living with diabetes: ingredients, labels, recipe modification & eating out

2005 Oklahoma Cooperative Extension Service 1

Living with Diabetes:Living with Diabetes:Ingredients, Labels, Ingredients, Labels,

Recipe Modification & Recipe Modification & Eating OutEating Out

Barbara Brown, Ph.D., Barbara Brown, Ph.D., R.D./L.D.R.D./L.D.

Food SpecialistFood SpecialistOklahoma Cooperative Oklahoma Cooperative

Extension ServiceExtension Service


Today we willToday we will

• Examine features of food labels Examine features of food labels important for diabetics to read & important for diabetics to read & understandunderstand

• Look at functions of ingredients in Look at functions of ingredients in food & available market food & available market substitutionssubstitutions

• Receive tips for recipe modificationReceive tips for recipe modification• Learn suggestions for eating out Learn suggestions for eating out

with diabeteswith diabetes


Food labels:Food labels:Key points for diabeticsKey points for diabetics

• Ingredient listIngredient list• Nutrition Facts panelNutrition Facts panel•Serving sizeServing size•% Daily Value% Daily Value

• Nutrient content claimsNutrient content claims• Health claimsHealth claims


Ingredient listIngredient list

• In descending order by weightIn descending order by weight• Need to know terms for Need to know terms for

carbohydrates & fatcarbohydrates & fat


Several formats Several formats availableavailable


Using Nutrition FactsUsing Nutrition Facts• Top changes with foodTop changes with food

• Product-specific info. Product-specific info. (serving size, calories, (serving size, calories, nutrient info.nutrient info.

• Bottom footnote with Bottom footnote with Daily Values for 2,000 & Daily Values for 2,000 & 2,500 calorie diets 2,500 calorie diets • Found only on larger Found only on larger

packagespackages• Does not changeDoes not change


Serving sizeServing size

• Standardized to ease comparison Standardized to ease comparison of similar foodsof similar foods

• Amounts usually eaten at 1 timeAmounts usually eaten at 1 time• Given in household & metric Given in household & metric

measuresmeasures


Serving size vs. Serving size vs. exchangesexchanges

• Nutrition Facts serving may not equal Nutrition Facts serving may not equal exchange servingexchange serving• ExamplesExamples

•Fruit juice: Fruit juice: •Nutrition Facts = 1 c, exchange = Nutrition Facts = 1 c, exchange = 1/2 cup1/2 cup

•Oatmeal: Oatmeal: •Nutrition Facts = 1 Nutrition Facts = 1 •Exchange = 1/2 cupExchange = 1/2 cup


Daily ValuesDaily Values• Made of 2 dietary Made of 2 dietary

standardsstandards•Daily Reference Daily Reference

Values (DRVs)Values (DRVs)•Reference Daily Reference Daily

Intakes (RDIs)Intakes (RDIs)• Only “Daily Value” Only “Daily Value”

appears on labelappears on label• Based on 2000 cal Based on 2000 cal

dietdiet

% Daily Value


TransTrans fat fat

• Required by 1/1/06Required by 1/1/06• Increases low-Increases low-

density lipoprotein density lipoprotein (LDL) cholesterol (LDL) cholesterol levelslevels• Raises risk of Raises risk of

coronary heart coronary heart diseasedisease


Hydrogenation changes Hydrogenation changes shapeshape

Unsaturated fatUnsaturated fat TransTrans Fat Fat

H | -C = C- |

H

H H | |-C = C-


Using Using TransTrans fat fat informationinformation

• Combine grams Combine grams saturated fat & saturated fat & transtrans fat & fat & look for lowest look for lowest combined combined amountamount

• Look for lowest Look for lowest % Daily Value % Daily Value for cholesterolfor cholesterol


Making the best fat Making the best fat choicechoice

Butter Margarine, stick

Saturated Fat : 2g+ Trans Fat : 3g

Combined Amt: 5gCholesterol: 0%

Saturated Fat: 7g+ Trans Fat: 0g



Making the best fat Making the best fat choicechoice

Margarine, stick

Saturated Fat: 2g+ Trans Fat: 3g


Margarine, tub

Saturated Fat: 1g+ Trans Fat: 0.5g

Combined Amt: 1.5gCholesterol: 0%


Nutrient content claim: Nutrient content claim: freefree

• No, only trivial or "physiologically No, only trivial or "physiologically inconsequential" amount of 1 or more inconsequential" amount of 1 or more of:of:• fat, saturated fat, cholesterol, fat, saturated fat, cholesterol,

sodium, sugars, caloriessodium, sugars, calories•"calorie-free" = less than "calorie-free" = less than 5/serving5/serving

•"sugar-free" & "fat-free" = less "sugar-free" & "fat-free" = less than 0.5g/servingthan 0.5g/serving

• Synonyms: "without," "no," "zero"Synonyms: "without," "no," "zero"


Nutrient content claim: Nutrient content claim: lowlow

• Can be used on foods that can be Can be used on foods that can be eaten frequently without eaten frequently without exceeding dietary guidelines for exceeding dietary guidelines for one or more of: one or more of: •Fat, saturated fat, cholesterol, Fat, saturated fat, cholesterol,

sodium, and calories sodium, and calories


Low: descriptors Low: descriptors • low-fat: 3g or less/serving low-fat: 3g or less/serving • low-saturated fat: 1g or less/serving low-saturated fat: 1g or less/serving • low-sodium: 140mg or less/serving low-sodium: 140mg or less/serving • very low sodium: 35mg or less/serving very low sodium: 35mg or less/serving • low-cholesterol: 20mg or less & 2g or low-cholesterol: 20mg or less & 2g or

less of saturated fat/serving less of saturated fat/serving • low-calorie: 40 calories or less/servinglow-calorie: 40 calories or less/serving


““Low-carb” labelingLow-carb” labeling

• ““Net carbs,” “effective carbs”Net carbs,” “effective carbs”•No federal regulation definesNo federal regulation defines•Typically used as result when Typically used as result when

fiber & certain sweeteners fiber & certain sweeteners (sugar alcohols & glycerin) are (sugar alcohols & glycerin) are subtracted from total subtracted from total carbohydrate contentcarbohydrate content


Lean & extra leanLean & extra lean• Can describe fat content of meat, Can describe fat content of meat,

poultry, seafood, & game meatspoultry, seafood, & game meats•Lean:Lean: less than 10g fat, 4.5g or less than 10g fat, 4.5g or

less saturated fat, & less than less saturated fat, & less than 95mg cholesterol/serving & per 95mg cholesterol/serving & per 100g100g

