pyramid, or Exchange Lists for Meal Planning 43 . Carbohydrate counting is used more often today as clients learn the importance of employing amounts and food sources of carbohydrates, label reading, and food records. Pattern management, calculating insulin-to-carbohydrate ratios and correction factors are advanced forms of meal planning 43 .

Recommendation for Tuna

Gestational diabetes is the onset of high blood sugar (or carbohydrate intolerance) that is generally detected around the twenty-eighth week of pregnancy. Because this condition is caused by the placenta putting out large doses of anti-insulin hormones, as soon as the placenta is removed (during the baby's delivery), the condition disappears in almost all cases. Women diagnosed with gestational diabetes have very specific dietary concerns and should work with a qualified nutritionist (registered dietitian) on appropriate meal planning.

What other people are saying about this ebook

The best read ever on the subject of gaining lean muscle. I can now say that after several weeks of getting used to the meal planning and food calculations that I now know the calorific value and nutritional content of everything I eat. I can also now pick up any food, look at the label and instantly know what it all means. The end result has been 10lbs of rock solid muscle gained in just over 1 month simply by training less and eating more and better. In my now 2 years of training I have never felt more on target, and never looked better.

Making the Nutritional Guidelines Work for

You get a lot more flexibility both in meal timing and what you eat with intensive insulin therapy, in which you either take insulin injections before each meal, or with an insulin pump, which contains a continuous subcutaneous insulin infusion (CSII). Before you give yourself an injection, you determine how much carbohydrate you plan to eat and calculate the amount of insulin accordingly. There are many resources for learning the carbohydrate level of foods, including food labels. A list of resources for carbohydrate counting and meal planning for diabetes may be found at the end of this chapter. In the following section, you'll find a carbohydrate counting list, which shows the carbohydrate content of various foods. While a carb counting list includes foods from the starch, fruit, and dairy group, it does not contain foods from the fat, vegetable, and protein groups. Keep in mind that each food in the carbohydrate counting list is 15 grams of carbohydrate within the stated portion...

Serving size helpings dont help

Meal planning requires total control over not just what you eat, but also how much. This is more difficult in practice than it might seem at first glance, particularly when you're sharing home cooking with the rest of your family. Assume that Doris managed to lose the weight she set out to, and now she's back eating the 1770 calories a day that keeps her weight stable. After a few months of stable weight, Doris decides to put the annoyance of planning meals and charting weight behind her and rely on her judgement. And all from one extra helping of mashed potatoes a day. Doris was overweight most of her life because she wasn't born with a built-in eat watch. She lost weight when she remedied that shortcoming by planning her meals around the number of calories she burned, guided by the trend of her weight. After becoming slender for the first time since grade school, she made the mistake of removing the eat watch. She fell back on her body's feedback mechanism to tell her how much to...

Planning and scheduling meals

A really rigid meal plan and schedule makes the early days of a diet much easier to stomach. I'd suggest, before you start, sitting down and working out the first five days' menus in complete detail, based on the meal plan you've developed as described in chapter 8. That way, when you do feel hungry, you're at least certain when your next meal is coming and what it will consist of just pull out the plan and look. If you space your meals evenly through the day and balance the calories among them, a glance at the plan assures you that, however hungry you feel at the moment, you don't have that long to go before you can eat something to assuage your hunger.

Medical nutrition therapy

There are no specific dietary guidelines for pregnant women with preexisting diabetes. Current guidelines for nutrition recommendations in pregnant women without diabetes may be used for pregnant women with type 1 diabetes and type 2 diabetes. Individualizing the meal plan is the key to providing adequate calories and nutrients to the woman and fetus. The meal plan works concurrently with the insulin regimen to achieve target blood glucose levels. The goals of MNT for pregnancy and diabetes are (1) to provide adequate nutrients for maternal-fetal nutrition, (2) to provide sufficient calories for appropriate weight gain, and (3) to achieve and maintain optimal glycemic control.

