Program Manual Part 1:
   Useful Information and Resources for

            Food for Life Program
 Eating and Cooking to Beat Diabetes in Indian

Physicians Committee for Responsible Medicine
      Edited by Caroline Trapp, MSN, CNP, BC-ADM, CDE
           Director of Diabetes Education and Care

                                            Revised 7 27 2011
              Table of Contents

Resources                            Page
   Welcome                            2
   Power Plate Foods                  5
   Meal Ideas                         6-8
   Power Plate Complete Nutrition     9
   Weekly Meal Planners (blank)       10-13
   Homework for Class 2               14
   The Three Sisters (a poem)         15
   Quick Fiber Check                  16-17
   All About Beans                    18-22
   Important Information about
        Medication for Blood Sugar
        and Blood Pressure            23-24
   Monitoring Blood Sugar             25-26
   Grocery Store Treasure Hunt        27
   Cooking Grains                     28
   Grow Your Own Sprouts              29
   How to Make-Over a Recipe          30
   Make Your Own Non-Dairy Milk       35-38
   Test Your Knowledge                39

                                Welcome! The information in this booklet helps to
                                answer the question, ―What foods can I eat to get
                                healthy, and to stay healthy?‖ Four food groups
                                make up the Power Plate, a pattern of eating built
                                around whole grains, vegetables, legumes and
                                fruits, that has been shown in many scientific
                                studies to help people who have diabetes to turn it
                                around, or avoid it in the first place. Heart disease,
                                kidney disease, arthritis, bowel problems and
                                certain cancers – these same foods fight these
                                diseases, too.

                              We thank our partners, the Indian Pueblo Cultural
                              Center in Albuquerque, NM, the Navajo Nation
                              Special Diabetes Project in Window Rock, AZ, and
                              the Center for Lifelong Education at the Institute for
American Indian Arts in Santa Fe, NM, for hosting multi-week classes based on
the Food for Life Power Plate foods to prevent and treat diabetes, as well as our
cooking instructors, chefs Lois Ellen Frank of Santa Fe, NM and Walter
Whitewater of Pinon, NM, for being leaders in introducing a new way of eating,
one which is actually centuries old.

For most people, it takes a little time for a new way of eating to feel entirely
comfortable. But soon, things fall into place, and that’s when the magic starts.
Your energy levels get higher and higher, and aches and pains start to melt
away. Your waistline trims down, and people start to ask you what your secret is.
If you have other health issues, like high cholesterol or high blood pressure, they
are likely getting better day by day.

This pattern of eating has been proven to be healthy for everyone: children,
pregnant women, elders, athletes, and everyone in-between.

But don’t take any of this on faith. Give the recipes and meal ideas contained in
these pages a try. Affordable, safe, effective, delicious and filling – try it yourself,
and share with others who need help boosting their own health and vitality. And
please join us at Physicians Committee for Responsible Medicine (pcrm.org or
ThePowerPlate.org) for more resources.

Neal Barnard, MD
Physicians Committee for Responsible Medicine
Washington, DC

" We are in a time when our younger generation
wants to learn our traditional ways and reclaim the
history of who they are, including, and especially, the
foods that sustained our Ancestors.

Returning to an ancestral plant-based diet is a way to
reclaim our health. The foods that many Native
communities ate in the past included corn, beans, and
squash, known as "The Three Sisters." Wild harvested
roots, vegetables, fruits, grains, nuts, beans, and herbs
were also enjoyed. These provided a healthy diet, low in
fat and high in nutrients. To heal diabetes and other
health-related ailments, Native Americans are now
rejecting highly processed foods and large amounts of animal-based foods.

When traditional foods are revitalized, all of the cultural traditions associated with
them are also revitalized - the songs that go with the planting, the
sustainable agricultural techniques that each tribe uses, traditional knowledge on
how to harvest wild foods, the foods that have medicinal qualities, the language,
the stories, the baskets...everything. Native Ancestral foods are a tradition worth

                                                          Chef Lois Ellen Frank
                 Food Historian, Award-Winning Author, Caterer, Ph.D. candidate
                                      Red Mesa Cuisine, Santa Fe, New Mexico

                         ―Pills and shots are like Band-Aids. They don’t really get
                         at the underlying problems that cause diabetes and other
                         chronic diseases. The resources, recipes and meal ideas
                         described here have the power to heal, and to prevent
                         many diseases in the first place. I hope you will give them
                         a try. Work with your health care provider to safely adjust
                         or eliminate medications. And enjoy the power that
                         comes from reclaiming your health.‖

                         Caroline Trapp, MSN, APRN, BC-ADM, CDE
                         PCRM Director of Diabetes Education and Care

    Power Plate Foods to Reverse Diabetes
            (Recipes and information at www.ThePowerPlate.org)

   All animal products
   Fats: all lard, shortening, butter,
     and limit oils
   Carbohydrates that raise blood sugar:
          Sugar, honey, cold cereals made with sugar or white flour
          White and most wheat breads
          Sweets and breads made with white flour

    Unlimited vegetables, especially all varieties of dark leafy greens
    Unlimited fresh, frozen, dried or unsweetened canned fruits
    Unlimited beans, peas and lentils
    Unlimited grains: Old-Fashioned oatmeal, muesli cereal, bran
     cereals, brown or white rice, wild rice, barley, quinoa, millet,
     amaranth, etc.
    Pasta noodles (egg-free), corn tortillas
    Potatoes: Sweet potatoes, yams, new potatoes, redskins
    Non-dairy milks on cereals and in recipes (Soy, Almond, Rice)
    Use agave nectar instead of sugar or honey
    Choose rye or 100% whole wheat breads
    Small amounts nuts and seeds
    Use a swipe of oil or small amount of oil spray to grease pans,
     and sauté onions and peppers in water or vegetable broth
    Water, tea, coffee (if desired)


 Hot cereals: oatmeal with cinnamon, raisins, banana, a small handful of nuts
  or seeds, and/or applesauce
 All Bran or muesli cereal with non-fat soy or rice milk and/or berries, peach or
 Apples, strawberries, bananas, oranges or other fruit
 Pumpernickel or rye toast, topped with jam (no butter or margarine) or beans
  and salsa
 Oven-roasted sweet potato ―home fries‖ solo or smothered with ―sautéed‖
  mushrooms, peppers and onions
 Burrito filled with vegetarian ―refried‖ beans, lettuce, and tomato (no egg or
 Tofu scrambler (sauté firm tofu and spices with cooked onions and peppers)
 Fat-free meat substitutes (e.g., Gimme Lean fat-free ―sausage‖ or ―bacon‖)

