So you’ve just been told you have type 2 diabetes and you don’t know where to begin. Here’s a brief interview with diabetes expert, Diane Kress, RD CDE that might just get you started in the right direction.
When diabetics first are diagnosed, is there a feeling of dread when it comes to diet restrictions? Is this a misconception?
When people are diagnosed with diabetes, their first reactions run the gamut:
*I should have prevented this.
*Why did I eat all that (fill in the blank) ice cream, pasta, bread, junk food, fast food, ad infinitum.
*From now on I will have to eat diet food and never have sugar, pasta, bread, dessert again
*Now I am going to be like grandma/grandpa…I’ll have to inject insulin and will end up having an amputation, blindness, or need dialysis
*There is no way I can have diabetes. I exercise, eat right, and look and feel great. There must be a mistake.
*I’ll just take the medication and continue living just like I’m living. The medication will take care of the diabetes.
It turns out that none of these “first reactions” is entirely true. Misinformation often begins based on the way a person hears of their diagnosis and what they are given in terms of education afterward. Some people get their diagnosis over the phone from the practice’s nurse, some are told at a health screening, some test on a home monitor and register a very high reading, some are told by their physician.
The diagnosis is important….it should come after at least one (with a repeat for confirmation) fasting glucose or hemoglobin A1C reading in the diabetes range.
The education about the diagnosis is VERY important. Knowledge is power. If a person is told they have a lifetime disease that can cause grave complications if not treated correctly and is not given the information they need to manage the disease, they are at a disadvantage and will have difficulty reaching and maintaining health and wellness.
It’s important for those diagnosed with diabetes to respect the fact that they have a lifetime disease that can cause damage to the body but it is also a VERY controllable and manageable disease and complications are not necessary if the disease is managed properly.
What are a few of the most important guidelines a diabetic should consider when rearranging or planning out a diet?
1. Eat within one hour of wake up in the morning and within one hour of bedtime. This meal or snack should include a healthy carbohydrate ( like whole grain bread, fresh fruit, whole grain unsweetened cereal, light yogurt) and healthy quality protein (like low fat cheese, cottage cheese, eggs/egg whites, natural peanut butter or almond butter).
2. Carbohydrate foods are the foods that convert directly to blood sugar. To even out your blood sugar, consider having 1-2 controlled portions of carbohydrate at a meal and 1 serving at a snack.
3. The following are examples of carbohydrates.
Fresh fruit, whole grain bread, whole grain bread products, whole grain crackers, whole grain cereal, brown rice, whole grain pasta, lite yogurt, low fat milk, legumes (dried beans), sweet potato, corn.
4. Consume neutral vegetables liberally as they do not have a large impact on blood sugar, are filled with fiber and antioxidants, vitamins, minerals.
The following are examples of neutral vegetables:
Green beans, broccoli, cauliflower, all types of lettuce, spinach, bean sprouts, Brussels sprouts, kale, 1 tomato, ½ cup tomato or vegetable juice, onions, all types of peppers, cucumbers, mushrooms.
5. The real numbers that matter on a food label in terms of blood sugar are:
Do this simple math: Total carbohydrate grams – dietary fiber grams = net carb grams. If the result is 11-20 net carb grams, that’s considered ONE serving of carbohydrate. When it comes to carbs, try to have 1 or 2 servings at a meal and 1 serving at a snack.
6. Try to buy bread, bread products, cereals, crackers with 2 grams or more fiber/serving. Fiber is part of total carbohydrate but it does not convert to blood sugar. Fiber is important for GI health, regularity of bowel movements, helps decrease risk of cancers, feeling of fullness, and deceases cholesterol.
7. Try not to go over five hours without a meal or snack. For ease, consider eating meal/snack/meal/snack/meal/snack.
8. Since carbohydrate is the nutrient with the biggest impact on blood sugar, do not consume large quantities of high carb foods at one time: sweetened drinks, bagels, heavy breads, pizza, rice, pasta, rich desserts, fries. These foods need not be eliminated, but…it’s important to realize that having a burger on a BUN with FRIES and a regular SODA will cause blood sugar to sky rocket. Better alternative: Burger with lettuce/tomato/onion (no bun), ½ serving small fries, sugar free drink.
9. If you do “over do it” at a meal or snack….move your body within 1-2 hours afterward. Take a 15 minute walk and drink lots of water to help burn the resultant blood sugar.
10. Water intake is very important. If you are 5’3” or taller, drink 64 ounces or more water/decaf fluids every day. (under 5’3” = minimum of 48 ounces water)
11. Exercise or physical activity is as important as food. Make sure to move your body for a minimum of 30 minutes over and above your typical activity (especially 1-2 hours after eating) every day. It is best to put some activity in after breakfast and after dinner ….15 minutes or more after breakfast and dinner is great for all day blood sugar control.
12. Be aware that sugar free doesn’t mean safe for people with diabetes. In most cases, these companies use less sugar but replace it with another carbohydrate that turns into blood sugar. Look at total carbohydrate grams – dietary fiber = net carb grams. You may be surprised to learn that many “sugar free” foods have more carbohydrate than their regular food counterpart.