Trend tracking and monthly adjustment

Partial month charts are an interesting way to watch the trend begin to drop initially and then settle into a steady decline, but don't attach too much significance to the first couple of weeks or try to adjust your meal plan based on every week's change in the trend. After a month, look at the trend chart, compare the weekly weight loss rate and daily calorie deficit with what you planned, and make the appropriate adjustments to your meal plan or diet plan as described on page 209. When you adjust your meal plan to increase or decrease calorie intake, don't expect to see the change reflected immediately in the trend line remember, it lags behind. Give any change at least two weeks to show up in the trend or, better, wait until the next monthly review of your plan. Since the effect of changes is subtle and slow to emerge in the trend, monthly adjustment is adequate and keeps you from constantly fiddling with your meal plan.

If Your Doctor Prescribes a Special Eating Plan

Like your medication, a doctor-prescribed eating plan-perhaps sodium-modified, high-fiber, gluten-free, or blenderized liquid-is essential to healthcare and disease management. In the world of medicine, a special meal plan is part of medical nutrition therapy. If your doctor prescribes a special eating plan as part of your treatment for whatever conditions you might have Get enough guidance so you can successfully comply. Ask for a referral to a registered dietitian for help in planning and monitoring your nutrition needs. You need an approach that matches your physical and personal needs and your food preferences. Caution Let your doctor or dietitian know about any supplements you take. Follow the special nutrition plan faithfully. Record what you eat, your challenges, and successes to share later with your healthcare provider or dietitian. That's especially important if this is a long-term change in your eating regimen. Use Nutrition Facts and ingredient lists on food labels as...

Increase calories gradually

At the end of your diet, don't just take the calorie deficit from your last month's trend chart and immediately add that number to your meal plan. That's a guaranteed prescription for a disheartening bounce upward in weight. All the time you've been dieting, your body has become more and more efficient at using the limited number of calories you've been supplying and accustomed to meeting its needs by burning fat. Remember how difficult it was getting the body to start burning fat at the start of the diet those awful first few days At the end of your diet it also takes a while to shift from burning fat to meeting all your calorie needs from food. Fortunately, there's no discomfort associated with this process. Instead, divide the calorie shortfall over a number of weeks, and each week add that number of calories to your meal plan. For example, suppose the trend chart for the last full month of your diet indicated a shortfall of 560 calories a day. For a four week transition you'd...

The Fourteen Day Energy to Burn Diet

Now that you have the know-how to create a nutrition strategy for your active lifestyle, and suggestions from the elite, we think it's time to create a diet that works for you To get you started, we have carefully created a fourteen-day meal plan for a 2,500-calorie diet. You can rest assured that these meals are nutrient-packed, generous in vitamins and minerals, meet your fiber needs, and give you the right ratios of carbohydrates, proteins, and good fats.

How will I feel right after I eat

Think about how you'll feel if you do go and wolf down something to slake your hunger. Yes, the hunger will be gone, but will what replaces it be an improvement You've invested a great deal of effort in getting to this point of your diet, and at this very moment it's all on the line. All the monitoring, all the calculation, all the analysis of the trend and the carefully crafted feedback systems are for nought if you ignore the meal plan whenever it proves uncomfortable. Weigh the immediate surcease of hunger with the feeling of accomplishment you'll have after the next regular meal in knowing you weathered a difficult time and emerged still on course.

What food is worth it

When hunger strikes, you're already undoubtedly thinking of food, so why not put in concrete terms Turn to the table of calories on page 301 and look up the foods you're tempted to wolf down. Think about their calories compared to the calorie deficit in your meal plan, and work out, in your mind, how much longer your diet will run if you add such a food every day. Rather than increasing your focus on food, that may let you balance the food you're craving in a purely numerical way against the forecast length of your diet and the knowledge that once the diet is done your weight problem will be solved and you'll never have to endure hunger like this again.

