Diabetes in Adults

How Does Diet Affect Diabetes?

A healthy diet is a crucial part of managing diabetes. People who have diabetes should watch:

• What time they eat (meals and snacks should be about the same time every day)
• How much they eat (meals and snacks should be about the same size every day)
• The balance of what they eat at each meal (not too much of one type of food).

In the beginning, you will probably work with a dietitian to plan meals and snacks. You may follow a plan called “carbohydrate counting.” Carbohydrate counting is keeping track of starchy foods and sugar, which have the most effect on blood sugar.

The Balanced Diet

Meals and snacks can be based on the food pyramid. Your dietitian may tell you just how many servings you need of each food, and how large a serving should be.

• The largest part of each meal should be the foods at the bottom of the pyramid, such as whole grain breads, pasta and rice, and starchy vegetables like potatoes, corn, peas and beans.
• Every day, you should have several servings of vegetables and fruit.
• Protein should come from lean meats, chicken, turkey, or fish, or meat substitutes like beans, eggs or low-fat cheese.
• Dairy foods should be either non-fat or low-fat.
• Eat fats and sugars only in small amounts.

The Food Pyramid

This pyramid shows approximately where food should come from, with much more from the wide parts than the narrow.

Fat and sugar: Use sparingly

Dairy foods (two to three servings): Choose non-fat or low-fat

Protein (two to three servings): Meat, poultry, fish, eggs, beans: Choose lean protein sources, such as skinless chicken and fish. Limit egg yolks to 3-4 per week, 1/2 cup of beans can be substituted for 1 serving of meat or fish

Vegetables (three to five servings): Eat all different types and colors

Fruit (two to four servings): Eat whole fruit rather than drinking fruit juice so you get enough fiber

Grains and starchy vegetables (six to 11 servings): Choose whole grain breads, and a wide variety of other starches

Salt

High blood pressure often goes along with diabetes. High sodium intake has been linked to high blood pressure.

• Cut down gradually on salt used in cooking and at the table.
• Avoid high-sodium foods such as chips, snack crackers, processed meats, and canned soups.

Sugar

There is no need to avoid all sugar. However, use sugar sparingly and try not to add additional sugar to foods.

• Eat sugar as part of a meal (for example, in fruit pies, frozen yogurt, or pudding).
• Avoid too much sugar between meals. Drink diet soft drinks, not regular.
• Don’t waste your money on “diabetic” foods. They are often high in fat to make up for lack of sugar.
• Avoid processed foods, which are often high in sugar and fat and low in nutrients.

Fats

Fats may not cause blood sugar to fluctuate in people with diabetes, but they still should be reduced, especially if you are trying to lose weight.

People with diabetes have a much higher than average risk of heart disease. You can reduce that risk if you cut down on saturated fat, which is found in meat, dairy foods, and solid vegetable fats.

• Choose lean meats; take the skin off chicken.
• Instead of butter or hard margarine, eat “good” fats from oils such as canola or olive, or from nuts. Choose margarine that lists a liquid oil as the first ingredient.
• Buy skim or low-fat milk, and non-fat or low-fat yogurt. Limit the amount of regular cheese: choose a low-fat type.
• Avoid fried foods. Grill, broil, boil or bake instead.
• Limit egg yolks to three to four per week.

Alcohol

Ask your diabetes team how much alcohol (if any) you can have with meals.

Don’t drink alcohol on an empty stomach. Have it with a meal and sip it slowly.

Research shows that if your diabetes is under control, a moderate amount of alcohol has only a minimal effect on blood sugar. A moderate amount is defined as:

• No more than two alcoholic drinks daily for men
• One alcoholic drink daily for women

One drink equals:

• One 12-ounce can of beer
• One 5-ounce glass of wine
• One 1-ounce shot glass of whiskey.

If your blood sugar is not under control or you have diabetes complications, avoid large amounts of alcohol. It can worsen some complications, including nerve damage, coronary artery disease and high blood pressure.

Also keep in mind that alcohol is high in calories. If you’re trying to lose weight, alcohol can make that more difficult.

Snacks

Snacks can help keep blood sugar from dipping too low between meals. These should not be high in sugar and fat, like candy or chips, but foods such as:

• Peanut butter and crackers
• Cheese and crackers
• Low-fat sugar-free yogurt
• Fresh fruit
• Bran muffins
• Graham crackers

Always carry a source of carbohydrate, eg, glucose tablets, in case yor blood sugar gets too low. This may occur if you are taking either insulin, or to a much less extent, a sulfonylurea agent. It is much more likely to occur if you skip meals, eat less than usual or exercise more than usual.

Eating Out

When you eat out, stick to the same plan you follow at home.

• Eat servings about the same size as you have at home. If there is food left over, ask for a doggy bag.
• Avoid food high in fat. Order foods that are broiled, boiled, steamed, grilled, or baked, not fried.
• If you order salad, ask for the dressing on the side, and use only a little.
• Have fruit for dessert or, as a treat, split one dessert with a friend or two.
• If your doctor has asked you to limit salt, ask for low-sodium dishes.