1.Bread, Starches, Cereals (Most Commonly Used)
- Rice (mostly long grain rice)
- Beans (Red, Pink, Pigeon Peas or Guandules), Roman (Dominican favorite), Black (Cuban favorite), Chick peas, lentils
- Bread (mostly white), Saltines
- Oatmeal, Farina, Cold Cereals, Yellow Hominy Corn
- Viandas (root vegetables) Viveres (root vegetables –Dominican Republic) Plantains (Green/Yellow), Green bananas, Taniers (Yautia), Chayote Squash, Cassava, Manioc, Breadfruit, Malanga, Calabaza (local pumpkin), Cornstarch, Casabe(flat bread made of cassava flour)
Practices and Counseling Tips:
- Hispanic patients often use “Cornflakes and Cheerios” when naming most cold cereals
- Whole wheat bread is often considered diet bread and not having an impact on blood glucose levels
- Root vegetables may or may not fried.
- Anecdotally, most Caribbean Hispanics acknowledge the relationship between rice, plantain and cassava and blood glucose levels, while the use of other starchy root vegetables and blood glucose level is less clear
- Rice is cooked with oil – Corn oil is the preferred one
Tips: Suggest substituting some rice with chayote squash or calabaza/ahuyama, which contains less carbohydrate per serving. Emphasize portion control.
2.Vegetables (Most Commonly Used)
- Lettuce, Okra, Tomatoes, Peppers, Onions, Cucumbers, Broccoli, Eggplant, Carrots, String beans, Cabbage, Watercress, Cilantro
Practice and Counseling Tips:
- Caribbean Hispanics do not normally consume large quantities of vegetables, however, some vegetables are pureed and used to season foods. Encourage use of “sofrito” (seasoning made of pureed cilantro, peppers, onions, recao (green leaf), and garlic) in most dishes
- Encourage salads with lunch and dinner
3.Fruits (Most Commonly Used)
- Oranges, Papaya, Mango, Pineapple, Grapefruit, Banana, Grapes, Quenepas, Chirimoya, Soursop, Mamey, Sapote, Parcha, Guava, Tamarind, Nispero, Custard Apple, Star Fruit
Practice and Counseling Tips:
- Fruits are eaten raw, in juice or nectar (fruit pulp, water and high fructose corn syrup) frozen (used in “batidas” or smoothies – most “batidas” are prepared with evaporated or whole milk.
- Tip – Suggest using non-fat or low-fat milk
- Some fruits are considered “good/beneficial” in the treatment of diabetes/cholesterol such as grapefruit and papaya while others are considered to have a negative impact (mango and orange)
- Tip – Ask the patient which fruits have a positive/negative benefit and counsel accordingly
4.Milk, Yogurt (Commonly Used)
- Evaporated Milk, Sweet Condensed Milk, Regular Milk, Low-fat milk, Skim Milk, Yogurt
Practice and Counseling Tips:
- Diet milk often refers to any milk without the “red top” – Diet milk is not considered to impact blood glucose levels
- Stress that “diet” foods are not calorie and/or carbohydrate free
- Suggest use of low-fat evaporated and sweet condensed milk
.Protein Foods (Commonly Used)
- Cod Fish, Chicken, Pork (Shoulder or pork chops) Beef, Turkey, Eggs, Goat, Nuts, White Cheese, Edam/Gouda (Refer as queso de papa) Mozzarella, Chorizo, Morcilla, Salchichon, Beef Tripe, Oxtail, Vienna Sausage, Kipe (fried meat pattie made of ground beef, seasonings, and bulgur wheat- Dominican)
Practice and Counseling Tips:
- Cod Fish is normally salted and prepared with root vegetables and olive oil
- High fat meats are used in rice, beans and meat dishes as flavors – Encourage use of leaner meats.
- Suggest adding vegetables to meats
- Provide a list of leaner cuts of meats/substitutes
6. Fats (Commonly Used)
- Avocadoes, Olive Oil, Corn oil, Vegetable, Lard, Butter, Margarine, Mayonnaise, Cream cheese,
Practice and Counseling Tips:
Mazola corn oil is commonly used. However, it is common to use “Mazola” to describe any other oil used
Olive oil is often used daily
Puerto Ricans often use pork fat to season rice dishes
Avocadoes and nuts are normally considered to be “high in cholesterol” and “bad for diabetes”
- Tip- Explain difference between fat and cholesterol
- Lard is seldom used
7.Sweets
- Tembleque, Majarete, Flan, Arroz con dulce, Preserves and Jellies made from Guava, Papaya, Coconut milk, Piraguas (Shaved ice cones with syrup (tamarind, raspberry, pineapple, coconut), dulce de leche (caramel)
Practice and Counseling Techniques:
Tembleque and Majarete are pudding- like desserts prepared with milk, coconut milk, cornstarch, cornmeal, rice flour and sugar
Tip: Suggest using lower fat milk, and non-nutritive sweeteners
Most nutrient composition of desserts can be obtained from www.goya.com
Emphasize portion control
Drinks
Rum, Ponche, Coquito(raw eggs, milk, coconut milk- eggnog like) Malta, Mabi, Coffee, Beer, Herbal Teas (Chamomile, Passiflora, Cinnamon, Peppermint, Ginger, Aloe), Batidas, Oatmeal shakes, Morirsoñando
Practice and Counseling Tips:
Suggest use of pasteurized eggs for coquito (usually served in December)
Oatmeal shakes are made with whole or evaporated milk – Tip: Suggest non-fat alternatives
Morirsoñando is a traditional Dominican beverage made using evaporated milk and orange juice. Tip – Suggest use of low-fat milk
Coffee is prepared using 3 parts milk to one part coffee (espresso) Tip – Count as ½ to 1 CHO exchange
Malta , a non-alcoholic beverage made of barley and hops often perceived as highly nutritious and not considered to impact blood glucose levels – Tip: Include Malta in food frequency questionnaire – A 12-ounce bottle contains 214 calories and 48 g. of CHO
8.Herbs
- Sofrito,Adobo, Sazon, oregano, Alcaparrado, achiote (annatto seed), bay leaves, sour orange, Mojo (made with lime, sour orange, lemon juice, herbs), Bijol, Bija, Cumin
Practice and Counseling Tips:
Most commercially prepared seasonings are high in sodium –
- Alcaparrado (mixture of capers, olives and pimentos in vinegar) is added to rice and meat dishes – It is high in sodium
- Sour orange (used in marinades) may cause possible interaction with statin drugs
- Mavi – drink made out of a tree bark
Drago, Lorena. Beyond Rice and Beans: The Caribbean Latino Guide to Eating Healthy with Diabetes. Alexandria, VA: American Diabetes Association;2006
www.diabetes.org or lorena@lorenadrago.com
