Most of you know that I’m a dietitian and a diabetes educator. I’ve spoken with numerous people (both patients and health-care professionals) about “diet and nutrition” over the years. I’ve seen, heard, and felt frustration, boredom, and resignation. I’ve also encountered positivity, hope, and humor. Some people treat diabetes meal planning as simply one more task they need to accomplish in their daily self-management plan. Others fret and agonize over how difficult and punishing it can be.
I don’t have diabetes, but as a nutrition professional, I can relate to the struggles around knowing what and how much to eat and how those food choices impact one’s diabetes. I can understand the disappointment and discouragement when someone tries so hard to count carbs, watch portions, eat more vegetables, etc., but then sees a high (or low) blood sugar reading. As a result of talking with and learning so much from others, I’m always on the lookout for ways to make eating easier for diabetes management. I’m not talking about resorting to a stringent or fad diet, such as cutting out all carbs. Few people can sustain that way of eating for long. Rather, I’m looking for ways to help guide people in making better food choices, controlling portions, keeping blood sugars in target, and lowering the risk of obesity and other chronic diseases at the same time. Oh, and the food needs to taste good and be fulfilling, too. Is that really so much to ask?
One of the dangers of research is that we sometimes read too much into it. For example, we (and the media) often “weight” studies very heavily and draw conclusions too soon, especially from studies that only looked at, say, 10 or 50 people. For study results to be truly significant, large, randomized clinical trials (RCTs) need to be conducted that usually involve thousands of subjects. Nonetheless, there are a few recent study results that I thought might prove to be helpful and practical for you:
Eat your vegetables…and protein…first! This is probably good advice for anyone, diabetes or no diabetes. But there’s a reason for people with diabetes to take note. Eleven people who were obese with Type 2 diabetes were given a meal of broccoli with butter, salad, chicken breast, ciabatta bread, and orange juice. This study included two meals that were eaten one week apart. For the first meal, blood sugar levels were checked in the morning. The subjects then ate the carb part of the meal first, then the protein, veggies, and fat 15 minutes later. A week later, the same folks again had their blood sugar checked before eating, then ate the protein, veggies, and fat first, and the carb last. The findings? When the carb was eaten last, blood sugar levels were significantly lower at 30 minutes, 60 minutes, and 120 minutes after the meal. The take-home message: Changing the order in which you eat your carb, protein, and fat (saving the carb for last) might go a long way in improving your blood sugars, and you don’t have to give up anything to eat!
Eat a variety of foods. This advice may seem worn and tired (how many times have you heard THAT?). But once again, there’s a good reason for doing so, besides ensuring that you get the nutrients that you need. Perhaps you’ve heard of a little thing called the microbiome? The microbiome refers to the trillions of bacteria living in your gut. It’s a fascinating topic of research for scientists, because the microbiome appears to be linked with both health and disease, including obesity and diabetes. In this particular study, 30 people with prediabetes and Type 2 diabetes were given a mixture of inulin, beta glucan, and antioxidants twice daily. A control group received a placebo. Those taking the formula showed a shift in the composition of their gut bacteria, as well as better glucose control, increased satiety (feelings of fullness), and less constipation. The head researcher believes that eating a variety of foods can lead to the same effect, helping to diversify gut bacteria (a good thing) and improving metabolic health. The take-home message: Eat healthy and different foods. Don’t cut out carbs, for example, thinking that they’re bad. And shy away from those fad diets.
Don’t rule out the low-fat diet just yet. If you have diabetes and want to lose weight, you had better not touch those carbs, or so the mantra goes. But not so fast. A recent study published in the journal Cell Metabolism compared two diets that were equal in calories: low carb and low fat. Nineteen overweight adults spent two, two-week periods in a metabolic ward. For the first study period, the people reduced their carbohydrate intake by about 800 calories. During the second study period, they reduced their fat intake by about 800 calories. And they exercised for one hour a day for both study periods. The results? Cutting carbs lead to a loss of body fat of 53 grams per day; cutting the fat lead to a fat loss of 89 grams per day. Now, the take-home message isn’t that low fat is necessarily better than low carb when it comes to weight loss; instead, the point is that cutting calories in a way that you can stick with is what leads to weight loss. In other words, choose an eating plan that makes sense for you. That might mean lower carb for some, and lower fat for others.
I know these studies were small in size, and that “more research is needed.” But I found these three studies to be promising and basically, good advice that we all can follow. One of the studies involved making a simple food switch — and look how it worked out! The other two studies seem to vindicate food: Eating a variety of it and choosing an eating plan that works for you are messages that I can fully support!
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