By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
When I was actively seeing patients, I always tried to spend a little extra time with the folks who had diabetes—talking with them about their diet and coaching them on how to eat better. It was so, so important, given that diabetes significantly increases the risk for heart attack and stroke.
One of the things I learned from that experience was that many people don’t fully understand how to adjust their eating habits to manage their blood sugar.
Setting up a healthy and satisfying diet that doesn’t hurt—and, in fact, will help—your blood sugar is easier than you think. Let’s take a look at how you can get started during your next trip to the grocery store.
What Type of Diabetes Diet Plan Is Best?
There’s been some research over the past few years suggesting that a Paleo-style diet is best for reducing the symptoms of metabolic syndrome (a common precursor to diabetes), including blood sugar levels. Most docs, though, will recommend a more generic low-carbohydrate diet for diabetes.
I usually advised my patients to simply follow my Pan-Asian Modified Mediterranean (PAMM) diet, with a few additional modifications to accommodate their blood sugar needs. These three rules are effective for controlling blood sugar and minimizing your risk for diabetes complications, and don’t be surprised if you lose a little weight along the way, too.
Diabetes Diet Rule #1: Get Carb-Smart
A lot of people assume that if you have diabetes, it means you have to cut carbohydrates completely out of your diet. That’s not true. What’s more, it’s not always healthy.
You can still eat a moderate amount of carbs on a diabetes diet so long as your choices are what I call “carb smart.” By that, I mean sticking to only carbs that are low glycemic. These carbs are digested and absorbed more slowly than others, so they won’t cause wild fluctuations in your blood sugar level.
As you would expect, sweets and processed foods are off the table. No debate, no questions. So, too, are most crackers, bread, pasta, and pretzels—basically any food made with refined white flour and sugar. Diabetes or not, the glucose from foods like these hits your bloodstream like a bomb. That’s damaging enough when you’re healthy. But when you have blood sugar issues, it can be downright dangerous.
What carbs can you eat? I like fruits and vegetables because they’re rich in fiber and antioxidant nutrients like vitamin C. Just don’t overdo it on the fruit, and stay away from the riper pieces. Many fruits get sweeter as they age.
If you don’t know whether a carb is low- or high-glycemic, look it up on the glycemic index. As a general rule, though, the more natural and whole a food is, the healthier it tends to be and the more appropriate it is for a diabetes diet.
Carbs are also healthier if you apply the next two rules to how you eat them.
Diabetes Diet Rule #2: Add Fiber
As you get familiar with the glycemic index, one of the things you’ll notice is that diabetes-friendly carbs—sweet potatoes, beans, carrots, legumes, greens, and the less processed kinds of oatmeal, among others—contain more fiber than their higher glycemic counterparts.
Because fiber-rich foods require more time to digest, the nutrients in them are released more slowly—which means they have a moderating effect on blood sugar levels. Multiple studies have confirmed that increasing fiber intake helps with both short- and long-term blood sugar control.
So, if you’re craving a few bites of pasta, for example, opt for brands made from whole grains or wheat alternatives, like lentils—and then combine it with a veggie like broccoli. It’s not an ideal choice for someone with diabetes, but the higher fiber content will help minimize the glucose surge, and the veggies will supply you with additional vitamins and minerals.
One more note. At least one of the research studies looking at fiber suggests that soluble fiber—fiber that dissolves in water—is the most effective kind of fiber for helping to get blood sugar under control. Good sources of soluble fiber include beans, oatmeal, apricots, oranges, Brussels sprouts, asparagus, and ground flaxseed.
Diabetes Diet Rule #3: Balance Carbs With Healthy Fats and Protein
Another part of being carb smart is this: If you’re going to eat carbohydrates, pair them with healthy fats and proteins.
This is a principle that I’ve talked about a few other times, including in my discussion about healthy breakfast foods. Like fiber, the addition of the fat and protein slows the digestive process and the release of glucose into the bloodstream, which helps keep blood sugar on an even keel.
So, if you’re going to include carbs with your meal, choose low-glycemic options and pair them with generous portions of lean protein, such as salmon, organic eggs, buffalo, or organic grass fed steak, as well as healthy fats like extra virgin olive oil or avocado.
Diabetic Food Recommendations
Here are a few more tips:
- To sweeten your coffee or tea, add D-ribose instead of sugar or honey. It’s sweet, but it has a negative glycemic effect.
- Make avocados, nuts (macadamia nuts, walnuts, and almonds), chick peas, lentils, and broccoli staples in your meal planning. All of these foods require very little insulin for your body to process, and they help to slow the release of glucose into your bloodstream.
- Fruits contain natural sugar, called fructose. Your best bet is to avoid very ripe fruit, which is higher in fructose, and minimize your intake of high index items like watermelon, pineapple, mangos, papayas, and dried fruit. Berries, apricots, and apples are some of the lowest fruit on the index.
- If you have to eat prepackaged foods, read labels carefully and watch for “hidden sugar.” To enhance flavor and increase shelf life, food manufacturers often add ingredients like high-fructose corn syrup or other artificial sweeteners to foods you would never expect them to be in, like salad dressings.
- Avoid sodas—or “liquid candy,” as I call them—like the plague. They are full of added sweeteners and have no nutritional value whatsoever.
- When possible, eat vegetables raw (onions and kale are two of my favorites). Raw, vegetables are packed with natural enzymes, antioxidants, minerals, and fiber. Cooking destroys some of this nutrient value. In fact, eating less cooked food—and eating less overall—are keys to success.
For more on learning how to work with these diabetes food rules, as well as some great-tasting recipes, I highly recommend checking out two of my cookbooks: The Healing Kitchen and The Great Cholesterol Myth Cookbook.
- Bajorek SA and Morello CM. Effects of dietary fiber and low glycemic index diet on glucose control in subjects with type 2 diabetes mellitus. Ann Pharmacother. 2010 Nov;44(11):1786–92.
- Boers I et al. Favourable effects of consuming a Palaeolithic-type diet on characteristics of the metabolic syndrome: a randomized controlled pilot-study. Lipids Health Dis. 2014 Oct 11;13:160.
- Feinman RD, et al. Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base.
- Fujii, H et al. Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. Nutr J. 2013;12:159.
- Manheimer EW et al. Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis. Am J Clin Nutr. 2015 Oct;102(4):922–32.
- Post RE et al. Dietary fiber for the treatment of type 2 diabetes mellitus: a meta-analysis. J Am Board Fam Med. 2012 Jan-Feb;25(1):16–23.
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