Slide 3 Diets for students with diabetes follow Meal Plan Basics - - - PDF document

Slide 1

Meal Plans for Serving Students with Diabetes

Child Nutrition Programs Oregon Department of Education

Hi, this is Janet Beer for the Child Nutrition Programs at the Oregon Department of Education. Schools are required by the American Disabilities Act and USDA to accommodate the dietary needs of students with diabetes. The purpose of this presentation is to review exchange and carbohydrate meal plans for students with diabetes.

Slide 2

Meal Plan Basics - all diets

• Planned meals/snacks
• Variety of foods
• No forbidden foods
• Portion size is critical
• May include snacks

– General fund $ should pay

Individuals with diabetes should eat regular meals and snacks. These meals are planned with a variety of methods including exchanges, and carbohydrate

• counting. Meal plans are tailored to the

needs of the individual student. Like all Americans, students with diabetes should eat a variety of healthy

• foods. Sweets and desserts used to be

forbidden but are now considered in the same way as in the regular Food Guide Pyramid. They may be eaten in small amounts if they fit into the students particular food plan. For any meal plan to be successful the portion sizes are critical. Medication dosages are matched to the carbohydrate content of the meal and

• ver or under portioning can upset this

balance. If a student with diabetes is required to have snacks that are not part of the school meal program these costs should be reimbursed by the general fund.

Slide 3

Meal Plan Basics - all diets

• Reduce

– fat + saturated fat – simple sugar + sweets

• Increase

– whole grains + fiber – lean meats + low fat dairy – fruits + non-starchy vegetables

Diets for students with diabetes follow general dietary recommendations. Meals are planned to be lower in fat, saturated fat, simple sugars and sweets. They should be higher in whole grains and fiber. Meats should be lean and dairy products should be low fat. They also include increased consumption of fruits and vegetables.

Slide 4

Diabetic Exchanges (will vary)

• Starches
• Meat and meat substitutes
• Milk and yogurt
• Fruits + fruit juice
• Non-starchy vegetables
• Fats
• Free Foods

One method of planning meals uses exchange food lists. Exchange lists provide a pattern to follow rather then specifying which foods to eat. In the lists foods are grouped so that they have similar nutrient levels. The portion size of each individual product is varied so that each one will have approximately the same amount

• f calories, carbohydrate, protein and
• fat. Foods in a group may then be

“exchanged” or traded to plan the days meals. The specific food groups and exchange values will vary and it is important that the student use the one provided by their medical care provider.

Slide 5

Sample daily plan - 2000 calorie

• Starches - 10
• Meat and meat subs - 7 ounces
• Milk and yogurt - 3
• Fruits + fruit juice - 4
• Non-starchy vegetables - 5
• Fats - 10
• Free Foods – as allowed

A sample daily plan for a 2000 calorie diet might include the following exchanges: 10 starches 7 meat or meat substitutes 3 milk or yogurts 4 fruit or fruit juices 5 non-starchy vegetables 10 fats and free foods as allowed Free foods generally include items like diet drinks, coffee, and dietetic

• candies. Some may be eaten in any

quantity and some will have a daily maximum consumption. The total days exchanges are divided into 3 meals and may or may not include snacks.

Slide 6

Mayo Clinic Web Site Exchanges

Sample exchange lists can be found on many web sites, including the Mayo

• Clinic. On this sample list ¼ of a 4
• unce bagel counts as one starch

serving as does ½ of an English muffin.

Slide 7

Sample Lunch I tems Amount Exchanges Hamburger Bun One 2 starch Beef Patty Cooked 1 1/2 ounce 1 1/2 meat American Cheese 1/2 ounce 1/2 meat Tossed Salad 1 cup 1 NS veg Ranch, Low Fat 2 T 1 fat Ketchup 2 T free Apple 1 small 1 fruit NF Choc Milk 8 oz 1 milk + 1 starch

If a student had a meal pattern that included 3 starchs, 2 meat or meat substitutes, one non starchy vegetable,

• ne fat, one fruit and one milk they

might select a lunch that contains these items. A 1.75 ounce hamburger bun counts as two starch exchanges. A 1.5 ounce cooked beef patty is 1 ½ meat exchanges. One slice of American cheese is ½

• unce an counts as ½ meat exchange

On cup of tossed salad is one exchange of a non-starch vegetable. Two tablespoons of ketchup is free, but will have a daily maximum amount. One small apple is one fruit exchange. Non-fat chocolate milk has sugar added so it counts as both one milk exchange and one starch exchange.

