The Diabetes Diet
Healthy Eating Tips to Prevent, Control, and Reverse Diabetes
People with diabetes have nearly double the risk of heart disease and are at a greater risk of developing mental health disorders such as depression. But most cases of type 2 diabetes are preventable and some can even be reversed. Taking steps to prevent or control diabetes doesn’t mean living in deprivation; it means eating a tasty, balanced diet that will also boost your energy and improve your mood. You don’t have to give up sweets entirely or resign yourself to a lifetime of bland food. With these tips, you can still take pleasure from your meals without feeling hungry or deprived.
What's the best diet for diabetes?
Whether you’re trying to prevent or control diabetes, your nutritional needs are virtually the same as everyone else, so no special foods are necessary. But you do need to pay attention to some of your food choices—most notably the carbohydrates you eat. While following a Mediterranean or other heart-healthy diet can help with this, the most important thing you can do is to lose a little weight.
Losing just 5% to 10% of your total weight can help you lower your blood sugar, blood pressure, and cholesterol levels. Losing weight and eating healthier can also have a profound effect on your mood, energy, and sense of wellbeing. Even if you’ve already developed diabetes, it’s not too late to make a positive change. By eating healthier, being more physically active, and losing weight, you can reduce your symptoms or even reverse diabetes. The bottom line is that you have more control over your health than you may think.
The biggest risk for diabetes: belly fat
Being overweight or obese is the biggest risk factor for type 2 diabetes. However, your risk is higher if you tend to carry your weight around your abdomen as opposed to your hips and thighs. A lot of belly fat surrounds the abdominal organs and liver and is closely linked to insulin resistance. You are at an increased risk of developing diabetes if you are:
- A woman with a waist circumference of 35 inches or more
- A man with a waist circumference of 40 inches or more
Calories obtained from fructose (found in sugary beverages such as soda, energy and sports drinks, coffee drinks, and processed foods like doughnuts, muffins, cereal, candy and granola bars) are more likely to add weight around your abdomen. Cutting back on sugary foods can mean a slimmer waistline as well as a lower risk of diabetes.
Planning a diabetes diet
A diabetic diet doesn’t have to be complicated and you don’t have to give up all your favorite foods. The first step to making smarter choices is to separate the myths from the facts about eating to prevent or control diabetes.
|Myths and facts about diabetes and diet|
Myth: You must avoid sugar at all costs.
Fact: You can enjoy your favorite treats as long as you plan properly and limit hidden sugars. Dessert doesn’t have to be off limits, as long as it’s a part of a healthy meal plan.
Myth: You have to cut way down on carbs.
Fact: The type of carbohydrates you eat as well as serving size is key. Focus on whole grain carbs instead of starchy carbs since they’re high in fiber and digested slowly, keeping blood sugar levels more even.
Myth: You’ll need special diabetic meals.
Fact: The principles of healthy eating are the same—whether or not you’re diabetic. Expensive diabetic foods generally offer no special benefit.
Myth: A high-protein diet is best.
Fact: Studies have shown that eating too much protein, especially animal protein, may actually cause insulin resistance, a key factor in diabetes. A healthy diet includes protein, carbohydrates, and fats. Our bodies need all three to function properly. The key is a balanced diet.
As with any healthy eating program, a diabetic diet is more about your overall dietary pattern rather than obsessing over specific foods. Aim to eat more natural, unprocessed food and less packaged and convenience foods.
- Healthy fats from nuts, olive oil, fish oils, flax seeds, or avocados
- Fruits and vegetables—ideally fresh, the more colorful the better; whole fruit rather than juices
- High-fiber cereals and breads made from whole grains
- Fish and shellfish, organic chicken or turkey
- High-quality protein such as eggs, beans, low-fat dairy, and unsweetened yogurt
- Trans fats from partially hydrogenated or deep-fried foods
- Packaged and fast foods, especially those high in sugar, baked goods, sweets, chips, desserts
- White bread, sugary cereals, refined pastas or rice
- Processed meat and red meat
- Low-fat products that have replaced fat with added sugar, such as fat-free yogurt
Choose high-fiber, slow-release carbs
Carbohydrates have a big impact on your blood sugar levels—more so than fats and proteins—so you need to be smart about what types of carbs you eat. Limit refined carbohydrates like white bread, pasta, and rice, as well as soda, candy, packaged meals, and snack foods. Focus on high-fiber complex carbohydrates—also known as slow-release carbs. They are digested more slowly, thus preventing your body from producing too much insulin.
What about the glycemic index?
High glycemic index (GI) foods spike your blood sugar rapidly, while low GI foods have the least effect on blood sugar. While the GI has long been promoted as a tool to help manage blood sugar, there are some notable drawbacks.
- The true health benefits of using the GI remain unclear.
- Having to refer to GI tables makes eating unnecessarily complicated.
