Managing diabetes effectively involves a multifaceted approach, with diet playing a crucial role. A well-structured diabetes diet helps control blood sugar levels, manage weight, and improve overall well-being. There isn't a single "best" diet for everyone with diabetes; the ideal eating plan is individualized based on personal preferences, cultural background, existing health conditions, and other factors like food costs and access to healthy options. This article explores various diabetes diet plans, offering reviews and insights to help you make informed decisions in consultation with your healthcare team.
The Importance of a Diabetes Diet
A diabetes diet is a healthy-eating plan that helps control blood sugar. It means eating the healthiest foods in moderate amounts and sticking to regular mealtimes. It's a healthy-eating plan that's naturally rich in nutrients and low in fat and calories. Key elements are fruits, vegetables and whole grains. When you eat extra calories and carbohydrates, your blood sugar levels rise. If blood sugar isn't controlled, it can lead to serious problems. These problems include a high blood sugar level, called hyperglycemia. 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.
Eating well and maintaining a moderate weight can be important for your health. But if you have diabetes, excess weight may make it harder to manage your blood sugar levels and may increase your risk of some complications. If your doctor recommends it, even a modest amount of weight loss - around 5% - can improve blood sugar management and other diabetes outcomes.
Key Principles of a Diabetes-Friendly Diet
An ideal meal plan for diabetes:
- Is rich in nutrients
- Is high in fiber
- Is low in calories
- Emphasizes fresh fruits and vegetables, whole grains, lean proteins, and healthy fats
When you have diabetes, managing your blood sugar is very important. Eating habits that include regular meals and snacks throughout the day may be better suited to losing weight with diabetes than what you may typically think of with short-term “diets” and those that involve long periods without food.
Read also: Recipes for Gestational Diabetes
While calories remain important, if you have diabetes, you’ll also need to keep track of your carbohydrate intake. Your healthcare team or a dietitian can provide you with a target carb number for meals and snacks. According to the American Diabetes Association (ADA), there is no set carb target for all people with diabetes. Rather, all eating plans should be individualized. However, the ADA’s Standards of Care note that many people with diabetes get about 45% of their daily calories from carbs, including complex carbs, fruits, and vegetables.
Popular Diabetes Diet Plans
1. Low-Carb Diets
You don't have to give up carbohydrates because you have diabetes. If you want to try a diet that limits them, like Atkins or South Beach, talk to your doctor about it. Research on the benefits of low-carb diets for type 2 diabetes is still mixed. But a review written by 25 leading experts says this style of eating should be the first step in managing the disease, since it can "reliably reduce high blood glucose." Many eating styles focus on limiting carb consumption, but not all of them may work for you. Consulting your diabetes care team and nutritional experts is always a good first step in figuring out what meal plans and food choices may be best for you.
- What it is: Limits carbohydrate intake, focusing on proteins and fats.
- Pros: Can effectively reduce high blood glucose and may lead to weight loss. Research suggests it can be beneficial for people with diabetes and may help reduce the amount of insulin you need to take each day.
- Cons: May be challenging to stick with long-term and can present risks for people who have kidney disease or are at risk for eating disorders.
- Foods to eat: Lean protein, vegetables, fruits, healthy fats.
- Foods to avoid: Bread, pasta, quinoa, and rice, sugary foods and sweets, high carb fruits, starchy vegetables, beans and legumes.
- Expert Opinion: Many studies have shown that moderately low carb diets help improve insulin sensitivity and other markers of type 2 diabetes.
2. Mediterranean Diet
This heart-healthy diet uses lots of fruits and veggies as well as fish, chicken, nuts, olive oil, legumes, and whole grains. What you won't eat often: Red meat, butter, and salt. Studies have shown the diet can help keep blood sugar levels under control. You can have wine with meals, but the American Diabetes Association recommends no more than one drink per day if you're a woman, two if you're a man.
- What it is: Emphasizes fruits, vegetables, whole grains, legumes, nuts, and healthy fats like olive oil.
- Pros: Can help keep blood sugar levels under control, may reduce risk of diabetes, cancer, metabolic syndrome, heart disease, and insulin resistance.
- Cons: --stay mindful of carb intake as more foods with carbs are permitted.
- Foods to eat: Fruits, non-starchy vegetables, lean proteins, healthy fats, whole grains.
- Foods to avoid: Foods high in saturated fat, like full-fat dairy and fatty meats, added sugars, refined grains.
- Expert Opinion: Mediterranean-type food choices may be successful in lowering fasting glucose levels, reducing body weight, and reducing the risk of metabolic disorder, according to a 2020 review of studies.
