Diabetes – a condition that affects how the body produces and uses insulin. People are either born with Diabetes (type 1) or develop diabetes over time (type 2). Two other forms of diabetes also exist – these are prediabetes and gestational diabetes. Prediabetes is a condition characterized by higher than normal blood sugar levels, but not high enough to give a formal diagnosis of type 2 diabetes. Gestational diabetes occurs during pregnancy and typically resolves on its own. 

No matter the type of diabetes, diet works wonders at helping control insulin levels. So, what does a Diabetic Diet look like? 

Managing and Controlling Blood Sugar and Insulin Levels

Globally, diabetes presents a significant challenge. According to the World Health Organization, worldwide cases have doubled since 1980. Overweight populations, the globalization of fast Food, and lack of general knowledge of how eating patterns contribute to the prevalence of the disease contribute to the spread. Diabetes is a metabolic disease in that the body no longer can produce enough insulin, a hormone from the pancreas that breaks down glucose, the sugar that results from digestion. 

As a result, glucose is not able to reach the cells to provide energy. The resulting hyperglycemia or too high a concentration of sugar in the blood is a severe condition that causes a host of health problems. There are many types of diabetes, including gestational diabetes that affects pregnant women and their babies; type 1 diabetes, a congenital form of the disease wherein the pancreas produces no insulin; the most common is type 2 diabetes that can be prevented, treated or reversed by healthy eating plans and exercise, in many cases. 

Nearly ten percent of the population has diabetes. Diabetes has a high mortality rate, with most diabetics dying before reaching age seventy. Diabetics run a high risk of heart disease and stroke. Additionally, elevated blood sugars tax the kidneys causing nerve pain and, in some cases, either partial or full loss of vision. The economic burden looms close to catastrophic. 

In 2015, medical costs worldwide came to about $827 billion to treat diabetes comorbidities. The overwhelming consensus is that to curb the rise of the epidemic, people must be empowered with the information of how their actions can help prevent and often put in complete remission this terrible disease. (WHO)

Dietary intervention is vital to stave off the host of potential complications a diabetic diagnosis brings. Most physicians prescribe a visit with a registered dietician shortly after diagnosing prediabetes or diabetes. In a 2010 study in Taiwan, onsite monitoring by a dietician improved glycemic control in patients with uncontrolled type 2 diabetes. 

Dieticians act as lifestyle coaches who educate patients as to what to eat with diabetes. They function as case managers who help facilitate meal planning. Dieticians advise which foods are diabetes diet-friendly. As community educators, dieticians inform people what current diet guidelines are. They provide vital education to ensure that diabetics have a diet rich in nutrients that is satisfying, and that helps keep their blood sugar in the target range recommended by their physician.

One important way dieticians show up is as accountability guides for those who are following a diabetic diet for weight loss. The recommendation is to increase activity to 150 minutes per week and lose 7% of starting body weight. These are modest changes that most people can meet with the right support. 

Patients who feel a sense of obligation and/or think that they have control over their conditions tend to keep their appointments with dieticians. In a small study of 100 patients who received 12-week nutritional guidance, only three dropped out. The ninety-seven who remained all reduced their waist circumference had lower blood sugars, and reduced HDL cholesterol at the end of the program. (Diabetes Care, Journal of the American Dietary Association, Journal of Human Nutrition and Dietetics)

The Difference Between Noom and Other Plans and Programs

When it comes to learning how to eat and how to live for weight loss, Noom works from a psychological perspective. According to the Chief of Psychology for Noom, Dr. Andreas Michaelides, “By understanding the past behaviors and attitudes of all types of users, we know the best way to meet our users where they are in their journey to help them maximize their change of long-term weight-loss success.” Noom, as a weight-loss platform, uses the power of food logging, among other advanced technologies, to teach simple, key behaviors for lasting change. Behavior changes that include self-efficacy, motivation, and knowledge are just the start of how psychology can interact with food, so you lose more weight in a way that lasts a lifetime.

Noom works with tech-based tools partnered with support from real-life coaches in a structured program that connects the user with the social support and positive reinforcement needed to change behavior in a way that increases the likelihood of success.

Not all dietary changes are for everyone, and no two weight-loss plans should be the same, which is precisely how Noom works. By identifying specific areas where changes can be made to reach goals of weight loss and health improvement successfully, users realize where their best moves are to be made and how those changes are incorporated into a lifestyle they can adopt for the long-term.

Prediabetes

Prediabetes, or borderline diabetes, is when someone has high blood glucose but not high enough to be a full diabetic. To prevent developing full-blown diabetes, the soundest course of action is to make lifestyle changes. The most important two steps are to follow a borderline diabetic diet and get more exercise. 

