Health Care Quarterly:

Fast food dining with diabetes? Proper choices make it possible

As anyone living with diabetes knows, following a healthy eating plan and eliminating junk food from your diet — foods low in nutritional value but high in calories, sugar, carbohydrates and fat — is essential to managing your condition and keeping your sugar (glucose) levels in check.

Many people think following a healthy diet means foregoing the occasional fast-food restaurant stop, but that’s not necessarily true. Of course preparing a nutritious meal at home — of whole grains, a lean protein such as fish or chicken and a salad or steamed, nonstarchy vegetable such as broccoli or cauliflower — will always be the best choice, but the daily demands of work and family can make doing that every night impossible.

Fast food menus can be a hot bed of bad nutrition — extra-large sizes, sugary drinks and fatty fried foods — but the good news is that healthier menu options such as whole grain buns, salads and fresh fruit make it easier than ever to customize your order to meet your dietary needs. By following basic guidelines for good nutrition — and limiting fast-food visits to no more than two times a week — you can stay on track even when you’re crunched for time.

Get the facts: While most fast-food restaurants readily post calorie information on their menus, finding details like fat, sugar, sodium and carbohydrate content can require a bit more research. Look for the information ahead of time on the restaurant’s website, or just ask for it at the counter. Your goal is to identify choices with fewer than 400 calories, 20 grams of fat, and 800 milligrams of sodium per serving.

Beware of buns…and forget the fries: The bun can be most unhealthy part of a fast-food sandwich. The body converts carbohydrates such as bread, pasta, and starchy vegetables like potatoes into glucose during digestion, which can cause a diabetic’s blood sugar level to spike. Some grilled chicken sandwiches (a great menu choice, by the way) are served on whole grain rolls. You can also limit bread consumption by ditching the top bun and eating your sandwich open face. Another alternative is to avoid bread altogether and ask for your sandwich to be wrapped in lettuce.

If you’re hitting the drive-through for a quick breakfast, remember to steer clear of high-carb biscuits, rolls and muffins (even low-fat versions can be loaded with excess calories and sugar) and give your day a healthy start with items such as yogurt, cold cereal with fat-free milk, scrambled eggs, or pancakes with sugar-free syrup. Skip the side of sausage or bacon, as these contain too much saturated fat.

Fries are also on the no-go list for people with diabetes — and anyone seeking to live a healthier lifestyle. Instead of fries, ask to substitute a more nutritious option, such as a small side salad with light or fat-free dressing, fresh fruit slices or a fruit cup.

Skip the sauce: Mayo, dressing, “secret sauce” — all of these rich, high-fat, high-sugar options spell bad news for health-conscious customers. Even ketchup and barbecue sauce can have too much added sugar and sodium. Order your sandwich plain and add flavor with mustard, extra tomatoes, onion, pickles and lettuce instead.

Forego the upgrade: Don’t “supersize” it. Don’t go deluxe. Don’t go double. Bigger isn’t always better; in this case, bigger means more calories, sugar, fat and sodium.

Wet your whistle wisely: Round out your fast-food meal with a healthy drink choice. Water is best, but unsweetened ice tea or a diet soda will also hydrate you while keeping your blood sugar level in check.

For more guidance on living a healthy, active lifestyle with diabetes, HealthCare Partners of Nevada offers educational materials as well as classes about managing diabetes. Nurses are also available to counsel diabetic patients on a one-on-one basis. Learn more about the organization and its resources by visiting www.hcpnv.com.

Dr. Michael Gonzales is an endocrinologist with HealthCare Partners Nevada, a DaVita Medical Group.

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