    Vegetable-based soups: carrot-ginger, mixed vegetable, mushroom-
      barley, etc.
    Legume-based soups: black bean, vegetarian chili, spinach lentil,
      minestrone, split pea, etc.
    Instant or prepared soups as long as they are low-fat and free of animal
    Garden salad with lemon juice, fat-free dressing, or soy or teriyaki sauce
    Legume-based salads: Three-bean, chickpea, lentil, or black bean and
      corn salads
    Grain-based salads: Noodle, couscous, bulgur or rice salads
    Commercial bagged salad are fine, but look for the fat-free or no-added fat
      versions. Top with cooked beans and fat- and dairy-free dressings.
    Black bean dip, peppers, tomatoes and lettuce wrapped in a whole wheat
    CLT: cucumber, lettuce and tomato sandwich with mustard on
      pumpernickel or rye bread. Vary with grilled tempeh or tofu.
    Hummus sandwich tucked into whole wheat pita with grated carrots,
      sprouts and cucumbers
    Black bean and sweet potato burrito with corn and tomatoes
    Sandwich made with fat-free meat alternatives such as barbeque seitan,
      Lightlife Smart Deli turkey style or Yves veggie pepperoni slices and your
      favorite sandwich veggies

DINNER — Give legumes and grains the starring role in all your meals. Start with
beana add a rice or other grain or potato dish, and add a couple of vegetables.

Legumes: Use generous amounts of legumes, such as:
 Pintos, vegetarian refried and baked beans, black beans, garbanzos, kidney
    beans, lentils, split peas
 Grains: pasta, brown rice, barley, quinoa, couscous, millet, or others
 Potatoes: Favor sweet potatoes and yams, instead of baking potatoes.
 Breads: Pumpernickel, rye or whole-grain breads are preferred. Avoid breads
    that contain oil, eggs or milk.
Try any vegetables you like. Lemon juice on greens or broccoli enhances the
taste. Enjoy vegetables that are:
       *Steamed               *Roasted with herbs    *Fresh

Main Dishes:
 Pasta marinara: Some commercial sauces are fine (any brand that has less
  than 2 grams fat per serving and free of animal products).
 Beans and rice: Try black beans with salsa, vegetarian baked beans, or fat-
  free refried beans.
 Soft tacos: Prepare this dish with flour tortilla, beans, lettuce, tomato, and
 Fajitas: Lightly sauté sliced bell peppers, onion, and eggplant in a non-stick
  pan, with fajita seasonings.
 Chili: Vegetarian boxed or canned versions are fine.
 Veggie lasagna: Made with low-fat tofu to replace the ricotta, layered with
  grilled veggies.
 Vegetable stir-fry: Season with soy sauce or other low-fat stir-fry sauce. Be
  sure to use a non-stick pan. Serve over pasta, beans, or rice.
 Fat-free vegetarian burgers: Look for lentil burgers or other commercial
  brands, such as Boca Burgers.

 Fresh or cooked fruit
 Fruit smoothie (made with frozen fruit, pitted dates or agave nector or frozen
  fruit juice concentrate as a sweetener, water and/or non-dairy milk and/or
  juice. Sneak in some frozen spinach for a nutritious kick!)
 Carrot, celery, or other vegetables with low-fat hummus or bean dip
 Vegetarian Cup o’ Soup brands (split pea, lentil, etc.)
 Baked tortilla chips with salsa or bean dip
 Air-popped popcorn topped with nutritional yeast for cheesy flavor
 Toast with jam (no butter or margarine)


 Explore new recipes, new books, new products.
 Be strict with yourself. It is easier than teasing yourself with small amounts of
  the foods you are trying to leave behind.
 Focus on the short term – give it 100% for a few weeks.
 If you have trouble finding recipes you like, please discuss this with group
  leaders or participants. There are always solutions.

 Canned beans
 Use frozen vegetables or canned vegetables instead of fresh.
 Fat-free meat-substitutes are quick and can ease the transition.
 Buy prepared salads that are fat-free or have no-added fats.
 Try low-fat (less than 5g fat per meal), vegan, frozen meals (Amy’s, Mon
  Cuisine, Cedarlane Natural Foods and Dr. McDougall).

 Travel Tips:
   Request non-dairy vegetarian meals for flights
   All hotels will have oatmeal, pasta with tomato sauce, potatoes, and
     vegetable plates, even if not on the menu.
   Bring along instant soup cups or instant oatmeal, nuts, fruit.

   Dining Out: Look for ethnic restaurants, especially Japanese, Chinese,
    Mexican, and Italian, as they normally have many vegetarian dishes.
     Japanese: Edamame (soy beans in pod); vegetable sushi; miso soup
     Chinese: rice with steamed tofu and vegetables (no oil)
     Mexican: bean burrito, without the cheese, sour cream, and guacamole;
       spanish rice. Ask the waiter to bring out warm corn tortillas to dip in the
       salsa and tell them to take away the fried chips.
     Italian: pasta e fagioli (soup); pasta marinara; ask that your meal is made
       with little or no oil.
     Thai: vegetarian selections with rice; avoid coconut milk
     Indian: rice dishes or breads (beware of curries—very oily)
     Middle-Eastern: tabouleh; hummus with whole wheat pita; lentil soup
     American: vegetable plate; salad bar; baked beans; spaghetti; fruit plate;
       veggie burger; vegetable soup; for salads, ask for no dressing, or try
       lemon or lime juice, ask that fatty toppings, such as cheese, bacon, eggs,
       olives, and avocados, be left off.

