It is important to eat the right amount of calories to help you reach and stay at a reasonable body weight. The amount of calories you need depends on your size, age and activity level. Eating the right number of calories is important for many reasons. Eating too many calories cause weight gain, which will worsen diabetes and increase your risks for high blood pressure and heart disease. Your body makes and/or uses insulin best when you are at your desirable weight.

It is also important to limit the amount of fat in your diet , because high levels of blood fats are associated with heart disease. People with diabetes run a greater risk of developing heart disease than other people.

Good nutrition. It is important to eat a variety of food each day. Your body works better if you eat a balanced diet that includes the right amounts of vitamins, minerals, carbohydrate, protein, and fat. Carbohydrate is the major source of energy. Protein builds muscle and tissue and provides some energy. Fat is the storage form of energy. Most foods contain a mixture of these. A carbohydrate has four calories per gram of weight, and is found in starches, bread, fruit, vegetables, and milk. Protein also has four calories per gram of weight. Protein is found in meat and milk, and small amounts of protein are found in starches, bread and vegetables. Fat is higher in calories - nine calories per gram of weight. Fat is found in meat, dairy products, oils and nuts. Insulin is needed to use carbohydrate, protein and fat properly.

Here are some principles of good nutrition:

 Eat less fat. The average American adult eats too much fat. Too much fat may cause heart and blood vessel disease. Eat fish, poultry, and other lean meats. Watch your portion sizes of all meat - it's easy to eat too much. Eat fewer high-fat foods such as cold cuts, bacon, gravy, salad dressing, margarine, and solid shortening. Drink skim or low fat milk and eat less ice cream, butter and cheese.

 Eat more complex carbohydrates, those high in fiber. Carbohydrate foods are a good source of energy, vitamins, and minerals. Fiber in foods may help to lower blood-glucose and blood-fat levels. All people should increase the amount of carbohydrate and fiber they eat. This can be done by eating more dried beans, peas, and lentils; more whole grain breads, cereals, and crackers; and more fruit and vegetables. Foods that are high in fiber are noted in this site.

 Eat less sugar. All people, including those with diabetes, should eat less sugar. Sugar has lots of calories and no vitamins or minerals, and it causes dental cavities. Foods high in sugar include: desserts such as frosted cake and pie, sugary breakfast foods, table sugar, honey, and syrup. One 12-ounce can or regular soft drink has nine teaspoons of sugar.

 Eat foods with a low Glycemic Index level. T he glycemic index (GI) ranks foods on how they affect our blood sugar levels. This index measures how much your blood sugar increases in the two or three hours after eating. The glycemic index is about foods high in carbohydrates. Foods high in fat or protein don't cause your blood sugar level to rise much. A lot of people still think that it is plain table sugar that people with diabetes need to avoid. The experts used to say that, but the glycemic index shows that even complex carbohydrates, like baked potatoes, can be even worse. When you make use of the glycemic index to prepare healthy meals, it helps to keep your blood sugar levels under control. This is especially important for people with diabetes, although athletes and people who are overweight also stand to benefit from knowing about this relatively new concept in good nutrition.

 Use less salt. Most of us eat too much salt. The sodium in salt can cause the body to retain water, and in some people it may raise blood pressure. High blood pressure is made worse by eating too much salt and sodium. Try to use less salk in cooking and at the table. Foods that are high in sodium, such as processed and convenience foods, are noted in this site.

 Use alcohol in moderation. It is best to avoid alcohol altogether. If you like to have an alcoholic drink now and then, ask your dietitian how to work it into your meal plan. If you take insulin, it is important to eat food with your drink.

A diabetes meal plan and the exchange lists will help you to meet all these goals. The first step is to talk with your dietitian, who will determine your daily nutritional needs and help you work out your own nutritional needs prescription. This prescription will match the calories, carbohydrate, protein, and fat you eat with your own activity level, and with the insulin in your body.

You and your dietitian can work out a specific meal plan for you. Your meal plan is a guide which shows the number of food choices (exchanges) you can eat at each meal and snack. Your meal plan is designed so that you will eat more than half of your total daily calories as carbohydrate, and you will eat less fat and protein.

The six exchange lists help to make your meal plan work. Foods are grouped together on a list because they are alike. Every food on a list has about the same amount of carbohydrate, protein, fat and calories. In the amounts given, all the choices on each list are equal. Any food on a list can be exchanged or traded for any other food on the same list.

The six lists are: starch,/bread, meat and substitutes, vegetables, fruit, milk and fat.

Using the exchange lists and following your meal plan will provide you with a great variety of food choices, and will control the distribution of calories, carbohydrate, protein and fat throughout the day, so that your food and your insulin will be balanced. This balance is what gives you good blood-glucose control.

Different meal plans for the different types of diabetes:

Insulin-Dependent Diabetes. The most important nutrition principle for people with insulin-dependent diabetes is consistency. Meals should be eaten at about the same time each day. The amounts and types of food eaten at each meal should be about the same from day to day. This is important because the food you eat is planned to balance your insulin injections and your activity. Your meal plan and the exchange lists can help you to be consistent, so that your food and insulin work together to regulate your blood-glucose levels. If your meal plan and your insulin are out of balance, wide swings in blood-glucose can occur. You may suffer from insulin reactions or from the symptoms of high blood glucose.

Non-Insulin-Dependent Diabetes. Most people with non-insulin-dependent diabetes are over-weight. Thus, the most important nutrition principle for people with this type of diabetes is weight control. You can lose weight by eating less food and increasing your exercise. it is still important to eat a balanced diet, even while losing weight. Your dietitian will help you determine the number of calories you need and set weight goals and give you tips to help you reach those goals.

You may have to change the way you eat. Many people ask if they can eat the same food as the rest of their family. The diabetes meal plan is not much different from the way everyone should eat. However, it is true that many people do not eat in such a healthy way. And it's very hard to change habits, especially about food. Just remember - make changes gradually, set short-term goals, and reward yourself when you are successful.

To make your meal plan work, you will need to eat what is prescribed for you. Serving sizes are very important to the success of your meal plan. If you eat too much food or too little food, your blood-glucose regulation and your weight will be affected. To help you estimate serving sizes accurately, you will need to measure or weigh your food for the first week or so, and again periodically as time goes on to see how you're doing. Suggestions for how to measure your serving sizes are included in the "Management Tips" section of this site.

It is very important to see your dietitian regularly when you are first learning how to use your meal plan and the exchange lists. Your meal plan can be adjusted if it is not working out for you. The only way to make it right is to see your dietitian and solve the problems.

Your meal plan may need to be changed as time goes on. Changes in lifestyle such as work, school, vacation or travel require adjustments in your meal plan. Your weight may change, your eating habits may change, your activity may change - any of these changes means you may need a new meal plan. As children grow they need more calories, and when they reach adulthood they need fewer. Check in with your dietitian regularly to review your meal plan, ask any questions you may have, and learn about new nutrition information. Regular nutrition counseling can help you make positive changes in your eating habits.

Remember, your meal plan is written just for you - it takes your likes and dislikes into consideration. It is flexible and can be adjusted for your varying needs. it is intended to help you achieve your nutrition goals. You can change your eating habits, and you'll feel better and be healthier, too.