By Michelle May, M.D.
Co-Author of Eat What You Love, Love What You Eat with Diabetes
For those already familiar with the concepts of mindful eating and intuitive eating, you understand the challenges of applying these non-restrictive approaches when someone has specific dietary needs or a chronic condition that is impacted by what you eat (as if there are any conditions that aren't impacted by what you eat!).
In fact, it's one of the most common questions I get from audience members and other health professionals when I present on mindful eating: "But what do you do when you can't eat what you love because you have diabetes?" they ask.
My answer: People will eat what they love anyway so you might as figure out how to balance eating for enjoyment with eating for nourishment - and in this case, for optimal blood glucose management.
All Foods Can Fit
We know (as you do) that rigidity just doesn't work long term so we simply aren't interested in giving people a bunch of unsustainable rules to follow. Instead, like many other health professionals, we fully embrace the "all foods can fit" philosophy using the principles of balance, variety, and moderation. Mindful eating is perfect for learning how to eat what you love in moderation while eating a varied and balanced diet. (Our recent series of posts on the debate about butter vs. margarine is a good example of how mindful eating is applied to complex nutrition questions.)
As you can imagine, while we were writing Eat What You Love, Love What You Eat with Diabetes, we had many long conversations about how to balance our non-restrictive approach with the goal of achieving target blood glucose levels. We were nearly finished with the first draft of the manuscript when the launch of MyPlate was announced. First it was "Argggghhhh!" then it was "Aha!" We quickly agreed that this simple visual icon of a balanced meal was a practical way to convey complex nutrition information for a healthy diet. So we went back to the drawing board - literally!
Eat What You Love, Love What You Eat with Diabetes Plate
Unfortunately MyPlate doesn't yet have a version for people with diabetes (or allow significant modification of the original graphic), so we designed a new Eat What You Love, Love What You Eat with Diabetes Plate to help people with diabetes apply MyPlate tools. Download Eat What You Love Love What You Eat with Diabetes Plate with Tips
As you can see, the key difference is that we put the foods that contain a significant amount of carbohydrate (grains and starchy vegetables, fruit, and dairy) in the upper right quadrant of the graphic. (Each serving is approximately 15 grams of carbohydrate.) This helps readers adjust the total amount of carbohydrate they eat at each meal or snack so their carbohydrate intake doesn’t exceed their body’s ability to process the glucose.
Mindful Meal Planning
As we say in chapter 7, Mindful Meal Planning, "Our goal is to teach you what you need to know about nutrition to manage your blood glucose and keep yourself healthy. Simultaneously, we want to give you a flexible approach to eating that is enjoyable and sustainable."
Since people eat food, not macronutrients, we like the plate planning method. Here's a brief summary of some of the key concepts for mindful meal planning that we explain throughout the Nourish chapters in the book. (PLEASE, don't take this out of context; WHAT you eat is only one part of the Mindful Eating Cycle!)
- Start by picturing your meal and visually dividing your plate in half.
- Fill the left half of your plate with salad and other low-carbohydrate vegetables.
- Divide the other half of your plate in half again and put lean protein in the bottom section.
- Your carbohydrate choices - grains, starchy vegetables, fruit, and dairy - go in the top right.
- A carbohydrate choice contains approximately 15 grams of carbohydrate. Adjust the number of servings for your carbohydrate goal.
- Add healthy fats in moderation for flavor, satiety, and more stable blood glucose levels.
- If you are having dessert, replace one or more of your carbohydrate choices with the desired sweets.
From this foundation, we build a mindful all foods can fit approach. And yes, that does include sweets and desserts! (Watch for a blog post about that coming soon.) With awareness of nutrition and meal planning techniques, you can design flexible meals and snacks that are nourishing and satisfying and that help you keep your blood glucose in the target range.