Diabetes Diet Recommendations

Registered dietitian explains how to eat to manage diabetes
October 1, 2019

Anyone—expert or not—will tell you that a healthy diet is essential for managing diabetes, and they are right. However, there is no one-size-fits-all “diabetes diet.” Rather, diabetes patients should follow general dietary guidelines to keep their blood sugar at healthy levels, and the guidelines are not much different from those for good general nutrition.

“Really, everyone should be eating this way, not just those who have diabetes,” said Priscilla Benavides, RD, LDN, MS, health educator with the Diabetes Education Program at the Texas A&M Coastal Bend Health Education Center and Texas A&M Healthy South Texas. “It’s not as if a person with diabetes has to eat a certain way, and everybody else can eat whatever they want. We should all be eating healthfully to prevent diet-related diseases, like diabetes and heart disease.”

Benavides says the first thing to know is that a diabetes diagnosis does not mean you have to deprive yourself completely of the foods you enjoy. In fact, she says phrases like, “I can’t eat this” or “I’m not allowed to eat that” can make us feel like we are being punished for having diabetes.

“Everything is allowed. You just have to learn what is worth it and what isn’t,” Benavides said. “Once you understand what you are putting in your body, it’s easier to make smart food choices.”

The number of calories you need depends on a number of factors such as your age and activity level. Your health care provider can give you a recommended amount based on your specific needs. The following general guidelines are based on a 2,000-calorie diet and follow recommendations of the American Diabetes Association.

Fill your plate

When you think of dieting, do you imagine wide-open expanses of plate dotted with tiny bits of broccoli or bean sprouts? If this is what you’ve been told dieting looks like, then your stomach might be grumbling just thinking about eating healthfully.

However, you’ll be relieved to know that Benavides recommends the complete opposite of this.

“Have a full plate of food and more,” Benavides said. “Fill your plate with non-starchy vegetables, lean protein and carbohydrates, then add some fruit and dairy on the side.”

Benavides recommends following the Plate Method, which is an easy “formula” for building a healthy meal. Start with a 9-inch-diameter plate and fill half of it with non-starchy vegetables, like green beans, zucchini, salad, carrots and—yes—broccoli and bean sprouts. Then fill one quarter with starches and the other quarter with lean protein. Starches include grains, bread, beans, cereals and starchy vegetables such as corn, peas and potatoes. Healthy protein choices are lean meats, eggs, seafood, tofu and nuts. Once you’ve filled your plate, add a serving of fruit and/or dairy on the side.

“If you don’t remember anything else about nutrition, this method is a good rule of thumb to live by,” Benavides said.

Evenly space your meals

The key to managing diabetes is keeping blood sugar levels as close to target goals as possible throughout the day.

“We run into trouble if our blood sugar spikes too high or dips too low,” Benavides said. “What we eat and when can have a large impact on that.”

She recommends eating throughout the day and—contrary to dieting folklore—never skipping a meal. Space meals four to five hours apart and eat healthy snacks in between if needed.

Count carbohydrates

Of all the foods we eat, carbohydrates affect blood sugar levels the most. This is because the digestive system breaks down carbohydrates into sugar that then enters the blood stream for energy. Because we need carbohydrates for this energy, it is important to keep them in your diet, although in reasonable amounts.

Carbohydrate containing foods include grains, starchy vegetables, fruit and fruit juice, milk, yogurt, sweets, desserts and soda.

For most people with diabetes, counting carbohydrates ensures they are staying within their daily recommended value and eating a consistent amount of carbs at each meal. For those with type 1 diabetes and those who are on mealtime insulin, counting carbohydrates is critical. If you fall into the second group, be sure you are working with your health care provider on your specific carb to insulin ratio and follow it closely.

The 2019 Standards of Medical Care in Diabetes states that there is no ideal amount of carbohydrates for all people with diabetes. Benavides emphasizes monitoring blood sugar levels to find the amount of carbohydrates that helps you meet your goals. “A good starting point for a healthy amount of carbohydrates is 45 to 60 grams per meal,” Benavides said.

She has an easy way to follow this recommendation called “carb choices.” Think of a clock divided into four quarters. Each quarter is a carb choice, or 15 grams of carbs. To build a meal, fill the clock with four carb choices (60 grams of carbohydrates).

Some examples of single carb choices are:

  • One slice of bread
  • 1/3 cup of cooked rice or pasta
  • 1/2 cup of cereal
  • 1/4 cup of granola
  • One plain small roll
  • One 4 1/2 inch waffle
  • One small apple
  • Half of a banana
  • One cup of yogurt or milk
  • 2 tablespoons of raisins
  • 1 cup of macaroni and cheese

“Don’t just think about food. Beverages also contribute to our carb and calorie count,” Benavides said. Some soft drinks, for instance, contain 40 grams of carbs, or nearly three carb choices, which is almost a whole meal’s worth.

The bottom line

“Most of us are really concerned about our external environment—what’s in our water or the air we breathe—and its impact on our health. But we should be equally, if not more, mindful of our internal environment and the food we are putting into our bodies,” Benavides said. “After all, nutrition is one area in our lives where we can choose what we expose our body to, so it’s in everyone’s best interest to try to eat the healthiest food they can, whether they have diabetes or not.”

— Lindsey Hendrix

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