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Strategies for Healthy Eating With Diabetes

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Strategies for Healthy Eating With Diabetes

Whether you’re brand new to having diabetes or you’ve had it for many years, one of the areas of diabetes self-management that can be the most challenging is healthy eating. You might feel confused about what you should eat, in part due to what you might read on the internet or the latest news about foods to avoid. What better time to talk nutrition! These tips can help.

Eating patterns

Healthy eating to help manage your diabetes doesn’t have to be confusing. Gone are the days of rigid “diabetic diets” with foods that don’t always taste good or that are different from what your family eats. There’s a lot of flexibility when it comes to how you prefer to eat; in other words, what eating pattern you might choose to follow. You might decide to follow a vegetarian eating plan, a Mediterranean-style eating plan, or even a low-carbohydrate eating plan. It’s important to communicate your preferences with your healthcare team so that they can support you and adapt your diabetes treatment plan accordingly. For example, if you choose a lower-carb eating plan, you may need less of your diabetes medication.

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Strategies for healthy eating

No matter what eating pattern you choose, there are some basic “strategies” that can be helpful as you navigate the effects of your food choices, amounts and timing on your diabetes management. Remember, too, that other factors besides food impacts your glucose levels: medication, physical activity, stress and illness all play a role, too. Let’s take a closer look at what tends to work for most people.

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Start the day off right: eat breakfast.

Not everyone is a fan of eating breakfast in the morning, but there’s a reason for eating something when you wake up: you’re providing your body with nourishment to fuel yourself for the day ahead. Studies show that eating breakfast may make it easier to lose weight, especially if the breakfast includes protein to help stave off cravings late morning and help you feel fuller throughout the day.

When it comes to diabetes, eating breakfast is important if you take mealtime insulin or diabetes pills (sulfonylureas) that may cause your blood sugar to drop. Taking your medication and not eating puts you at risk for hypoglycemia (low blood sugar). Even if you don’t take insulin or sulfonylureas, breakfast can help keep your glucose levels more stable (fewer peaks and valleys) over the course of the day.

Common breakfast foods tend to be full of sugary and refined carbs. Not only are these foods lower in nutrition than whole-grain, unrefined carbs, they can cause your blood sugars to crash and burn, leaving you feeling depleted and sluggish later on.

Strategy:

Go for a breakfast that combines unrefined carbs with protein and some healthy fat. Suggestions include: Whole-grain toast topped with an egg and some avocado, plain Greek yogurt or skyr topped with nuts and berries (which are lower in carb than some other fruit), steel-cut oatmeal with a dollop of nut butter, or a breakfast burrito made with eggs, beans and the veggies of your choice (try baby spinach and red pepper).

Include protein at each meal.

Protein, one of the three major nutrients, is needed for building, maintaining and repairing tissues and organs, making hormones and enzymes, and for supporting a healthy immune system. Including a protein food at your meals may help you feel full, which, in turn can help you eat less and can help make it easier to keep your blood sugars in your target range.

While some protein is good, more isn’t necessarily better. In fact, eating large amounts of protein foods (think: a 12-ounce steak), especially if it’s not combined with some carb, has been shown to significantly increase post-meal glucose levels in people with type 1 diabetes. And remember: protein contains calories and, depending on the source, may contain saturated fat, too.

Strategy:

As you plan your meals, make room for a few ounces of protein. Examples include poultry, fish, lean meat, eggs, tofu, beans, nut butters, cottage cheese and Greek yogurt. If you have kidney disease, talk with your doctor or dietitian about how much protein is safe for you to eat.

Eat those fruits and veggies.

Fruits and vegetables are the mainstay of a healthy eating plan — even for people who have diabetes. Yes, fruit and even some vegetables contain carbohydrate. But that doesn’t mean you can’t eat them if you have diabetes. And here are reasons why you SHOULD eat them:

· Lower blood pressure

· Reduced risk of heart disease and stroke

· Lower risk of some types of cancer

· Improved eye health

· Fewer digestive problems

· Reaching and maintaining a healthy weight

Including fruits and vegetables in your eating plan may make it easier for you to manage your blood sugars, too. That’s because they contain fiber (which can help slow the rise in blood sugar) and, compared to other foods, they tend to be lower in calories. Nonstarchy vegetables, such as green beans, lettuce, summer squash and broccoli are really low in carb, too.

Strategy:

Challenge yourself to include a serving of fruit (e.g., a small piece of fruit or 1/2 cup of cut-up fresh or frozen fruit) or a vegetable (1/2 cup cooked or 1 cup raw) — or even both — at each of your meals. Steer clear of fruit juices or canned fruit packed in syrup.

Control your carbs.

Foods that contain carbohydrate include grains (and foods made from grains, such as bread and cereal), fruit, milk and yogurt, sweets and sweetened drinks. Beans, or legumes, contain carb as well as protein. Carbs give you energy, and when you choose healthful ones, they provide a lot of other nutrients, as well.

Managing diabetes is a balancing act when it comes to carbs, though. That’s because carb foods, when digested, raise blood sugar. The good news is that watching your carb food portions, staying active and, if needed, taking diabetes medicine as prescribed can help you balance out your blood sugars with the carbs that you eat.

If you need help with or have questions about the right amount of carb for you, meet with a dietitian or diabetes educator. They can give you guidance around carb goals, based on your individual preferences. It’s also a good idea to meet with a dietitian if you’re thinking of following a low-carb eating plan; talk out the pros and cons of doing so, and if you go forward with this, make sure to discuss the impact of a low carb plan on other factors, such as the dose of your diabetes medications, your kidney health and even your food budget.

Strategy:

Go for carb foods that are less refined — that means whole-grain bread, pasta, rice and cereal, as well as fresh fruit, and unsweetened milk and yogurt. When it comes to portions, aim to fill one-quarter of your plate with a carb food.

Switch up the order in which you eat your foods.

Meal planning can seem so complex, and it’s not uncommon for people with diabetes to struggle with the “eating part” of diabetes management. But some things about eating with diabetes aren’t really that difficult, and that includes the order in which you eat your foods. A study published in the journal Diabetes Care in 2015 looked at adults with type 2 diabetes and obesity who took metformin. They were fed meals containing carbohydrate, vegetables, protein and fat, but switched up the order in which they ate their foods. The findings: blood sugars were lower after meals when the subjects ate their vegetables and protein foods before the carb foods.

Strategy:

Start off your meals by eating your vegetables/salad and protein food first; save the carbs for last.

Experiment to learn how foods affect your glucose levels.

Not everyone with diabetes checks their blood sugars, but there definitely are benefits to doing so. It’s hard to know how your food, as well as your activity level and medications impact your glucose levels unless you check your blood sugar with a meter. Some people use CGM (continuous glucose monitoring) instead of a meter; CGM gives you your glucose levels every few minutes, 24 hours a day.

Even if you don’t check your blood sugars often, you might benefit from doing so before and after your meals on occasion (called paired checking). This will give you insight into how your blood sugars change after you eat a meal or a particular food.

Strategy:

Check your blood sugar right before you start eating your meal or snack. Then, two hours later, do another blood sugar check. A blood sugar rise of no more than 30 to 50 points means that the meal or snack was a good choice for you! And for most people with diabetes, a blood sugar of 180 two hours after a meal is the goal.

Want to learn more about eating well with diabetes? Read “Improving Your Recipes: One Step at a Time,” “Top Tips for Healthier Eating” and “Cooking With Herbs and Spices.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

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