                                Weekly Menu Planner
Monday   Tuesday       Wednesday        Thursday          Friday         Saturday   Sunday



                 Provided by Physicians Committee for Responsible Medicine.
         For more ideas, visit www.ThePowerPlate.org and www.21DayKickStart.org

                                Weekly Menu Planner
Monday   Tuesday       Wednesday        Thursday          Friday         Saturday   Sunday



                 Provided by Physicians Committee for Responsible Medicine.
         For more ideas, visit www.ThePowerPlate.org and www.21DayKickStart.org

                                Weekly Menu Planner
Monday   Tuesday       Wednesday        Thursday          Friday         Saturday   Sunday



                 Provided by Physicians Committee for Responsible Medicine.
         For more ideas, visit www.ThePowerPlate.org and www.21DayKickStart.org

                             Before We Meet Again

     Find a food label from a food that is high in fiber (3 grams or more) and
      one that is low in fiber (1 gram or less). Write down the product names
      and the amount of fiber, or bring the labels to class to help everyone learn.
Try out a new recipe that contains plant foods that are high in fiber (such
as one that combines the Three Sisters).

                        Before Our Second Meeting…..

1. Try out a new class recipe, and/or have a few meals that do not have any
animal products.

2. Make a record of everything you eat in one day. Not a ―good‖ day or ―bad‖
day, just a typical day. Bring to class next week.

Food (only one food or ingredient per line):















                      Class 2

                The Three Sisters

            Three plants grow in the same soil,
                  In the same sunlight,
                  Sharing the same air.
        Corn pushes skyward, carrying her sister,
     The entwined bean plant, with her as she grows.
 In turn, beans nourish the soil and strengthen the corn.
                 The third sister, squash,
Uses her broad leaves and spiny vines to protect them all.

  When we live together as well as these three sisters,
  In harmony and enduring peace with our neighbors,
         With the animals, and with the Earth
           The world will be a better place.
         In the short time we have on Earth,
         We dedicate ourselves to this ideal.

                                              Author unknown

                                 Quick Fiber Check

The Quick Fiber Check is a handy little tool. Using its simple scoring concept,
which takes only a minute or two to learn, you’ll automatically be able to estimate
the fiber content of virtually everything in the grocery store.

To check your own meals, write down everything you ate or drank for one full day
on this form. Now, next to each food, jot in its fiber score, using the following

Beans: For each serving of beans or lentils (one serving = one half cup) or any

food that includes about this amount of beans or lentils as an ingredient, mark 7.

One cup of soy milk or one-half cup of tofu rates 3.

Vegetables: For each serving of vegetables (one serving = one cup), mark 4.

An exception is lettuce, for which one cup scores 2. A potato with skin scores 4;

without the skin, it scores 2.

Fruit: For each medium piece of fruit (e.g., apple, orange, banana, one cup of

apple sauce, a banana smoothie), mark 3. For one cup of juice, mark 1.

Grains: For each piece of white bread, bagel, or equivalent, score 1. Whole

grain breads score 2. One cup of cooked pasta scores 2. One cup of rice scores

1 for white and 3 for brown. One cup of cooked oatmeal scores 4. Score 3 for

typical ready-to-eat cereals, 1 for highly processed and colored cereals, and 8 for

bran, or check package information.

Meat, poultry, or fish: Score 0. Animal products do not contain fiber.

Eggs or dairy products: Score 0.

Sodas, water: Score 0.

Interpreting Your Quick Fiber Check Score

Less than 20 grams: You need more fiber in your diet. As it is, your appetite

will be hard to control, and you may have occasional constipation. Boosting fiber

will help tame your appetite and can cut your risk of many health problems.

20-39 grams: You are doing better than most people in Western countries, but

as you bring more fiber into your diet, you will find that it makes foods more

satisfying and cuts your calorie intake a bit.

40 grams or more: Congratulations. You have plenty of healthy fiber in your

diet. It tames your appetite and helps keep you healthy. Fiber also reduces your

risk of cancer, heart disease, diabetes, and digestive problems.

                             Quick Fiber Check

Food (only one food or ingredient per line):     Fiber

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

_______________________________                  ________

Total                                            ________

                                All About Beans

                        Adapted from Catherine DiCocco, Cancer Project Cooking Instructor

Jump out of your bean rut and try some of the many varieties of dried beans
available today.

Why go through the trouble of cooking beans from scratch? Let me count the
ways…. You have a larger variety of dried beans to chose from; you can vary
their taste by adding different herbs and spices during the cooking process, and
they are a lot cheaper than buying all those cans! They can be made up in large
batches, drained, and frozen in smaller portions to use later in soups, salads, and

Bean Math
Using dried beans is also the most economical choice. One 15oz. can of organic
pinto beans yields approximately 1.5 cups of beans for $1.99 a can. That’s $1.32
per cup. One pound of dried organic pinto beans (approximately 2 cups) yields 6
cups cooked beans for $1.49. That’s $0.25 per cup. Beans are high in protein,
low in fat, and an excellent replacement for meat.

                             Bean Cooking Basics


      Sometimes you will find small rocks among dried beans. Take time to
spread them out by the handful on a light-colored plate or pan so you can pick
out anything that is not a bean. Rinse the beans in fresh water.

Soak – Two Methods

        Overnight – Cover the beans with water, at least several inches above the
top of the beans. Soak up to 12 hours at room temperature, or up to 24 hours in
the refrigerator.

        Quick Soak – Place sorted and rinsed beans in a pot with three times the
volume of water. Boil for 10 minutes. Remove from heat and let soak for 1 hour.
Drain the beans, cover with 1 inch of fresh water, and return to the stove to
continue cooking. Beans are done when they are tender, slightly soft when you
pinch them. Seasonings and salt should be added after the beans have begun to
swell I their skins.

Small beans such as lentils and split peas do not need to be soaked.

Cooking Dried Beans

            Replacing Home-Cooked Beans with Canned Beans

Using canned beans can save time and energy when you are busy. To replace 1
and ½ cups of home-cooked beans in any recipe, use 1 can (15 ounces) of
canned beans. To get rid of the salt in the canned beans, drain the beans, rinse
them well and drain them again before using.

                         Managing Digestive Problems

A new diet can mean a change in bathroom habits – for the better! Eating high-
fiber foods helps keep our body ―regular.‖ In our studies, many people reported
bowel movements increased from a few times a week to one-three times a day.
This is normal, and healthy!

While not a good topic of conversation for the dinner table, or anywhere else
people gather, it is worth saying a few things here about why it is important to
have frequent bowel movements. This is the way our body gets rid of toxins,
cholesterol, medications, waste hormones, and everything else that can make us

Why do some people have bowel movements only a few times a week, and have
to strain to do so? Lack of fiber, or plant-roughage, is the most common cause. A
shift to a plant-based, Power-Plate diet will cause more frequent bowel
movements, up to two or three times a day. This change at first might be
startling, but is good for you, keeping you healthier and feeling better.