- The GI is not a measure of a food’s healthfulness.
- Research suggests that by simply following the guidelines of the Mediterranean or other heart-healthy diets, you’ll not only lower your glycemic load but also improve the quality of your diet.
|Choosing carbs that are packed with fiber (and don’t spike your blood sugar)|
|Instead of…||Try these high-fiber options…|
Brown or wild rice, riced cauliflower
White potatoes (including fries and mashed potatoes)
Sweet potatoes, yams, cauliflower mash
Whole-wheat pasta, spaghetti squash
Whole-wheat or whole-grain bread
Sugary breakfast cereal
High-fiber, low-sugar cereal
Steel-cut or rolled oats
Low-sugar bran flakes
Peas or leafy greens
Be smart about sweets
Eating a diabetic diet doesn’t mean eliminating sugar altogether, but like most of us, chances are you consume more sugar than is healthy. If you have diabetes, you can still enjoy a small serving of your favorite dessert now and then. The key is moderation.
Reduce your cravings for sweets by slowly reduce the sugar in your diet a little at a time to give your taste buds time to adjust.
Hold the bread (or rice or pasta) if you want dessert. Eating sweets at a meal adds extra carbohydrates so cut back on the other carb-heavy foods at the same meal.
Add some healthy fat to your dessert. Fat slows down the digestive process, meaning blood sugar levels don’t spike as quickly. That doesn’t mean you should reach for the donuts, though. Think healthy fats, such as peanut butter, ricotta cheese, yogurt, or nuts.
Eat sweets with a meal, rather than as a stand-alone snack. When eaten on their own, sweets cause your blood sugar to spike. But if you eat them along with other healthy foods as part of your meal, your blood sugar won’t rise as rapidly.
When you eat dessert, truly savor each bite. How many times have you mindlessly eaten your way through a bag of cookies or a huge piece of cake? Can you really say that you enjoyed each bite? Make your indulgence count by eating slowly and paying attention to the flavors and textures. You’ll enjoy it more, plus you’re less likely to overeat.
Tricks for cutting down on sugar
Reduce soft drinks, soda and juice. For each 12 oz. serving of a sugar-sweetened beverage you drink a day, your risk for diabetes increases by about 15 percent. Try sparkling water with a twist of lemon or lime instead. Cut down on creamers and sweeteners you add to tea and coffee.
Don’t replace saturated fat with sugar. Many of us replace saturated fat such as whole milk dairy with refined carbs, thinking we’re making a healthier choice. Low-fat doesn’t mean healthy when the fat has been replaced by added sugar.
Sweeten foods yourself. Buy unsweetened iced tea, plain yogurt, or unflavored oatmeal, for example, and add sweetener (or fruit) yourself. You’ll likely add far less sugar than the manufacturer.
Check labels and opt for low sugar products and use fresh or frozen ingredients instead of canned goods. Be especially aware of the sugar content of cereals and sugary drinks.
Avoid processed or packaged foods like canned soups, frozen dinners, or low-fat meals that often contain hidden sugar. Prepare more meals at home.
Reduce the amount of sugar in recipes by ¼ to ⅓. You can boost sweetness with mint, cinnamon, nutmeg, or vanilla extract instead of sugar.
Find healthy ways to satisfy your sweet tooth. Instead of ice cream, blend up frozen bananas for a creamy, frozen treat. Or enjoy a small chunk of dark chocolate, rather than a milk chocolate bar.
Start with half of the dessert you normally eat, and replace the other half with fruit.
Be careful about alcohol
It’s easy to underestimate the calories and carbs in alcoholic drinks, including beer and wine. And cocktails mixed with soda and juice can be loaded with sugar. Choose calorie-free mixers, drink only with food, and monitor your blood glucose as alcohol can interfere with diabetes medication and insulin.
Spot hidden sugar
Being smart about sweets is only part of the battle. Sugar is also hidden in many packaged foods, fast food meals, and grocery store staples such as bread, cereals, canned goods, pasta sauce, margarine, instant mashed potatoes, frozen dinners, low-fat meals, and ketchup. The first step is to spot hidden sugar on food labels, which can take some sleuthing:
Do some detective work
Manufacturers are required to provide the total amount of sugar in a serving but do not have to spell out how much of this sugar has been added and how much is naturally in the food. The trick is deciphering which ingredients are added sugars. Aside from the obvious ones—sugar, honey, molasses—added sugar can appear as agave nectar, cane crystals, corn sweetener, crystalline fructose, dextrose, evaporated cane juice, fructose, high-fructose corn syrup, invert sugar, lactose, maltose, malt syrup, and more.
