Daily Meal Planning Guide

When you find out you have diabetes there are so many things to Some key things to remember no matter which meal plan you choose learn! One of the first things you may want to know is – what can I to follow: eat? Choosing healthy foods can help you control your blood glucose. A daily meal plan is an important part of your diabetes management, • Keep your food intake consistent from day to day along with physical activity, blood glucose checks, and often diabetes medications. • Make half your grains whole grains There is no one meal plan that works for everybody with diabetes. • Choose whole fruits and vegetables often This guide will provide you with three ways that may help you plan your meals. • Go with lean protein

• Balance Your Plate: Many people with diabetes like to keep meal • Get your calcium-rich foods planning simple. This food plan can help you to easily portion out your food. • Know your limits on fats, salt, and sugars

• Food List for Meal Planning and Personal Meal Plan: If you want • Choose water instead of sugary beverages, juice “drinks”, to count servings of food and follow a plan that is good for your and sports drinks diabetes too, check out the Food List for Meal Planning and the Personal Meal Plan. This plan will help you know how much of Checking your blood glucose will help you to see how your food carbohydrate, protein, and fat you can eat each day. choices affect your blood glucose control. • Carbohydrate Counting: There are many carbohydrate foods A Registered Dietitian (RD) can help you make a meal plan that best to enjoy, including grains, fruits, vegetables, milk products and meets your needs and lifestyle. Ask your healthcare provider, diabetes those with sugar. Carbohydrate foods raise your blood glucose educator, hospital, or local diabetes association for the names of RDs level more than proteins and fats. This meal planning approach in your area who work with people that have diabetes. helps you to keep track of how much carbohydrate you eat at your meals and snacks. Many people who take insulin like to use this plan. Visit us at www.LillyDiabetes.com

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Balance Your Plate Fill this ¼ of the plate with a starch, grain, or starchy vegetable, such as corn, peas or potatoes. One fruit serving is 1 small fresh fruit, 2 Tbs. dried fruit, or ½ cup canned fruit or unsweetened fruit juice.

Use fat-free/low-fat milk and milk products.

Fill this ½ of the plate with non-starchy vegetables, such as broccoli, carrots, cauliﬂ ower, Fill this ¼ of the plate with lean meat, or green beans. poultry or ﬁ sh. If you choose a plant- based protein, such as dried beans, consider the carbohydrate content as part of your total carbohydrate amount for the meal. Practical Nutrition: The Idaho Plate Method Practical Diabetol 1998;17:42-45.

Try your hand at these guidelines for estimating portion sizes*:

Your palm, not including A ﬁst is about 1 cup Your thumb is about Your thumb tip is about ﬁngers and thumb, is about or about 30 grams of 1 tablespoon or 1 serving 1 teaspoon or 1 serving 3 ounces of cooked and carb for foods such as of regular salad dressing, of margarine, mayonnaise boneless meat. 1 cup ice cream or reduced-fat mayonnaise or other fats such as oils. 1 cup cooked cereal. or reduced-fat margarine.

These portion estimates are based on a woman’s hand size. Hand sizes vary. Measuring or weighing foods is the most accurate way to ﬁ gure out a portion size.

*Adapted from: Warshaw, H.S., Kulkarni, K. Complete Guide to Carb Counting 2nd Edition. Alexandria, VA: American Diabetes Association, 2004; and Wondering How Much to Eat? Do the Hand Jive! Diabetes Spectrum 1999; 12:177-178.