Any digestive problems that might occur with a new way of eating are not
harmful. Here are some simple things to do for digestive problems.


Constipation often occurs from not eating enough fiber. To relieve constipation, it
is generally helpful to eat plant foods and drink more water. Fiber is found in
whole grains, beans, peas and legumes, and fruits and vegetables. A plant–
based diet will have plenty of fiber.

Adults should eat 25 to 35 grams (or more) of fiber per day. It is important to
remember to drink more water or other liquids. Aim for 8 to 10 cups per day.

Walking more, or increasing any kind of exercise, may also help to cure


Some people find they get slightly ―gassy‖ when they first switch to a Power Plate
diet. Passing gas is a normal, healthy function, though may not be so good for
your social life.

Here are some tips to ease problems with gas from eating beans:

      After soaking dried beans, drain them, and then cook them in fresh water.
       It may also help to add a pinch of baking soda to the soaking water.

      Make sure the beans are thoroughly cooked – they should be tender.
      Drain and gently rinse canned beans. This also decreases the amount of
       salt in some brands.
      People who eat beans regularly have little or no trouble digesting them, so
       start with smaller servings by putting beans in soups, salads and stews.
       Work up to larger and more frequent servings.
      Smaller beans are easier to digest for some people, so try black beans,
       black–eyed peas, and lentils, and work your way up to pinto, kidney and
       fava beans.
      Add a strip of kombu, a sea vegetable, to beans during cooking.


Changing to a plant-based diet may cause loose stool at first in a small number
of people. When experiencing problems with diarrhea, it can be very helpful to
eat rice and well–cooked green, yellow, and orange vegetables, and, as we
always recommend, avoid dairy products. A small handful of nuts or a tablespoon
of nut butter may also help. Drink plenty of water to avoid becoming dehydrated.

       Medications for Diabetes and Blood Pressure, and Diet Change

Perhaps you would like to take less medication, or avoid it in the first place. A
healthy diet of grains, legumes, vegetables and fruits can help. Below is
information about diabetes medications that can cause low blood sugar and/or
make it hard to lose weight. Discuss this with your health care provider.

Low Blood Sugar
It is exciting news that a plant-based diet may lower your blood sugar. Lowering it
to a normal range is a good thing, but you don’t want it to go too low. This can
happen by combining a powerful way of eating with strong medications.

Low blood sugar, or hypoglycemia, can give you a headache, or make you feel
dizzy or shaky or anxious. If you monitor your blood sugar, you might find you
have these symptoms if your blood sugar drops below 70. Not all of the pills used
for diabetes will cause low blood sugar, but if you are taking one of the
medications that can – and you change your diet – be prepared to: 1) treat low
blood sugar if it occurs and 2) notify your health care provider if you begin having
frequent low blood sugar readings, such as two or more times in one week. Also
be sure to let your provider know if your blood sugar gets so low that someone
else has to help you get treatment. Ask what range is too low for you, and about
having your medication reduced or eliminated.

Below is a list of pills that can cause low blood sugar. These pills can make you
feel hungry if you go too long without eating, which can lead to overeating and
weight gain.

       Table 1: Common Diabetes Pills That May Cause Low Blood Sugar
       Amaryl (glimiperide)
       Avandaryl (Avandia and Amaryl combination)
       Diabinese (chlorpropamide)
       Diabeta or Micronase or Glynase (glyburide)
       Glucotrol or Glucotrol XL (glipizide)
       Glucovance or Metaglip (glyburide/metformin combination)
       Prandin (repaglinide)
       Starlix (nateglinide)
       Januvia (sitagliptin)

Weight Gain
Another group of medications to be aware of are those that can cause weight
      Table 2: Common Diabetes Pills that Cause Weight Gain and/or
      Make It Hard to Lose Weight
      All those listed in Table 1
      Actos (pioglitizone)
      Avandia (rosiglitazone)

       Avandamet (rosiglitazone and metformin)
       Actoplus Met (pioglitizone and metformin)
       Avandaryl (Avandia and Amaryl)

A Few Words about Insulin
Any type of insulin combined with a powerful change in diet may cause your
blood sugar levels go too low. In this situation, mild low sugar is good! It is a sign
that your body is responding to a new way of eating, and that it may be time to
cut back on your insulin. See the section on Low Blood Sugar above, and follow
up with your health care provider. Even if you have never or rarely had low blood
sugar or a reaction to insulin, if you make a major change in your diet, it is a good
idea to always be prepared for an unexpected insulin reaction with some hard
candies or glucose tablets.

Some people see a drop in blood sugar as soon as they change their diet, and
need to reduce the amount of insulin needed right away; others may need more
time before this occurs.

Insulin will cause weight gain if you eat more calories than your body needs. The
Power Plate way of eating may reduce the amount of insulin needed and allow
you to lose weight, or avoid weight gain.

A Few Words about Glucophage (Metformin) for Diabetes
Glucophage (metformin) is the most common diabetes pill. Because it tends to
make people feel full, some lose a few pounds. It should not be used in people
with any kidney or liver problem (which can be checked with periodic blood
tests), or congestive heart failure. It is not recommended for those who drink
excess alcohol. By itself, it usually does not cause low blood sugar. The most
common side effects are gas, bloating, stomach cramps and diarrhea. Taking
this medication on a full stomach may help. The side effects usually go away
over time, but if they persist, this may not be a good medication for you. People
taking metformin should have their B12 level checked periodically.

Consider Blood Pressure Medication
A plant-based diet has been shown to correct high blood pressure. Dizziness,
especially when changing positions, such as from sitting to standing, is a sign
that blood pressure may be getting too low. Work with your health care provider
to monitor your blood pressure and your blood pressure medication(s).

The worst type of diabetes is diabetes that is uncontrolled for a long time. Use all
of the resources to beat this disease: healthy diet, exercise if you are able, and, if
needed, medication as prescribed. A change in your lifestyle may reduce your
need for medication(s). Do not stop any medication without talking to your health
care provider.
                                                                    C.Trapp 5/2010

                            Know Your Numbers
                           *How to Obtain a Meter
                           *Blood Sugar Monitoring
                              *What’s Too Low?