Researchers are currently pursuing medication interventions, but these are a relatively low priority considering that modest lifestyle adjustments can curtail the course of the disease. Medication only shows short-term benefits, while interventions that center around adopting healthier habits can prevent developing full diabetes. Prediabetes is on the rise. Complications like neuropathy, nephropathy, chronic kidney disease, cardiovascular disease, and diabetic retinopathy all are associated with prediabetes. (The Lancet, Maturitas, The Lancet)

Importance of Maintaining Blood Sugar Levels

To delay or avoid diabetic complications, patients must control blood glucose levels. Actions to ensure success include:

• Patients must commit to adhering to a healthy diabetic meal plan.
• Diabetics need to get at least 150 minutes of activity each week.
• Newly diagnosed diabetics should learn to monitor their blood glucose levels.
• To make the necessary lifestyle changes, they need to develop new coping skills because stress hurts blood sugar.
• To manage diabetes, patients need to improve their problem-solving skills.
• Diabetics, types 1 and 2, have to take their medications as prescribed by their healthcare providers.
• Reducing risky behaviors helps patients take the necessary lifestyle interventions seriously.

These seven factors lead to better outcomes for diabetic patients. (Journal of Diabetes and Metabolic Disorders, Diabetes Care, Clinical Diabetes)

Prevent Prediabetes from Becoming Diabetes

35% of adults in the United States have prediabetes and are at risk for type 2 diabetes. Everyone who has type 2 diabetes went through a prediabetic phase. Those highest risk for developing prediabetes are forty-five or older, overweight or obese, have a family history of diabetes, and tend to be physically inactive. Other contributing factors include race, economic class, stress, and hypertension. Lifestyle interventions such as going on a diabetic diet to lose weight to lose between 5-10% of starting body weight and forsaking sedentary habits make the most sense during the prediabetic phase because doing so has been shown to prevent or at least postpone onset.

It’s essential to raise awareness among primary care healthcare providers of prediabetes. If more healthcare providers were aware of borderline diabetes as an opportunity to curtail the disease, many believe that more healthcare providers would aggressively recommend borderline diabetic diets as treatment measures.

Individual counseling, workplace programs, and community groups are each methods to increase awareness among physicians and laypeople alike to the ways that interventions prevent type 2 diabetes.

For patients under sixty years old who have a family history of diabetes and a body mass of at least thirty-five, metformin has shown short-term benefit. Medication is currently reserved for those at the highest risk. 

Physicians may fare better meeting with patients to discuss the importance of nutrition, diabetic diet basics, and how relatively small changes can preserve their health and improve the quality of their lives. Public awareness of prediabetes and the proven effect that lifestyle interventions have can save lives. (Journal of Hospital Management and Health Policy, Metabolism Clinical, and Experimental, The Permanente Journal, CFP-MFC, HealthAffairs, BMJ, JCEM, The Diabetes Educator, AJPM)

Diabetes and Your Health

Fat Intake and Diabetes/Blood Glucose

Contrary to what is conventionally believed, a high-fat, low-carbohydrate diet can be useful in managing blood glucose levels. High-fat diets that are low in carbohydrates suppress appetite, which may aid in weight-loss efforts. The science is inconclusive as to exactly why a diabetic diet that’s low carb and high in fat causes weight loss and also keeps blood sugars in a good target range. The prevailing notion is that substantially reducing carbohydrates reduces calories, and that results in weight loss.

Diets that are high in unsaturated fats are shown to be the most beneficial to diabetics. Monounsaturated fats and polyunsaturated fats like those found in nuts, seeds, olive oils, and avocados may be better for blood sugar stability than a diabetic diet that is low carb but high in animal fats. (PLoS One, The American Journal of Clinical Nutrition, European Journal of Nutrition)

Hyperglycemia

Diabetics who remain sedentary run a higher risk of chronic hyperglycemia. Other factors that contribute to hyperglycemia, or high blood glucose, include failure to adhere to a diabetic diet meal plan, infection, illness, hormonal fluctuations, and/or medical complications. Symptoms of hyperglycemia include:

• Blurred vision
• Frequent urination
• Headache
• Chronic thirst

Sedentary living is associated with a higher prevalence of hyperglycemia. According to the ADA, American Diabetes Association, diabetic patients do not show motivation enough to change their habits because medical caregivers currently do not stress the serious consequences of high blood glucose levels. Too many healthcare providers stress the importance of maintaining normal blood sugars without listing the adverse effects that come from having blood glucose levels that are chronically too high. They stress that it’s more motivating to list the harms that come from sustained hyperglycemia over time. That without treatment and change of habits, these conditions become inevitable. 

Unregulated blood glucose over time can lead to premature death from heart disease or chronic kidney disease. Other complications of diabetes that stem from hyperglycemia are neuropathy or nerve pain, limb deadness that often leads to amputations, and loss of vision from diabetic retinopathy. (Diabetes Care, Biological Research for Nursing, MedlinePlus.gov, Mayo Clinic)

Nerve Damage

Diabetic neuropathy currently affects 50% of diabetics. Hyperglycemia remains a significant contributor to the disorder. Symptoms include pain with no apparent stimuli. The itching, burning is worse at night and interrupt sleep. It affects extremities, mostly legs, and feet. Over time, nerves die, and degrees of numbness can lead to diabetics being unaware of wounds that grow gangrenous and lead to amputations. Neuropathy also affects digestive nerves. This can lead to a lack of appetite or the inability to eat enough calories each day.