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Key Starchy Vegetables Serving Size !!Strawberries 1 1/4 cup whole berries Breadfruit 1/4 cup small cubes Cantaloupe, small 1/3 melon or * Foods marked with * should be counted Corn, cooked 1/2 cup 1 cup cubed (11 oz) as 1 starch + 1 fat per serving Corn on cob, large 1/2 cob (5 oz) Cherries, sweet fresh 12 (3 oz) !! Foods marked with ! contain more than ! Hominy, canned 3/4 cup Dried fruits (blueberries, cherries, 3 grams of dietary fi ber per serving ! Peas, green, cooked 1/2 cup cranberries, mixed fruit, raisins) 2 Tbsp 1 1 Grapefruit, large /2 (11 oz) ! Foods marked with ! contain 480 mg Plantain, ripe /3 cup Potato Grapes, small 17 (3 oz) or more of sodium per serving 1 baked with skin 1/4 large (3 oz) Guava /2 cup 1 oz= ounce boiled, all kinds 1/2 cup or 1/2 medium (3 oz) ! Kiwi 1 (3 /2 oz) 3 tsp= teaspoon * mashed with milk and fat 1/2 cup Mandarin oranges, canned /4 cup 1 1 Tbsp= Tablespoon French fried (oven-baked) 1 cup (2 oz) Mango, small /2 fruit (5 ½ oz) or /2 cup 1 Resources: Spaghetti/pasta sauce 1/2 cup ! Orange, small 1 (6 /2 oz) 1 Choose Your Foods: Exchange Lists for Diabetes, ! Squash, winter (acorn, butternut) 1 cup Papaya /2 fruit or 1 cup cubed (8 oz) 1 American Diabetes Association and American Yam, sweet potato, plain 1/2 cup Passion fruit /4 cup Dietetic Association, 2007. 1 Yucca /3 cup Peaches (fresh, medium) 1 (6 oz) Beyond Rice and Beans by Lorena Drago Pears (fresh, large) 1/2 (4 oz) Crackers and Snacks Serving Size 3 (American Diabetes Association, 2006) Pineapple (fresh) /4 cup Crackers Plums *round, butter-type 6 dried (prunes) 3 Starch saltines 6 small 2 (5 oz) Graham cracker, 2 1/2 inch square 3 1 Each serving from this list contains 15 grams Tamarind /4 cup whole or 1 oz dried Popcorn 1 1 carbohydrate, 0-3 grams protein, 0-1 gram fat Watermelon 1 slice or 1 /4 cups cubes (13 /2 oz) * !!with butter 3 cups and 80 calories. Fruit Juice Serving Size !!! lower fat or no fat added 3 cups Apple, grapefruit, orange, pineapple 1/2 cup These foods are the cornerstone of a healthy Pretzels 3/4 oz Fruit juice blends, 100% juice, eating plan. Most of their calories come from Snack chips (tortilla chips, potato chips) grape juice, prune juice 1/3 cup carbohydrate, a good source of energy. Many foods fat-free or baked 15-20 (3/4 oz) from this group also give you fi ber, vitamins and * regular 9-13 (3/4 oz) minerals. Prepare and eat starchy foods with as Beans, Peas and Lentils Milk little added fat as possible. Choose whole grain (Count as 1 Starch + 1 Lean Meat) Serving Size Milk and yogurt are rich in calcium and protein. starches as often as you can. !!Baked beans 1/3 cup In general, a single serving of starch is: Choose