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Many people believe that if you have diabetes, you have to follow a "special" diet and that there are some foods you are never allowed to eat. This simply isn't true.

People with diabetes can still enjoy their favorite foods and can eat some of just about anything they want. But to keep weight and blood-sugar levels in their target range, the American Diabetes Association strongly encourages people with diabetes to work with their health-care team-which should at least include a physician, a certified diabetes educator and/or a registered dietitian-to create customized meal plans based on their individual tastes, lifestyles and ethnic/cultural eating habits. This approach to meal planning has been shown to help lower glucose, lipids and blood -pressure levels, which in turn helps ward off the serious complications associated with diabetes.

New Guidelines About What to Eat
Earlier this year, a panel of experts put together by the association completed its review of a large body of scientific research focused on how the food we eat affects people with diabetes and their health. The association's revised nutritional guidelines, published in January 2002, provides people with diabetes and their health-care providers with the information they need for making choices about what to eat and planning meals.

For example, studies cited in the association's nutritional guidelines found that people with diabetes benefit by eating fewer than 300mg per day of dietary cholesterol. How much of that cholesterol comes from eggs, meat or a small portion of a rich dessert is up to you and your health-care provider, but it's the total amount that counts.

Research suggests that the optimal meal plan for long-term health includes carbohydrates from whole grains, fruits, vegetables and low-fat milk. As with any meal plan, however, it is not enough to pay attention on an occasional basis. In fact, numerous studies have shown that when weight loss and exercise programs are not sustained over time, whatever benefits they may have achieved are lost. For this reason, among others, the association does not recommend fad diets, which have been shown to be extremely difficult to maintain, but rather a plan that you can use every day.

Weight Loss
Obesity is one of the greatest predictors of type 2 diabetes and a major contributor to diabetes-related complications. Yet, nearly 65 percent of American adults now qualify as either overweight or obese, pushing the number of people at risk to a dangerous level.

A major study sponsored by the National Institutes of Health (NIH) and supported by the American Diabetes Association provided encouraging results for people struggling to lose weight: Even moderate weight loss (losing 5-7 percent of body weight) can make a big difference in preventing type 2 diabetes, when combined with a regular exercise program. Other studies have shown that losing weight helps maintain better blood-glucose control, which in turn helps to prevent diabetes-related complications.

Commit to Stay Fit- No Matter What Your Age
The NIH study found that increased physical activity and weight loss reduced the risk of developing type 2 diabetes by up to 60 percent, regardless of age or ethnicity. In fact, changes in exercise and meal planning were more effective for people over the age of 60 than for any other demographic group.

Another study, published in the October 2002 issue of Diabetes Care, showed dramatic results from lifestyle changes in people over 60. Researchers in Australia found that high-intensity resistance training, combined with moderate weight loss, significantly improved glycemic control in people over the age of 60 who already had type 2.

Middle-aged men who have not yet developed diabetes but who are at high risk for it may take heart from another study, published in the September 2002 issue of Diabetes Care, which showed that going to the gym is not the only way to keep diabetes at bay. The study found that moderate or vigorous leisure-time physical activity-in the form of skiing, jogging, swimming, cycling or playing sports-improved the health of middle-aged men in Finland. Men who engaged in at least one hour of vigorous physical activity a week were two-thirds less likely to develop symptoms of the metabolic syndrome-impaired glucose tolerance, high triglycerides, high blood pressure and high levels of fat in the midsection-all of which put a person at risk for diabetes.

No matter your age or sex, a consistent exercise program is key to reducing the risk of diabetes and diabetes-related complications.

Get a Handle On Your Stress
In addition to careful meal planning and increased physical activity, learning to manage stress is an important step for people with diabetes. Everyone knows that stress is unhealthy, but it is part of everyone's life. However, research shows that learning to handle stress can actually reduce average blood-glucose levels significantly. A study released earlier this year found that people with type 2 diabetes who took part in stress-management programs could lower their A1C levels (a measure of blood glucose over a three-month period) by as much as half a percentage point. Previous studies have shown that this is enough of a reduction to lower the risk of developing complications such as retinopathy (damage to the eyes, which can ultimately lead to blindness), stroke and kidney failure.

Carbs Count:
Foods high in carbohydrates-bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt, potatoes, corn, peas, sweets-raise your blood-sugar levels the most. For many people, eating 3 or 4 servings of a carb choice at each meal and 1 or 2 servings at snack time is about right. This gives you the nutrients you need and still helps you keep blood-glucose levels on target.

Watch Serving Sizes:
Consult a registered dietitian and/or certified diabetes educator about serving sizes. For example, for starchy side dishes, 1/2 cup (or the size of a small fist) of rice, noodles or corn counts as a serving. For meat, one serving size of fish or chicken is about the size of a deck of cards. Learn how to check serving sizes. Start with measuring your food at home using measuring spoons, cups and a food scale. You'll get to know the serving sizes and then you can figure out how much to have when you're eating away from home.

Tips for Meal Planning
Check Your Plate:
An easy way to plan meals is to rate your plate:

· Is about one fourth of your plate filled with carbs such as bread, noodles, rice, corn, fruit and milk?
· Is one fourth of your plate filled with main-dish (protein) foods such as meat, poultry, fish or meat substitute?
· Is at least half of your plate filled with vegetables (salad or cooked vegetables such as carrots, broccoli or spinach)?

Check Your Blood Sugar:
Monitor your blood-sugar levels on a regular basis to see how your food choices are affecting your levels. If you can't use your meal plan or it isn't working, ask your health-care provider or dietitian to help you make a new one.

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