If you live in the US, it’s likely you’ve come across someone in your life who has diabetes or for whom high blood sugar is a concern. It is estimated that over 29 million or 9.3% of the American population has either Type 1 or Type 2 diabetes, and that 86 million are pre-diabetic, meaning they have higher than normal blood sugar levels. That’s a lot! The good news is that although a component of many diabetes cases is genetic, for many, changes in eating and lifestyle can make a significant impact.
If you have diabetes or are pre-diabetic, basically it means that your body cannot make or properly use insulin or absorb energy in the form of glucose from the foods you eat. Your body needs glucose in order to function properly. Taking this into consideration, it’s important to create a personalized meal plan for your personal situation, medical condition and lifestyle with a dietitian or medical professional. However there are some common tips, myths and facts that can be helpful for anyone living with diabetes.
What is a healthy diabetic diet? One that contains everything any healthy diet would contain—vegetables, fruits, whole grains, healthy fats, lean protein and, yes, some sugar. Particularly important are the right amount of calories and the right balance of carbohydrate, protein and fat. Some specific helpful tips include:
- Limiting foods that are high in sugar
- Eating smaller portions, spread out over the day
- Being careful about when and how many carbohydrates you eat
- Eating a variety of whole-grain foods, fruits, vegetables, protein and fat every day
- Eating less fat
- Limiting your use of alcohol
- Using less salt
Here are some myths and facts about healthy eating for diabetes:
Myth: The only way to lower blood sugar levels and weight is to eat little or no carbs.
Fact: Our bodies need glucose (blood sugar) to function properly. Glucose provides the energy we need to move, for organs to function, for the brain to think, etc. If you just simply stop eating carbs, your body will convert the protein that you eat into glucose, and you could still have high blood sugar if you are insulin resistant. So you need some carbs in your diet, but not too many.
It is helpful to eat smaller amounts of carbs throughout the day. If you snack, having 15 grams or 1 carb serving as a snack coupled with protein helps stabilize your blood sugar. Focus on making healthy food choices such as fruit in moderation, low carb and low glycemic veggies, whole grains, lean protein and healthy fats.
Myth: If you have diabetes, you should never eat starchy foods, such as bread, potatoes and pasta.
Fact: Starchy foods can be part of a healthy meal plan, but portion size is key. Wondering how much carbohydrate you can have? As I mentioned earlier, it’s important to come up with a personalized meal plan with your own dietitian or health professional, but a place to start could be 30-60 grams of carbohydrate per meal, and 15 grams for a snack, depending on your size and weight loss goals. Once you know how much carbs to eat at a meal, choose your food and the portion size to match.
Myth: Fruit is a healthy food so I can eat as much as I want.
Fact: Fruit is a healthy food. It contains fiber, vitamins and minerals. However fruit contains sugar in the form of fructose, so the amount of fruit you eat should to be limited to what you plan out in a meal plan rather that eaten ad lib.
Myth: People with diabetes can’t eat sweets or chocolate.
Fact: Excess sugar is not good for anyone’s diet whether you have diabetes or not. If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more “off limits” to people with diabetes than they are to people without diabetes. The key to sweets is to have a very small portion and save them for special occasions so you focus your meal on more healthful foods.
Myth: Sugar-free foods won’t affect blood sugar levels.
Fact: Sugar-free foods are not necessarily carbohydrate-free foods. For example, grains are sugar free but still affect blood sugar, as do sugar alcohols (e.g. sorbitol, xylitol), which are often used as sweeteners in sugar-free foods. Sugar alcohols provide fewer calories and make less of an impact on blood sugar than regular sugar but they can still elevate glucose levels.
WHAT ELSE CAN HELP?
In addition to keeping track of the carbs you are eating there are some other factors to consider that affect how quickly and how much your blood sugar rises.
1. Glycemic Index (GI)
The glycemic index of foods is a measure of how quickly a food will cause the blood sugar to rise, so it’s helpful to eat foods with a low glycemic index. Some examples of low GI foods are broccoli, mushrooms, eggplant and cauliflower.
Carbs containing soluble fiber such as oats, beans and barley digest slower, therefore they don’t give you quick rises in blood sugar. Any fiber helps blood sugar so eating high fiber low carb veggies like avocado, broccoli, cauliflower, spinach, green beans, is healthy.
3. Resistant Starch
Fiber is usually classified as soluble or insoluble. Resistant starch, sometimes referred to as the third type of fiber, is considered good for gut health as a prebiotic but also creates a smaller glucose peak. It is found in partially milled whole grains, some legumes and in some unripe fruit. It has also been found that the carbs in cooked then cooled starchy foods such as potatoes, rice and pasta converts to resistant starch and therefore causes less of a blood glucose rise.
4. Balanced Meals
Combining your carbs with protein and fat slow down blood sugar rises.
5. Other nutrients are involved with blood sugar metabolism:
- Adequate Magnesium alters insulin secretion and action. Low levels increase insulin resistance.
- Chromium helps insulin bind to the cell’s receptor sites and increases blood sugar uptake.
- Zinc influences carb metabolism and a deficiency may decrease insulin action.
- Cinnamon decreases fasting glucose levels by potentiating the action of insulin and stimulating glucose uptake into the cells.
- Green tea increases insulin activity.
- ALA or alpha lipoic acid improves insulin receptor sensitivity and glucose metabolism.
Healthy eating, combined with exercise and weight loss, is critical to managing diabetes and the complications of diabetes. They also happen to be helpful for overall health and well-being! I have found that it is helpful to my patients to focus on GIVING yourself a variety of delicious healthy foods as part of a healthy meal plan, rather than what you are GIVING UP. After all, you are in control of how you balance out your sources of nutrients, carbs and exercise to create an overall healthy lifestyle.
Lea Basch is a registered dietitian and has been in the nutrition industry for over 30 years, most of which she spent at Longmont United Hospital in Boulder, Colorado, where she was one of the founders of the facility’s nutrition program. Longmont’s Planetree philosophy of caring for the body, mind and spirit of patients is very much in line with Lea’s interest in both traditional and alternative therapies for treating chronic illnesses. Gluten-intolerant herself, Lea now focuses much of her time on the latest research and issues relating to gluten-free diets and other food intolerances. She is a diabetes educator and is a Registered Dietitian with the American Dietetic Association. Lea’s lifelong passion has been combining the science of nutrition with the heart that it takes to change lifelong habits.
Lea received her BS and MS in Nutrition and Dietetics at Florida International University and BA in Education at University of Florida. Ask Lea your nutrition questions at Lea@tastefulpantry.com
References: WebMD.com, nim.nih.gov, diabetes.org, mayoclinic.org