Diabetes is a chronic condition that affects how your body metabolizes sugar (glucose). A diabetes diet is a healthy-eating plan that helps control blood sugar. It's a way of eating that's naturally rich in nutrients and low in fat and calories. Key elements are fruits, vegetables, and whole grains. If you have diabetes or prediabetes, your health care provider will likely recommend that you see a dietitian to help you develop a healthy-eating plan. The plan helps you control your blood sugar, also called blood glucose, manage your weight, and control heart disease risk factors.
Understanding Diabetes and Insulin
Insulin is the hormone that regulates blood sugar levels. When blood sugar levels are high, the pancreas will make more insulin and release it so that cells are able to receive blood sugar. This is why insulin is often called the key which unlocks cells. When cells reach sugar capacity, insulin helps store the remaining sugar in the liver.
There are two main types of diabetes:
- Type 1 Diabetes: The body does not make enough, or any, insulin on its own. The beta cells within the pancreas that produce insulin are damaged or destroyed.
- Type 2 Diabetes: Cells are not responding to insulin or are resistant to it. People with type 2 diabetes might benefit from insulin shots but are often given oral medications and told to change their diet and exercise habits to reverse or delay the long-term effects of diabetes.
The Importance of Diet in Diabetes Management
When you eat extra calories and carbohydrates, your blood sugar levels rise. If blood sugar isn't controlled, it can lead to serious problems, including a high blood sugar level, called hyperglycemia. You can help keep your blood sugar level in a safe range. For most people with type 2 diabetes, weight loss also can make it easier to control blood sugar. Weight loss offers a host of other health benefits. A diet for people living with diabetes is based on eating healthy meals at regular times. A registered dietitian can help you put together a diet based on your health goals, tastes, and lifestyle. The dietitian also can talk with you about how to improve your eating habits. Make your calories count with nutritious foods.
General Dietary Goals for Diabetes Management
Dietary advice for those with diabetes has evolved and has become more flexible and patient-centered over time. Nutrition goals from the American Diabetes Association (ADA) 2024 include the following:
Read also: Holistic Diet Plan
To promote and support healthful eating patterns, emphasizing a variety of nutrient-dense foods in appropriate portion sizes, to improve overall health and:
- achieve and maintain body weight goals.
- attain individualized glycemic, blood pressure, and lipid goals.
- delay or prevent the complications of diabetes.
To address individual nutrition needs based on personal and cultural preferences, health literacy and numeracy, access to healthful foods, willingness and ability to make behavioral changes, and existing barriers to change.
To maintain the pleasure of eating by providing nonjudgmental messages about food choices while limiting food choices only when indicated by scientific evidence.
To provide an individual with diabetes the practical tools for developing healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods.
The American Association of Clinical Endocrinologists (AACE) guidelines has similar nutrition goals for people with type 2 diabetes.
Read also: Weight loss experiences at AlternaCare
Key Components of a Diabetes Diet
During digestion, sugars and starches break down into blood glucose. Sugars also are known as simple carbohydrates, and starches also are known as complex carbohydrates. Dietary fiber includes all parts of plant foods that your body can't digest or absorb. Fiber moderates how your body digests food and helps control blood sugar levels.
A healthy diabetes diet contains a variety of foods that help regulate blood sugar, boost metabolism, and curb hunger. To support your health, include foods rich in fiber, potassium, magnesium, vitamin C, and calcium. These nutrients help regulate blood sugar, blood pressure, and cholesterol.
- Non-Starchy Vegetables: According to the Diabetes Plate, non-starchy vegetables should make up half of your meal. Dark green leafy vegetables are packed with vitamins and minerals such as vitamins A, C, K, and folate; iron; calcium; and potassium. These foods are low in calories and carbohydrates and fit on the non-starchy vegetables section of the Diabetes Plate. Additionally, try adding dark leafy vegetables like spinach, collards, and kale to salads, soups, and stews.
- Fruits: Eat fruits in moderation. Berries are a great option for a diabetes meal plan, packed with antioxidants, vitamins C and K, manganese, potassium, and fiber. They are naturally sweet and can be a great option to satisfy your sweet tooth without added sugar. Most of us know citrus fruits are a great vitamin C source, but did you know they also have fiber, folate, and potassium? From grapefruits, oranges, lemons, limes, and beyond, choose whole fruits over juices to get the full benefits of eating fruit, including the fiber from the pulp.
- Whole Grains: Whole grains are rich in vitamins and minerals like B vitamins, magnesium, iron, and manganese. They are a great source of fiber too. Look for products that have the first ingredient with the word “whole” in it. Some examples of whole grains include whole oats, quinoa, barley, farro, and whole wheat. Whole grains such as whole wheat bread and pasta, brown rice, oats, and quinoa are an excellent source of fiber. Fiber acts like an outer shell covering these carbs. That shell has to be broken down, so there’s a slight delay in the flow of sugars into the bloodstream. Whole grains not only help control diabetes but can help lower cholesterol and prevent other chronic diseases.
- Protein: According to the Diabetes Plate, protein foods should fill up one quarter of your plate. Beans are high in quality carbohydrates, low-fat protein, and soluble fiber. They’re also good sources of magnesium and potassium, helping stabilize blood sugar levels and control hunger. There are different kinds of beans like kidney, pinto, navy, or black beans, and legumes like chickpeas, split peas, and lentils that all offer a host of nutrient-packed benefits. These plant-based proteins do contain carbohydrates, but ½ cup also provides as much protein as an ounce of meat without the saturated fat. To save time, you can use canned beans. But be sure to drain and rinse them to get rid of as much added salt as possible. Choosing dry beans, peas, and legumes are not only affordable, but you can personalize them with your own flavors.
- Healthy Fats: Foods containing monounsaturated and polyunsaturated fats can help lower your cholesterol levels. Avocados are primarily composed of monounsaturated fatty acids (MUFAs), which can increase "good" (HDL) cholesterol while lowering "bad" (LDL) cholesterol and triglycerides.
- Dairy: Milk and yogurt can help build strong bones and teeth with calcium. In addition to calcium, many milk and yogurt products are fortified to make them a good source of vitamin D. More research is emerging on the connection between vitamin D and good health. Milk and yogurt contain carbohydrates, which you will need to plan for when you have diabetes. Look for yogurt products that are lower in fat and added sugar. Try adding some natural sweetness to low-fat plain Greek yogurt with berries and top with walnuts for a satisfying breakfast.
- Fish: Eat heart-healthy fish at least twice a week. Fish such as salmon, mackerel, tuna, and sardines are rich in omega-3 fatty acids. These omega-3s may prevent heart disease. Fish high in Omega-3 Fatty Acids may help reduce the risk of heart disease and inflammation. Fish high in these healthy fats are sometimes referred to as "fatty fish." Salmon is well known in this group and other fish high in omega-3 are herring, sardines, mackerel, trout, and albacore tuna. Choose fish that is broiled, baked, or grilled to avoid extra carbohydrate and calories that would be in fish that is breaded and fried. Try eating fatty fish at least twice a week to get the nutritional benefits.
- Nuts: An ounce of nuts can go a long way in getting key healthy fats, magnesium, and fiber and can help manage hunger. Some nuts and seeds, such as walnuts and flax seeds, are also a good source of omega-3 fatty acids. Nuts provide healthy unsaturated fats, fiber, and magnesium, which can aid carbohydrate metabolism. When deciding what to choose, go with plain or unsalted nuts to maintain good heart health. Be mindful of portion sizes-one ounce (1/4 cup) contains about 170 calories.
Foods to Limit or Avoid
Just as important as loading your plate up with healthy whole foods is limiting foods that can spike your blood sugar levels. Certain foods negatively affect your blood sugar levels, cause inflammation, and trigger immune responses.
- Refined Sugar: Refined sugar rapidly spikes blood glucose, and soda, fruit juice, and other sugary beverages are the worst culprits. These forms of sugar enter the bloodstream rapidly and can cause extreme elevations in blood glucose. Even though natural sweeteners like raw honey and maple syrup are better options, they can still affect blood sugar levels, so only use these foods on occasion.
- Grains: Grains, especially gluten-containing grains like wheat, contain large amounts of carbohydrates that are broken down into sugar within only a few minutes of consumption. Gluten can cause intestinal inflammation, which affects hormones like cortisol and leptin, and can lead to spikes in blood sugar.
- Conventional Cow’s Milk: Conventional cow’s milk and dairy products should be eliminated, especially for people with type 1 diabetes. Dairy can be a fantastic food for balancing blood sugar if it comes from goat’s, sheep, or A2 cows - all pasture-raised.
- Alcohol: Alcohol can dangerously increase blood sugar and lead to liver toxicity. Research published in Annals of Internal Medicine found that there was a 43 percent increased incidence of diabetes associated with heavy consumption of alcohol, which is defined as three or more drinks per day.
- Hydrogenated Oils: Remove hydrogenated, rancid oils from your diet, including vegetable oil, soybean oil, cottonseed oil, and canola oil.
- Saturated Fats: Avoid high-fat dairy products and animal proteins such as butter, beef, hot dogs, sausage, and bacon.
- Trans Fats: Limit trans fats.
- Cholesterol: Limit cholesterol sources, including high-fat dairy products and high-fat animal proteins, egg yolks, liver, and other organ meats.
- Sodium: Aim for no more than 2,300 mg of sodium a day.
Strategies for Meal Planning
You may use a few different approaches to create a healthy diet to help you keep your blood sugar level within a typical range. The American Diabetes Association offers a simple method of meal planning. It focuses on eating more vegetables. Because carbohydrates break down into sugar, they have the greatest effect on your blood sugar level. To help control your blood sugar, you may need to learn to figure out the amount of carbohydrates you are eating with the help of a dietitian. You can then adjust the dose of insulin accordingly. A dietitian can teach you how to measure food portions and become an educated reader of food labels. A dietitian may recommend you choose specific foods to help plan meals and snacks. One serving in a category is called a choice. A food choice has about the same amount of carbohydrates, protein, fat, and calories - and the same effect on your blood sugar - as a serving of every other food in that same category. Some people who live with diabetes use the glycemic index to select foods, especially carbohydrates. This method ranks carbohydrate-containing foods based on their effect on blood sugar levels. When planning meals, take into account your size and activity level.
- Carb Counting: Many people opt for carb counting, which involves measuring the amount of carbohydrates that you consume at each meal.
- The Plate Method: The plate method is another simple strategy for planning your diabetic diet menu. With this method, half of your plate should be comprised of non-starchy vegetables like leafy greens, broccoli, cauliflower, and carrots.
- Portion Control: Managing how much you eat can help you regulate your calorie intake and maintain a moderate weight. Consequently, weight management promotes healthy blood sugar levels and has been shown to reduce the risk of developing type 2 diabetes. Monitoring your serving sizes also helps prevent blood sugar spikes.
You may manage portion sizes by:
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- eating slowly
- measuring and weighing your food
- using smaller plates
- avoiding all-you-can-eat restaurants or those that serve large portions
- reading food labels and checking the serving sizes of each item
- keeping a food journal
- using a food-tracking phone app
Additional Tips for Managing Blood Sugar
Regular Exercise: Regular exercise and physical activity can help you manage your weight and increase insulin sensitivity. Increased insulin sensitivity means your cells can use the glucose in your bloodstream more effectively. Exercise also helps your muscles use blood sugar for energy and muscle contraction. If you have problems with blood sugar management, consider routinely checking your levels before and after exercising. This will help you learn how your body responds to different activities and keep your blood sugar levels from getting too high or low. You can still benefit from shorter sessions even if you have trouble dedicating more time to exercise throughout the week. For example, try aiming for 10-minute exercise sessions 3 times a day for 5 days, with the goal of 150 minutes per week.
Stay Hydrated: Drinking enough water could help you keep your blood sugar levels within healthy ranges. In addition to preventing dehydration, it helps your kidneys flush out excess sugar through urine. One 2021 review of observational studies found that people who drank more water had a lower risk of developing high blood sugar levels. Drinking water regularly may rehydrate the blood, lower blood sugar levels, and reduce diabetes risk. Keep in mind that water and other zero-calorie drinks are better for hydration. Avoiding sugar-sweetened options is ideal, as these can raise blood glucose, drive unwanted weight gain, and increase diabetes risk.
Get Adequate Sleep: Less than optimal sleeping habits and a lack of rest can affect blood sugar levels and insulin sensitivity, increasing the chance of developing type 2 diabetes. They can also increase appetite and promote weight gain. Sleep deprivation also raises levels of cortisol, which plays an essential role in blood sugar management. Adequate sleep is about both quantity and quality. Adults are advised to get 7 to 8 hours of high quality sleep per night.
Manage Stress: Stress can affect your blood sugar levels. When stressed, your body secretes hormones called glucagon and cortisol, which cause blood sugar levels to rise. Stress management strategies may include:
- exercise
- meditation
- mindfulness
- deep breathing
- journaling
- arts and crafts
- psychotherapy
- your favorite hobbies
Monitor Blood Glucose Levels: Monitoring blood glucose levels can help you better manage them. You can do so at home using a portable blood glucose meter, known as a glucometer. You can discuss this option with a doctor. Keeping track lets you determine whether to adjust your meals or medications. It also helps you learn how your body reacts to certain foods.
"Superstar" Foods for Diabetes
These foods are rich in protein, healthy fats, vitamins, minerals, antioxidants, and fiber.