fat-free, low-fat and reduced-fat variet- !!Beans, cooked (black, garbanzo, kidney, lima, ies for health. They have less saturated fat and 1 • 1/2 cup of cooked cereal, grain navy, pinto, white) /2 cup cholesterol than whole milk products. or starchy vegetable !!Lentils, cooked (brown, green, yellow) 1/2 cup 1 1 Fat-free (skim) or low-fat (1%) milk and yogurt: • /3 cup of cooked rice or pasta !!Peas, cooked (black-eyed, split) /2 cup • 1 oz of a bread product such as 1 slice of Each serving from this list contains 12 grams whole wheat bread carbohydrate, 8 grams protein, 0-3 grams fat and 100 calories. • 3/4 to 1 oz of most snack foods (some snack Fruits foods may also have extra fat) Each serving from this list contains 15 grams Milk, buttermilk, acidophilus milk, Lactaid 1 cup 1 Bread Serving Size carbohydrate, 0 grams fat, 0 grams protein and Evaporated milk /2 cup Bagel, large (about 4 oz) 1/4 (1 oz) 60 calories. Yogurt, plain or fl avored with 1 a low calorie sweetener 2/3 cup (6 oz) *Biscuit, 2 /2 inches across 1 Fruits are good sources of fi ber, regardless if they Bread (whole wheat, white or rye) 1 slice (1 oz) are fresh, frozen, or dried. Fruit juices contain very Reduced-fat (2%) milk and yogurt: Each serving *Cornbread 1 3/4 inch cube (1 1/2 oz) from this list contains 12 grams carbohydrate, 1 little fi ber. Choose fruits instead of juices whenever English muffi n /2 possible. When using canned fruit, choose fruit 8 grams protein, 5 grams fat and 120 calories. Hot dog or hamburger bun 1/2 (1 oz) packed in its own juice or light syrup. Milk, acidophilus milk, kefi r, Lactaid 1 cup Pancake 4 inches across, ¼ inch thick (1) Yogurt, plain 2/3 cup (6 oz) Pita pocket bread (6” across) ½ In general, a single serving of fruit is: Roll, plain, small 1 (1 oz) • ½ cup of canned or fresh fruit or unsweetened Whole milk and yogurt: Each serving from this Tortilla, corn or fl our (6” across) 1 fruit juice list contains 12 grams carbohydrate, 8 grams *Waffl e 4 inch square or 4 inches across (1) • 1 small fresh fruit (4 oz) protein, 8 grams fat and 160 calories. • 2 tablespoons of dried fruit Cereals and Grains Serving Size Milk, buttermilk, goat’s milk 1 cup Fruit Serving Size 1 Cereals, cooked (oats, oatmeal) 1/2 cup Evaporated milk /2 cup Apple, unpeeled, small 1 (4 oz) Cereals, unsweetened, ready-to-eat 3/4 cup Yogurt, plain 8 oz Applesauce, unsweetened 1/2 cup Couscous 1/3 cup Banana, extra small 1 (4 oz) Dairy-Like Foods Serving Size Granola, low-fat 1/4 cup Berries Chocolate milk Pasta, cooked 1/3 cup fat-free 1 cup !!Blackberries 3/4 cup Rice, white or brown, cooked 1/3 cup 3 (1 fat-free milk + 1 carbohydrate) Blueberries /4 cup whole 1 cup !!Raspberries 1 cup (1 whole milk + 1 carbohydrate)

