Dear Diabetes: Is there such a thing as a diabetic diet?
I’m asked this question a lot! Patients come to me with all kinds of ideas and misconceptions about what a diabetic diet might be. Some try to avoid “white” foods, grains, desserts or fruit. Some think they need to eat every three or four hours. And still others think a so-called diabetic diet includes unlimited amounts of meats or whole grains. Although there are some basic principles to follow, I individualize each diet for the client’s lifestyle, food preferences, and other factors. Here are a few guidelines to keep in mind when determining what your diabetic diet might look like:
Balance: Since carbohydrates affect blood glucose more than protein and fat do, many people think they need to completely avoid carbohydrate-rich foods. Good news! It’s not true. Living with diabetes doesn’t take away either your right or your need to eat healthfully. Instead of simply avoiding carbohydrates, make wholesome carb choices in order to feel energized, stay focused on tasks, and enjoyed a well-rounded mix of foods. In moderate amounts, as part of a diabetes meal plan put together with the help of your care team, carb-containing foods such as whole grains, nonfat or low-fat milk and yogurt, starchy vegetables, and fruits can be a part of your diet. There is no reason to seek out special foods made for people living with diabetes because all you need are the same nutritious foods everyone can enjoy.
Spread out: My advice is to eat at least three meals daily and to spread your food intake evenly throughout the day. The amount of food you eat, especially the amount of carbohydrate, affects the subsequent change in your blood glucose. Typically, a small amount of food raises blood glucose a small amount, and a large amount of food spikes it a large amount. If you skimp on breakfast and lunch to gorge on a big spaghetti dinner, for example, you may expect your post-dinner blood sugar level to be higher than you may wish.
Reduce sodium and unhealthy fats: While these don’t directly affect your blood glucose levels, keeping sodium and unhealthy fat levels in check is another part of developing a more healthful meal plan. The American Diabetes Association guidelines recommend that people with diabetes have 2,300 mg sodium or less per day. If you have diabetes and hypertension (high blood pressure), you should be shooting for 1,500 mg or less per day. Read nutrition labels carefully, and prepare as much food from scratch as possible, since most of the sodium in the average person’s diet comes from packaged foods and restaurant meals. Avoid trans fats in processed foods completely. If you see the words “partially hydrogenated oil” on a food label, the product will have at least trace amounts of trans fats. To cut saturated fats, avoid animal fat as much as possible: Use nonfat and low-fat dairy products, trim fat from meat, and peel off poultry skin.
Different foods for different folks: Since everyone’s likes and dislikes, lifestyle, and diabetes are different, it shouldn’t be surprising that their diets should be different, too. There are many paths to a healthy plate. I have had patients manage their diabetes while eating a vegan diet, a vegetarian diet, or an omnivore diet. Some patients count carbs and calories, others use diabetic exchanges, while still others use a simple method called the Plate Method. The key to success is finding a balanced diet you can live with.
The one meal plan to avoid is an overly restrictive one. If your food choices don’t taste good and you can’t follow the plan, they probably won’t help you. A registered dietitian skilled in diabetes management may help you structure a meal plan that works for you and your diabetes. Find a registered dietitian in your area through the Academy of Nutrition and Dietetics.
That was the long answer to the question. Here’s the short answer: In my opinion, a diabetic diet is based on wholesome, appetizing foods eaten in moderate amounts, and spread throughout the day.
For more stories in the Dear Diabetes series, visit The DX archive.
Jill Weisenberger, MS, RD, CDE*, is the author of Diabetes Weight Loss Week by Week, contributing editor for Environmental Nutrition, and has written for many publications including EatingWell, Diabetic Living, Her Sports + Fitness, and LifeScript. Weisenberger is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.
*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.
© 2012 The DX: The Diabetes Experience