What can and can’t you eat if you have diabetes? That’s one of the top questions that dietitians are constantly asked, and rightly so. A lot of people with diabetes struggle to figure this out. Having diabetes doesn’t mean you have to give up everything you love to eat. If you enjoy Friday night pizza night, for example, there’s no need to forgo that. You can also indulge in a scoop of ice cream, if you wish, or have a slice of cake on your birthday. If you decide that you would rather not, that’s OK. The point is that it’s possible to have your cake and eat it too, so to speak.
If you do want to eat a couple of slices of pizza on a Friday night, you may need to put some effort in to making it work out so that your blood sugars don’t soar through the roof. Checking your blood sugar before and after eating pizza (or whatever the food may be) is a great first step to learn how a specific food or meal impacts YOUR blood sugar, not anyone else’s. Making a few tweaks is a likely option, too. For example, maybe you order thin crust vs. thick crust pizza. Or perhaps you make your own pizza with a lower-carb, cauliflower-based crust. There are options to make things work.
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There is no one “diet” that is going to work for everyone who has diabetes. That’s because food preferences, culture, lifestyle and health factors (to name a few) all play a role in what will work best for you and perhaps your family. Your eating plan should be individualized to you. You might decide to go the lower-carb route or take a more moderate approach and eat more Mediterranean style.
Nutrition at a high level
We all need a balance of nutrients to be healthy and lower the risk of health problems. Completely eliminating or avoiding certain food groups means that you risk deficiencies and other issues. A good example is the risk of vitamin B12 deficiency in someone following a vegan diet.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, “To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine, if you take any. What you choose to eat, how much you eat, and when you eat are all important in keeping your blood glucose level in the range that your health care team recommends.”
And the American Diabetes Association states that a healthy eating plan includes:
• Fruits and vegetables
• Lean meats and plant-based sources of protein
• Less added sugar
• Less processed foods
Foods to avoid with diabetes: what shouldn’t you eat?
There are certainly foods that are best to limit, and maybe for some people, avoid altogether. The three main reasons to avoid/limit a food or beverage are that:
• They can cause spikes in your blood sugar.
• They can lead to weight gain (or make it hard to lose weight).
With the caveat that everyone is different in terms of how their glucose levels respond to certain foods, there are definitely some food “troublemakers” that can wreak havoc and are best to stay away from.
Most people agree that soda offers few, if any, health benefits. (There are almost 10 teaspoons of sugar in a 12-ounce can of cola!). But other beverages that may seem a little a little more healthful are really no better than soda. A good example is fruit juice. Sure, it may contain vitamins, minerals and possibly a small amount of fiber. But sugar is often added to certain fruit juices; even the “natural” sugar found in unsweetened juices still packs calories and carbs. Put another way, a 12-ounce glass of orange juice has just about the same amount of sugar as that 12-ounce can of cola.
Other beverages to steer clear of include:
• Sweetened iced tea
• Sweetened coffee drinks, such as lattes and Frappuccinos
• Sports and energy drinks, such as regular Gatorade, Red Bull and Monster Energy
• Chocolate milk
• Sweetened plant “milks” such as vanilla or chocolate almond or soymilk
• Coconut water
Tip: The one time that you may want to reach for regular soda or juice is when your blood sugar is low. These drinks will raise your blood sugar quickly.
Grains and grain-foods that are refined — that is, they’ve had their bran and germ removed — are more likely than whole grains to impact glucose levels. Examples of refined grains include:
• White rice
• White pasta
• White bread
• White flour
• Saltine crackers
Bottom line: Refined carbs are more likely to cause spikes in blood sugar. They also are missing a bunch of fiber, vitamins, minerals and other nutrients that we need for heart health and overall nutrition.
Tip: You don’t need to cut out carbs — just go for the healthier ones. Brown rice, quinoa, barley, millet, buckwheat, oatmeal, popcorn and whole-wheat bread are good choices. “Try a sprouted grain bread,” says Melinda Maryniuk, RD, CDE. Amanda Kirpitch, RD, CDE, notes that “Cereals can quickly raise blood sugars — switch to steel-cut oats, which have the added benefit of heart-healthy fiber.” If you’re in doubt as to whether a food is whole grain or not, read the ingredient list: the first ingredient should be a whole grain.
Fruit is an excellent source of fiber, vitamins, minerals and antioxidants. Plus, it’s delicious and makes a great snack. But if you reach for dried fruit, such as raisins, dried figs or dried apricots, you’ll get more than you bargained for. Here’s why: dried fruit is dehydrated, meaning, the water is removed. The nutrients become concentrated in dried fruit, and that includes the sugar content. Here’s an example:
• 1 cup of grapes contains 104 calories and 27 grams of carbohydrate
• 1 cup of raisins contains 433 calories and 115 grams of carbohydrate
You can see what a difference in calories and carbs there is between fresh and dried fruit.
Bottom line: It’s OK to fit small portions of dried fruit into your eating plan. In general, though, go for fresh fruit, which has more volume and, therefore, is more filling.
Tip: Shy away from chocolate-covered or yogurt-covered dried fruit. These coatings, while tasty, add more calories and usually pack a decent amount of unhealthy fat, as well.
Breaded and fried foods
It’s sure hard to resist the smell of fried chicken or doughnuts fresh out of the fryer. And, yes, they taste good too! That’s because fat adds a lot of flavor to foods. Of course, fat adds a bunch of calories, as well. Add a coating of breadcrumbs or other type of breading, and that breading will soak up oil, which means even more calories.
All of this fat can create several problems, including higher blood sugars hours later, weight gain and, depending on the type of fat used in cooking, higher bad (LDL) cholesterol levels. There’s also some concern that frying foods leads to the formation of toxic substances that can cause inflammation and an increased risk of certain diseases, such as heart disease.
Bottom line: Go easy on fried foods and breaded foods. Find other ways to prepare your foods that don’t involve as much fat. Or balance out a fatty food with a lower-calorie food. Jo-Anne Rizzotto, RD, CDE, advises, “If you want a burger, swap out the fries for a side salad.” “Get used to baking and broiling foods,” says Heather Leonard, RD, CDE.
Tip: If you’re finding it hard to give up frying your foods, consider investing in an air-fryer — this uses much less oil than traditional ways of frying.
Like fatty foods, people often crave salty foods. There may be emotional and medical reasons for why people have a salt craving, but for the most part, sodium, like fat, makes food taste better. Over time, taste buds get used to higher-sodium foods. While we all need some sodium in our diets, many people get too much. And a high sodium intake is linked with high blood pressure, heart disease and stroke, as well as possible bone loss.
The American Heart Association lists the top sources of sodium in the U.S. diet, aptly names the “Salty Six:”
• Breads and rolls
• Cold cuts and cured meats
• Burritos and tacos
Sodium not only adds flavor, it’s used as a preservative, a color enhancer and a texturizer, as well. Most of the sodium that we get is in fast foods and processed foods.
Bottom line: Read labels for sodium. A low-sodium food has no more than 140 milligram of sodium per serving. Not everything has to be low in sodium, but aim to choose foods with no more than 400 milligrams per serving.
Tip: Give yourself some time — after a while of cutting back on salt and salty foods, your taste buds won’t even miss the sodium!