What 10 power foods do you recommend that are great for keeping blood sugar levels steady and people feeling full? Why are they great?.
As previously mentioned, it is carbohydrate foods that turn to blood sugar. Protein, healthy fat, and neutral veggies do not have a great impact on blood sugar so they will keep blood sugar steady and give a feeling of fullness.
****Have a serving or two of healthy carbohydrate at a meal and a serving of carbohydrate at a snack: Fresh fruit, whole grain bread, whole grain bread products, whole grain crackers, whole grain cereal, brown rice, whole grain pasta, lite yogurt, low fat milk, legumes (dried beans), sweet potato, corn.
2 carbs at breakfast + lean protein or healthy fat
1 carb at midmorning snack + lean protein or healthy fat
2 carbs at lunch + lean protein or healthy fat
1 carb at midafternoon snack + lean protein or healthy fat
2 carbs at dinner + lean protein or healthy fat
1 carb at night snack + lean protein or healthy fat
MAKE SURE to have one of these lean protein and/or healthy fats, and neutral veggies with these meals/snacks:
Eggs or egg whites
Low fat cheese (made from 2% milk), cottage cheese, ricotta cheese, Greek yogurt
Lean pork, lamb, game
Lean beef (85% or leaner ground beef, sirloin, flank, round steak)
Natural peanut butter or almond butter
Fish or seafood
Poultry (skinless is best)
Soy or tofu
Nuts (no honey coating), walnuts, almonds, cashews, peanuts
Sidenote: Neutral veggies are terrific anytime as they have almost no impact on blood sugar AND provide fullness, fiber, vitamins, minerals, antioxidants. Green beans, broccoli, cauliflower, all types of lettuce, spinach, bean sprouts, Brussels sprouts, kale, 1 tomato, ½ cup tomato or vegetable juice, onions, all types of peppers, cucumbers, mushrooms.
What foods do you recommend avoiding?
In general, when diabetes is controlled, you can have a small serving of even the following foods. You must realize they are carbs, high impact carbs, and they convert to blood sugar in a BIG way. So make their uses few and far between:
Sweets and sugary desserts
Sugar, honey, agave nectar
Candy, even sugar free candy and chocolates
Condensed carbs: bagels, pizza crust, large wraps, rolls, pretzels, burritos
I’m personally not a fan of saccharin or aspartame. In place of sugar use small amounts of Stevia, sucralose, erythritol.
What is the importance of keeping a daily food journal? What information should be included in the log?
I recommend that in the beginning when patients with diabetes are learning about diet….it is very helpful for them to write down what they are eating to make sure they have 1 or 2 healthy carb servings at a meal and 1 healthy carb serving at a snack as well as lean protein/healthy fat/and neutral veggies.
Remember to put the time of each meal or snack, too
Highlight the carb food choices at each meal or snack
Note the quantity of the carb foods you consumed
If you are controlling your blood sugar with diet/exercise or diet/exercise/oral medications, your physician may recommend that you test as soon as you wake up for the day and after one meal a day (taken at 2 hours AFTER the start of that meal). You can put these readings on your food log so you can see how certain foods affect your blood sugar.
Note your exercise on this log
Note your water/decaf intake on this log
Why does paying attention to diet matter specifically for a diabetic population?
Diabetes is a genetically mediated disease that is progressive in nature. Type 2 diabetes includes inadequate amount of insulin and/or insulin resistance. The one nutrient that converts to blood sugar and requires immediate insulin release is carbohydrate. So, by understanding how carbs relate to blood sugar, what foods are carbs, which are the healthiest carbs and to balance them with healthy protein, fats, and neutral veggies…you can control your blood sugar.
In addition to food, other environmental stressors affect blood sugar readings including:
Dietary intake of carbohydrate foods
If a person chooses carbohydrate foods wisely, spreads them throughout the entire day/night, and gets physically active….they can absolutely positively impact the future course of this disease. Proper diet and activity decreases and maintains weight, amount and doses of medication, stress level, inflammation, and improves other labs such as cholesterol, triglycerides, Vitamin D, blood pressure, CRP.
The positive aspect of diabetes is that it need not be out of your control. Learn how to control your diabetes and you can become the healthiest your have ever been
Diane Kress, RD CDE is a registered dietitian and certified diabetes educator with over 30 years experience specializing in diabetes. She has type 2 diabetes and is the author of the NY Times Bestselling books: “The Metabolism Miracle, The Metabolism Miracle Cookbook, and The Diabetes Miracle.” In January, 2013, she was named as a “Top 10 RD Making a Difference” by “Today’s Dietitian” magazine. Her websites: http://www.themetabolismmiracle.com and http://www.thediabetesmiracle.com Read her diabetes blog: http://www.dianekress/wordpress.com. She moderates the online support group at : http://www.Miracle-Ville.com.
She can be reached for speaking engagements and interviews at http://firstname.lastname@example.org