Healthcare providers treat neuropathy with anticonvulsants, antidepressants, and, in extreme cases, opioids. And while there are lifestyle changes people can make to slow the onset of diabetic complications, for a lot of diabetics, primarily type 1 diabetics, nerve damage from diabetes will happen regardless of whether they smoked, ate healthily or jogged daily. To better understand how to treat neuropathy, researchers are currently looking into exactly how it develops.

Neuropathy can feel like agony. To be in constant pain is a source of toxic stress. It decreases the quality of life and contributes to depression. Diabetic patients who suffer from neuropathy have such an increased risk for depression that the complication is the most reliable indicator that someone will develop diabetes-related depression. 

Researchers conclude that chronic pain, lack of sleep, and diminished quality of life all contribute to depression among diabetics who suffer from nerve damage. (World Journal of Diabetes, Kidney Disease, World Journal of Diabetes, Medscape)

Keeping blood sugar in check is vital to overall health. Noom can help with the easy-to-use food logging system that’s supported and managed by nutritionists.

Heart Damage

Someone with diabetes is 65% more likely to die from cardiovascular disease regardless of other existing risk factors. Heart disease is more common in type 2 diabetics. In fact, heart disease is the most common cause of death in type 2 diabetics. Diabetics are two to four times more likely to die from cardiovascular incidents. 

Hardening of the arteries, atherosclerosis, is the most common kind of heart damage related to diabetes. The buildup of plaque from high cholesterol begins before high blood sugar is detectable. Heart failure is the other major cause of heart disease death in diabetic patients.

Inflammation is an indicator of heart disease. Where arteries are full of plaque and as the pressure grows, so grows inflammation as well. The body reacts to the plaque like it does any threat. The body uses swelling to block off the plaque, but often blood clots form when blood pressure grows too high and blood vessels burst. The plaque and resulting clots are how most heart attacks in the incidence of stroke happen. (NIDDK, Heart.org, MedlinePlus.gov, Diabetes Care)

Kidney Damage

High blood glucose levels cause damage to blood vessels in the kidneys. Hypertension contributes to high incidents of kidney disease in diabetics. Chronic kidney disease is also called diabetic kidney disease, CKD, DKD, kidney disease of diabetes, and diabetic nephropathy. Diabetes is the leading cause of kidney disease and failure. Other risk factors are:

• People who are heavy smokers increase their risks for both diabetic kidney disease and kidney disease that is caused by high blood pressure. Smoking slows the blood flow to the kidneys down. Smoking also interferes with medication meant to treat hypertension.
• Poor eating patterns that do not adhere to guidelines for diabetic diet for type 1 diabetes lead to uncontrolled blood glucose, which leads to kidney damage.
• High-sodium diets raise blood pressure that causes damage to kidney tissue. People who have both diabetes and hypertension must reduce sodium in their diets to preserve their kidney’s health and function.
• Lack of exercise contributes to weight gain. Sedentary people also have high risks for high blood pressure because the heart has to work harder to pump blood to vital organs. When the kidneys lack nutrients, they begin to die.
• Not taking medications as prescribed allows conditions to run rampant in the body. Failure to take medications and refusing to make lifestyle changes necessary to treat diabetes and high blood pressure put your life at serious risk.
• Being overweight raises your risk of developing both diabetes and high blood pressure. Just losing 10% of your starting body weight reduces your chances significantly.
• Having heart disease means that you already have a weakened heart muscle that does not efficiently pump blood to the kidneys, which leads to damage.

Diabetes is the most common cause of kidney failure. One in four adults with diabetes has kidney failure. The decline of one’s kidneys due to chronic kidney disease as a complication of diabetes is painful. One of the first symptoms is pain in the lower back. The kidneys lose their efficiency as filters. Protein and blood pass through in the urine. Over time, waste does not pass through the kidneys. It gets stored in the body. Kidney disease doesn’t usually develop until at least 15 years in the course of diabetes. 

Type 1 diabetics are most at risk for chronic kidney disease. Healthy habits postpone and, in some cases, help avoid kidney damage and failure. To monitor your kidney health, have your healthcare provider check your kidneys annually if you have type 2 diabetes and if you’ve had type 1 diabetes for more than five years. The best way to preserve your kidneys’ function as long as possible is to adhere to the prescribed program to keep your blood glucose within your recommended target range. (International Journal of Nephrology, World Journal of Diabetes, MedlinePlus.gov, NIDDK)

Maintaining Healthy Blood Glucose Level

How to Keep Blood Sugar Stable

For type 1 diabetes, the target range for blood sugar is 90-130 mg/DL for adults and teens between thirteen and nineteen years old before meals. After meals, blood glucose levels should be below 180 mg/DL. At bedtime, a suitable range for blood glucose is between 90-150 mg/DL. With type 2 diabetes, the pre-meal target range for blood glucose should be 70-130 mg/DL for adults and after meals no more than 180 mg/DL.

