Diabetes and a Healthy Diet

What you eat makes a big difference when you have diabetes. The right foods can be an ally in your fight to keep your blood sugar levels in check. When you build your diet, four key things to focus on are carbs, fiber, fat, and salt. Here's what you should know about each of them.

Carbs

Carbs give you fuel. They affect your blood sugar faster than fats or protein. You’ll mainly get them from:

  • Fruit
  • Milk and yogurt
  • Bread, cereal, rice, and pasta
  • Starchy vegetables like potatoes, corn, and beans

Some carbs are simple, like sugar. Other carbs are complex, like those found in beans, nuts, vegetables, and whole grains.

Complex carbohydrates are better for you because they take longer for your body to digest. They give you steady energy and fiber.

You may have heard of “carbohydrate counting.” That means you keep track of the carbs (sugar and starch) you eat each day. Counting grams of carbohydrate, and splitting them evenly between meals, will help you control your blood sugar.

Talk to your doctor, a registered dietitian, or a diabetes educator about how to keep track of how many carbs you eat. They may recommend that you use the glycemic index. It ranks how different foods raise your blood sugar. The higher the index, the more it raises your levels.

If you eat more carbohydrates than your insulin supply can handle, your blood sugar level goes up. If you eat too few, your blood sugar level may fall too low. You can manage these shifts by knowing how to count carbs.

One carbohydrate serving equals 15 grams of carbohydrates.

A registered dietitian can help you figure out a carbohydrate counting plan that meets your specific needs. For adults, a typical plan includes two to four carb servings at each meal, and one to two as snacks.

You can pick almost any food product off the shelf, read the label, and use the information about grams of carbohydrates to fit the food into your type 2 diabetes meal plan.

Anyone can use carb counting. It’s most useful for people who take more than one daily shot of insulin, use an insulin pump, or want more flexibility and variety in their food choices.

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Fiber

You get fiber from plant foods -- fruits, vegetables, whole grains, nuts, beans, and legumes. It helps with digestion and blood sugar control. You feel fuller, so you eat less, which is a plus if you need to lose weight.

People who eat high-fiber diets tend to be less likely to get high blood pressure and heart disease.

Most Americans don't eat enough fiber. So focus on these foods:

  • Fresh fruits and vegetables
  • Cooked dried beans and peas
  • Whole-grain breads, cereals, and crackers
  • Brown rice
  • Bran foods

It’s best to get fiber from food. But if you can’t get enough, taking fiber supplements can help. Examples include psyllium, methylcellulose, wheat dextrin, and calcium polycarbophil. If you take a fiber supplement, increase the amount you take slowly. This can help prevent gas and cramping. It’s also important to drink enough liquids when you increase your fiber intake.

Fat

Diabetes makes you more likely to get heart disease. So you’ll want to limit unhealthy fat such as saturated fats and trans fats.

The main sources of saturated fats are cheese, beef, milk, and baked items.

Avoid trans fats, which are bad for your heart. Check the ingredients list for "partially hydrogenated" oils. Also, know that if a product says "0 grams trans fat," it may actually have up to half a gram of trans fat per serving.

For a healthy diet:

  • Choose lean cuts of meat.
  • Don't fry foods. Instead, you can bake, broil, grill, roast, or boil.
  • Choose low-fat or fat-free dairy foods. Include them in your daily carbohydrate count.
  • Use vegetable cooking spray or cholesterol-lowering margarine that has stanols or sterols.
  • Pick liquid vegetable oils instead of animal fat.

A registered dietitian can give you more information on how to prepare and choose the right fats for you.

Salt

Diabetes raises your risk of getting high blood pressure. Too much salt can add to that risk. Your doctor or dietitian may ask you to limit or avoid:

  • Salt and seasoned salt (or salt seasonings)
  • Boxed mixes of potatoes, rice, and pasta
  • Canned meats
  • Canned soups and vegetables with salt
  • Cured or processed foods
  • Ketchup, mustard, salad dressings, other spreads, and canned sauces
  • Packaged soups, gravies, and sauces
  • Pickled foods
  • Processed meats: lunch meat, sausage, bacon, and ham
  • Olives
  • Salty snack foods
  • Monosodium glutamate (MSG)
  • Soy and steak sauces

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Low-Salt Cooking Tips

  • Use fresh ingredients and foods with no salt added.
  • For favorite recipes, you may need to use other ingredients and cut out or use less salt.
  • Try orange or pineapple juice as a base for meat marinades.
  • Check the sodium on food labels.
  • Choose frozen entrees that have 600 milligrams or less of sodium. Limit yourself to one of these frozen entrees per day.
  • Use fresh, frozen, or no-added-salt canned vegetables. Rinse them first.
  • If you buy canned soup, look for low-sodium ones.
  • Avoid mixed seasonings and spice blends that include salt, such as garlic salt.