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Smoothies, fl avored, regular 10 oz Muffi n (4 oz) 1/4 muffi n (1 oz) Meat and Meat Substitutes (1 fat-free milk + 2 ½ carbohydrate) (Count as 1 carbohydrate + 1/2 fat) Soy milk, regular, plain 1 cup Pie, commercially prepared fruit, Meat and meat substitutes are rich in protein. (1 carbohydrate + 1 fat) 2 crusts 1/6 of 8-inch pie Whenever possible, choose lean meats. Portion Yogurt (Count as 3 carbohydrates + 2 fats) sizes on this list are based on cooked weight, after juice blends 1 cup Pudding bone and fat have been removed. The carbohy- (1 fat-free milk + 1 carbohydrate) regular (made with reduced-fat milk) 1/2 cup drate content varies among plant-based proteins, with fruit, low-fat 2/3 cup (6 oz) (Count as 2 carbohydrates) so read food labels carefully. (1 fat-free milk + 1 carbohydrate) sugar-free or sugar- and fat-free 1/2 cup (made with fat-free milk) Lean meats and meat substitutes: Each serving Sports drink 1 cup (8 oz) from this list contains 0 grams carbohydrate, Sweets, Desserts, Sugar 1 Tbsp 7 grams protein, 0-3 grams fat and 45 calories. and Other Carbohydrates Syrup Beef: Select or Choice grades: light (pancake type) 2 Tbsp ground round, roast (chuck, rib, rump), Each serving from this list contains 15 grams regular (pancake type) 1 Tbsp round, sirloin, steak (cubed, fl ank, of carbohydrate; the amount of protein, fat and Yogurt, frozen, fat-free 1/3 cup porterhouse, T-bone), tenderloin 1 oz calories varies. You can substitute food choices Cheeses with 3 grams of fat or less per oz 1 oz from this list for other carbohydrate-containing Cottage cheese 1/4 cup foods (such as those found on the Starch, Fruit or Nonstarchy Vegetables Egg whites 2 Milk lists) in your meal plan, even though these Fish, fresh or frozen, plain: catfi sh, cod, foods have added sugars or fat. The foods on this Each serving from this list contains 5 grams fl ounder, haddock, halibut, orange roughy, list do not have as many vitamins, minerals and carbohydrate, 2 grams protein and 25 calories. salmon, tilapia, trout, tuna 1 oz fi ber. Choose foods from this list less often if you You should try to eat at least 2 to 3 nonstarchy Hot dog with 3 grams of fat or less per oz 1 are trying to lose weight. Many sugar-free, fat-free vegetable servings each day. Choose a variety of Pork, lean and reduced-fat products are made with ingredi- vegetables to benefi t from their important vitamins, Canadian bacon 1 oz ents that contain carbohydrate, so check the Total minerals and antioxidants. When using canned Rib or loin chip/roast, ham, tenderloin 1 oz Carbohydrate information on the Nutrition Facts vegetables, choose no salt added versions or rinse Poultry, without skin 1 oz food label. regular canned vegetables. In general, a single Processed sandwich meats with serving of a nonstarchy vegetable is: 3 grams of fat or less per oz 1 oz Food Serving Size • ½ cup of cooked vegetables or vegetable juice Tuna, canned in water or oil, drained 1 oz 1 7 • 1 cup of raw vegetables Brownie, small, unfrosted 1 /4 inch square, /8 Medium-fat meat and meat substitutes: inch high (about 1 oz) Each serving from this list contains 0 grams (Count as 1 carbohydrate + 1 fat) Amaranth or Chinese spinach carbohydrate, 7 grams protein, 4-7 grams Cake Beans (green, wax, Italian) fat and 75 calories. frosted 2-inch square (about 1 oz) Bean sprouts (Count as 2 carbohydrates + 1 fat) Broccoli Beef: corned beef, ground beef, meatloaf, unfrosted 2-inch square (about 1 oz) Cabbage (green, bok choy, Chinese) Prime grades trimmed of fat (prime rib) 1 oz (Count as 1 carbohydrate + 1 fat) !!Carrots Cheeses with 4-7 grams of fat per oz: Candy bar, chocolate/peanut 2 “fun size” Caulifl ower feta, mozzarella, pasteurized processed bars (1 oz) 1 1 Celery cheese spread, reduced-fat cheeses, (Count as 1 /2 carbohydrates + 1 /2 fats) string cheese 1 oz Candy, hard 3 pieces Cucumber Egg 1 Cookies Eggplant 1 Greens (collard, kale, mustard, turnip) Fish, any fried product 1 oz chocolate chip 2 cookies (2 /4 inch across) (Count as 1 carbohydrate + 2 fats) Jicama Pork, cutlet, shoulder roast 1 oz vanilla wafer 5 cookies Mushrooms, all kinds, fresh Poultry, with skin or fried 1 oz (Count as 1 carbohydrate + 1 fat) Okra Ricotta cheese 2 oz or 1/4 cup Doughnut, cake, plain 1 medium (1 1/2 oz) Onions ! Sausage with 4-7 grams of fat per oz 1 oz (Count as 1 1/2 carbohydrates + 2 fats) Pea pods High-fat meat and meat substitutes: Each serving Flan (caramel custard) 1/2 cup !!Peppers (all varieties) from this list contains 0 grams carbohydrate, (Count as 2 carbohydrates) Radishes Fruit juice bars, frozen, 100% juice 1 bar (3 oz) 7 grams protein, 8+ grams fat and 100 calories. 1 ! Sauerkraut Gelatin, regular /2 cup Spinach Bacon Granola or snack bar, Squash (summer, crookneck, zucchini) ! pork 2 slices regular or low-fat 1 bar (1 oz) Tomatoes, fresh and canned ! turkey 3 slices (Count as 1 1/2 carbohydrates) Cheese, regular: American, bleu, brie, Hot chocolate, regular 1 envelope added ! Tomato sauce ! Tomato/vegetable juice cheddar, hard goat, Monterey jack, to 8 oz water queso and swiss 1 oz (Count as 1 carbohydrate + 1 fat) Water chestnuts *! Hot dog: beef, pork or combination 1 Ice cream light and no sugar added 1/2 cup Pork sparerib 1 oz (Count as 1 carbohydrate + 1 fat) Processed sandwich meats with 8 grams regular 1/2 cup of fat or more per oz: bologna, pastrami, (Count as 1 carbohydrate + 2 fats) hard salami 1 oz Jam or jelly, regular 1 Tbsp