Putting the Guidelines to the Test

To help you follow a heart-smart diet, here's a seven-day food plan that incorporates lean proteins and low-fat dairy products, unsaturated fats, loads of fresh fruit and vegetables, and plenty of fiber. Plus, it's easy to follow. This meal plan is based on approximately 1,800 calories, so if your doctor recommends you lose weight, you may need to scale down portions and trim off a few foods. On the other hand, if your weight is stable (or you could stand to gain a few pounds), increase the lean protein portions and add some more olive oil, fruits, and veggies.

Advantages and Disadvantages

An advantage of the food exchange system is that it provides a system in which a wide selection of foods can be included, thereby offering variety and versatility to the person with diabetes. Other advantages of the lists are (1) they provide a framework to group foods with similar carbohydrate, protein, fat, and calorie contents (2) they emphasize important management concepts, such as carbohydrate amounts, fat modification, calorie control, and awareness of high-sodium foods (3) by making food choices from each of the different lists a variety of healthful food choices can be assured and (4) they provide a system that allows individuals to be accountable for what they eat. Furthermore, with an understanding of the nutrient composition of the exchange lists, nutrient values from food labels can be used and a wider variety of foods can be incorporated accurately into a meal plan.

How to Improve Your Diet

To help maintain an appropriate intake of calories, it is important that when adding food to your meal plan, you take something else away, assuming you are now eating enough. For example, if you need to increase your fruit and milk intake but are on target with the other food groups, you will need to look at your intake of discretionary calories. These are calories you need to maintain your weight but don't necessarily need for nutrients. Foods such as soda, potato chips, sauces, butter, and cookies can be considered sources of discretionary calories. To avoid consuming too many calories, you may need to decrease the amount you eat of foods high in fat and sugar.

Strategy The Penthouse Suite

While you don't necessarily have to stay at a 5 star hotel or choose the penthouse suite, one great strategy for you road warriors is to choose a hotel chain that offers rooms suites with kitchens or kitchenettes. If you know a nice kitchen setup is waiting for you, you won't have much difficulty sticking to your meal plan. Just have your cabbie drop you at the grocery store on your way from the airport. Once you get to your hotel room you can rest assured that you'll be able to eat as well as when you're at home.

Management of Gestational Diabetes

MNT is the cornerstone of treatment in the management of GDM. The American Diabetes Association and the American College of Obstetricians and Gynecologists recommend nutritional counseling by a registered dietitian and an individualized meal plan 3, 58 . The American Dietetic Association's evidence-based Nutrition Practice Guidelines have identified the following MNT goals for GDM (1) to achieve and main-

Historical Background

The first major revision of the exchange lists was published in 1976. The goals at that time were to be more accurate in the caloric content of listed foods, to emphasize fat modification, and to provide for individualized meal plans to be used with the exchange lists. The American Diabetes Association and the American Dietetic Association published the latest version of the Exchange Lists for Meal Planning in January 2003. Food lists were updated and the Other Carbohydrate list was renamed the Sweets, Desserts, and Other Carbohydrates list. Each list begins with generalized servings of exchange. The nutrient values from the 1995 and 2003 exchange lists are the same and are listed in table 2. Also included in the booklet are a listing of free foods (foods containing less than 20 calories and 5 grams of carbohydrate) combination foods (entrees, frozen entrees, soups), and fast foods. see also Diabetes. American Diabetes Association, and American Dietetic Association (2003). Exchange...

Treatment for Diabetes

Following the diagnosis of diabetes, a diabetic patient undergoes medical nutrition therapy. In other words, a registered dietician performs a nutritional assessment to evaluate the diabetic patient's food intake, metabolic status, lifestyle, and readiness to make changes, along with providing dietary instruction and goal setting. The assessment is individualized and takes into account cultural, lifestyle, and financial considerations. The goals of medical nutrition therapy are to attain appropriate blood glucose, lipid, cholesterol, and triglyceride levels, which are critical to preventing the chronic complications associated with diabetes. For meal planning, the diabetic exchange system provides a quick method for estimating and maintaining the proper balance of carbohydrates, fats, proteins, and calories. In the exchange system, foods are categorized into groups, with each group having food with similar amounts of carbohydrate, protein, fat, and calories. Based on the individual's...

Secret weapons

These secret weapon foods should remain secure in the arsenal except in times of crisis. If you want to include a midnight snack in your meal plan, fine allocate a reasonable number of calories to it (not too many, as you don't want lots of calories in the system while you're sleeping see page 180), and make a list of alternatives with about that number of calories. But if you find a frequent need for an emergency buck-you-up, it's a sign your calorie balance over the day is uneven or you're trying to lose weight too quickly (see below). These problems should be addressed by revising the diet and or meal plans, not by frequently resorting to unplanned snacks, however low calorie.

Weight

Luke et al. 11 examined the maternal weight gain stratified by BMI as it relates to the optimal fetal growth and weight in twins. In this historical cohort study of 2,324 twin pregnancies, optimal rates of fetal growth and birth weights were associated with varying rates of maternal weight gain, depending on the pregravid BMI and the period of gestation. These data were obtained over a 20-year period, from 1979-1999, in four different locations, with no specific information on meal plans, dietary interventions, or changes in dietary habits. The authors concluded that the rates of maternal weight gain in twin pregnancies are best viewed as guidelines that can be used antenatally.

Definition

The word exchange refers to the fact that each item on a particular list in the portion listed may be interchanged with any other food item on the same list. An exchange can be explained as a substitution, choice, or serving. Each list is a group of measured or weighed foods of approximately the same nutritional value. Within each food list, one exchange is approximately equal to another in calories, carbohydrate, protein, and fat. To use the exchange lists, an individual needs an individualized meal plan that outlines the number of exchanges from each list for each meal and for snacks. The American Diabetes Association recommends that because of the complexity of nutrition issues, a registered dietitian, knowledgeable and skilled in implementing nutrition therapy into diabetes management and education, be the team member developing and implementing meal plans. The meal plan is developed in cooperation with the person with diabetes and is based on an assessment of eating changes that...

Proportional feedbag

You're not relying on your appetite it's still broken, in all likelihood, and shouldn't be trusted in any case. You're using your eyes to measure what your stomach can't how much to eat at a sitting. After a year of stable weight, you will probably have become sufficiently accomplished at this skill so the only time you resort to a calorie table is upon encountering new food items, to find something comparable among the foods you regularly eat. As you practice the skill of planning meals by eyeball, the trend provides constant guidance. Any tendency to err in either direction quickly manifests itself in a rising or falling trend, which not only tells you there's a problem but how many calories you're high or low. Further, the band and the brick wall protect you during the transition from formal meal plans to your own judgement. If you try to dispense with meal plans too early, the trend will let you know by exceeding the band or hitting the brick wall, and the planning and adjustment...

Energy

Once energy needs are established, it is important that the pregnant woman understands how to translate her calorie needs into appropriate food choices to support a healthy pregnancy. Requirements for some nutrients, such as protein, iron, and calcium, are increased during pregnancy. Therefore, pregnant women should focus on nutrient dense foods foods that provide a lot of nutrients relative to the number of calories . For example, one egg will contribute high-quality protein, essential fat, as well as a variety of vitamins and minerals, for approximately 75 calories. Too often patients are given calorie levels that may be specific to their needs without adequate instruction on how to incorporate these guidelines into their daily routines. Twenty-four-hour diet recalls conducted and evaluated by a registered dietitian, in combination with appropriate nutrition education materials, can be very useful in assisting the individual in translating their usual diet into meal plans that are...

Exchange System

Prior to the development of exchange lists in 1950, meal planning for persons in the United States with diabetes was chaotic, with no agreement among the major organizations involved with diabetes and nutrition. To solve this problem, the concept of exchange, or substitution, of similar foods was developed by the American Dietetic Association, the American Diabetes Association, and the U.S. Public Health Service. The goal was to develop an educational tool for persons with diabetes that would provide uniformity in meal planning and allow for the inclusion of a wider variety of foods.

