» What is a "free food"?
» Making healthy food choices
» Reading food labels
» Sweeteners & desserts
» Frequently-asked questions about nutrition
People with diabetes have the same nutritional needs as anyone else. Along with exercise and medications (insulin or oral diabetes pills), nutrition is extremely important for good diabetes control. By eating well-balanced meals in the correct amounts, you can keep your blood glucose level as close to normal (non-diabetes level) as possible.
The following tips and guidance, provided by the American Diabetes Association, may be helpful for you. More information can be obtained at http://www.diabetes.org/nutrition-and-recipes/nutrition/overview.jsp.
What is a "free food"?
"Free foods" are foods that can be eaten freely without affecting diabetes control or weight, those with less than 20 calories and 5 grams carbohydrate per serving. Examples include diet soft drinks, sugar-free gelatin dessert, sugar-free ice pops, sugarless gum and sugar-free syrup.
Sugar-free does not mean carbohydrate-free. Compare the total carbohydrate content of a sugar-free food with that of the standard product. If there is a big difference in carbohydrate content between the two foods, you may want to buy the sugar-free food. If there is little difference in the total grams of carbohydrate between the two foods, choose the one you want based on price and taste. Make sure to read the label carefully to make the best choice.
"No sugar added" foods do not have any form of sugar added during processing or packaging, and do not contain high-sugar ingredients. But remember, they may still be high in carbohydrate, so you have to check the label. Fat-free foods can be higher in carbohydrates and contain almost the same calories as the foods they replace. Fat-free cookies are a good example. Fat-free foods are not necessarily a better choice than the standard product, so read your labels carefully.
Making healthy food choices
Knowing what to eat can be confusing. Everywhere you turn, there is news about what is or isn't good for you. Some basic principles have weathered the fad diets, and have stood the test of time. Here are a few tips on making healthful food choices for you and your entire family:
- Eat lots of vegetables and fruits. Try picking from the rainbow of colors available to maximize variety. Eat non-starchy vegetables such as spinach, carrots, broccoli or green beans with meals.
- Choose whole grain foods over processed grain products. Try brown rice with your stir fry or whole wheat spaghetti with your favorite pasta sauce.
- Include dried beans (like kidney or pinto beans) and lentils into your meals.
- Include fish in your meals 2-3 times a week.
- Choose lean meats like cuts of beef and pork that end in "loin" such as pork loin and sirloin. Remove the skin from chicken and turkey.
- Choose non-fat dairy such as skim milk, non-fat yogurt and non-fat cheese.
- Choose water and calorie-free "diet" drinks instead of regular soda, fruit punch, sweet tea and other sugar-sweetened drinks.
- Choose liquid oils for cooking instead of solid fats that can be high in saturated and trans fats. Remember that fats are high in calories. If you're trying to lose weight, watch your portion sizes of added fats.
- Cut back on high calorie snack foods and desserts like chips, cookies, cakes, and full-fat ice cream.
- Eating too much of even healthful foods can lead to weight gain. Watch your portion sizes.
Reading food labels
Reading labels can help you make correct and healthy wise food choices. Most packaged foods in the grocery store list nutrition information on the package in a section called the "Nutrition Facts."
- The Nutrition Facts tell you the serving size and the amount of various nutrients such as total fat, saturated fat, cholesterol, sodium, and fiber per serving
- Nutrient content claims such as "low fat" provide a reliable description of the product.
- The list of ingredients shows the ingredients in descending order by weight.
- Foods that are exempt from the label include foods in very small packages, foods prepared in the store, and foods made by small manufacturers.
Sweeteners & desserts
Having diabetes used to mean a lifetime of meals that lacked the most pleasant aspect of taste: sweetness. Today, the rules for avoiding sugar have been relaxed. If you have diabetes, that doesn't mean you can't eat sweets. New artificial sweeteners can give you sweetness that tastes as good as sugar, without sugar's effect on your weight. People with diabetes can eat desserts, use sweeteners, and still keep their blood glucose (sugar) levels in their target range. These options are available for sweetening your foods:
- Sugar and other sweeteners with calories including honey, brown sugar, molasses, fructose, cane sugar and confectioners' sugar
- Reduced-calorie sweeteners including erythritol, hydrogenated starch hydrolysates, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol
- Low-calorie sweeteners such as ascelfume potassium, aspartame, saccharin and sucralose
Frequently-asked questions about nutrition
What foods can I eat a lot of? Are some fats better than others? What vitamins can help my diabetes? Learn the answers to these questions and more in this section.
1. Why do I need to see a dietitian?
Registered dietitians (RDs) have training and expertise in how the body uses food. RDs who understand diabetes can teach you how the food you eat changes your blood glucose level and how to coordinate your diabetes medications and eating. Do you know how many calories you should eat each day? How to cut down on the fat in your meals? How to make eating time more interesting? An RD can help you learn the answers to these, and lots of other questions. Your dietitian will work with you to create a healthy eating plan that includes your favorite foods.