Slide 8

• Carbs in foods counted
• Wider variety - more flexible
• Easy to learn
• More accurate = better

control

• Insulin based on food eaten
• Some plans subtract fiber if it

is > 5 grams Carbohydrate Counting

Meals can also be planned by carbohydrate counting. Carbohydrate content of individual foods is totaled up to a specific number for the meal or

• snack. This is a simpler and more

flexible way to plan a meal. It will provide a greater variety of choices. Carbohydrate counting provides a more accurate guess of how blood glucose will rise after a meal or snack and may make it easier to match medication amounts to foods

• consumed. Insulin amounts can be

adjusted before each meal based on the grams of carbohydrate in that meal. Some meal plans allow the individual to decrease the carbohydrate count for a food item if it contains 5 or more grams of fiber. It will be necessary to provide the fiber content of foods for these meal plans.

Although all foods are allowed with meals planned by carbohydrate counting this does not mean that an individual can eat two candy bars and count that as their lunch. It is still important to eat a balanced diet that is limited in sweets.

Slide 9

I tem Amount Carbs Cereal 1 cup 22 Turkey Sausage, Egg & Cheese Pocket

• ne

18 Pineapple Chunks 1/2 cup 15 WW Mini Bagel and Light Cream Cheese 1.7 oz bagel, 1 oz. cream cheese 27 Skim Milk 8 oz 13 LF Chocolate Milk 8 oz 28

Sample Carb Counts

Sample carbohydrate counts are listed

• n this slide. There are a great number
• f web sites and books that provide the

carbohydrate count of foods. Portions can be varied to increase or decrease the carbohydrate content as needed. The school nurse will know which resource your district prefers to use.

Slide 10

I tem Amount Carbs Cereal 1 cup 22 Pineapple 3/4 cup 15 Bagel 1/2 13.5 Light Cream Cheese 1/2 oz Skim Milk 8 oz 13 Total Carb 63.5

Breakfast with 65 carbs

A sample breakfast containing 65 grams of carbohydrate could include: One cup of unsweetened cereal 3/4 cup of fresh pineapple ½ of a 2 ounce bagel ½ ounce light cream cheese And 8 ounces of skim milk. The total carbohydrate count for this meal would be 63.5.

Slide 11

• PPT’s
• General info
• Calculating Recipes
• Carbohydrate Content Lists
• Generic – fruit/veg and other
• ODE commodity
• Processed commodity
• Branded
• Resource List
• Web site

http://www.ode.state.or.us/search/page/?id= 2004

ODE Tools

There are a number of additional tools for serving students with diabetes. These include a PowerPoint with general information and one on calculating the carbohydrate and fiber content of a recipe. There are detailed lists of foods with carbohydrate content and fiber content. These lists include generic items, ODE commodity products, processed commodity items and branded products. There is also a list of additional resources. All of these items can be found at the link on the bottom of this slide.

Slide 12

Questions?

For additional information contact your Specialist at Child Nutrition Programs Oregon Department of Education 503-947-5891

If you have additional questions or comments please contact your specialist in the Child Nutrition Programs at the Oregon Department of Education. Thank you for your interest in learning about meal plans for serving students with diabetes. Your efforts to serve these students well will make an impact

• n their immediate and future health.

Slide 13

The U.S. Department of Agriculture prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/ or employment activities.) I f you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office,

• r call (866) 632-9992 to request the form. You may also write a letter

containing all of the information requested in the form. Send your completed complain form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 I ndependence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov I ndividuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (Spanish). USDA is an equal opportunity provider and employer.