Which Seasonings Can Replace Salt?

Herbs and spices improve the natural flavors in food without using salt. Make these mixtures to use for meats, poultry, fish, vegetables, soups, and salads.

Spicy blend

2 tablespoons dried savory, crumbled

¼ teaspoon freshly ground white pepper

1 tablespoon dry mustard

¼ teaspoon ground cumin

2½ teaspoons onion powder

½ teaspoon garlic powder

¼ teaspoon curry powder

Saltless surprise

2 teaspoons garlic powder

1 teaspoon basil

1 teaspoon oregano

1 teaspoon powdered lemon rind or dehydrated lemon juice

Herb seasoning

2 tablespoons dried dill weed or basil leaves, crumbled

1 teaspoon celery seed

2 tablespoons onion powder

¼ teaspoon dried oregano leaves, crumbled

A pinch of freshly ground pepper

Spicy seasoning

1 teaspoon cloves

1 teaspoon pepper

2 teaspoons paprika

1 teaspoon coriander seed (crushed)

1 tablespoon rosemary

How Much Can You Eat?

Check the serving sizes on nutrition labels. Servings may be smaller than you think. Eat only the amount of food in your diabetes meal plan. Extra calories lead to extra fat and pounds.

Don't skip meals, though. Eat them, and snacks, at regular times every day.

What Is the TLC Diet for Diabetes?

If you also have high cholesterol, your doctor probably will recommend something called the TLC (therapeutic lifestyle changes) plan.

The goal is to lower your cholesterol level, drop extra weight, and get more active. That helps prevent heart disease, which is more common when you have diabetes.

On the TLC diet, you will:

  • Limit fat to 25%-35% of your total daily calories.
  • Get no more than 7% of your daily calories from saturated fat, 10% or less from polyunsaturated fats, and up to 20% from monounsaturated fats (like plant oils or nuts).
  • Keep carbs to 50%-60% of your daily calories.
  • Aim for 20-30 grams of fiber each day.
  • Allow 15%-20% of your daily calories for protein.
  • Cap cholesterol at 200 milligrams per day.

You'll also need to get more exercise and keep up with your medical treatment.

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Can You Have Sugar?

You might have heard that people with diabetes shouldn't have any table sugar. While some doctors say that, others take a more forgiving view.

Most now say that small amounts of the sweet stuff are fine, as long as they're part of an overall healthy meal plan. Table sugar doesn’t raise your blood sugar any more than starches.

Remember, though, that sugar is a carb. So when you eat sweet foods like cookies, cake, or candy, don’t eat another carb or starch (for example, potatoes) that you would’ve eaten that day.

In other words, substitute, don't add. Ultimately, the total grams matter more than the source of the sugar.

Account for any food swaps in your carbohydrate budget for the day. Adjust your medications if you add sugars to your meals. If you take insulin, tweak your dose to account for the added carbs so you can keep your blood sugar under control as much as possible. Check your glucose after eating sugary foods.

Read food labels so you know how much sugar or carbs are in the things you eat and drink. Also, check how many calories and how much fat are in each serving.

Other Sweeteners

You can add artificial ones to your food and drinks. Many have carbs, though, so check the label carefully. If necessary, adjust the other foods in your meal or your medication to keep your blood sugar under control.

Certain sweeteners called sugar alcohols have some calories and can slightly raise your glucose levels. If you eat too much of them, you can get gas and diarrhea. Examples include:

You can also use stevia to make things sweet. It's a natural product with no calories.

What About Alcohol?

Ask your doctor if it's OK for you to drink booze. If they say yes, do it only occasionally, when your blood sugar level is well-controlled. Most wine and mixed drinks have sugar, and alcohol also has a lot of calories.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on September 08, 2020

Sources

SOURCES:

FDA: "Talking About Trans Fat: What You Need to Know."

American Diabetes Association: “Type 2,” “What Can I Eat?” “Diabetes and Heart Health -- What’s the Connection?” “What About Protein?”

Joslin Diabetes Center: “Carb Counting 101.”

California Medical Association.

University of New Hampshire: “Plant Stanols and Sterols.”

UpToDate: “Patient information: High-fiber diet (Beyond the Basics).”

American Diabetes Association: "People Will Lose More Weight With a Modified Low-Carbohydrate Diet Than a Low-Fat Diet."

American Heart Association: “Whole Grains and Fiber.”

National Diabetes Education Program: "Recipe and Meal Planner Guide."

National Institute on Aging, National Institutes of Health: "Therapeutic Lifestyle Changes."

UpToDate: “Patient information: High-fiber diet (Beyond the Basics)."

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