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5 Tips for Italian Cuisine

Ways to make it diabetes-friendlier

Pizza, pasta, Parmigiana … Italian food certainly has an abundance of satisfying flavors. But, many people, especially those living with diabetes, may hesitate to indulge in this wonderful cuisine because it can bring with it carbs and calories. In my view, however, the foods you love may have a place in a healthy meal plan, as long as you are prepared. So before you say no grazie to your favorite dishes, check out my five tips for a healthier Italian meal.

1. Order a starter. It might seem counter-intuitive, but starting off with a small soup or salad can actually help trim calories in your overall meal. Soups and salads can help fill you up without a lot of calories, so you may be satisfied with less of the potentially high-carb, high-calorie main course. Of course, starting out with a giant bowl of cream-based soup is not what I have in mind! Some Italian classics that make wonderful starters are a cup of minestrone or pasta fagioli, a traditional soup with small noodles, veggies, and fiber-loaded beans. Or try my “dip and stab” method: order a salad with a measured amount of dressing – about two tablespoons – on the side. Lightly dip the tines of your fork into the dressing, then stab the salad to get just a taste of dressing on each bite. Be skimpy with other higher-calorie salad add-ons, such as cheese, nuts, and croutons.

Two other personal favorites are shrimp cocktail and prosciutto with melon, both of which satisfy with a lower carb and calorie count. While I’m all about eating what you love, I do advise skipping the antipasto platter. The vegetable-to-meat ratio is often less than ideal, with a small amount of lettuce and peppers, and a large portion of fatty, salty meats and cheeses.

2. Don’t fear pasta. Some people are surprised that, as an RD and CDE, I don’t “ban” pasta for those living with diabetes. I don’t believe in banning, but I do believe in portion control! Pasta is high in carbohydrates – a single cup of cooked pasta has as many carbs as two or three slices of bread – and many restaurants put several cups on the plate. Try to think of a serving as just one cup of cooked pasta. My favorite trick is to select a side order of spaghetti with a fish entrée. The second choice, for those who don’t have trouble leaving food on their plates, is to order a main-dish pasta selection with lots of vegetables and some lean protein such as shrimp or chicken. Eat all the greens and protein, but leave the excess pasta. Pile on the veggies when you make Italian cuisine at home, too. Add spinach, mushrooms, carrots, broccoli, zucchini, eggplant, or almost any vegetable you like to your sauce. Interesting tip: by cooking or requesting your pasta prepared al denteslightly firm pasta has a lower glycemic index than pasta cooked to a soft consistency.

3. Be menu-aware. Don’t you just hate it when you think you’ve ordered something good for you, but your server brings you something greasy and fried or cheesy and creamy? I’ve created this guide of what to watch for as you navigate an Italian menu, but when in doubt, ask lots of questions.

●      Anything labeled Parmesan or Parmigiana: This preparation invariably means whatever you order – chicken, veal, or eggplant – will arrive doused in flour, fried, and loaded with cheese.

●      Alfredo: A sauce made of butter, cheese and cream. A restaurant serving of Fettuccini Alfredo can easily include 100 grams of carbohydrate, nearly 50 grams of saturated fat, and more than 1,200 calories.

●      Tomato-based sauces (marinara, pomodoro, puttanesca): Ask your server how the specific restaurant prepares these sauces or read the label when buying in the supermarket. They can make healthier, low-fat choices, but are often prepared with added sugars and may affect blood sugar unexpectedly.

●      Bolognese sauce: The meat used in this tomato-based sauce is often quite fatty, and the sauce is sometimes made with cream, as well. I advise patients with a real craving for Bolognese to consider simply ordering a small dish of the sauce without the pasta. This can lower the carbs and calories (though not the fat).

●      Pesto sauce: Usually made of basil, pine nuts, Parmesan cheese, and olive oil, pesto is normally high in calories. Pesto itself can be healthy and delicious, but it’s best used in small amounts to flavor a dish instead of heavily coating pasta.

●      Oil and garlic sauce, known as aglio et olio in Italian: Just as it’s name implies, a sauce made simply of olive oil and garlic. Like pesto, this is a potentially healthier choice, but high in calories, so ask for a small portion.

4. Be picky about pizza. Help keep carbs down by choosing thin crust instead of deep-dish or pan pizza. If you’re eating in a restaurant, ask if you can order pizza light on the cheese. Restaurants often use a sweet tomato sauce on pizza, which may affect blood sugar. A delicious solution is to order your pizza with fresh sliced tomatoes instead of sauce. For pizza-making at home, try experimenting with reduced-fat cheeses to find one that melts well and satisfies your taste preferences. Try using a ready-made whole-wheat crust or make your own with white whole-wheat flour. No matter where you enjoy your pizza, add lots of veggies, skip the meat, and share your pie with friends to keep portion size reasonable.

5. Do as the Italians Do. Don’t eat… dine. Savor your meal the way the Italians do. One difference between a typical American and most Mediterraneans is that their meals are enjoyed more slowly, with lunches and dinners often lasting much longer. It probably doesn’t need repeating, but our portions are much larger, too. So eat like the Italians – slow down, savor your meal, enjoy it with others, and eat smaller portions.

Buon appetito!

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.

© 2014 The DX: The Diabetes Experience

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  1. May 3rd, 2014, 10:36 AM

    What about how to handle the long time between the lunch and dinner and still be able to enjoy dinner, while on an insulin pump?

    1. The DX Editors
      May 5th, 2014, 11:22 AM

      Thank you for your comment! It is best for you to speak with your diabetes care team for your specific needs. You may also find some additional information and tips for diabetes-friendlier eating, including snacks, here: