If you're diagnosed with diabetes, you should definitely seek the nutritional advice of a registered dietitian, preferably one who is certified as a diabetes educator (credentials will read R.D., C.D.E.). The goal of nutrition therapy is to restore and maintain blood glucose levels to as near normal as possible. This means balancing your food with insulin and activity levels. What's more, you'll want to maintain appropriate cholesterol and triglyceride levels, consume the right number of calories for maintaining a reasonable weight, and improve your overall health by eating right.
Like everyone else, people with diabetes should (and can) consume carbohydrates, which are found in starches such as breads and pastas; vegetables like corn, potatoes, peas, and winter squash; fruit; and dairy products. They should also get the same recommended amount of fiber per day: up to 25 to 35 grams.
How much carbohydrate can a diabetic eat? When figuring it out, the total amount of carbohydrate is a strong predictor of your blood sugar response. According to the American Diabetes Association (ADA), monitoring grams of carbohydrate remains a major strategy in controlling blood sugar. However, the type of carbohydrate also influences blood glucose level. To figure out how quickly a carbohydrate will raise your blood sugar, nutrition experts use something called the Glycemic Index (GI), a numerical rating based on how quickly a carbohydrate raises blood sugar. The higher the number, the greater the blood sugar response to a certain food, which means the quicker an increase in your blood sugar. Of course, diabetics will benefit most from foods that have a low GI. Believe it or not, certain healthy foods, like carrots and potatoes, may cause a sharper increase in blood glucose than some candy bars. Often, a healthy food has a higher GI than a less healthy food. For instance, watermelon has a GI of 72, while cheese tortellini has a GI of 50. Many factors affect the GI of a food: how you prepare it, for instance, and what other foods are consumed along with it (fat and protein). If you have watermelon for dessert right after eating a peanut butter sandwich, for example, the fat in the peanut butter will lower the GI of the watermelon. Certainly, eating food combinations that yield lower glycemic responses can be beneficial for blood sugar regulation.
People with diabetes who don't have good blood sugar control may need more protein than nondiabetics. But since the average protein intake in the United States is far above the Recommended Dietary Allowance (RDA), this isn't a cause for great concern. The usual protein intake (15 to 20 percent of total calories) is enough, as long as kidney function is normal. A diabetic with compromised kidney function may need to follow a protein-restricted food plan.
Fats and Oils
People with diabetes are more sensitive to cholesterol in the diet, and it's recommended that less than 10 percent of the total caloric intake should come from saturated fat. If your LDL cholesterol is greater than 100 mg/dl, then just 7 percent is recommended. It's also advisable to consume no more than 200 mg of dietary cholesterol each day. On the other hand, monounsaturated fats are terrific, as are the omega-3s. To reap the benefits of omega-3 fatty acids, it's recommended that you eat two to three servings of fatty fish each week. Or try adding ground flaxseeds to your food.
Advice on Alcohol
The same recommendations for the general public apply to people with diabetes. If you choose to drink alcohol, the daily limit should be one drink for adult women and two drinks for men.
What constitutes a drink? Either a 12-ounce beer, a 5- to 6-ounce glass of wine or 11/2 ounces of a distilled spirit like gin or rum. It's very important that alcohol be consumed with food in order to reduce the risk of hypoglycemia, or low blood sugar. And when calculating your daily food plan, don't forget to count the alcohol as part of the day's calories.
Food for Thought
Caffeine intake before eating carbohydrates appears to elevate blood sugars in people with Type 2 diabetes. If you've been diagnosed with Type 2, make an effort to drink decaffeinated beverages.
Sweeteners Beyond Sucrose
Here's a guide to the various sweeteners now on the market:
- Fructose. Although it doesn't raise the blood sugar as much as ordinary table sugar (sucrose), it may adversely affect the levels of fat in the blood. It's not recommended as a sweetening agent.
- Sugar alcohols. These include mannitol, sorbitol, and xylitol, all of which produce a lower glucose response than fructose or sucrose. Still, there's no evidence that they aid in weight loss or improve blood sugar control, and they may also cause diarrhea, abdominal cramping, or gas, especially in children.
- Artificial sweeteners (saccharin, aspartame, acesulfame potassium, and sucralose). The FDA has approved these for the general public, and they can be an effective tool for diabetics.