•Extra lean:Extra lean: less than 5g fat, less less than 5g fat, less than 2g saturated fat, & less than 2g saturated fat, & less than 95mg cholesterol/serving & than 95mg cholesterol/serving & per 100g per 100g


More nutrient content More nutrient content claimsclaims

• High:High: food contains 20% or more food contains 20% or more of %DV for a particular of %DV for a particular nutrient/servingnutrient/serving

• Good source:Good source: food contains 10- food contains 10-19% of %DVfor a particular 19% of %DVfor a particular nutrient/servingnutrient/serving


ReducedReduced

• Nutritionally altered food Nutritionally altered food contains at least 25% less of a contains at least 25% less of a nutrient or calories than the nutrient or calories than the regular foodregular food•Claim can't be made if regular Claim can't be made if regular

food already meets food already meets requirement "low" claimrequirement "low" claim


LessLess

• Food, whether altered or not, Food, whether altered or not, contains 25% less of a nutrient contains 25% less of a nutrient or calories than the regular foodor calories than the regular food


Meanings of LightMeanings of LightMeanings of LightMeanings of Light

• 1/3 fewer calories or 1/3 fewer calories or 1/2 fat of reference 1/2 fat of reference foodfood

• Sodium content of low-Sodium content of low-calorie, low-fat food calorie, low-fat food lowered 50%lowered 50%

• Can describe texture Can describe texture &/or color&/or color•Label must explain Label must explain

intentintent


When label says When label says “More”“More”

• 1 serving contains a nutrient 1 serving contains a nutrient that is at least 10% of Daily that is at least 10% of Daily Value more than in reference Value more than in reference foodfood


Health claimsHealth claims

• Describe how food or Describe how food or food component food component relates to a disease or relates to a disease or health-related health-related conditioncondition

• Wording regulated by Wording regulated by FDAFDA


3 types of health claims3 types of health claims

1.1. ApprovedApproved

2.2. AuthorizedAuthorized

3.3. Qualified health claimsQualified health claims


1.1. Approved health Approved health claimsclaims

• 1990 Nutrition Labeling & 1990 Nutrition Labeling & Education Act (NLEA) provides Education Act (NLEA) provides for FDA to issue regulations for FDA to issue regulations authorizing health claims for authorizing health claims for foods & dietary supplements foods & dietary supplements after FDA's careful review of after FDA's careful review of scientific evidence submitted in scientific evidence submitted in petitionspetitions


Approved health claimsApproved health claims

• Calcium & osteoporosisCalcium & osteoporosis• Sodium & hypertensionSodium & hypertension• Dietary fat & cancerDietary fat & cancer• Dietary saturated fat & Dietary saturated fat &

cholesterol & risk of coronary cholesterol & risk of coronary heart disease (CHD)heart disease (CHD)



• Fiber-containing grain products, Fiber-containing grain products, fruits, & vegetables & cancer fruits, & vegetables & cancer

• Fruits, vegetables & grain Fruits, vegetables & grain products that contain fiber, products that contain fiber, particularly soluble fiber, & particularly soluble fiber, & risk of CHDrisk of CHD

• Fruits & vegetables & cancerFruits & vegetables & cancer



• Folate & neural tube defectsFolate & neural tube defects• Dietary sugar alcohol & dental Dietary sugar alcohol & dental

cariescaries• Soluble fiber from certain foods Soluble fiber from certain foods

& risk of CHD& risk of CHD• Soy protein & risk of CHDSoy protein & risk of CHD• Plant sterol/stanol esters & Plant sterol/stanol esters &

CHD riskCHD risk


2.2. Authorized health Authorized health claimsclaims

• 1997 FDA Modernization Act 1997 FDA Modernization Act (FDAMA) provides for health (FDAMA) provides for health claims based on an claims based on an authoritative statement of a authoritative statement of a scientific body of the U.S. scientific body of the U.S. government or National government or National Academy of SciencesAcademy of Sciences

• Such claims may be used after Such claims may be used after submission of notification to submission of notification to FDA FDA


Claims authorized based on Claims authorized based on authoritative statements authoritative statements

by federal scientific bodiesby federal scientific bodies

• Whole grain foods & risk of heart Whole grain foods & risk of heart disease & certain cancersdisease & certain cancers

• Potassium & risk of high blood Potassium & risk of high blood pressure & strokepressure & stroke


3.3. Qualified health Qualified health claimsclaims

• 2003 FDA 2003 FDA Consumer Health Consumer Health Information for Better Nutrition Information for Better Nutrition InitiativeInitiative provides for qualified provides for qualified health claims where the quality health claims where the quality and strength of scientific evidence and strength of scientific evidence falls below that required to issue falls below that required to issue an authorizing regulationan authorizing regulation

• Claims must be qualified to assure Claims must be qualified to assure accuracy & non-misleading accuracy & non-misleading presentation to consumerspresentation to consumers


Allowed qualified health Allowed qualified health claimsclaims

• CHD riskCHD risk•Nuts, walnutsNuts, walnuts•Omega-3 fatty acidsOmega-3 fatty acids•B vitamins & vascular diseaseB vitamins & vascular disease•Monounsaturated fatty acids Monounsaturated fatty acids

from olive oilfrom olive oil• Neural tube defectsNeural tube defects•0.8mg folic acid0.8mg folic acid


Ingredients of concernIngredients of concernto diabeticsto diabetics

• Carbohydrates Carbohydrates •Simple—SugarsSimple—Sugars•Complex—starches Complex—starches •Fiber—indigestible Fiber—indigestible

carbohydratescarbohydrates•Low-calorie sweetenersLow-calorie sweeteners

• FatsFats• SodiumSodium


Simple carbohydrates—Simple carbohydrates—Sugars or caloric Sugars or caloric

sweetenerssweeteners• Occur naturally in fruits, dairy Occur naturally in fruits, dairy

products, some vegetables, products, some vegetables, honey, molasseshoney, molasses

• Refined sugars used in Refined sugars used in processing & as sweetenerprocessing & as sweetener

• Most high sugar foods have Most high sugar foods have lower nutritional valuelower nutritional value