Menu mixandmatch

As you gain experience with planning meals, you'll undoubtedly amass a larger and larger collection of different meals, all of which are interchangeable in terms of calories. Also, you'll come to learn which restaurant foods are roughly equivalent in calories to your normal allocation for each meal. As this happens, you'll probably conclude that meal planning, which originally seemed likely to endow something you once derived great joy from, eating, into an exercise with all the romance and excitement of double-entry bookkeeping, is actually liberating. No longer do you have to worry whether you're eating too much or too little. No more do you have to forego something you like because you gulped too much at lunchtime. Now you'll be able to know, in advance, how much food to make or order, eat everything you make, and enjoy it all without feeling guilty. Does the detail and complexity of planning meals seem out of place in our age of modern conveniences Does adding up tables of...

Summary

The original dream was of a device that monitored, moment by moment, the calories we ate and burned, that told us when to eat and when to stop. On our many side-trips into apparently unrelated areas of engineering, mathematics, and management, we've found a way, starting from nothing more than daily weight, to accurately calculate the balance of calories eaten against calories burned. We've discovered the simple link between this calorie balance and weight gain or loss. Finally, we've developed a way, meal planning, to accurately control the number of calories we eat without disrupting our meal schedule or forswearing the kinds of food we enjoy. Taken together, these techniques constitute an eat watch they monitor calories in and calories burned (actually their balance, which is all that matters), and they tell us how much to eat, and when.

Why plan meals

The goal of meal planning is a predictable and reliable daily calorie intake. We can't really wear an eat watch to tell us when to stop eating, but we can accomplish the same objective with a little paperwork in advance. By planning meals then sticking to the plan, you're not only guaranteed to achieve your goal, you eliminate the uncertainty about meals and the need for on-the-fly judgements about what, when, and how much to eat that are a prime contributor to weight gain in people living stressful, chaotic lives.

Eating out

Restaurants pose their own special problems. On the one hand, portion sizes are generally reasonable (at least here in health-conscious California), and you aren't tempted to take extra helpings as at home. Fast food joints, despite their reputation, actually work fine with meal planning. Since the individual items of food are completely standardised and the calorie contents are published in any number of books, you can just choose what you order to total up to the allotment for the meal you're having. As long as you don't order more than that, you're home free.

And around we go

Surely, what we have here is a feedback system, and like any feedback system, it just keeps on going. Information daily weight, the trend calculated from it, and the actual calorie balance determined from the trend, leads to action controlling calories eaten by adjusting your meal plan. Feedback is negative since, when you discover too few calories going in, you compensate by adding calories to the meal plan and vice versa. Control is proportional because adjustments to the meal plan are incremental, based on the degree to which reality, reflected in the trend line, diverges from the goal. (A bang bang diet would, by contrast, let you eat anything you liked as long as you were within 10 pounds of your goal. When the scale cried tilt, you'd have to stop eating lunch until you got back to the goal. Some people actually do this, but it's stressful to the body and hardly a way to enjoy life.) Suppose you take up jogging and run a couple of miles every other day. The number of calories you...

Conclusion

MNT is a key component in the management of GDM. An individualized meal plan should be designed to provide adequate energy and nutrients for maternal and fetal health and promote appropriate weight gain based on prepregnancy BMI. The registered dietitian will use food, blood glucose and, if necessary, ketone records to adjust the meal plan. After delivery, lifestyle modifications will be necessary to reduce the long-term risk of developing type 2 diabetes. These modifications should focus on diet, physical activity and achieving and maintaining a healthy weight.