- Avocado: This nutrient-packed food is important for contributing fat-soluble vitamins and fiber and can help you feel full.
- Berries: Berries are a great option for a diabetes meal plan, packed with antioxidants, vitamins C and K, manganese, potassium, and fiber. They are naturally sweet and can be a great option to satisfy your sweet tooth without added sugar.
- Citrus Fruit: Most of us know citrus fruits are a great vitamin C source, but did you know they also have fiber, folate, and potassium? From grapefruits, oranges, lemons, limes, and beyond, choose whole fruits over juices to get the full benefits of eating fruit, including the fiber from the pulp.
- Dark Green Leafy Vegetables: Packed with vitamins and minerals such as vitamins A, C, K, and folate; iron; calcium; and potassium, these foods are low in calories and carbohydrates and fit on the non-starchy vegetables section of the Diabetes Plate. Additionally, try adding dark leafy vegetables like spinach, collards, and kale to salads, soups, and stews.
- Fish High in Omega-3 Fatty Acids: Omega-3 fats may help reduce the risk of heart disease and inflammation. Fish high in these healthy fats are sometimes referred to as "fatty fish." Salmon is well known in this group and other fish high in omega-3 are herring, sardines, mackerel, trout, and albacore tuna.
- Legumes: There are different kinds of beans like kidney, pinto, navy, or black beans, and legumes like chickpeas, split peas, and lentils that all offer a host of nutrient-packed benefits. These plant-based proteins do contain carbohydrates, but ½ cup also provides as much protein as an ounce of meat without the saturated fat.
- Milk and Yogurt: You may have heard milk and yogurt can help build strong bones and teeth with calcium. In addition to calcium, many milk and yogurt products are fortified to make them a good source of vitamin D. More research is emerging on the connection between vitamin D and good health.
- Nuts: An ounce of nuts can go a long way in getting key healthy fats, magnesium, and fiber and can help manage hunger. Some nuts and seeds, such as walnuts and flax seeds, are also a good source of omega-3 fatty acids.
- Whole Grains: Whole grains are rich in vitamins and minerals like B vitamins, magnesium, iron, and manganese. They are a great source of fiber too. Look for products that have the first ingredient with the word “whole” in it. Some examples of whole grains include whole oats, quinoa, barley, farro, and whole wheat.
Addressing Micronutrient Deficiencies
High blood sugar levels and diabetes have been linked to micronutrient deficiencies, including chromium and magnesium.
- Chromium: Chromium is involved in carb and fat metabolism. It may enhance insulin’s action, thus aiding blood sugar regulation.
- Magnesium: Magnesium also benefits blood sugar level regulation. Diets rich in magnesium are associated with a significantly reduced risk of diabetes. In contrast, low magnesium levels may lead to insulin resistance and decreased glucose tolerance in people with diabetes.
Potential Benefits of Certain Foods and Supplements
Multiple foods and plants are known to have medicinal properties. However, the quality of evidence on these ingredients is low due to insufficient human studies or small sample sizes. Therefore, no conclusive recommendations can be made regarding their use.
Some of the foods touted to have anti-diabetes effects include:
- Apple cider vinegar: According to a 2014 article, this ingredient may reduce blood sugar levels by delaying the emptying of your stomach after a meal.
- Cinnamon: This spice is said to improve blood sugar levels by enhancing insulin sensitivity and slowing the breakdown of carbs in your digestive tract. This moderates the rise in blood sugar after a meal. Nevertheless, more research is needed.
- Berberine: Research suggests this compound lowers blood sugar by stimulating enzymes’ breakdown of glucose, promoting your tissue’s use of sugar and increasing insulin production. More studies are needed.
- Fenugreek seeds: Like the other foods on this list, more high-quality studies in humans are needed, but there is some evidence that fenugreek may help support blood sugar management.
It’s essential to talk with your doctor before adding any of these foods to your diet if you’re already taking diabetes medications, as some herbal supplements may negatively interact with them. Finally, the Food and Drug Administration (FDA) does not regulate supplements like it regulates prescription medications. Purchasing supplements that an independent lab has tested for purity and ingredient content is important.
Shopping on a Budget
Eating healthy with a diabetes-friendly food list doesn’t have to be expensive. Shop your local markets for foods and produce that is in season or on sale. Vegetables and fruit in other forms (frozen, canned, or dried) are great choices, just be sure to select ones without added sugar or sauces. Rinse canned vegetables to help reduce sodium. Look for frozen or canned fish and lower sodium nuts. Dry beans and legumes and whole grains you cook from scratch are affordable and allow you to personalize with your favorite flavors.