Functions of sugar in Functions of sugar in foodsfoods

• SweetenerSweetener• Tenderizer in bakingTenderizer in baking• Caramelize under heatCaramelize under heat• Enhance growth of Enhance growth of

yeastyeast• Control gelling process Control gelling process

in jellies/preservesin jellies/preserves• PreservativePreservative



• Add to smoothness of frozen Add to smoothness of frozen dessertsdesserts

• Increase consumption of nutrient-Increase consumption of nutrient-rich foods that would probably rich foods that would probably not be eatennot be eaten•Examples: oatmeal, grapefruit, Examples: oatmeal, grapefruit,

cranberriescranberries• Incorporate air into shortening Incorporate air into shortening

during creamingduring creaming



• Stabilize egg foamsStabilize egg foams• Delay coagulation of egg Delay coagulation of egg

proteins in custardsproteins in custards• Improve appearance & Improve appearance &

tenderness of canned fruitstenderness of canned fruits• Help retain color & flavor of Help retain color & flavor of

frozen fruitsfrozen fruits• Enable wide variety of candies Enable wide variety of candies

through varying degrees of through varying degrees of recrystallizationrecrystallization


Caloric sweetener Caloric sweetener choiceschoices

• Table sugar is most commonTable sugar is most common•Contains glucose + fructoseContains glucose + fructose• Includes light & dark brown Includes light & dark brown

sugarsugar• Other high sugar ingredientsOther high sugar ingredients•HoneyHoney•Molasses Molasses •Corn syrupCorn syrup•Maple syrupMaple syrup


Ingredient label words Ingredient label words meaning sugarmeaning sugar

• SucroseSucrose• FructoseFructose• GalactoseGalactose• GlucoseGlucose• High-fructose High-fructose

corn syrup corn syrup (HFCS)(HFCS)

• LactoseLactose• MaltoseMaltose• Other “ose” Other “ose”

wordswords


More label termsMore label terms

• ““Naturally occurring sugars”Naturally occurring sugars”•Those in food/beverages that Those in food/beverages that

come from ingredients come from ingredients themselvesthemselves•Fruits, vegetables, milkFruits, vegetables, milk

• ““Added sugars”Added sugars”•Added during manufacturing, Added during manufacturing,

cooking, at tablecooking, at table•Sucrose, corn syrup, HFCS, Sucrose, corn syrup, HFCS, honey, molasses, etc.honey, molasses, etc.


““No sugar added”No sugar added”

• No form of sugar added during No form of sugar added during processingprocessing

• No high-sugar ingredientsNo high-sugar ingredients• May still be high in carbohydrateMay still be high in carbohydrate• Read Nutrition Facts panelRead Nutrition Facts panel


Food Categories% of total added sugars consumed

Regular soft drinks 33.0

Sugars and candy 16.1

Cakes, cookies, pies 12.9

Fruit drinks 9.7

Dairy desserts & sweetened milk foods

8.6

Other grains 5.8

Major sources of addedsugars in U.S. diet

Source: Dietary Guidelines for Americans 2005


FructoseFructose• A monosaccharideA monosaccharide• Added to foods in liquid or Added to foods in liquid or

crystalline formcrystalline form•Crystalline form made from Crystalline form made from

corn starchcorn starch


Liquid form: High fructose Liquid form: High fructose corn syrup (HFCS)corn syrup (HFCS)

• Glucose + fructoseGlucose + fructose• Made from corn syrupMade from corn syrup• Examples: Examples: •HFCS 42 used in baking (42% HFCS 42 used in baking (42%

fructose)fructose)•HFCS 55 used in beverages HFCS 55 used in beverages

(55% fructose)(55% fructose)


HFCS & foodsHFCS & foods• Amount eaten has risen in parallel Amount eaten has risen in parallel

with increasing obesitywith increasing obesity•Does not prove HFCS causes Does not prove HFCS causes

obesityobesity•Proportion of total sugar in diet Proportion of total sugar in diet

has remained constant since 1970 has remained constant since 1970 (15-16%)(15-16%)•Table sugar has gone downTable sugar has gone down

• Total caloric intake rose from 3300 Total caloric intake rose from 3300 to 3900/person from 1970-2000to 3900/person from 1970-2000•Based on availability dataBased on availability data


Sugar substitutes Sugar substitutes (low-calorie sweeteners)(low-calorie sweeteners)

• Don’t affect blood sugar levelsDon’t affect blood sugar levels• Some foods containing artificial Some foods containing artificial

sweeteners can still affect blood sweeteners can still affect blood sugar because of other sugar because of other carbohydrates or proteins in the carbohydrates or proteins in the foodsfoods

• Foods containing artificial Foods containing artificial sweeteners may be sugar-free but sweeteners may be sugar-free but may not be carbohydrate-freemay not be carbohydrate-free


Choosing sugar-free foods:Choosing sugar-free foods:read labels carefullyread labels carefully

• Compare carb content of sugar-Compare carb content of sugar-free with standard foodfree with standard food•Big difference—may be reason Big difference—may be reason

to buy sugar-freeto buy sugar-free•Little difference—base choice Little difference—base choice

on taste, coston taste, cost


Potential benefits to Potential benefits to diabeticsdiabetics

• Offer way to control caloric intakeOffer way to control caloric intake• Help with weight control & weight Help with weight control & weight

lossloss•Help reduce calorie intake & Help reduce calorie intake &

therefore help lose weighttherefore help lose weight• Provide greater variety of low Provide greater variety of low

calorie foods & beveragescalorie foods & beverages•Easy to incorporated into dietEasy to incorporated into diet


ProductCalories

withSugar

With Low-Cal. Sweeten

er

Cal.Save

d

Soft drink (12 oz.)

150 0 150

Coffee (1 cup) 35 5 30

Strawberry yogurt(1 cup)

230 100 130

Vanilla ice cream(1/2 cup)

170 90 80

Gelatin dessert(1/2 cup)

70 10 60

Chocolate pudding(1/2 cup)

160 80 80


Low-calorie sweetenersLow-calorie sweeteners

• Sweet taste with few or no Sweet taste with few or no caloriescalories

• Undergo extensive safety testingUndergo extensive safety testing• All FDA-approved meet same All FDA-approved meet same

safety standardsafety standard• Will not perform most of sugar’s Will not perform most of sugar’s

functions in recipesfunctions in recipes


Currently approved low-Currently approved low-calorie sweetenerscalorie sweeteners

SweeteneSweetenerr

Brand namesBrand names Times sweeter Times sweeter than sucrosethan sucrose

Acesulfame Acesulfame potassiumpotassium

Sweet One, Sweet One, Swiss Sweet, Swiss Sweet, SunettSunett

600 600

AspartameAspartame NutraSweet, NutraSweet, EqualEqual 200200

SaccharinSaccharin Sweet N Low, Sweet N Low, Sugar TwinSugar Twin 300300

SucraloseSucralose Splenda Splenda 600600


Currently approved low-Currently approved low-calorie sweetenerscalorie sweeteners