- Rich in oleic acid, a fatty acid that occurs naturally in animal- and vegetable-based fats and oils.
3. DASH (Dietary Approaches to Stop Hypertension) Diet
Nutrition experts recommend this eating plan, designed to help lower blood pressure, to lots of people because it emphasizes fruits, vegetables, low-fat dairy, whole grains, lean meats, fish, nuts, and beans. (It does allow for some sweets, too. You should eat those in moderation.) A 2011 study found that it can improve insulin sensitivity when it's part of an overall weight loss program with exercise. The DASH eating plan was originally developed to help treat or prevent high blood pressure (hypertension). But it may also lower the risk of other diseases, including diabetes. And it may have the additional benefit of helping you lose weight.
- What it is: Emphasizes fruits, vegetables, low-fat dairy, whole grains, lean meats, fish, nuts, and beans.
- Pros: Can improve insulin sensitivity, reduce inflammation, and boost energy. May also lower the risk of other diseases, including diabetes. And it may have the additional benefit of helping you lose weight.
- Cons: None noted.
- Foods to eat: Lean protein: fish, poultry; plant-based foods: vegetables, fruits, beans, nuts, seeds; dairy: fat-free or low fat dairy products; grains: whole grains; healthy fats: vegetable oils.
- Foods to avoid: The plan also limits sweets, sugary beverages, and red meats. The National Heart, Lung, and Blood Institute advises people with diabetes who are following this plan to limit their sodium intake to 2,300 milligrams per day. You may have a lower sodium limit if you have certain other health conditions.
- Expert Opinion: Research has found that it can improve insulin resistance and has other benefits, such as lowering the risk of developing other chronic conditions.
4. The Zone Diet
Its goal is to keep blood sugar levels stable. Meals are 40% carbs, 30% protein, and 30% fat. Carbs are ranked as good or bad based on the glycemic index. You'll have foods like chicken and barley, but not potatoes and egg yolks. A 2015 study found it had a positive effect on glycemic control and waist size, so it may be a good choice.
Read also: Managing Diabetes on Dialysis
- What it is: Aims to keep blood sugar levels stable with meals consisting of 40% carbs, 30% protein, and 30% fat.
- Pros: May have a positive effect on glycemic control and waist size.
- Cons: None noted.
- Foods to eat: Chicken, barley, and other foods with a low glycemic index.
- Foods to avoid: Potatoes, egg yolks, and other foods with a high glycemic index.
- Expert Opinion: A 2015 study found it had a positive effect on glycemic control and waist size, so it may be a good choice.
5. Weight Watchers
You get a set number of points to "spend" as you eat. Most vegetables have zero points, so you can eat as much of them as you like, while fast foods and desserts are assigned high point values. Studies say it's effective. And the company offers a program for people with type 2 diabetes that includes fitness advice and support from a counselor with expertise in treating the disease.
- What it is: A points-based system where you get a set number of points to "spend" on food.
- Pros: Studies say it's effective. And the company offers a program for people with type 2 diabetes that includes fitness advice and support from a counselor with expertise in treating the disease.
- Cons: None noted.
- Foods to eat: Most vegetables have zero points, so you can eat as much of them as you like.
- Foods to avoid: Fast foods and desserts are assigned high point values.
- Expert Opinion: Studies say it's effective.
6. Paleo Diet
The idea behind this trendy diet is to eat the way early humans did before modern farming, when we were hunter-gatherers. That means no dairy, refined sugar, grains, or legumes, and no processed vegetable oils like soybean oil or canola oil. You can have fruits and veggies, lean meats (preferably grass-fed), fish, nuts, and seeds. Small studies show this eating strategy can improve blood sugar and diabetes. The paleo diet centers on the belief that the processing of foods is to blame for chronic disease. Followers of the paleo diet eat only what they believe our ancient ancestors would have been able to hunt and gather.
- What it is: Mimics the eating habits of early humans, excluding dairy, refined sugar, grains, legumes, and processed oils.
- Pros: Small studies show this eating strategy can improve blood sugar and diabetes. The results of a small, short-term 2017 study suggest that a paleo diet may improve blood sugar regulation and insulin sensitivity in people with type 2 diabetes.
- Cons: May be hard to follow long-term because it is more restrictive, leaving out whole food groups.
- Foods to eat: Protein: meat, poultry, fish; plant-based foods: nonstarchy vegetables, fruits, seeds, nuts (excluding peanuts); healthy fats: olive oil, avocado oil, coconut oil, flaxseed oil, walnut oil.