Diabetics need to know how to test their blood glucose levels. They need to check at least once daily, or however many times they’re directed to by their healthcare providers. Diabetics also should know what to do when their blood sugar becomes either too high or too low. In these cases, it’s essential to check to see if they’re following healthy diabetic eating habits, monitor, and adjust insulin amounts and injection sites. Stress levels wreak havoc on blood sugar stability. Illnesses cause fluctuations in blood sugar as do weight gain or loss.

To sustain proper blood sugar levels, patients have to move their bodies. The recommendation is to get thirty minutes of exercise five days a week. One need not strain. Walking is the most accessible exercise regime to start. Then again, any activity that gets the body moving makes a big difference. People should vary their physical activities to get the most out of their exercise time. Equally important to exercise is to stick to whatever diabetic diet plan works best for your body. It’s best to avoid sitting for more than thirty minutes at a time. Get up every half hour or so, stretch and move around. (MedlinePlus.gov, NIDDK)

Healthy Food Choices

To remain healthy, it is not necessary to subscribe to a strict diabetic diet. You can and should continue to enjoy your favorite foods but in moderation. Have them less often and in smaller portions. Healthy diabetic eating involves eating a variety of foods each day. The food groups, as they relate to a typical diabetic diet, are as follows:

• Starchy Vegetables include food such as potatoes, beets, and corn.
• Non-starchy vegetables are the leafy greens, cruciferous veggies like cauliflower, and stems like celery. Butternut squash and pumpkin also are non-starchy vegetables.
• Grains are the category where most carbohydrate-dense foods are found. Foods like wheat, oatmeal, bread, pasta, rice, and quinoa are all grains.
• Protein to most people means meat, but there are many plant-based proteins like tofu, tempeh, many legumes, and beans.
• Healthy fats include extra virgin olive oil, nuts, seeds, and avocados.
• Low-fat dairy includes such foods as 2% milk, reduced-fat Greek yogurt, and light cheeses.
• Fruits include berries, apples, pears, and melons.

Diabetics must watch their sodium intake, limit the consumption of added sugars, alcohol, and sweets. (NIDDK, American Diabetes Association, American Diabetes Association)

Tracking Food Intake

Personal accountability in managing type 2 diabetes is paramount. To make the necessary changes involved in keeping blood sugar within safe ranges, you must keep track of what you’re eating as part of your daily diabetic diet. One can keep a pad and paper to track what you eat, or you can employ one of the many apps available, like Noom. 

Whatever the method, recording diabetes-friendly food intake while following even a simple diabetic diet can help you lose weight. Another benefit of keeping a food diary of your daily diabetic diet is tracked over time, you can see how different diabetes-friendly foods affect blood glucose levels. Having a record of what you eat along with your blood sugar numbers is a helpful tool in maintaining diabetes types 1 and 2.

When keeping a record of food intake while on a diabetic diet, many concentrate their attention on counting carbohydrates. The typical diabetic diet aims to have an individual consume no more than 250 grams of carbohydrates per day. Carbohydrates all get broken down into sugars by the body. The four food categories that provide carbohydrates are starchy vegetables, fruits, low-fat dairy, and, of course, complex carbohydrates like grains. Using nutrition labels, the diabetic finds and records how many grams of carbohydrates eaten in one day.

Another way to keep track of what you eat is to simply log every morsel that passes through your lips. Keeping a food journal is a proven way to empower a patient to be an active participant in their treatment. Even those who have diabetes type 1 benefit from keeping a food journal. They can trace how different foods cause blood glucose levels to rise. Doing so helps determine what foods are most diabetic friendly.

For those following a diabetic type 2 diet, their primary aim from their healthcare provider is likely to lose weight. Keeping track of calories consumed each day helps tremendously in that endeavor. To drop pounds, one needs to consume fewer calories than one burns off during the day. To have a record of every calorie consumed keeps people honest. Most people, if they are not recording in real-time, underreport their food intake.

Some people also track their food consumption by recording their adjusted insulin dosages in addition to what foods they eat. Diabetics must know how to adjust their dosages if they are insulin-dependent. This method is most useful to people who are following a diabetic diet type 1. Type 1 diabetics produce no insulin naturally and require insulin injections to live. No amount of behavior modification can reverse their condition. Still, healthy lifestyle choices can postpone or avoid complications and improve quality of life. (NIDDK, American Diabetes Association)

What Does A Diabetic Diet Consist Of?

The ideal diabetic diet is really little more than a healthy, nutrient-dense diet full of a variety of whole foods that are delicious and enjoyed in moderation. Diabetic diets consist of foods that break down slowly in the body. Foods that are diabetic-friendly increase your health and vitality. The best foods for diabetics do not come in packages. Good food for diabetics comes from nature. The more unrefined food a diabetic person consumes, the better. A diabetic diet for type 1 diabetics supports their body. It helps them postpone the complications that come from having diabetes for an extended period.