Unlike many chronic diseases, if you have diabetes you have the good fortune to
be able to know, minute by minute, how you are doing. A blood glucose monitor
is fairly easy to learn to use. The readings can let you see the effect of a
particular meal, exercise, or medication. Here is what you need to get started.

Obtaining a Meter
Q.    Who Should Test Their Blood Sugar At Home?

A.    You should test your blood sugar if you have been diagnosed with
       diabetes AND
      1.     Take any of the medications that can cause low blood sugar (See
             the handout, ―Know Your Medications‖) AND/OR
      2.     Have been told you have ―uncontrolled diabetes‖ (generally defined
             as an A1c test of 6.5 – 7% or higher), AND
      3.     You or someone in your home is capable of learning to use the
             blood glucose meter.

Q.    Do I need a prescription?

A.    You can purchase a blood glucose meter at most pharmacies without a
      prescription. However, most insurance plans will pay for a meter and the
      testing supplies if you have a prescription. Sometimes you can take a
      meter prescription into any pharmacy. However, many insurance plans
      work with specific pharmacies or durable medical equipment companies.
      Your best bet to save time and money is to call the toll-free phone number
      on the back of your insurance care and ask how and where to obtain
      diabetes testing supplies.

      When choosing a meter, look for one that has a memory and requires a
      very small drop of blood (3 ug or smaller). Some meters allow you to
      download the readings to your computer. This is an especially good
      feature if you are an insulin user who is doing many tests each day.

Blood Sugar Monitoring
Q.    Do you have any tips for how to learn to use the meter?

A.    Most blood glucose meters have a toll-free phone number on the back.
      Call for free over-the-phone training.

Q.    What should my blood glucose (also called ―blood sugar‖) levels be?

A.    It depends on when you test. The American Diabetes Association
      suggests the following as a weekly average:

      Pre-Meals:                   70-130
      1-2 Hours After Meals:       Below 180
      At Bedtime:                  100-140

Q.    When and how often should I test?

A.    Check with your health care provider for guidance. Usually, insulin-users
      test three times a day and non-insulin users test once a day (and this is
      how your insurance plan determines how many test strips/month they will
      cover, unless there are other conditions requiring more frequent tests).

      In general, if you do not take insulin for your diabetes and are not having
      trouble with erratic blood sugars, test once a day. Vary the test time: do
      some tests before meals and some tests two hours after. That way, by the
      end of a week or two, you have a number of readings at different times
      and can really have a good idea of how often you are within the targets
      described above. You can also see the trends: are you usually high at
      night but lower in the morning? Or maybe your readings are fine before
      meals but much too high afterwards. Identifying the trends is the first step
      towards figuring out how to achieve good control.

      Insulin users are encouraged to test more often; three or more times a
      day. The best time(s) to test depend on what type of insulin(s) you use.
      Check with your health care provider.

      Some health care providers suggest that you test before each meal and at
      bedtime for three days in a row prior to your appointment, and bring the
      record with you.

      If you take diabetes pills or insulin, be sure to test anytime you don’t
      feel well or suspect a ―low‖ blood sugar. Making a change in what
      you eat or how active you are may cause you to start having low
      blood sugars.
Low Blood Sugar
Q.    How do I recognize and treat low blood sugar?

A.    The most common symptoms of low blood sugar are: Headache, or
      feeling grouchy, anxious, sweaty, shaky, dizzy and/or lightheaded.

      Low blood sugar tends to come on suddenly; one minute you feel fine, the
      next you just don’t feel right. It is most likely to occur if you have gone too
      long without eating, or if you are more active than usual.

     A blood sugar reading of 69 or lower is usually considered too low, but
     check with your care provider regarding your target range. Many people
     do not have symptoms until their blood sugar is much lower, maybe 55-65.
     But don’t wait for it to get that low before getting some treatment. Low
     blood sugar can slow your reflexes, which can be a concern especially
     when driving. If you are at risk of low sugar, it is a good idea to always
     have a treatment with you.

     Good treatments:       ½ cup of any kind of juice
                            ½ cup of regular (not diet) soft drink
                            5-6 pieces of hard candy
                            3-4 glucose tablets (sold at drugstores)
                            1 or 2 teaspoons of sugar
     Repeat this treatment after 15 minutes if your blood sugar is still below 79,
     or whatever your target for normal is. If it is close to a mealtime, go ahead
     and eat. If it is the middle of the night, be sure to eat something a little
     more substantial to prevent your blood sugar from dropping back down. A
     small bowl of oatmeal or a slice of toast with a bean spread would work

     Remember: treat low blood sugar with a treatment, not a ―treat!‖ A candy
     bar contains sugar, but also fat, and will not bring your blood sugar up
     very quickly.

Q.   When should I notify my health care provider about my blood sugar

A.   Call for two mild low blood sugars in one week, or if you have a low blood
     sugar that requires help from another person. Ask your health care
     provider if these are the right guidelines for you.

     High blood sugar is also a concern. If you are above 140 for several days
     in a row, or above the target set with your health care provider, be sure
     you notify him or her.
                                                               Ctrapp 2007, 10/2010

                                Class 4
                     GROCERY STORE TREASURE HUNT

1) Find one or two fruits and vegetables in every color of the rainbow:
       Orange:                            Red:
       Dark Green:                        Yellow:
       Purple:                            Blue:

2) Find a fruit or vegetable that you have never before tried:

3) Does this store carry fresh herbs?         Bulk herbs and spices?

1) Find a Fat-free Vinaigrette salad dressing:

  1) Find Fat Free Refried Beans:
  2) Find Vegetarian Baked Beans:
  3) Locate canned fruit with no added sweetener:

  1) What kinds of dried grains do you see?

   2) Name one that you have never tried before:

  1) Name a brand of dried pasta that is made without egg:

  1) Locate a marinara/pasta sauce that has less than 2 grams of fat per
      serving and is made without cheese or meat:
  2) Find a jar of applesauce with no added sugar:

1) Locate and name the brand of a loaf of rye or pumpernickel bread:
2) If not rye or pumpernickel, find a brand of 100% whole wheat or a bread with 3
or more grams of fiber per slice:
3) Can you find a corn or flour tortilla with less than 1-2 grams of fat per serving?