!!"#$%&&&'"#$%&&&' (()*)+,&&&-./0.'/&12)*)+,&&&-./0.'/&12 ! Sausage with 8 grams fat or more Saturated Fats Serving Size Combination Foods per oz: bratwurst, chorizo, Italian, Bacon, cooked, regular or turkey 1 slice Combination foods contain foods from more than one knockwurst, Polish, smoked, summer 1 oz Butter, stick 1 tsp food list, but with the help of a Registered Dietitian Cream, half and half 2 Tbsp Plant-based proteins: Each serving from this (RD) you can fi t these foods into your meal plan. list contains 7 grams protein and a variable Cream cheese amount of carbohydrate, fat and calories. reduced-fat 1 1/2 Tbsp (3/4 oz) Entrees Serving Size Beans, peas and lentils are also found on the regular 1 Tbsp (1/2 oz) ! Casserole type (tuna noodle, lasagna, macaroni Starch list. Nut butters in smaller amounts are Sour cream and cheese) 1 cup (8 oz) (Count as 2 carbohydrates + 2 medium-fat meats) found in the Fats list. reduced-fat or light 3 Tbsp regular 2 Tbsp Frozen Meals/Entrees Serving Size Food Amount 1 !!Burrito (beef and bean) 1 (5 oz) Beans, lentils, or peas (cooked) /2 cup (Count as 3 carbohydrates + 1 lean meat + 2 fats) (Count as 1 starch + 1 lean meat) 1 Free Foods !Enchilada 1 (11 oz) !!Hummus /3 cup (Count as 3 carbohydrates) (Count as 1 carbohydrate + 1 high-fat meat) Each serving from this list has 5 grams or less ! Pizza, cheese/vegetarian, Nut spreads: almond butter, cashew of carbohydrate and less than 20 calories per thin crust 1/4 of a 12 inch (4 1/2-5 oz) butter, peanut butter, soy nut butter 1 Tbsp serving. Eat up to 3 servings per day of the free (Count as 2 carbohydrates + 2 medium-fat meats) (Count as 1 high-fat meat) foods with a serving size noted without counting 1 !Taco 1 (5-6 oz) Tempeh /4 cup any carbohydrate. Choices listed without a serving (Count as 2 carbohydrates) (Count as 1 medium-fat meat) size noted can be eaten whenever you like. For Tofu 4 oz (1/2 cup) Soups Serving Size (Count as 1 medium-fat meat) better blood glucose control, spread your servings ! Bean, lentil or split pea 1 cup of these foods throughout the day. (Count as 1 carbohydrate + 1 lean meat) ! Tomato (made with water) 1 cup Fats Low Carbohydrate Foods Serving Size (Count as 1 carbohydrate) Cabbage, raw 1/2 cup Each serving from this list contains 0 grams Gelatin, sugar-free or unfl avored carbohydrate, 0 grams protein, 5 grams fat and Gum These Food Lists are not intended to be all 45 calories. Jam or jelly, light or no sugar added 2 tsp inclusive. Consult with your RD about any Choose heart-healthy fats from the monounsatu- Salad greens foods that you eat which are not listed. rated and polyunsaturated groups more often. Sugar substitutes (low calorie sweeteners) In general, a single serving of fat is: Modifi ed Fat Foods • 1 teaspoon of regular margarine, vegetable oil with Carbohydrate Serving Size or butter 1 Cream cheese, fat-free 1 Tbsp ( /2 oz) • 1 tablespoon of regular salad dressing Creamers Unsaturated Fats nondairy, liquid 1 Tbsp Monounsaturated Fats Serving Size nondairy, powdered 2 tsp Avocado, medium 2 Tbsp (1 oz) Salad dressing Nut butters (trans-fat free) 1 1/2 tsp fat-free or low-fat 1 Tbsp Nuts fat-free Italian 2 Tbsp almonds, cashews 6 nuts Condiments Serving Size macadamia 3 nuts Barbecue sauce 2 tsp peanuts 10 nuts Catsup (ketchup) 1 Tbsp pecans 4 halves Mustard Oil: canola, olive, peanut 1 tsp 1 ! Pickles, dill 1 /2 medium Olives, black (ripe) 8 large 1 Salsa /4 cup Olives, green (stuffed) 10 large Taco sauce 1 Tbsp Polyunsaturated Fats Serving Size Vinegar Margarine Drinks/Mixes lower-fat spread 1 Tbsp ! Bouillon, broth, consommé stick, tub or squeeze 1 tsp Carbonated or mineral water, club soda Mayonnaise Coffee or tea reduced-fat 1 Tbsp Diet soft drinks or sugar-free drink mixes regular 1 tsp Oil: corn, cottonseed, fl axseed, grape Seasonings seed, saffl ower, soybean, sunfl ower 1 tsp Flavoring extracts Salad dressing Garlic reduced-fat 2 Tbsp Herbs, fresh or dried regular 1 Tbsp Nonstick cooking spray Spices Worcestershire sauce