Diabetic Diet Guidelines

There is no one daily diabetic diet that meets everybody’s needs. When it comes down to diabetic diet basics, there is, however, a list of standardly accepted recommendations that can help diabetics stay as healthy as possible.

• Every day, diabetics must eat three meals and have at least one snack. Snacking is more a factor of people following a diabetic diet type 1 because type 1 diabetics do not produce insulin on their own and need to medicate to digest their foods.
• Diabetics must not skip meals. Skipping meals leads to blood sugar drops that can be just as dangerous to the body as having blood sugars go too high. Low blood sugar levels cause slurred speech, slower brain function, and possible seizures.
• Meals need to be about four to five hours apart. Eat adequate fat and fiber to slow digestion and make sure that you feel full and satisfied longer.
• Before bed, have a snack to keep blood sugar from getting too low while sleeping. Snacks should have between 15-30 grams of carbohydrate. It’s also advised to pair the carb with some protein.
• If the gap between meals will be more than five hours, eat a carbohydrate snack. Snacks, again, are essential for folks on a diabetic diet type 1 plan.
• Adopt a meal schedule. Eat meals at about the same time each day. Find a program that fits into your life’s daily rhythm and activity levels.
• Take any medications at the same time every day as well. There are plenty of ways to bring your medicines with you during the day. 
• Have two to four servings of carbohydrates each day. This applies to those following a diabetic diet low carb style. Carbohydrates provide the energy for cellular respiration, the primary function of life. It is never a good idea to try to eliminate all carbs from your diet.
• Diabetics need to eat two to four servings of fruit daily. To make your food more diabetic-friendly, it’s likely that you’ll significantly cut sweets from your diet to stay healthy. Fruits provide natural sweetness along with heart-healthy fiber. Some fruits are so full of antioxidants that they help reduce risks of cardiovascular disease and reverse insulin dependence.
• Remember to count dairy as a carbohydrate because lactose is a naturally-occurring sugar. If you eat dairy, you should have it no more than three times a day because of the lactose. Also, remember to choose reduced-fat dairy over skim or whole fat. Skim acts like a simple sugar, and whole fat is too full of unhealthy saturated fats. (CDC, NIDDK)

Portion Control

Few people monitor what they eat and drink. Instead, they allow sensory input like how appetizing something looks or smells to influence how much they consume. The size of the plate, how long one’s been sitting at the table, and how much has been served on the plate also determine how much most people eat. This leads to oversized portions that lead to overweight people who find themselves at greater risk for diabetes. To reign in distorted portion sizes, diabetics must become mindful of proper portion control. Luckily it is a skill that people can learn. Whatever diabetic diet meal plan one opts to adhere to, learning to eat appropriate portions will improve one’s health outcome.

One way to learn portion control is through the plate method diabetic meal plan. The idea is to use the geography of a plate to measure out portions. One half the plate is for green, non-starchy vegetables. One quarter is designated for grains. The other quarter is where the protein portion goes. One piece of fruit and a serving of low-fat dairy round out the meal. It is simple. It requires no measuring. It also helps visually train the eye to recognize what goes where and how much should be there on a plate. The most important thing is to use a dish that isn’t too large.

Another way to learn portion control is by learning to eyeball correct portions by using a comparison chart to learn correct portion sizes. For example, a portion of lean protein, like skinless chicken breast, is about the size of a deck of cards. A portion of fish is about the size of a checkbook. A proper serving of grains is about the size of a tennis ball. Starchy vegetable portions are about the size of a cupcake liner. One serving of dry spaghetti has the diameter of a nickel. The proper portion of nuts would fit in a shot glass. A serving of cheese should be the size of a domino. Nut butter portions are about the size of a ping-pong ball.

While these visual cues are quite helpful, in the beginning, when you are first learning to reign in your portions, it is still advisable to use measuring cups and measuring spoons to get an accurate idea of what correct serving sizes look like. A food scale comes in handy for this purpose as well. Often serving sizes are given in weights and not volume. Once you have a grasp of how to measure your food, it’s fine to rely on visual cues. Every so often, though, it’s a good idea to measure out portions again. Many people, after a while, start to overestimate portion sizes.

Other tricks to unlearn portion distortion include:

• Refrain from eating directly out of containers. Measure out a serving size and sit down and eat it.
• Measure out snack foods beforehand into small containers or plastic baggies.
• Keep a measuring spoon or cup near the foods you regularly eat.
• Split meals when dining out as restaurant servings tend to be enormous.

(NIDDK, MedlinePlus.gov, MyHealth VA, Tufts)

Choose a Meal Plan to Regulate Blood Sugar

It may not be necessary to completely overhaul one’s diet entirely to make it diabetic-friendly. Some foods serve the body better than others. A healthy eating plan is rich in nutrients. Having a firm grasp on diabetic diet basics is central to reaching and keeping blood glucose levels in the target range that keeps severe complications such as cardiovascular disease, hypertension, and high cholesterol at bay. To do so, you need to understand how different nutrients function in your diet. Learn to have the correct balance of carbohydrates, fats, proteins, and other food groups will help keep your weight down as well.