Adjust Calories

As long as you're carefully following the meal plan you know your calorie intake is close to 1700. The only possible cause of the discrepancy, then, is that you're actually burning 2300 calories a day rather than the 2200 you guessed. Now you get to choose if you feel fine losing 1 1 4 pounds a week and prefer to get the diet over with so much the quicker, stay with your original meal plan. If, on the other hand, the extra calorie shortfall is bothering you, simply adjust your meal plan to supply 1800 calories a day the 2300 you really burn minus 500

Assured stability

From everything we've learned about feedback systems you might remark, Well, of course it works How could it possibly fail And of course it can't, as long as each link in the feedback loop continues to function. Once you implement this plan, the only way you will ever substantially diverge from whatever weight goal you set for yourself is by eating more or fewer calories than your meal plan prescribes, or ceasing to calculate your weight trend and adjust your meal plan based upon it. planning meals, you will have purchased total freedom in the kinds of food you eat, your meal schedule, and how much or how little you choose to exercise. As long as you keep the calories where the meal plan dictates and continue to adjust them as the trend varies, no change will cause your weight to creep very far from where you want it. This is truly worth it. Eat what you like, not what somebody says you should. Schedule meals around your life, not your life around some permanent weight maintenance...

The fast track

By far the simplest and most healthy way to get your diet underway is to start directly on the meal plan you've laid out for the duration of the diet, choosing when you begin as described above. Grit your teeth, reassure yourself that in three or four days you'll be feeling fine, and get it over with. There is, however, an alternative. I don't recommend it, but I have done it myself, and if you find it impossible to get through the first few days of dieting on the regular meal plan, you might consider it. The idea is to start your diet by drastically cutting your calorie intake for the first few days to engage in a partial fast. Huh I'm hungry and you're telling me to eat less If frustration with getting into a diet leads you to try this approach, be reasonable. Don't consider going totally off the feed. Instead, plan a calorie intake of 500 to 600 calories for each of the first two days of your diet, then move on to the regular meal plan. Since you'll be eating very little,...

Postpartum

There are no contraindications to lactation for the woman with diabetes, and women should be encouraged to breastfeed. The meal plan is adjusted to include additional snacks to avoid hypoglycemia, which may be more frequent during lactation. Women with type 2 diabetes and choosing to breastfeed are advised to continue insulin therapy for the duration of lactation 35, 50 . Oral antidiabetic agents may resume once breastfeeding is terminated or if the woman chooses to formula feed her infant.

The sunday ritual

First, on your designated day, sit down and come up with your meal plan for the week. It should only take a few minutes to lay out 7 different breakfast meals, 7 different lunch meals, 7 different dinner meals, and 2-3 additional snacks for each day. And who says each meal has to be different I often just plan to eat the same breakfast, the same lunch, etc., for each day, and I'll only switch it up only on a weekly basis. Some like to do it more often, and that's fine. I find it easier to simplify things. Next, once the meal plan is laid out, add up exactly how much of each food you'll need over the 7 days and go pick those foods up at the grocery store.

Feedback on the job

Happens, bang-bang negative feedback is triggered to ensure the trend is quickly reversed and brought back to the goal. Resuming a meal plan already proven effective for losing weight (or adding comparable calories if the trend hits the brick wall below the weight goal), provides absolute assurance the trend cannot slip out of control. This constitutes very strong negative feedback that kicks in when the brick wall is hit, shown by the steep rise in the feedback curve at that threshold.

Alyce M Thomas

Self-management is the key to reducing the risks associated with diabetes and pregnancy. For women with preexisting diabetes, these include medical nutrition therapy (MNT), insulin therapy, self-monitoring of blood glucose and ketones, and physical activity. Current nutrition recommendations for the treatment of diabetes may be used for pregnant women with type 1 diabetes and type 2 diabetes. MNT is the cornerstone of treatment for women with GDM. Most women with GDM can control their blood glucose by following a carbohydrate modified meal plan that also provides sufficient energy and nutrients to promote maternal and fetal health. Occasionally, medication may be added to maintain optimal blood glucose control.