Can you find Tofu? Hummus? Non-dairy Milk(s)? Vitamin B12?

Growing Your Own Sprouts
       Growing your own sprouts is much easier than you think and the end
result gives you healthy ingredients for almost any dish.
       Begin with seeds. For this article I used alfalfa, radish, lentil, mung bean,
adzuki bean, and broccoli. What I found out is that stores such as Wild Oats and
Whole Foods have sprout making products and complete kits that you can use to
grow almost any sprout and that you can buy the larger beans and lentils in the
bulk section of the store. You will need pint or quart size canning jars and
cheesecloth. These jars work great because you can remove the inner lid piece
and use the outer screw top over the cheesecloth.
       Place enough seeds to cover the bottom of the jar. Cut a piece of
cheesecloth the size of the jar opening and place on top of the jar. Screw the out
lid over the cheesecloth and you are ready to go. Fill the jar with water and soak
the seeds overnight in water, then pour out the liquid the following morning.
Place the jar(s) in a warm dark place (I put my jars on top of my refrigerator) and
then rinse them with once a day. In 5 to 7 days, depending on the seeds you are
growing, you will have fantastic and delicious sprouts.

How to Make Over a Recipe: Four Steps

Incorporating healthier meals into your daily menu is easy. You can start by
adapting the recipes you already use. Using healthy versions of favorite dishes
will make your new diet much easier to follow. The step-by-step process below
will show you how to make over a favorite recipe.

Step 1: Substitute plant ingredients for major animal-product ingredients in
a recipe. This is often the only adjustment necessary. Some examples include:

      Vegetarian pasta sauce instead of meat sauce. Use vegetarian burger
       crumbles or texturized vegetable protein (TVP) to make a vegetarian
       "meat" sauce. Another option is to use plenty of chunky vegetables to
       make a vegetable marinara sauce.
      Bean and rice burritos instead of beef burritos
      Moo shoo vegetables instead of moo shoo pork
      Barbecued tofu instead of barbecued ribs
      Bean chili instead of meat chili
      Veggie burger instead of meat burger
      Chickpea salad instead of chicken salad
      Scrambled tofu instead of scrambled eggs

Step 2: Replace minor animal-product ingredients with plant ingredients or
leave them out.

      Use vegetable stock instead of chicken or beef stock.
      Leave the bacon bits, anchovies, and fish sauce out of recipes that call for
       them and add some additional herbs or spices instead.

Replacing eggs and dairy products is easy:

      Try leaving the eggs out of the recipe. This works best with breads and
      Use a commercial egg-replacer powder (available at health-food stores).
      Other easy egg replacers include mashed tofu, ground flaxseed blended
       with hot water, cornstarch, or a banana. Replace cow's milk with soymilk,
       rice milk, or almond milk.
      Leave the cheese out of salads, sandwiches, and casseroles, and make
       pizza without cheese, using plenty of sauce and vegetable toppings

Step 3: Reduce or eliminate added fat or oil. Sautéing in water or vegetable
stock is an easy way to replace the oil. In baked goods, use prune purée,
applesauce, mashed low-fat tofu, or bananas to replace some or all of the fat.

Step 4: Reduce or eliminate added salt. This is especially important when
using ingredients like canned foods that already have sodium in them. A dash of
lemon juice or vinegar will bring out the flavors without extra salt.

Step 4: Let herbs and spices boost the flavor. After reducing the fat and salt
content, herbs and spices can increase the flavor. Be sure to taste the dish as
you add small amounts and add more to suit your taste.

Replacing Eggs

Good reasons to avoid using eggs your diet include:

      About 70 percent of the calories in eggs are from fat, and a big portion of
       that fat is saturated, the kind associated with heart disease, breast cancer,
       and diabetes.
      They are also loaded with cholesterol—about 213 milligrams for an
       average sized egg.
      Because eggshells are fragile and porous and conditions on egg farms are
       crowded, eggs are the perfect host to salmonella—the bacteria that is the
       leading cause of food poisoning in the United States.

Smart cooks have found good substitutes for eggs. Eggs are used for
binding, leavening, and adding moisture to baked goods, but they can easily be

      If a recipe calls for just one or two eggs, you can often skip them.
       Add two tablespoons of water for each egg eliminated to balance out the
       moisture content of the product.
      Egg replacers are available in many natural food stores. Avoid
       reduced–cholesterol egg products, such as EggBeaters, which contain
       egg whites. Instead, choose egg replacers that egg–free and are usually
       in a powdered form. Replace eggs in baking with a mixture of the
       powdered egg replacer and water according to package directions.
      Make your own ―egg replacer.‖ Use 1 heaping tablespoon of soy flour or
       cornstarch plus 2 tablespoons of water to replace each egg in a baked
       product. Or add 1 tablespoon ground flax seed to 3 tablespoons hot water
       to replace each egg.
      In casseroles or savory baked products, use 1 ounce of mashed tofu in
       place of an egg.
      In muffins and cookies, half a mashed banana or 2 tablespoons of
       applesauce can be used instead of an egg; this may also enhance the
       flavor of your recipe.
      For vegetarian loaves and burgers, use any of the following to bind
       ingredients together: tomato paste, mashed potato, moistened bread
       crumbs, or rolled oats.

Delicious Dairy-Free Dining

Eliminating dairy products from the menu is easy, healthy, and tasty. It
takes just a week or two to break the dairy habit, and, even in this short time,
many people who go dairy-free can experience major health benefits, such as a
drop in blood cholesterol levels, weight loss, and relief from allergies, asthma,
indigestion, or chronic stomach problems.

Most dairy products can be easily replaced by the many delicious dairy-
free alternatives available. Next time you're at the grocery store, take a few
minutes to see the surprising range of new nondairy products. Look for low-fat
choices that are free of trans fats or hydrogenated fats.

          Dairy Products                           Healthy Alternatives
             Cow's milk                                     
                                                         Almond milk
                                                          Rice milk

               Cream                         "Silk" soy creamer for coffee or tea
                                              Silken tofu, blended, for creamy
                                                      soups, dips or fillings

               Butter                                 Soy margarine
                                             Try our low-fat techniques and skip
                                                the added fat all together! (See

               Cheese                            Nutritional yeast adds a cheesy
                                                    taste to sauces, pizza, and

                                                  Add baked seasoned tofu slices
                                                   to sandwiches, or bite-sized
                                                   chunks to salads.