Recognize, too, that the best approach for your particular chemistry might be a combination of several different methods. There are many different ways to use diet and exercise to manage blood glucose. Taking care of your health does not need to feel like a hardship. None of the eating patterns represent a short term solution to fix a problem and then return to old habits. To increase vitality and health, pick a simple diabetic diet that you can stick with for the rest of your life. (NIDDK, American Diabetes Association)

Best Foods for Diabetes

Healthy Carbohydrates

Carbohydrates are the body’s primary source of energy and should not be avoided. Through digestion, our bodies break down carbohydrates into glucose that gets burned for energy in a diabetic diet plan. There are three main kinds of carbohydrates: starches, sugars, and fiber. Healthy carbohydrates have a high ratio of fiber to starch or sugar, and some also have protein. Protein and fiber slow digestion and rate that carbohydrates are absorbed. This lessens the food’s impact on blood glucose levels. When it comes to carbohydrates in a diabetic diet eating plan, not all are created equal. The following are some of the best carb options for diabetics.

● Lentils and beans are full of fiber and protein. It’s best to rinse before cooking to cut down sodium. They can be served as grains or combined with a complex grain like brown rice to deliver a complete protein in for a diabetic diet vegetarian option.

● Apples and pears when eaten with their skin on provide pleasant sweetness with a healthy dose of fiber. These fruits are full of antioxidants. They also have a high water content that coupled with their high fiber content makes them quite filling.

● Winter squashes like spaghetti squash, pumpkin, and butternut squash have high amounts of Vitamins A and C. These squashes have a dense, starchy feel but have low glycemic indices. For example, butternut squash has half the carbohydrates of the same amount of sweet potato. They are full of heart-healthy fiber.

● Berries such as raspberries, blueberries, and strawberries pack a lot of nutrients. They’re high in antioxidants; so, they help fight cancer-causing cells. They have lots of fiber that contribute to heart health and lowering cholesterol. They also are delicious and sweet.

● Low-fat Greek yogurt may be the best source of dairy for diabetics. It has higher amounts of protein that slow the body’s absorption of lactose. It has less of a carbohydrate load than other yogurts and dairy.

● Sweet potatoes, of all the starchy vegetables, has the most going for it nutritionally. They have very high concentrations of vitamins C and A. Sweet potatoes have a great deal of fiber, especially when eaten with the skin on. They have less of a glycemic impact than white potatoes.

● Bulgur wheat is a whole grain that has potential benefits as a diabetic diet food. It has more fiber than white or brown rice and can replace them in recipes. It’s a high-fiber grain.

● Oatmeal might be the most overlooked superfood in the pantry. Full of fiber that keeps the digestive tract and heart healthy, this grain might even reduce the need for insulin injections in type 2 diabetics because it contributes to weight management.

● Quinoa has a very low glycemic index and does not significantly affect blood sugar. It is a complete protein. It is an exceptional grain for diabetics to have as part of their diet. (American Diabetes Association, HealthLinkBC)

Are you getting enough healthy carbohydrates in your diet? Log your food each day, and night, with Noom, and you’ll know exactly what’s in your meals.

Healthy Fish

Eating fish that are rich in omega 3 fatty acids twice a week may protect against both diabetic-related kidney disease and eye damage. According to a Spanish study, people who had fish reduced their risk of diabetic blindness by up to 48%. Another study out of Britain, published by the American Journal of Kidney Diseases, showed that diabetics who eat fish two times per week, showed less protein in their urine, a sign of kidney damage. They also had fewer incidents of blood in their urine, as well as decreased blood pressure.

Fish can be a great addition to any diabetic diet or meal plan. Fish are high in protein, rich in vitamin D, and omega-3 fatty acids. Though fish can be pricey, there are less expensive options available. The best fish and seafood options are low in saturated fats, high in omega-3’s, and either steamed, baked, roasted, or poached. Some fish, like sardines, are high in calcium. Here is a list of the best fish and shellfish for diabetics.

• Salmon might be the healthiest fish you could eat. It is an excellent source of omega-3 fatty acids that promote heart health.
• Cod has niacin, Vitamin B3, which helps lower LDL.
• Tilapia is a lean source of protein.
• Trout has omega-6’s that fight inflammation.
• Shrimp may be relatively high in cholesterol, but is very low in fat, has no saturated fat or trans-fat. Studies show that shrimp can be included in a heart-healthy diet.
• Crab, lobster, and crawfish make you work for their flavorful meat. Their shells make for natural portion control.
• Canned tuna and salmon are both budget-friendly ways to enjoy the abundant health benefits of eating fish. Choose versions that are packed in water.
• Sardines have a lot of calcium.