SweetenerSweetener Times sweeter Times sweeter than sucrosethan sucrose

NeotameNeotame 7,000-13,0007,000-13,000

Tagatose (made Tagatose (made from lactose)from lactose) Almost the sameAlmost the same

BlendsBlends Synergistic Synergistic effectseffects


Problems using low-calorie Problems using low-calorie sweeteners in foodsweeteners in food

• Perform few of the functions of Perform few of the functions of sugarsugar•Do add sweetnessDo add sweetness•Some add bulkSome add bulk

• Aspartame/NutraSweet looses flavor Aspartame/NutraSweet looses flavor when heatedwhen heated

• Saccharin becomes bitter when Saccharin becomes bitter when heatedheated

• Use recipe formulated for productUse recipe formulated for product


Sugar alcoholsSugar alcohols

• ““Polyols”Polyols”• Chemical structure resembling Chemical structure resembling

both sugar & alcoholboth sugar & alcohol•Contain no ethanol like alcoholic Contain no ethanol like alcoholic

beveragesbeverages• Most are half as sweet as sucroseMost are half as sweet as sucrose•Maltitol & xylitol almost = Maltitol & xylitol almost =

sweetness of sucrosesweetness of sucrose


Sugar alcohols & calories Sugar alcohols & calories

• Incompletely metabolized & Incompletely metabolized & absorbed so body gets fewer absorbed so body gets fewer caloriescalories•1.5 to 3 calories/gram1.5 to 3 calories/gram

• Often combined with low-calorie Often combined with low-calorie sweetenerssweeteners


Occurrence of sugar Occurrence of sugar alcoholsalcohols

• Naturally in fruits & vegetablesNaturally in fruits & vegetables• Commercially produced from Commercially produced from

sucrose, glucose, starchsucrose, glucose, starch


Functions in foodFunctions in food

• Add bulk & textureAdd bulk & texture•Replace sugar 1:1Replace sugar 1:1•Also used to replace fatAlso used to replace fat

• Provide cooling effect or tasteProvide cooling effect or taste• Inhibit browning that occurs Inhibit browning that occurs

during heatingduring heating• Retain moisture in foodRetain moisture in food• Lower calories in foodLower calories in food


Sugar alcohols in foodsSugar alcohols in foods

Sugar Sugar alcohoalcoho

ll

Cal/Cal/

gragramm

Approx. Approx. sweetnessweetnes

s s (sucrose (sucrose = 100%)= 100%)

Typical food Typical food applicationsapplications

Sorbitol Sorbitol 2.62.6 50-70%50-70%Candies, chewing gum, Candies, chewing gum, frozen desserts, baked frozen desserts, baked goodsgoods

XylitolXylitol 2.42.4 100%100%Chewing gum, gum Chewing gum, gum drops, hard candy, drops, hard candy, specialty foodsspecialty foods

MaltitolMaltitol 2.12.1 75%75%Hard candy, chewing Hard candy, chewing gum, chocolates, baked gum, chocolates, baked goods, ice creamgoods, ice cream

IsomaltIsomalt 2.02.0 45-65%45-65% Candies, toffee, lollipops, Candies, toffee, lollipops, fudge, wafersfudge, wafers



Sugar Sugar alcoholalcohol

Cal/Cal/

gragramm

Approx. Approx. sweetnesweetne

ss ss (sucrose (sucrose = 100%)= 100%)


LactitolLactitol 2.02.0 30-40%30-40%

Chocolate, some Chocolate, some baked goods, hard & baked goods, hard & soft candy, frozen soft candy, frozen dairy dessertsdairy desserts

MannitoMannitoll

1.61.6 50-70%50-70%

Dusting powder for Dusting powder for chewing gum, chewing gum, chocolate-flavored chocolate-flavored coating for ice cream coating for ice cream & confections& confections



Sugar Sugar alcoholalcohol

Cal/Cal/

gragramm

Approx. Approx. sweetnesweetne

ss ss (sucrose (sucrose = 100%)= 100%)


ErythritolErythritol 0.20.2 60-80%60-80%Bulk sweetener Bulk sweetener in low calorie in low calorie foodsfoods

HydrogenatHydrogenated starch ed starch hydrolysatehydrolysates (HSH)s (HSH)

3.03.0 25-30%25-30%

Bulk sweetener Bulk sweetener in low calorie in low calorie foods, provide foods, provide sweetness, sweetness, texture & bulk to texture & bulk to variety of variety of sugarless foodssugarless foods


Labeling & sugar Labeling & sugar alcoholsalcohols

• Must include names on ingredient Must include names on ingredient list list

• Nutrition FactsNutrition Facts•Company may declare Company may declare voluntarilyvoluntarily

the number of grams/serving the number of grams/serving •If more than 1 in food, must If more than 1 in food, must use phrase “sugar alcohol”use phrase “sugar alcohol”

•RequiredRequired if “sugar-free” or “no if “sugar-free” or “no sugar added” claim is madesugar added” claim is made


Modifying sugar in Modifying sugar in recipesrecipes

• Identify ingredient(s) to changeIdentify ingredient(s) to change•Sugar, brown sugar, honey, Sugar, brown sugar, honey,

molasses, corn syrup, maple molasses, corn syrup, maple syrupsyrup

• Consider function in recipeConsider function in recipe• Options Options

1.1.Leave it aloneLeave it alone2.2.Reduce amountReduce amount3.3.Replace with other sweetenerReplace with other sweetener4.4.Leave it outLeave it out


General suggestionsGeneral suggestions• Baked goods & desserts: cut by 1/4-Baked goods & desserts: cut by 1/4-

1/21/2• In quick bread, cookies, pie In quick bread, cookies, pie

fillings, custard, puddings, & fruit fillings, custard, puddings, & fruit crispscrisps

•Less desirable for some cakesLess desirable for some cakes•Don’t decrease sugar in plain Don’t decrease sugar in plain

yeast breadsyeast breads• Increase sweet spices, vanillaIncrease sweet spices, vanilla•Raises impression of sweetnessRaises impression of sweetness


General suggestionsGeneral suggestions

• Decrease or Decrease or eliminate sugar eliminate sugar when canning &/or when canning &/or freezing fruits freezing fruits