               Yogurt                                          Soy yogurt

             Ice cream                        Soy or rice-based frozen desserts
                                                          or smoothies
                                             Frozen peach slices or grapes

Going Low-Fat: Low-Fat Cooking Methods

     Grill or oven-roast for a delicious, low-fat alternative to deep-
      fried foods.
     When oil is absolutely necessary to prevent sticking, apply a
      light coating of nonstick vegetable oil spray.
     Instead of sautéing vegetables in oil, heat a small amount of
      water, vegetable stock, wine, or other liquid in a large pan or
      skillet. Add the ingredients to be sautéed and cook over
      medium-high heat, stirring occasionally until tender (about five
      minutes for onions and most other vegetables). Add more liquid
      if needed.
     For cream soups, thicken soups with a potato instead. For soups
      that will be puréed, simply cook and purée the potato with the
      other soup ingredients. For other soups, cook a peeled and diced
      potato in enough water to cover it. When the potato is fork-
      tender, purée it in its cooking water in a blender and add it to
      the soup. You can also make bean or pea soups creamy by
      puréeing half the soup and mixing the purée back into the
     For sauces and gravies usually prepared with fat, flour, and
      liquid, eliminate the fat by toasting the flour in a dry pan until
      lightly browned. Whisk in the liquid to remove lumps, then cook
      over medium-low heat, stirring constantly until thickened.
     Replace oil in salad-dressing recipes with rice vinegar or any
      mild-flavored vinegar, vegetable cooking liquid, juice, or water.
      Use puréed soft tofu for a creamy base. If desired, use
      cornstarch to thicken the dressing.
     For baked goods, mashed banana, applesauce, cooked pumpkin,
      or prune purée can often replace all or part of the butter,
      vegetable oil, or shortening, with no change in taste or texture.
      Experiment with your recipes, adding a bit less fat each time and
      evaluating the results. When you cut the fat, you may need to
      add extra liquid to achieve the desired consistency. Replacing
      eggs with cholesterol-free, egg-free substitutes also cuts the fat
     Cooking without dairy products will also help to keep fat low.

Can You Improve This Recipe? Baked Spaghetti

From A River of Recipes: Native American Recipes Using Commodity Foods,

Makes 4-6 servings
                                            1. Preheat oven to 350ºF.
½ package (1 pound) spaghetti, cooked
                                            2. Rinse cooked spaghetti in cold water;
according to directions
                                            set aside to drain.
4 (15.5 ounce) cans tomatoes,
chopped, with juice
                                            3. Chop tomatoes as small as possible;
½ can luncheon meat, diced
                                            set aside with juice.
1 teaspoon vegetable oil
1 onion, diced
                                            4. Brown luncheon meat in large pan
1 bunch cilantro, chopped
                                            with oil.
1 teaspoon oregano
1 teaspoon sweet basil
                                            Add onion, lower flame and stir
pepper, to taste
                                            constantly until onions are brown. Add
1 teaspoon garlic powder
                                            tomatoes with juice, cilantro, oregano,
1 cup shredded cheese or Parmesan
                                            basil, pepper, and garlic powder.
To lower the sodium content: substitute     5. Bring to boil, reduce heat and simmer
lean ground beef or lean ground bison for   15-20 minutes, stirring occasionally.
luncheon meat. Or omit meat or both
luncheon meat and parmesan cheese.          6. In oiled 4 quart pan, layer half of the
To lower the fat content: omit cheese or    cooked spaghetti, ½ tomato mixture,
omit cheese and meat.                       then the rest of the spaghetti, then the
                                            rest of the tomato mixture. Top with

                                            7. Bake at 350ºF for 30 minutes.

Nutrition Information for each serving:
Calories 660 Kcal Cholesterol 60 mg Sugar 11 g Calcium 150 mg
Calories from fat 260 Kcal Sodium 1260 mg Protein 25 g Iron 8 mg
Total fat 29 g    Total Carbohydrate 92 g Vitamin A 300 RE
Saturated fat 12 g Dietary Fiber 5 g     Vitamin C 22 mg

          Bonus: Plant Milks as an Alternative to Dairy Products

I. Overview of Plant Milks

   Plant milks can be made from…
           o nuts e.g. almonds, walnuts, macadamia nuts, cashews, brazil nuts,
               pecans, pine nuts, etc.
           o seeds e.g. pumpkin, hemp, sunflower, sesame
           o grains e.g. oats, rice
           o other legumes e.g. soy beans
           o fruit e.g. coconut

   Plant milks can be store-bought and/or homemade:
            find in refrigerated section next to dairy products and in aseptic shelf-
               stable cartons; coconut milk comes pasteurized in a can and is the extract
               of the grated flesh of mature coconuts (use sparingly due to its high
               saturated fat content)
            popular store brands include Silk, 8th Continent, Eden, Pacific Foods,
               Health Valley, Vitasoy, Westbrae, Westsoy, Rice/Soy/Almond/Hemp/Oat
               Dream, Living Harvest, Blue Diamond Almond Breeze, 365, etc.
            brands and formulas (light, plain, flavored, etc.) taste quite different – if
               you’re new to these products, try several to see which one(s) suit you
            many have vitamins and minerals added: calcium, vitamin D, vitamin B-
               12, riboflavin
            Approx. $1.50 to $3 for 32 oz.
            easy to make
            tastes better?!
            as economical as commercial brands – cost depends on the plant used
               e.g. last night I purchased 1 cup of walnuts for $2.66
            ingredients available in bulk bins which reduces packaging
            milk can be stored in re-purposed glass jars

   Plant milks have the following nutritional benefits:
           o no saturated fat from an animal
           o cholesterol-free
           o usually less in calorie content
           o as mentioned above, many commercial varieties have vitamins and
               minerals added such as calcium, vitamin D, vitamin B-12, riboflavin – see
               handout from Vegetarian Resource Group (www.vrg.org) for a
               comparison of brands
           o oat milk, in particular, is high in fiber since the whole grain is used

           o   hemp milk is high in Omega 3 essential fatty acids
           o   walnut milk is high in Omega 6 essential fatty acids
           o   fresh coconut milk (coconut water blended with coconut meat) is high in
               ascorbic acid, B vitamins, proteins, and electrolytes; it has powerful
               antibacterial and antiviral properties and is particularly good for boosting
               immunity; the medium chain fatty acids in coconut are more likely to be
               used for energy and less likely to be stored as fat, compared to other fats
               (source: Raw Food, Real World); coconut water is fat-free.