(American Journal of Clinical Nutrition)

High Fiber Foods

Fiber is a diabetic’s friend. Fiber is the indigestible portion of carbohydrates that does not raise blood sugar. Fiber adds bulk that makes you feel full. There two types of fiber are insoluble and soluble. Insoluble fiber can be found in foods like wheat bran, other whole grains, and vegetables. Insoluble fiber aids digestion by adding bulk to allow food to move along the digestive tract smoothly. Soluble fiber attracts water, slows digestion, and helps lower the risk of heart disease and lowers cholesterol. Foods like nuts, seeds, oat bran, and legumes are high in soluble fiber.

Insulin-dependent diabetics should take care and gradually increase fiber intake to the recommended 40g per day. Most people eat only about half that amount daily. Fiber affects the rate of digestion and can lead to low blood sugar. Too much fiber added to a diabetic diet too quickly can also cause discomfort like gas and bloating. It is worth it to incorporate more fiber into your diet. If you intend to follow a low-fat eating pattern, also eat a diet that is high in fiber to have sustainable weight loss. (Joslin Diabetes, New England Journal of Medicine, Diabetes Care)

Good Fats

Monounsaturated fats may benefit the heart when incorporated into a healthy diabetic diet. Most come from plants and include:

• Extra virgin olive oil
• Canola oil
• Safflower oil
• Sesame oil
• Peanut oil
• Flaxseed oil

Other sources of monounsaturated fats are olives, nuts, seeds, dark chocolate, and avocados.

Type 2 diabetics who consume a diet that gets no more than 30% of total calories from monounsaturated fats showed a drop in their fasting glucose level of up to 30 points. Diets rich in healthy fats reduce blood lipids and visceral fat. Extra virgin olive oil increases HDL, good cholesterol, levels. Flaxseed oil is a good source of omega 3’s that decrease LDL or bad cholesterol. Monounsaturated fats are rich in vitamin E that helps reduce the risk of colon cancer. 

Polyunsaturated fats carry many of the same benefits as monounsaturated fats. They provide essential fats that the body requires to function. They reduce cardiovascular disease risks and support the body’s ability to metabolize sugar more efficiently in type 2 diabetes. Sources of polyunsaturated fats include:

• Fish like salmon, herring, and tuna
• Fatty nuts like walnuts and pine nuts
• Seeds such as flaxseed, sunflower, and pumpkin
• Vegetable oils like sunflower, soybean, and corn
• Soybeans

Replacing saturated fats with unsaturated fats gives a tremendous boost to diabetic health. Consuming omega 3 fatty acids and other good for you fats can postpone or halt complications that uncontrolled blood glucose guarantees. (Progress in Lipid Research, Tufts University)

Foods to Avoid

Though it is true that to live well with diabetes, one needs not adopt a strict diabetic diet, there are foods that if indulged in do more harm than good. Sugary drinks like sodas, fruit juices, commercial flavored coffee drinks, fast food smoothies, high carb drinks, and milkshakes provide lots of sugar, fat, and lots of empty calories. All these can be made at home at a fraction of the cost to your health. There are plenty of diabetic diet drinks to choose from. You can make juice spritzers with seltzer water. Just add a dash of fruit juice to plain cold seltzer for a carbonated beverage that does not contain sugar. (American Diabetes Association, Medical News Today, Joslin Diabetes)

Saturated Fats

Having a diet too full of saturated fats is the fifth characteristic associated with developing type 2 diabetes. Saturated fats cause insulin resistance. Insulin resistance is when cells do not utilize the insulin produced by the pancreas to absorb sugars in the blood for energy. Saturated fats also cause pancreatic cells to die off and slow or halt insulin production. Diabetics who consume diets high in saturated fats have an even greater risk for heart disease and stroke. Saturated fats come from almost entirely from animal sources and include foods like:

• Lard
• Fatback and salt pork
• Butter
• Full fat dairy
• Marbled, high-fat meats
• Poultry skin

The ADA recommends that no more than 20% of daily fat intake be saturated fats. Some of these fats may be okay in moderation. For example, fatback and salt pork are traditionally used to season soups and bean dishes. You can cook your chicken with the skin on to keep it moist, but discard the skin before you eat it.

Rich high-fat cuts of meat, lard, and butter are all foods that were never meant to be consumed every day. Saturated fats clog the arteries and raise LDL. Replacing unhealthy saturated fats with polyunsaturated fats and monounsaturated fats even a few times a week dramatically reduces cardiovascular risks and complications from diabetes. (American Diabetes Association)

Trans Fats

Trans fats increase cholesterol levels. They are, in fact, less healthy than saturated fats. Trans fats have a stronger causal link to insulin resistance than saturated fats. Trans fats are created through a process called hydrogenation. The method of hydrogenation turns liquid oil into solid fat. Shortening and margarine are the two primary sources of trans fats. While those two foods have gone out of style, they are still the main ingredients in commercially made baked goods. Packaged cookies, crackers, and some chips remain sources of trans fats.