• Use unsweetened Use unsweetened frozen fruit or frozen fruit or fruit canned in fruit canned in juice or waterjuice or water


Complex carbohydratesComplex carbohydrates

• StarchStarch• Primary part of:Primary part of:•Grains (bread, rice, Grains (bread, rice,

pasta)pasta)•PotatoesPotatoes•BeansBeans•Some vegetablesSome vegetables


Reducing carbohydrates in Reducing carbohydrates in traditional foodstraditional foods

• Has been done Has been done in breads, pasta, in breads, pasta, cereals, cookies, cereals, cookies, cakes, juice, soft cakes, juice, soft drinks, candydrinks, candy


Methods to reduce Methods to reduce carbohydratescarbohydrates

• Increase amount of animal or Increase amount of animal or vegetable proteinvegetable protein•Replacing wheat or corn flour Replacing wheat or corn flour

with soy flourwith soy flour•Examples: soy-based chips, Examples: soy-based chips,

pasta, breadspasta, breads



• Increasing fiberIncreasing fiber•Example: fiber such as Example: fiber such as

cellulose replaces digestible cellulose replaces digestible form of carbohydrateform of carbohydrate

•Used in candy, cereals, bread, Used in candy, cereals, bread, pastapasta



• Sugar substitutes or Sugar substitutes or sugar alcohols (polyols) sugar alcohols (polyols) used in place of used in place of traditional sweetenerstraditional sweeteners•Used in soft drinks, Used in soft drinks,

fruit drinks, baked fruit drinks, baked goods, frozen dessertsgoods, frozen desserts



• Smaller portionsSmaller portions•Used for baked goodsUsed for baked goods•Bread—thinner Bread—thinner slicesslices

•Desserts—smaller Desserts—smaller pieces or pieces or less/single serving less/single serving containercontainer


Dietary fiberDietary fiber

• Excellent source contains five Excellent source contains five grams or more/servinggrams or more/serving

• A good source contains 2.5—4.9 A good source contains 2.5—4.9 grams/servinggrams/serving


Ingredients that indicate Ingredients that indicate fiberfiber

• Fruits & vegetables, especially Fruits & vegetables, especially those with edible skin (apples, those with edible skin (apples, beans) & those with edible seeds beans) & those with edible seeds (berries, summer squash)(berries, summer squash)•Fresh, frozen, canned, driedFresh, frozen, canned, dried


Terms & ingredients that Terms & ingredients that indicate fiber in grainsindicate fiber in grains

• Whole wheat pastaWhole wheat pasta• Whole grain cereals (whole Whole grain cereals (whole

wheat, wheat bran, oats)wheat, wheat bran, oats)• Whole grain breadsWhole grain breads•To be good source, one slice = To be good source, one slice =

at least three grams fiberat least three grams fiber•First ingredient whole grainFirst ingredient whole grain


Ingredients that indicate Ingredients that indicate fiberfiber

• Beans & legumesBeans & legumes• Nuts: good source of fiber & Nuts: good source of fiber &

healthy fathealthy fat•Watch portion sizes—many Watch portion sizes—many

calories in a small amountcalories in a small amount


Modifying recipes toModifying recipes toincrease fiberincrease fiber

• Keep peel on fruits & vegetablesKeep peel on fruits & vegetables• Add extra produce to casseroles, Add extra produce to casseroles,

soups, salads & other dishessoups, salads & other dishes• Add produce to muffins, Add produce to muffins,

pancakes & dessertspancakes & desserts• Substitute whole-wheat flour for Substitute whole-wheat flour for

1/2 of all-purpose flour in making 1/2 of all-purpose flour in making breads, muffins, pancakes, other breads, muffins, pancakes, other grain productsgrain products


Fats: Functions in foodFats: Functions in food

• TextureTexture• CrispnessCrispness• CreaminessCreaminess• MouthfeelMouthfeel• VolumeVolume• FlavorFlavor

• Transmit Transmit heat quicklyheat quickly

• ““Juiciness”Juiciness”• Retain Retain

moisturemoisture• Extends shelf Extends shelf

lifelife


Most popular fat-reduced Most popular fat-reduced foodsfoods

Food ItemFood Item % Reduced-fat % Reduced-fat consumersconsumers

Fat-free or low-fat milkFat-free or low-fat milk 6262

Salad dressings, sauces, Salad dressings, sauces, mayonnaisemayonnaise 6565

Cheese/dairy foodsCheese/dairy foods 5050

MargarineMargarine 4444

Chips/snack foodsChips/snack foods 4040

Meat productsMeat products 3939

Ice cream/frozen dessertsIce cream/frozen desserts 3636

Cakes/baked goodsCakes/baked goods 3232

Dinner entreesDinner entrees 3030

CandyCandy 1818


Replacing fats: Replacing fats: Systems approachSystems approach

• May require more than one May require more than one ingredientingredient

• Synergistic components used to Synergistic components used to reach functional & sensory reach functional & sensory characteristics of full-fat versioncharacteristics of full-fat version


Sources of fat replacersSources of fat replacers

• Protein-basedProtein-based• Carbohydrate-basedCarbohydrate-based• Fat-basedFat-based


Fat replacers: protein-Fat replacers: protein-basedbased

• Micropaticulated protein: Micropaticulated protein: SimplesseSimplesse•From whey, milk or egg proteinFrom whey, milk or egg protein•Digested as proteinDigested as protein

• Modified whey protein Modified whey protein concentrate: Dairy-Loconcentrate: Dairy-Lo•Heat denatured proteinHeat denatured protein

• Other: K-Blazer, Ultra-Bake, Other: K-Blazer, Ultra-Bake, Ultra-Freeze, LitaUltra-Freeze, Lita•Use different process or base Use different process or base

protein (corn)protein (corn)


Fat replacers: Fat replacers: carbohydrate-basedcarbohydrate-based

• Cellulose: purified & ground to Cellulose: purified & ground to microparticles that form network microparticles that form network with mouthfeel & flow of fatwith mouthfeel & flow of fat

• Dextrins: Amylum, N-OilDextrins: Amylum, N-Oil•4 cal/gram4 cal/gram

• Fiber: Opta, Oat Fiber, Ultracel, Z-Fiber: Opta, Oat Fiber, Ultracel, Z-TrimTrim•Gives structure, volume, holds Gives structure, volume, holds

moisture, adhesiveness, shelf moisture, adhesiveness, shelf lifelife



• Gums: Kelocgel, Keltrol, SlendidGums: Kelocgel, Keltrol, Slendid• Guar gum, gum arabic, locust bean Guar gum, gum arabic, locust bean

gum xanthan gum, carrageenan & gum xanthan gum, carrageenan & pectinpectin

• Non-caloric, thicken or gel, promote Non-caloric, thicken or gel, promote creaminesscreaminess