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This menu shows some of the ways the exchange lists can be used to add variety to your meals. Use the exchange lists to plan your own menus. Breakfast Examples

1 Fruit ½ cup orange juice 2 Starch/Bread 2 slices whole wheat toast 2 Fat 2 tsp margarine 1 Milk 1 cup 1% milk *Free Foods Coffee or tea

Lunch Examples

1 Meat ¼ cup tuna 2 Starch/Bread 2 slices rye bread 1 Vegetable 1 large tomato 1 Fruit ½ banana 1 Fat 2 tsp salad dressing, mayonnaise-type *Free Foods ¼ cup chopped celery

Afternoon Snack Examples

2 Fruit 1 small apple, 2 Tbsp raisins

Dinner Examples

2 Meat 2 oz. roast beef 3 Starch/Bread 1 small potato, ½ cup corn, 1 slice whole wheat bread 1 Vegetable ½ cup broccoli 1 Fruit 1¼ cup strawberries 2 Fat 2 tsp margarine *Free Foods salad greens, radishes, 2 Tbsp low-calorie salad dressing

Evening Snack Examples

2 Starch/Bread 6 graham crackers 1 Milk 1 cup 1% milk 1 Fruit ½3 cup canned pineapple 1 Fat 1 Tbsp cream cheese !!"#$%&&&' " # $ % & & & ' Personal Meal Plan

Meal Plan For: Phone: Carbohydrate – number of grams: With your RD, ﬁ ll in your personal meal plan below with the number of Date: Total Calories: Number of carbohydrate choices: grams of carbohydrate and/or number of carbohydrate choices for each meal Registered Dietitian: Protein (ounces): and snack (if needed).

Fat (grams):

Breakfast Snack Lunch Snack Dinner Snack (Time:______) (Time:______) (Time:______) (Time:______) (Time:______) (Time:______)

Carbohydrates

Starch

Fruits

Milk

Sweets, Desserts & Other Carbohydrates

Nonstarchy Vegetables

Meat & Meat Substitutes

Fats

Others

Free Foods

Menu Ideas (()')*+&&&,-./-*.&01 ) ' ) * + & & & , - . / - * . & 0 1 Diabetes Care and Education (DCE), a dietetic practice group of the American Dietetic Association (ADA), promotes quality diabetes care and education. DCE comprises members of the ADA who are leaders in the ﬁ eld of medical nutrition therapy (MNT) and care of people with diabetes. Their expertise is widely recognized throughout the diabetes community. We are pleased to have had the opportunity to collaborate with this group of professionals on the creation of Lilly’s new Daily Meal Planning Guide.

We hope you ﬁ nd it a valuable resource.

This guide has been developed, written and reviewed by: Authors: Tami A. Ross, RD, LD, CDE Patti B. Geil, MS, RD, FADA, CDE Reviewers: Connie Crawley, MS, RD, LD Alison Evert, MS, RD, CDE Carrie Swift, MS, RD, BC-ADM, CDE

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