   Plant milks can be used in the following ways:
           o enjoy a stand-alone glass; consider topping w/ cinnamon and/or nutmeg
               to make it like a ―nog‖
           o topping for cereal
           o creamer in coffee
           o creamy base for smoothies
           o creamy base for soups
           o creamy base for sauces

   Important note: While these products are popular with many adults and children,
    none should be used to replace breast milk or infant formulas. They are not suitable
    for use by infants as a main food since they do not resemble breast milk or infant
    formula in composition.

II. Making Plant Milks at Home

   Basic Tools:
           o blender, preferably high-speed like a Vita-Mix
           o   some plant milks require the use of a strainer e.g. nut milk bag (approx.
               $8; see sources below), layers of cheesecloth, t-shirt, wire mesh sieve
                      Sources for nut milk bags:
                      www.RawGlow.com (organic cotton nut milk bags)

   Basic Formula:
           o soak nuts for 1 to 2 hours up to overnight – harder nuts and nuts with
              skins e.g. almonds require longer soak times; discard soak water
           o seeds don’t need to be soaked
           o adjust ratio of fresh water to soaked nuts/seeds to your desired level of
           o use the sweetener of your choice: e.g. agave, dates, maple syrup
           o add salt to taste, preferably Himalyan or sea salt
           o add additional flavors as you like: vanilla, chocolate/cacao/carob,
              strawberry, banana, chai, etc.

            o   keep milk refrigerated and shake before serving

    Almond or Walnut Milk

    Source: Alive in 5 by Angela Elliott

    5 cups filtered water
    1 cup soaked raw almonds
    3 tablespoons raw agave nectar
    1+1/2 tablespoons vanilla flavor
    ¼ teaspoon salt, preferably Himalyan

    Combine the water and almonds in a blender, and process until smooth (approx. 2
    minutes). Strain, and set aside pulp for another recipe. Rinse out blender jar and
    pour milk back into it. Add the remaining ingredients, and process until smooth and

    Makes 6 servings.

    Hemp Milk

    Source: The Thrive Diet by Brendan Brazier

     3+1/2 cups water
    1 cup hemp seeds
    2 tablespoons agave nectar

    In blender, combine all ingredients.

    Keep refrigerated up to 2 weeks.

    Makes about 4 cups.

    Beautifying Pumpkin Mylk

    Source: Ani’s Raw Food Kitchen by Ani Phyo

    ½ cup pumpkin seeds
    ½ cup pitted dates
    ½ vanilla bean or ½ tablespoon vanilla extract
    pinch sea salt
    5 cups water

    Put the pumpkin seeds, dates ,vanilla bean, salt, and water in blender and blend until
    smooth. Will keep for four days in the fridge.

   Other Non-Dairy Options to Try: Rice Milk, Oat Milk, Soy Milk

    Source: www.DeliciousWisdom.com

Rice Milk

¼ cup uncooked brown rice
4 cups water
Optional: ½ teaspoon vanilla extract and/or sweetener, to taste

In a large pot, combine rice and water. Bring to a boil, cover, and turn to low heat.
Simmer for one hour. Let cool for a few minutes, and pour into a food processor.
Blend for about one minute or until smooth, adding optional vanilla and sweetener if
desired, then strain.

Yield: 3 to 4 servings.

Oat Milk

3 cups very hot water
1 cup rolled oats
2 teaspoons Sweet White or Barley Miso

Combine all ingredients in a container with a lid, being sure that miso is dissolved.
Cover tightly and refrigerate overnight. In the morning, blend until smooth in a
blender or food processor.

Soy Milk

1+ ½ cups dry, organic soy beans

   Soak beans for 10-24 hours in about 4 cups of clean water. Drain and rinse.
   In a food processor, blend another 4 cups of water with soaked beans until
    creamy and combined.
   Pour mixture into a large pot and add an additional 4 cups of water. Bring a
    boil. Mixture will bubble up and try to boil over the edge of the pot. Stop it by
    keeping a glass of water next to the stove and sprinkling a few drops over the top
    while giving a good stir, as well as turning down the heat. Turn the heat back up
    and it will rise up again almost immediately. Add another dash of water and stir
    again to get it back down. Continue doing this until mixture no longer bubbles up,
    which will take about ten or fifteen minutes. Once mixture stops bubbling, let it
    simmer for an additional ten minutes.
   Strain through two pieces of cheesecloth. This is most easily accomplished by
    putting a metal strainer over another pot and lining it with the cheesecloth, then
    squeezing the pulp with rubber gloves on to get every last bit of milk. Save the
    leftover soybean bits to make burgers or add to spaghetti sauce.
   Cover and cool immediately. The quicker the soymilk is cooled, the longer it will
    stay fresh. If, after cooling, you get a skin on the top-- strain it off right away or
    you'll be picking gross-looking (though perfectly harmless) pieces of stuff out of
    your milk for days. Yield: 9 cups


                                   Class 6 Review

  1. Name the 4 food groups on the Power Plate
     1. _______________________            2. _______________________

     3. _______________________               4. _______________________

  2. List one or two ideas for breakfast:

  3. List three ideas for lunch

  4. List three ideas for dinner

  5. List three ideas for snacks

  6. What one vitamin pill is needed for most adults over age 50, and everyone
  who follows the Power Plate diet, to prevent fatigue, nerve problems, and

  7. Calcium is important for bones. Ads on TV make people think milk and
  cheese are the best foods for calcium. Name 3 healthy calcium-rich foods:

  8. True or false? The Power Plate diet is good for children. _________
  9. True or false? The Power Plate diet is good for pregnant women. _____
  10. True or false? The Power Plate diet is good for athletes. ______

  11. Circle the correct answer: Animals foods are risky for people with
  diabetes or at risk of getting diabetes because:
     a. Animal foods tend to be high in fat, which can be bad for the heart
     b. Animal protein is hard on the kidneys, increasing the risk
        of kidney damage.
     c. Both a and b


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