En español | Long before the U.S. government replaced its pyramid-shaped nutrition chart with a round one, the American Diabetes Association (ADA) was using a plate to teach prevention and management of that disease.

Although diabetes today affects roughly 1 in 12 Americans — and more than 1 in 4 Americans age 65 and over — there is good news on that ADA plate, says diabetes educator Sue McLaughlin. By combining ADA's carefully balanced diet with regular exercise and weight control, people who have diabetes can prolong good health, says McLaughlin. "And those who don't have the disease but are at increased risk for its development may delay or prevent its onset."

See also: Connect with others living with Type 2 diabetes in the Online Community.

When the human body processes food, it breaks down sugars and starches into glucose — but to take the glucose from the blood into the cells that use it as fuel, the body needs a hormone called insulin. If insulin is scarce or absent, glucose builds up in the blood and can lead to complications including heart disease and stroke, kidney and nervous system disease, and blindness. In Type 2 diabetes, the most common form of the disease, the body either does not produce enough insulin, does not use it well, or both.

To help their bodies use glucose, people with Type 2 diabetes may use oral medications or insulin injections. "But anyone can, so to speak, 'out-eat' their diabetes medication" by consuming too much food or too many calories, McLaughlin says. So diet is critical to achieving the balance that keeps diabetics healthy, and to preventing progression of the disease for the estimated 79 million Americans with prediabetes (blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes).

"What's good for people at risk for diabetes, or who have diabetes, is generally what's good for all of us," McLaughlin says. "It's eating foods that are nutrient-dense, high in vitamins, minerals and fiber. It's eating those that are lower in fat and overall calories, and monitoring our intake of carbohydrate-containing foods that directly cause the blood sugar to rise. It's balancing 'calories in, calories out' by eating with good health in mind, and getting regular exercise so you maintain a good weight, ideally a body mass index of 25 or less." (Don't know your BMI? Use the Body Mass Index Calculator to calculate it.)

The ADA's "create your plate" campaign uses a 9-inch plate to manage portion size and nutritional balance in five steps:

1. Imagine a line down the middle of the plate, cutting it in half. Fill one half of the plate with non-starchy vegetables: salad, green beans, tomatoes, cabbage, carrots, cauliflower, broccoli.
2. Imagine a second line cutting the other half of the plate into two equal parts. Fill one of those parts with starchy foods: noodles, rice, corn, potatoes, beans, whole-grain bread.
3. Fill the remaining quarter of the plate with meat or meat substitute: lean beef or pork, poultry, fish, seafood, eggs, low-fat cheese, tofu.
4. Add one piece of fruit (or a ½-cup serving of fresh, frozen or canned-in-juice fruit).
5. Add an 8-ounce glass of non-fat or low-fat milk (or, if you don't want milk, another small serving of a carbohydrate such as a 6-ounce container of low-fat yogurt or a small roll).

(For breakfast, the plate is divided the same way but filled somewhat differently: starches in half the plate, fruit in one quarter of it and meat/meat substitute in the other quarter.)

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