2. Can I eat foods with sugar in them?
For almost every person with diabetes, the answer is yes! Eating a piece of cake made with sugar will raise your blood glucose level. So will eating corn on the cob, a tomato sandwich, or lima beans. The truth is that sugar has gotten a bad reputation. People with diabetes can and do eat sugar. In your body, it becomes glucose, but so do the other foods mentioned above. With sugary foods, the rule is moderation. Eat too much, and 1) you'll send your blood glucose level up higher than you expected; 2) you'll fill up but without the nutrients that come with vegetables and grains; and 3) you'll gain weight. So, don't pass up a slice of birthday cake. Instead, eat a little less bread or potato, and replace it with the cake. Taking a brisk walk to burn some calories is also always helpful.
3. Why does losing weight help my diabetes?
Weight loss helps people with diabetes in two important ways. First, it lowers insulin resistance. This allows your natural insulin (in people with type 2 diabetes) to do a better job lowering blood glucose levels. If you take a diabetes medicine, losing weight lowers blood glucose and may allow you to reduce the amount you're taking, or quit taking it altogether. Second, it improves blood fat and blood pressure levels. People with diabetes are about twice as likely to get cardiovascular disease as most people. Lowering blood fats and blood pressure is a way to reduce that risk.
4. How can I cut the fat in my diet?
Here are some beginning hints. See a dietitian for more advice. Stir-fry foods in tiny amounts of oil and lots of seasonings. Choose nonfat or low-fat selections, such as nonfat or 1% milk or low-fat cheese. Keep portion sizes on target. Avoid fried foods - bake, grill, broil or roast vegetables and meat instead.
5. Are some fats better than others?
Yes. Unsaturated fats are the healthiest for your body. This includes both monounsaturated and polyunsaturated fats. You can find these "healthy fats" in foods like nuts, vegetable oils, olives and avocados.
The fats to cut back on are the saturated and trans fats. Saturated fats are found in full-fat dairy products like ice cream, half and half, sour cream, cheese, and meats, chicken skin, bacon and lard. Trans fats are found in margarines and shortening as well as many processed packaged foods and sweets. Trying to cut back on how much saturated and trans fat you eat is important to help reduce your risk of heart attack and stroke.
6. What foods can I eat a lot of?
Forget about eating with abandon. The key to healthy living is moderation. Air-popped popcorn may be low in fat, but it still has calories. And calories count. If you can control the portion sizes of the food you eat, you will be able to eat a wider variety of foods, including your favorites, and still keep your blood sugar in your target range.
7. What can I do if I overeat over the holidays?
Put on your walking shoes and head for the pavement. Being more active helps lower your blood sugar, blood pressure and cholesterol. Physical activity uses up extra sugar in your blood and helps your insulin work better.
8. Can I use low calorie sweeteners?
Low calorie sweeteners are safe for everyone except people with phenylketonuria, who should not use aspartame. Calorie-free sweeteners like aspartame, saccharin, sucralose and acesulfame-K won't increase your blood glucose level. The sugar alcohols - xylitol, mannitol, and sorbitol - have some calories and do slightly increase your blood glucose level. Eating too much of any of these can cause gas and diarrhea.
9. How much weight should I lose each week?
Limiting your weight loss to 1/2 to 1 pound a week will keep you healthy, and let you enjoy the foods you love in small amounts. A slow steady weight loss is the key to keeping lost weight off.
10. Can I drink alcohol?
Yes, in moderation. Moderation is defined as two drinks a day for men and one drink a day for women. A drink is a 5-ounce glass of wine, a 12-ounce light beer, or 1-1/2 ounces of 80-proof distilled spirits. Make sure that your medications don't require avoiding alcohol, and get your doctor's okay.
11. Isn't glucose control easier if I eat the same things every day?
Probably, but this method of blood glucose control isn't very nutritious, not to mention boring. One of the keys to nutrition is eating a variety of foods each day. By checking your blood glucose two hours after starting to eat a meal, you can learn how different foods affect you. Over time, you will be able to predict how foods, and combinations of foods, affect your blood glucose level.
12. What vitamins will help my diabetes?
If you have a vitamin or mineral deficiency, it could be causing problems with your glucose control. For instance, one study found that taking the trace element chromium improved glucose control in subjects who had a chromium deficiency. More studies need to be done. If you choose a variety of fruits, vegetables, grains, and meat each day, and keep your blood sugar close to your target range, you probably don't need to take vitamin supplements because of diabetes.
13. Are there herbs that will help my diabetes?
Many herbs supposedly have glucose-lowering effects, but there are not enough data on any herb to recommend it for use in people with diabetes. Herbs are not considered food by the Food and Drug Administration and are not tested for quality or content. Therefore, products can be promoted as helping health conditions without having to show evidence of this. Discuss the herbal dietary supplements with your doctor or dietitian before trying them. They may interact poorly with your diabetes medication.