• Inulin: Raftiline, Fruitafit, FibrulineInulin: Raftiline, Fruitafit, Fibruline• 1-1.2 cal/gram1-1.2 cal/gram• Fiber & bulk Fiber & bulk • From chicory rootFrom chicory root



• Maltodextrins: CyrstalLean, Maltodextrins: CyrstalLean, Lorelite, Lycadex, Maltrin, Paselli Lorelite, Lycadex, Maltrin, Paselli D-Lite, Passeli Excel, Paselli SA2, D-Lite, Passeli Excel, Paselli SA2, STAR-DRISTAR-DRI•4 cal/gram4 cal/gram•From corn, potato, wheat & From corn, potato, wheat &

tapiocatapioca•Fat replacer, bulk, texture Fat replacer, bulk, texture

modifiermodifier



• Nu-TrimNu-Trim•From oat & barleyFrom oat & barley

• Oatrim: Beta-Trim, Trim ChoiceOatrim: Beta-Trim, Trim Choice•Hydrolyzed oat flourHydrolyzed oat flour•Fat replacer, body, texturizerFat replacer, body, texturizer•1-4 cal/gram1-4 cal/gram



• Polydextrose: Litesse, Sta-LitePolydextrose: Litesse, Sta-Lite•1 calorie/gram1 calorie/gram•Fat replacer & bulking agentFat replacer & bulking agent

• PolyolsPolyols•1.6-3.0 calories/gram1.6-3.0 calories/gram•Plasticizing & humectant Plasticizing & humectant

properties allow use as fat properties allow use as fat replacersreplacers



• Starch & Modified Food StarchStarch & Modified Food Starch•Provide body & textureProvide body & texture•1-4 cal/gram1-4 cal/gram•From potato, corn, wheat, oat, From potato, corn, wheat, oat,

rice, tapioca starchesrice, tapioca starches



• Z-TrimZ-Trim•From insoluble fiberFrom insoluble fiber•Oat, soybean, pea & rice Oat, soybean, pea & rice hulls, corn or wheat branhulls, corn or wheat bran


Fat replacers: fat-basedFat replacers: fat-based

• Emulsifiers Emulsifiers •9 calories/gram but less is used9 calories/gram but less is used

• Salatrim Salatrim •Short & long-chain acid Short & long-chain acid

triglyceride moleculestriglyceride molecules•Cal/gram variesCal/gram varies•One with 5 cal/g in useOne with 5 cal/g in use


Fat replacers: fat-basedFat replacers: fat-based• Lipid (Fat/Oil) AnalogsLipid (Fat/Oil) Analogs•OlestraOlestra•Calorie-freeCalorie-free•6-8 fatty acids attached to 6-8 fatty acids attached to sucrose moleculesucrose molecule

•Passes through body Passes through body undigestedundigested

•Stable under high heat Stable under high heat •Approved in salty snacks & Approved in salty snacks & crackerscrackers


OlestraOlestra

• May reduce absorption of fat May reduce absorption of fat soluble vitamin & carotenoids soluble vitamin & carotenoids eaten at same time as olestra eaten at same time as olestra containing foodcontaining food

• Label cautions:Label cautions:•Some people may experience Some people may experience

temporary digestive effectstemporary digestive effects•Vitamins A, D, E, K have been Vitamins A, D, E, K have been

addedadded


Substituting fat ingredients Substituting fat ingredients with lower fat optionswith lower fat options

• Cream, whole milk: evaporated fat-Cream, whole milk: evaporated fat-free milk or chicken broth thickened free milk or chicken broth thickened with cornstarch or flourwith cornstarch or flour

• Butter: soft tub margarineButter: soft tub margarine• Cheese: non-fat or low fat cheeses Cheese: non-fat or low fat cheeses

or 1/2 original cheese & ½ low fat or or 1/2 original cheese & ½ low fat or replace with reduced amount of replace with reduced amount of sharper cheesesharper cheese

• Meat: use lower fat cut or meat, or Meat: use lower fat cut or meat, or replace with soy-based substitutereplace with soy-based substitute


Substituting fat ingredients Substituting fat ingredients with lower fat optionswith lower fat options

• Ice cream: lowfat or fat-free Ice cream: lowfat or fat-free versionsversions

• Whole eggs: 2 egg whites for each Whole eggs: 2 egg whites for each whole egg or egg substituteswhole egg or egg substitutes

• Sour cream: mix nonfat yogurt Sour cream: mix nonfat yogurt with light sour cream, or nonfat with light sour cream, or nonfat sour cream or plain lowfat or sour cream or plain lowfat or nonfat yogurtnonfat yogurt

• Whipped cream: nonfat or lowfat Whipped cream: nonfat or lowfat versions of commercial productsversions of commercial products


Low fat guidelines for Low fat guidelines for recipesrecipes

• For recipe to be low fat, 1 serving should For recipe to be low fat, 1 serving should have 10g fat or less for main dish, & 5g have 10g fat or less for main dish, & 5g or less for dessert, side dish, snack or less for dessert, side dish, snack

• 1 teaspoon fat = 5g so look at total oil or 1 teaspoon fat = 5g so look at total oil or margarine in recipe & number of servingsmargarine in recipe & number of servings• 1 cup of oil = 48 teaspoons1 cup of oil = 48 teaspoons• To be “low fat” recipe with 1 cup oil To be “low fat” recipe with 1 cup oil

needs to serve 48 as side dish, 24 as needs to serve 48 as side dish, 24 as main dishmain dish



• Recipes with more than 1/2 cup Recipes with more than 1/2 cup fat are probably too high in fat fat are probably too high in fat to bother trying to modifyto bother trying to modify

• Take recipe with 1/2 cup or less Take recipe with 1/2 cup or less & cut fat by half& cut fat by half•May need additional liquidMay need additional liquid•Use skim milk, water, fruit Use skim milk, water, fruit juices as appropriatejuices as appropriate



• If cutting fat in 1/2 worked well, If cutting fat in 1/2 worked well, next time cut fat a little more, next time cut fat a little more, until product has right amount of until product has right amount of fat per serving & still tastes fat per serving & still tastes good good


Fat modified recipe Fat modified recipe problems?problems?