- Foods to avoid: Dairy, refined sugar, grains, or legumes, and no processed vegetable oils like soybean oil or canola oil.
- Expert Opinion: Some research has shown that paleo diets may help improve blood sugar regulation in people with type 2 diabetes, but other studies have shown they don’t. Keep in mind that paleo diets also tend to be high in fat, so managing the amount of fat you consume is important. A 2019 ADA report suggests that studies on the paleo diet are small and few, with mixed results. The paleo diet may be a good option for people with diabetes who do not have kidney disease.
7. Gluten-Free Diet
Gluten is a protein found in grains including wheat, rye, and barley. People with digestive disorders like celiac disease need to avoid it. Popular belief is that going gluten-free will help you lose weight, improve digestion, and boost energy. But these claims aren't backed up by science. Plus, gluten is in everything from salad dressing to vitamins. There's no need to follow this diet unless your doctor advises it. For people with celiac disease, eliminating gluten is necessary to avoid damage to the colon and the body. Celiac disease is an autoimmune disorder that causes your immune system to attack your gut and nervous system. It also promotes body-wide inflammation, which could lead to chronic disease.
- What it is: Eliminates gluten, a protein found in wheat, rye, and barley.
- Pros: May help ease digestive symptoms, reduce inflammation, and boost energy for people with celiac disease and non-celiac gluten sensitivity.
- Cons: Because it is restrictive, this diet may be hard to follow if you do not have a gluten allergy or sensitivity.
- Foods to eat: Fruits, vegetables, grains, legumes, nuts, seeds, healthy fats, gluten-free grains and starches (rice, tapioca, corn).
- Foods to avoid: Grains, breads, and pastas that contain gluten, wheat-based beer, gluten-containing sauces and dressings.
- Expert Opinion: People with celiac disease should follow this diet. There is no evidence that following this diet is harmful in people with diabetes, but there is no evidence that it is beneficial, either. While anyone with diabetes can follow a gluten-free plan, it may be unnecessarily restrictive for those without celiac disease. It’s also important to remember that “gluten-free” does not necessarily mean “low carb.” Plenty of gluten-free foods are highly processed and high in sugar. There is usually no need to complicate meal planning by eliminating gluten unless you have to.
8. Vegetarian and Vegan Diets
Limiting or avoiding animal products like chicken, fish, and yogurt can be a healthy way to eat. Just get plenty of fresh produce and other whole foods, as opposed to gorging on meatless "chicken" nuggets out of a box. Research shows that people who eat a plant-based diet get more fiber and take in less calories and fat than nonvegetarians.
- What it is: Limits or avoids animal products. Vegetarians typically avoid eating meat but may eat other animal products, such as milk, eggs, and butter. Vegans do not eat meat or any other type of animal product, including honey, milk, and gelatin.
- Pros: May reduce risk of heart disease, cancer, and diabetes, may improve gut health and kidney function, lower blood sugar levels, and reduce body fat. Strong research shows these diets are linked to benefits for type 2 diabetes, including reduced body weight and reduced fasting glucose.
- Cons: May be difficult to follow because they leave out whole food groups, may also be harder to get enough protein, vitamin B12, and other key nutrients.
- Foods to eat: Beans, soy, dark, leafy vegetables, nuts, legumes, fruits, whole grains.
- Foods to avoid: Meat and fish, eggs and dairy (vegan).
- Expert Opinion: This type of eating may help reduce weight, fasting glucose, and waist circumference.
9. Raw Foods Diet
People who follow this diet believe that high cooking temperatures destroy vital nutrients in food. They eat lots of fresh produce, seeds, and nuts, and they make meals with the help of gadgets like blenders and dehydrators. Although eating this way is likely to help you lose weight, there's no evidence it does anything to improve diabetes symptoms.
Read also: The Ultimate Guide to Heart and Diabetes Diet
- What it is: Focuses on consuming uncooked and unprocessed foods.
- Pros: Likely to help you lose weight.
- Cons: There's no evidence it does anything to improve diabetes symptoms.
- Foods to eat: Lots of fresh produce, seeds, and nuts.
- Foods to avoid: Cooked and processed foods.
- Expert Opinion: There are healthier, more effective diets out there.
10. Alkaline Diet
The theory behind this diet is that foods like wheat, meat, and sugar make your body more acidic, which can lead to long-term diseases. Foods like vegetables and seeds, on the other hand, can shift your body chemistry and make it more alkaline, helping you slim down and stay healthy.