Soft landing

After four to eight weeks of gradually adding calories to your meal plan, watching the trend line, and adjusting to the increased calorie intake, your weight should have settled within three pounds of the goal and the trend line should be close to flat. Daily weights will be coming

Previous page 117

In most medium-to-long-term studies, diets high in sucrose (versus diets high in starch) have been found to be compatible with good blood glucose and lipid control (10). While there are lingering concerns that extremely large amounts of sugars may have undesirable effects on blood triglycerides, this is not the case for the typical amounts of sucrose found in western diets (16). The most recent recommendations for people with diabetes in the USA (2) state 'Scientific evidence has shown that the use of sucrose as part of the meal plan does not impair blood glucose control in individuals with type I or type II diabetes.'

Ann Reed Mangels

Summary A vegetarian diet, defined as an eating style that avoids meat, fish, and poultry, can be healthful and nutritionally adequate for a pregnant woman. Some vegetarians, called vegans, avoid dairy products and eggs as well as meat, fish, and poultry. Vegan diets can also be healthful and nutritionally adequate for pregnancy. Vegetarian diets can provide numerous long-term health benefits including a lower risk of cardiovascular disease, some forms of cancer, and hypertension. Key nutrients for vegetarian pregnancy include protein, iron, zinc, calcium, vitamin D, vitamin B12, iodine, and omega-3 fatty acids. Vegetarian women should also be counseled to follow standard weight gain recommendations. A vegetarian or vegan diet can meet requirements for all of these nutrients although in some instances, fortified foods or supplements can be especially useful in meeting recommendations. The nutrient content of supplements targeted to pregnant vegetarians should be evaluated to make sure...

The Exchange System

Originally designed for diabetics, the exchange system is a widely used method of meal planning. Foods are divided into six groups or exchanges on the basis of their carbohydrate, protein, and fat content. Similar foods are placed in the same group. Many commercial weight loss programs use exchanges.

Thin at Any Cost

To help Alicia balance her food and exercise goals and to normalize her disordered eating patterns, I measured her percent body fat (a lean 18 percent) and calculated how many calories her body required each day. She needed about 1,200 calories for her resting metabolic rate, 600 calories for moderate daily activity, and 500 calories for purposeful exercise, adding up to about 2,300 total calories per day. Then I devised a meal plan to stabilize her eating. I helped Carol get a better perspective on an appropriate weight by measuring her percent body fat. By designing a meal plan, I helped her eat an appropriate diet. A referral to a coach at the local running club allowed her to train with an appropriate program. I also advised her to read some books about adult children of alcoholics (see appendix A), seek guidance from a suitable counselor, and perhaps join a support group such as Al-Anon or ACoA (Adult Children of Alcoholics).

Hyperglycemia

For diabetics, frequent blood glucose testing and diet management are critical to preventing hyperglycemia. Regular self-monitoring of blood glucose levels determines the degree of adjustment in insulin and diet. A registered dietician can conduct a nutritional assessment that will reveal nutritional needs critical to preventing and treating chronic complications of diabetes. This assessment, based on personal, cultural, and lifestyle preferences, is the foundation for a diabetic's dietary plan. For meal planning, the diabetic exchange system provides a quick method for estimating and maintaining the proper balance of carbohydrates, fats, proteins, and calories. In the exchange system, foods are categorized into groups, with each group comprised of foods with similar amounts of carbohydrate, protein, fat, and calories. Based on the individual's diabetes treatment plan and goals, any food on the list can be exchanged with another food within the same group. reduces cholesterol levels,...

The Future

The future of functional foods will undoubtedly involve a continuation of the labeling and safety debates. As consumers become more health conscious, the demand and market value for health-promoting foods and food components is expected to grow. Before the full market potential can be realized, however, consumers need to be assured of the safety and efficacy of functional foods. Future research will focus on mechanisms by which food components such as phytochemicals positively affect health, and whether these components work independently or synergistically. According to the American Dietetic Association, dietetics professionals will be increasingly called upon to develop preventive meal plans, to recommend changes in food intake, to enhance phytochemical and functional food intake, and to evaluate the appropriateness of functional foods and dietary supplements to meet preventive (and therapeutic) intake levels for both healthy persons and those diagnosed with disease. see also...