Category Archives: Patient


Teaching Carbohydrate Exchanges

Medical  nutrition therapy is an integral part of diabetes management. I am not a dietitian but I do try to teach my patients the diabetic exchange system. A formal diet plan by the dietitian includes a computation for how many carbohydrate exchanges or servings are allowed. In my clinic however, I just advise patients to keep to one cup of rice per meal and to take am and pm snacks equivalent to half a cup of rice.

How does that work out?

1/2 cup of rice = 1 cup noodles = 2 slices pan amerikano = 3 pieces pandesal = 1/2 cup oatmeal

So I tell my patient, if you’d rather eat pandesal in the morning – one cup of rice is equal to 6 pieces of pandesal. Of course I mean the P2 pandesal, the small ones. I used to say the P1 kind until a patient told me, “Dok, wala na pong pisong pandesal ngayon!”¬† But if the pandesal is for merienda, then only 3 pieces is allowed. If the patient prefers sliced bread, then he can have 4 slices for breakfast. One cup of rice is equal to one cup of oatmeal. There is a misconception that since oatmeal has fiber, you can eat as much as you want.

If for lunch, the patient would rather eat bihon, then 2 cups of bihon is equal to 1 cup of rice.

Dr. Philip Chua wrote about the calories in Filipino food. Check out this link if you’d like more information.



Next time you eat a salad


Think twice before reaching for the thousand island dressing!

Patients often tell me in the clinic that they are dieting for their diabetes. “I only eat salads now, Doctor!” they would swear. Salad dressing however can let slip in quite a bit of extra calories into your otherwise healthy selection of greens as the slide above shows – a whopping 200 calories more for 2 tablespoons of mayonnaise, so beware!

Watch out for the cheese as well. Cooking with Marlene says that each 1/4 cup of shredded cheddar cheese adds 115 calories and 10 grams of fat! Her advice is to use just a tablespoon or two of strong flavored cheese like Parmesan or blue cheese.