Nutrition plays a significant role in the overall management of diabetes. It is possible to take good care of yourself and control your diabetes if you understand what to eat, how much to eat, and when to eat. Choosing nutrient rich foods in appropriate portion sizes and healthy sources of carbohydrates can help control your blood glucose levels in your target range. Frequent self-monitoring of blood glucose can be used (with proper instruction) to keep track of the effects of meals and activity levels on blood glucose levels.1
Carb counting is key
Carbohydrates turn into glucose in the body and affect blood glucose levels more than fat or protein-containing foods. This does not mean that you have to give up all carbs; however, monitoring your total carbohydrate intake is essential. Choose carbs that come from nutrient-dense sources like fruit, vegetables, dairy, legumes and whole grains, along with controlled portion sizes. Eating five to six small meals per day with a specific amount of Carb Choices is recommended, such as BOOST Calorie Smart®, which has only 4 grams of sugar. Lastly, consider working with a Registered Dietitian Nutritionist (RDN) for a plan that fits your needs and goals.3
Choose sources of lean protein
Protein is an essential nutrient that is needed every single day, and unlike carbohydrates and fats, protein cannot be stored in the body. In diabetes management, protein appears to increase insulin response without increasing blood glucose concentrations. It also helps reduce hunger and improve satiety. Protein is found in various food sources that are either animal- or plant-based. Some examples of animal sources of protein are chicken, beef, eggs and milk, while legumes, soy, whole grains like quinoa, and nuts are plant sources.4-7
Focus on healthy fats
When incorporating fat into a diabetes meal plan, you should focus on foods that supply “healthy fats” while limiting “unhealthy fats” such as trans and saturated fats. Choose from mono and polyunsaturated fats, and omega-3 fats. Examples of healthy fat food sources include avocado, oils (olive and flaxseed), olives, nuts (almonds, cashews, pecans, peanuts, walnuts), seeds (pumpkin, sunflower, flaxseed) and fatty fish such as salmon and albacore tuna.8
Be sodium-savvy
People with diabetes should monitor their sodium intake, since they are more likely to have high blood pressure. Some examples of high-sodium foods include canned soups and vegetables, cold cuts, pizza, savory snacks, salted nuts, cereals, and condiments such as soy sauce, ketchup, mustard and pickles. One teaspoon of salt contains 2,300 mg of sodium – while 1,500 mg per day is ideal for most Americans. 9-12
Simple steps to help lower your risk of diabetes
While you can’t change the genes you inherit and how that influences your risk of developing diabetes, you can make some positive behavioral and lifestyle changes. If you are overweight, lose weight and get moving. Achieving a 7% weight loss goal and taking a brisk walk for 30 minutes each day can significantly reduce your risk for developing Type 2 diabetes. Also, if you smoke, quit, as smokers are 50% more likely to develop diabetes compared to nonsmokers. Finally, aim for 7-8 hours of sleep each night.2, 13-16
Set an action plan
When you have Type 1 or Type 2 diabetes, it is important to test your blood sugar regularly, have an action plan and set small goals with your healthcare team. Talk with your doctor and meet with an RDN regularly to help keep your meal plans in check, maintain your blood glucose levels in your target range, and provide encouragement to achieve a healthy lifestyle.1, 17
References
1. American Diabetes Association. Standards of Medical Care in Diabetes 2018. Diabetes Care 2018;41(S1):S1-S159.
2. American Heart Association. Sugar 101. 2017. http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Sugar-101_UCM_306024_Article.jsp#.WfjbmFWnHcs.
Accessed: February 6, 2018.
3. National Institute of Diabetes and Digestive and Kidney Diseases. Carbohydrate Counting. 2017.
https://www.niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-activity. Accessed: February 6, 2018.
4. Hamdy O, Horton ES. Curr Diab Rep. 2011;11(2): 111-9.
5. Richter CK, et al. Adv Nutr 2015;6(6): 712-28.
6. Vega-Galvez A, et al. J Sci Food Agri 2010;90(15): 2541-7.
7. American Diabetes Association. Protein Foods. 2017. http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/meat-and-plant-based-protein.html. Accessed: February 6, 2018.
8. American Diabetes Association. Fats. 2017. http://www. diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/fats-and-diabetes.html.
Accessed: February 6, 2018.
9. Franz MJ, et al. JAND. 2017; 117(10): 1659-1679.
10. Joslin Diabetes Center. Steps for Staying Healthy: Blood Pressure. 2017.
www.joslin.org/docs/Joslin_Steps_for_Staying_Healthy_BP_11-13-07.pdf. Accessed: February 6, 2018.
11. USDHHS and USDA. 2015-2020 Dietary Guidelines for Americans. 8th edition. December 2015. Available at: http://health.gov/dietaryguidelines/2015/guidelines/.
12. American Heart Association. How Much Sodium Should I Eat Per Day?.
https://sodiumbreakup.heart.org/how_much_sodium_ should_i_eat.
Accessed: February 6, 2018.
13. Li G, et al. Lancet 2008;371: 183-9.
14. Rana JS, et al. Diabetes Care 2007; 30:53-58.
15. Willi C, et al. JAMA 2007;298: 2654-2664.
16. Harvard School of Public Health, Nutrition Source. Simple Steps to Preventing Diabetes. 2017.
https://www.hsph.harvard.edu/nutritionsource/diabetes-prevention/preventing-diabetes-full-story/#Simple_steps.
Accessed: February 6, 2018.
17. Joslin Diabetes Center. All About A1C. 2017.
http://www.joslin.org/info/all_about_a1c.html.
Accessed: February 6, 2018.