A wise approach is to avoid products that have any of these added sugars at or near the top of the list of ingredients—or ones that have several different types of sugar scattered throughout the list. If a product is chock-full of sugar, you would expect to see “sugar” listed first, or maybe second. But food makers can fudge the list by adding sweeteners that aren’t technically called sugar. The trick is that each sweetener is listed separately. The contribution of each added sugar may be small enough that it shows up fourth, fifth, or even further down the list. But add them up and you can get a surprising dose of added sugar.
Let’s take as an example a popular oat-based cereal with almonds whose package boasts that it is “great tasting,” “heart healthy” and “whole grain guaranteed.” Here’s the list of ingredients:
Whole-grain oats, whole-grain wheat, brown sugar, almond pieces, sugar, crisp oats,* corn syrup, barley malt extract, potassium citrate, toasted oats,* salt, malt syrup, wheat bits,* honey, and cinnamon.
*contain sugar, high-fructose corn syrup, honey, and/or brown sugar molasses.
Combine brown sugar, sugar, corn syrup, barley malt extract, high-fructose corn syrup, honey, brown sugar molasses, and malt syrup, and they add up to a hefty dose of empty calories—more than one-quarter (27%) of this cereal is added sugar, which you might not guess from scanning the ingredient list.
Choose fats wisely
Some fats are unhealthy and others have enormous health benefits, so it’s important to choose fats wisely.
Unhealthy fats. The most damaging fats are artificial trans fats, which make vegetable oils less likely to spoil. Avoid commercially-baked goods, packaged snack foods, fried food, and anything with “partially hydrogenated” oil in the ingredients, even if it claims to be trans fat-free.
Healthy fats. The healthiest fats are unsaturated fats, which come from fish and plant sources such as olive oil, nuts, and avocados. Omega-3 fatty acids fight inflammation and support brain and heart health. Good sources include salmon, tuna, and flaxseeds.
Saturated fats. Found mainly in tropical oils, red meat, and dairy, there’s no need to completely eliminate saturated fat from your diet—but rather, enjoy in moderation. The American Diabetes Association recommends consuming no more than 10% of your daily calories from saturated fat.
Ways to reduce unhealthy fats and add healthy fats:
- Instead of chips or crackers, snack on nuts or seeds or add them to your morning cereal. Nut butters are also very satisfying.
- Instead of frying, choose to broil, bake, or stir-fry.
- Avoid saturated fat from processed meats, packaged meals, and takeout food.
- Instead of just red meat, vary your diet with skinless chicken, eggs, fish, and vegetarian sources of protein.
- Use extra-virgin olive oil to dress salads, cooked vegetables, or pasta dishes.
- Commercial salad dressings are often high in calories and trans fat so create your own with olive oil, flaxseed oil, or sesame oil.
- Add avocados to sandwiches and salads or make guacamole. Along with being loaded with healthy fats, they make for a filling and satisfying meal.
- Enjoy dairy in moderation.
Eat regularly and keep a food diary
It’s encouraging to know that you only have to lose 7% of your body weight to cut your risk of diabetes in half. And you don’t have to obsessively count calories or starve yourself to do it. Two of the most helpful strategies involve following a regular eating schedule and recording what you eat.
Eat at regularly set times
Your body is better able to regulate blood sugar levels—and your weight—when you maintain a regular meal schedule. Aim for moderate and consistent portion sizes for each meal.
Start your day off with a good breakfast. It will provide energy as well as steady blood sugar levels.
Eat regular small meals—up to 6 per day. Eating regularly will help you keep your portions in check.
Keep calorie intake the same. To regulate blood sugar levels, try to eat roughly the same amount every day, rather than overeating one day or at one meal, and then skimping the next.
Keep a food diary
A recent study found that people who kept a food diary lost twice as much weight as those who didn’t. Why? A written record helps you identify problem areas—such as your afternoon snack or your morning latte—where you’re getting more calories than you realized. It also increases your awareness of what, why, and how much you’re eating, which helps you cut back on mindless snacking.
Get more active
Exercise can help you manage your weight and may improve your insulin sensitivity. An easy way to start exercising is to walk for 30 minutes a day (or for three 10-minute sessions if that’s easier). You can also try swimming, biking, or any other moderate-intensity activity that has you working up a light sweat and breathing harder.
Learn how to lose weight and keep it off. If your last diet attempt wasn't a success, or life events have caused you to gain weight, don't be discouraged. The key is to find a plan that works with your body's individual needs so that you can avoid common diet pitfalls and find long-term, weight loss success.
Resources and references
Healthy Eating for Type 2 Diabetes – Harvard Medical School Special Health Report
Reducing Sugar and Salt: Strategies for minimizing risks to your health – Harvard Medical School Special Health Report
Simple Steps to Preventing Diabetes – Harvard School of Public Health
Diabetes Myths – American Diabetes Association
Diabetes nutrition: Including sweets in your meal plan – Mayo Clinic
Diabetes Diet, Eating, & Physical Activity – National Institutes of Health