• Replace only 1 source of fat at a Replace only 1 source of fat at a timetime

• Reduce fat slowly to level where Reduce fat slowly to level where changes are unacceptablechanges are unacceptable

• Choices if changes are Choices if changes are unsatisfactoryunsatisfactory•Have favorite recipe less oftenHave favorite recipe less often•Cut down on serving sizeCut down on serving size•Serve dish with lowfat foodsServe dish with lowfat foods


Supermarkets “health” Supermarkets “health” trendstrends

from the Center for Science in the Public from the Center for Science in the Public InterestInterest

• Health trends caused byHealth trends caused by•Pressure to sell healthPressure to sell health•Obesity, trans fat, whole grainsObesity, trans fat, whole grains

•Replacing carbsReplacing carbs•FDA allows more health claims FDA allows more health claims

on foodson foods•““scientific evidence scientific evidence suggests…”suggests…”


1. More whole grains1. More whole grains

• General Mills: All GM Cereals are General Mills: All GM Cereals are made with WHOLE GRAIN!made with WHOLE GRAIN!•Example: TrixExample: Trix

• Means some, not all flour, flour Means some, not all flour, flour is whole grainis whole grain•Still high in sugarStill high in sugar


2. Less sugar2. Less sugar• Sugar-free Milanos, Sugar-free Milanos, SnackWell’s SnackWell’s

Sugar-Free Fudge BrownieSugar-Free Fudge Brownie & & oatmeal cookies label: “not for oatmeal cookies label: “not for weight control”weight control”

• Ask: Ask: • Is it lower in calories?Is it lower in calories?•Has the serving size changed?Has the serving size changed?•Does it use only Splenda?Does it use only Splenda?• Is it nutrient dense?Is it nutrient dense?


3. No 3. No transtrans fat fat• Hershey’s Chocolate Dipped Hershey’s Chocolate Dipped

cookies have no trans fat but 5g cookies have no trans fat but 5g saturated fat/servingsaturated fat/serving

• Ask:Ask:•Did it ever have any?Did it ever have any?• Is it high in saturate fat?Is it high in saturate fat?• Is it really trans-free?Is it really trans-free?•““free” = 0.5g or lessfree” = 0.5g or less•If 0.49/serving x 3 = 1.47gIf 0.49/serving x 3 = 1.47g


4. More functional fiber4. More functional fiber

• Fiber in Dannon yogurt fiber Fiber in Dannon yogurt fiber from maltodextrin—3g/1/2 cupfrom maltodextrin—3g/1/2 cup

• Breyer’s CarbSmart ice cream Breyer’s CarbSmart ice cream fiber from polydextrosefiber from polydextrose

• Many breads raise fiber with Many breads raise fiber with cellulose from oat hull fiber, cellulose from oat hull fiber, wheat fiber, pea fiber, soy fiber, wheat fiber, pea fiber, soy fiber, cottonseed fiber, wood pulpcottonseed fiber, wood pulp

• Most are low in phyotchemicalsMost are low in phyotchemicals


4. Functional fiber4. Functional fiber

• AskAsk•How much fiber?How much fiber?• Is it naturally occurring fiber?Is it naturally occurring fiber?•Studies on benefits generally Studies on benefits generally use dietary, not functionaluse dietary, not functional

•Could it cause cramps or Could it cause cramps or diarrhea?diarrhea?•Sugar alcohols maySugar alcohols may


5. Weaker claims5. Weaker claims

• FDA allows qualified claims FDA allows qualified claims “scientific evidence suggests,” not “scientific evidence suggests,” not “proves”“proves”•Claims based on weaker evidenceClaims based on weaker evidence•Example: Example: Kashi Heart to HeartKashi Heart to Heart

• Ask: Ask: •Weak claim words: “supports,” Weak claim words: “supports,”

“maintains,” “promotes,” “maintains,” “promotes,” “evidence suggests”“evidence suggests”


6. More omega-3 fats6. More omega-3 fats

• Added to pasta from ground Added to pasta from ground flaxseedflaxseed•Example: Barilla Plus pastaExample: Barilla Plus pasta

• Also found in margarine spreads, Also found in margarine spreads, breads, eggs, barsbreads, eggs, bars

• Other ALA sources include Other ALA sources include walnuts, canola & soy oilswalnuts, canola & soy oils


6. More omega-3 fats6. More omega-3 fats

• Problem: flaxseed high in alpha-Problem: flaxseed high in alpha-linolenic (ALA) acid not a longer-linolenic (ALA) acid not a longer-chain omega-3’s chain omega-3’s eicosapentaenoic acid (EPA) & eicosapentaenoic acid (EPA) & docosahexaenoic acid (DHA)docosahexaenoic acid (DHA)•Not clear if ALA lowers sudden Not clear if ALA lowers sudden

death heart attack risk like death heart attack risk like EPA, DHAEPA, DHA


7. Self-styled symbols7. Self-styled symbols

• Companies highlight healthier Companies highlight healthier productsproducts•Example: Life cerealExample: Life cereal•““Smart Choices Made Easy” logoSmart Choices Made Easy” logo•Kraft products may have “Sensible Kraft products may have “Sensible

Solution” logoSolution” logo•Kellogg’s “Healthy Beginnings” Kellogg’s “Healthy Beginnings”

program has 5 logosprogram has 5 logos• Problem: companies develop own Problem: companies develop own

criteria for healthy foodscriteria for healthy foods


8. More phytosterols8. More phytosterols

• Natural compounds in small Natural compounds in small amounts in fruits, vegetables, nuts amounts in fruits, vegetables, nuts & beans& beans•At high levels can lower LDL At high levels can lower LDL

cholesterol about 10%cholesterol about 10%• Example: YoplaitExample: Yoplait• Ask: Ask: •How much per serving? (at least How much per serving? (at least

0.8g)0.8g)•Over 3/day, no increased effectOver 3/day, no increased effect


9. Added vitamins & 9. Added vitamins & mineralsminerals

• Added liberally to cereals, Added liberally to cereals, breakfast barsbreakfast bars

• Example: Kellogg’s Smart StartExample: Kellogg’s Smart Start• Ask:Ask:•Do you need it?Do you need it?•Are you getting too much?Are you getting too much?• Is it nutrient dense?Is it nutrient dense?


10. Repackaging10. Repackaging

• Smaller servings of foodsSmaller servings of foods•Pre-portioned packs inside a Pre-portioned packs inside a

large containerlarge container•Example: Oreo Thin CrispsExample: Oreo Thin Crisps

• Ask: Ask: • Is it nutrient dense?Is it nutrient dense?•How much does packaging cost?How much does packaging cost?• Is this environmentally friendly?Is this environmentally friendly?


11. Low-glycemic foods11. Low-glycemic foods• Next big fad???Next big fad???• Glycemic index measures speed Glycemic index measures speed

carbohydrate is digested & carbohydrate is digested & raised blood sugarraised blood sugar•Refined grains/sugars are highRefined grains/sugars are high•Whole grains are lowWhole grains are low

• New products introducedNew products introduced•2 in 19992 in 1999•175 in 2004175 in 2004


Eating out with diabetesEating out with diabetes

• Requires planning, wise choicesRequires planning, wise choices• Work with health care team to Work with health care team to

identify goalsidentify goals•Know how to make changes in Know how to make changes in

meal plan if restaurant doesn’t meal plan if restaurant doesn’t have what you wanthave what you want


How to order at How to order at restaurantsrestaurants

• Phone aheadPhone ahead•Ask to see menu—what fits planAsk to see menu—what fits plan•Are changes possible? Are changes possible?

• Be assertive, ask questions about Be assertive, ask questions about food, ingredients, preparationfood, ingredients, preparation

• Try to eat same portions as at Try to eat same portions as at homehome•Share, to-go container, leave on Share, to-go container, leave on

plateplate



• Get meat & fishGet meat & fish•Broiled without added fatBroiled without added fat•No breaded & fried—peel off if No breaded & fried—peel off if

can’t avoidcan’t avoid• Order baked potatoes plain & Order baked potatoes plain &

add:add:•1 tsp. margarine or low-cal 1 tsp. margarine or low-cal

sour cream and/or vegetable sour cream and/or vegetable from salad bar or menufrom salad bar or menu



• Ask for no added saltAsk for no added salt• ““On the side”—sauces, On the side”—sauces,

dressings, graviesdressings, gravies• Read menu creativelyRead menu creatively•Fruit cup for appetizerFruit cup for appetizer•Breakfast melon for dessertBreakfast melon for dessert•Combine salad with low fat Combine salad with low fat

appetizer as entréeappetizer as entrée



• Substitute or omit: Substitute or omit: double vegetables double vegetables instead of fries or ask instead of fries or ask for no friesfor no fries

• Ask for low fat version Ask for low fat version of dressing, margarine, of dressing, margarine, milkmilk

• Limit alcohol to cut Limit alcohol to cut caloriescalories


Eat on timeEat on time

• Ask others to eat at Ask others to eat at your regular timeyour regular time

• Plan to avoid Plan to avoid waiting for a tablewaiting for a table

• Be on time for Be on time for reservationreservation

• Do special dishes Do special dishes take extra time?take extra time?


Eat on timeEat on time

• If late lunch eat If late lunch eat fruit or starch fruit or starch serving from that serving from that meal at usual timemeal at usual time

• For very late dinner For very late dinner eat bedtime snack eat bedtime snack at usual dinner timeat usual dinner time•May need to May need to

adjust insulinadjust insulin


Fast food in AmericaFast food in America

• 47% of money spent on food will 47% of money spent on food will be spent at restaurants in 2005be spent at restaurants in 2005

• Healthy food is not trend at fast Healthy food is not trend at fast food restaurants—healthy is for food restaurants—healthy is for homehome•““Taste” important to 93.6%Taste” important to 93.6%•““Healthy” important to 69.1%Healthy” important to 69.1%


Fast food in AmericaFast food in America

• Fried chicken Fried chicken fastest-fastest-growing food growing food category in category in 20042004

http://www.mcdonalds.com/usa/eat/features/selects.html


Burger KingBurger King• Enormous Enormous

Omelet Omelet Sandwich: Sandwich:

• 2 eggs, 2 slices 2 eggs, 2 slices cheese, 3 cheese, 3 strips bacon, 1 strips bacon, 1 sausage pattysausage patty•730 calories, 730 calories,

47g fat47g fat


Pizza Hut—3Cheese Stuffed Pizza Hut—3Cheese Stuffed Crust PizzaCrust Pizza

• Pepperoni/slice: 360 cal, 14g fat, Pepperoni/slice: 360 cal, 14g fat, 7g saturated fat, 990mg sodium, 7g saturated fat, 990mg sodium,


KFC & Ben & Jerry’sKFC & Ben & Jerry’s

• KFC: Considering KFC: Considering returning to full returning to full namename

• Ben & Jerry’s—Ben & Jerry’s—wider cone holds 2 wider cone holds 2 scoops, not 1, & no scoops, not 1, & no more low carb more low carb choiceschoices


Carl’s Jr.Carl’s Jr.Monster Thick BurgerMonster Thick Burger

•2/3 pound 2/3 pound beefbeef

•3 slices 3 slices cheesecheese

•Bacon Bacon •Mayonnaise-Mayonnaise-

based saucebased sauce1,420 calories1,420 calories


Fast foodFast food

• Know nutritional Know nutritional value of foods value of foods orderedordered

• Fast food only once Fast food only once a daya day

• Order grilled, Order grilled, broiled, lean without broiled, lean without fat-based toppings & fat-based toppings & breadingbreading


Ordering fast foodOrdering fast food

• Choose fat-free Choose fat-free milk, sugar-milk, sugar-free beveragesfree beverages

• Watch for “big” Watch for “big” words or words or “double”“double”

• Choose buns, Choose buns, bread, English bread, English muffinsmuffins


Ordering fast foodOrdering fast food

• Choose thin Choose thin crust pizza with crust pizza with veggiesveggies

• Limit dressings Limit dressings on salads & on salads & high-fat salad high-fat salad bar itemsbar items

• Limit cheeseLimit cheese


Today youToday you

• Examined features of food labels Examined features of food labels important for diabetics to read & important for diabetics to read & understandunderstand

• Looked at functions of ingredients Looked at functions of ingredients in food & substitutions available on in food & substitutions available on the marketthe market

• Received tips for recipe Received tips for recipe modificationmodification

• Learned suggestions for eating out Learned suggestions for eating out with diabeteswith diabetes

living with diabetes: ingredients, labels, recipe modification & eating out

Documents

lessserving lowsaturated

servingsugarfree fatfree

c h h h c

lessserving lowcholesterol

low sodium

lessserving lowsodium

exchangesnutrition facts

functions of ingredients