- What it is: Based on the theory that certain foods can alter the body's pH levels.
- Pros: None noted.
- Cons: There's very little research to back these ideas up, so pass on this one for now.
- Foods to eat: Vegetables and seeds.
- Foods to avoid: Wheat, meat, and sugar.
- Expert Opinion: There's very little research to back these ideas up, so pass on this one for now.
11. Fasting or Intermittent Fasting
All of the different fasting diets out there are based on the thinking that taking an occasional break from eating could help you lose weight and possibly fight off chronic disease.
- What it is: Involves cycling between periods of eating and voluntary fasting on a regular schedule.
- Pros: Could help you lose weight and possibly fight off chronic disease.
- Cons: Can be dangerous for someone with diabetes.
- Expert Opinion: Going without food for too long can be dangerous for someone with diabetes.
Additional Tools and Methods
The Diabetes Plate Method
The Diabetes Plate Method is an easy way to think about and plan balanced, diabetes-friendly meals without having to measure, calculate, or count carbohydrates. The Diabetes Plate Method divides a standard 9-inch plate into three sections. You fill half your plate with nonstarchy vegetables, one-quarter of your plate with protein foods, and the remaining quarter with carbohydrate foods such as whole grains and fruits.
- Nonstarchy Vegetables (Half of the plate): broccolispinachkalegreen beansmixed salad greenscarrotssquashcauliflowerzucchinicabbageokratomatoesasparagusBrussels sproutsmushroomscucumbers
- Protein Foods (One-quarter of the plate): lean poultry or meatfish or seafoodeggscheeseplant-based protein foods such as black beans, kidney beans, pinto beans, lentils, nuts and nut butter, tofu, edamame (soybeans), and hummus
- Carbohydrate Foods (One-quarter of the plate): whole grainswhole grain foods such as whole grain bread and pastastarchy vegetables such as potatoesfruityogurtmilk
Higher carbohydrate foods have the most significant impact on your blood sugar. Limiting your portions of these foods to one-quarter of your plate can help you manage your blood sugar. There is no specific place on your plate for healthy fats such as monounsaturated fats and polyunsaturated fats, but you can incorporate them for flavor, fullness, and - importantly - heart health. You can wash down your meal with water or another calorie-free drink, such as unsweetened tea, sparkling or infused water, or a diet beverage.
Mayo Clinic Diabetes Diet Reviews
Several reviews highlight the Mayo Clinic Diabetes Diet, 3rd Edition, as a comprehensive and practical guide for managing type 2 diabetes through healthy eating and weight loss. The book emphasizes the connection between weight loss and diabetes management, with a two-step program ("Lose It!" and "Live It!") for initial weight loss and long-term maintenance. It incorporates five healthy habits for weight loss success and provides physician-approved recipes and meal plans. The book also offers an online platform for additional resources and support.
However, some reviews note that the information in the book is not significantly different from other sound diet books, mainly advising "lose weight and you will reduce type 2 diabetes risk." Some reviewers were disappointed by the limited information about managing blood sugar specifically. One review pointed out formatting errors in the book, particularly in the recipe section, and noted that the digital platform requires an additional purchase.
Science-Based Nutrition Recommendations
Every year, the American Diabetes Association (ADA) publishes our Standards of Care in Diabetes (Standards of Care). The Standards of Care is a set of practice guidelines based on the latest scientific research and clinical trials. These guidelines are used by health care professionals to treat diabetes and its related health conditions. Every five years, a group of experts come together for an in-depth review of the nutrition guidelines in the Standards of Care. The result of this review is called the Nutrition Consensus Report. This is the foundation for the ADA’s recommendations for nutrition. The Nutrition Consensus Report identifies nutrition strategies that have been shown to help people reach or stay at their blood glucose (blood sugar) targets, reach weight management goals, and low risk for health conditions related to diabetes. The nutrition recommendations highlight that eating plans should be based on the needs of each person. Your own eating plan will be based on your own needs and preferences.
The Gut-Blood Sugar Connection
Many people overlook the role of gut health in diabetes. Foods rich in fiber and probiotics can help your gut, which affects how your body processes sugar. Think yogurt, kefir and fermented vegetables like kimchi.
Tips for Sticking to a Diabetes-Friendly Diet
Adopting a new way of eating can feel overwhelming. Think about what you can eat: Don't stress about what's off-limits. If you're just getting started or have questions, it's always wise to contact your doctor. Having diabetes doesn't mean you have to give up good-tasting food. It's all about finding a balance that works for your life and keeps you healthy.