Healthcare providers regard trans fats as the worst fats you could eat. They raise the amount of bad cholesterol in your bloodstream and lower good cholesterol. Plaque and fatty deposits clog your arteries with the threat of rupture continually looming. If they do rupture, the result is a stroke or a heart attack that can lead to premature death. Trans fats are not foods that occur in nature, aside from in small amounts. They are a product of manufacture and should be wholly eliminated from your diet.

The FDA no longer considers partially hydrogenated vegetable oil as safe. Vegetable-based saturated fats like coconut oil and palm oil are not much better for you. The best fats to consume are polyunsaturated fats and monounsaturated fats. (Nutrition Review, UNSF, Mayo Clinic)

Cholesterol

Our bodies produce cholesterol naturally. It also comes from different animal foods we eat. Low-density lipoproteins, LDL, make up the “bad” cholesterol that clogs arteries and leads to increased risk of heart disease, hypertension, and stroke. The foods that have the most cholesterol are fatty meats like sausages, organ meats like liver, egg yolks, full-fat dairy, and poultry skin. Other foods laden with cholesterol are hard cheeses and fried foods.

Shrimp is low-fat food that, for some reason, has a high cholesterol content. It does not contribute to raising LDL, nor does it increase the risk of cardiovascular disease. Shrimp is universally considered a heart-healthy food.

Consuming a diet high in fiber is the best way to lower cholesterol in your blood. Omega 3 fatty acids also contribute to raising HDL. The best line of defense for a long life is to change the way you live. (Diabetes Care, American Diabetes Association, Medical News Today)

Sodium

High sodium intake increases the risk of heart disease in diabetic patients. Some high sodium foods people may not suspect include condiments like ketchup and soy sauce. The average American consumes about 3400 mg of sodium daily. The maximum recommended for a diabetic diet is 2300 mg. Processed foods like frozen ready meals, canned soups, and sauces, 

shelf-stable bottled vegetable juice, breakfast cereals, hot dogs, bacon, and processed luncheon meats have the most sodium.

There are many ways to lower sodium in your diet. Getting rid of salt shakers on your table makes a huge difference. You can season food with herbs, lemon juice, and zest, and other salt-free options. But the single most effective way to eliminate excess sodium in the diet is to stop eating commercially packaged foods. Shelf-stable packaged, processed food sneaks sodium into the diet.

With planning and preparation, it is possible to replace nearly every pre-packaged food product. When you make your meals, make extra portions and store them in the freezer to pop into the microwave on days when time is short. The more you cook for yourself and your family, the more control you have over what goes into the food you eat. Remember, what goes into your food ultimately goes into you. (American Diabetes Association)

Approaches to the Diabetic Diet

As far as what to eat with diabetes, the truth is that nearly anything goes, but to prevent premature death and complications such as blindness, chronic kidney disease, amputations, and heart disease, following a diabetic diet for type 2 diabetes is recommended. Luckily there are many approaches to choose from. Though the methods vary, they do all still adhere to standard diabetic diet guidelines. 

Most diabetic eating plans prescribe three meals and at least one snack each day. Nearly all focus on eating correct portion sizes. Though there are packaged foods labeled as diabetic diet foods, most eating plans for diabetics these days center on whole, unprocessed, or minimally processed foods that are rich in nutrients. Diabetic eating plans require patients to be mindful of what they eat. Nearly all involve tracking intake in some way. Every healthy eating plan comes with the added requirement of increasing exercise.

Do you know how to best partner new eating habits with exercise for the best results? Your Noom coach does, so check out Noom, get connected with your coach, and learn how to lose weight in just 10 minutes a day.

Plate Method

This is a relatively simple visual cue based guide to meal planning for diabetics. The Plate Method began at the University of Idaho. The approach was developed because studies show that diabetic diet education leads to better health outcomes from participants. 

Researchers based the approach on the Swedish Plate method. The purpose was to provide education in diabetic meal planning for people in more isolated areas who otherwise would not have access to dietitians to assist them in planning how they intend to manage their diabetes. 

The team developed a website and curriculum to teach portion control and how to shop for diabetic-friendly foods. They wanted an approach that was easy to learn and required very little math or technical skills.

The food is laid out on the plate as follows:

● One half of the plate is for non-starchy vegetables. Green vegetables provide the bulk of the nutrients required each day. They all have low glycemic indexes.

● One-quarter of the plate goes to protein. Proteins help slow the digestion process, which helps the body absorb the energy from the meal more efficiently.

● The remaining quarter of the plate is for grains. Any cooked grain is permitted in this program. Though it is recommended to eat whole grains like brown rice, quinoa, or bulgur.

● The rest of the meal is made up of a serving of low-fat dairy and a piece of fruit.

● Lastly, drinks like unsweetened ice tea, water with lemon, or an artificially sweetened soda are suggested.

This method is highly customizable. It is suitable for omnivores, vegetarians, and vegans. Fats are to be kept within recommended levels. This method helps teach proper portion control in a very easy way that involves no math. (American Diabetes Association)

Counting Carbohydrates

Counting carbohydrates is one of the oldest recommended meal plans for diabetics. A wide variety of foods are permitted. To properly count carbohydrates, one must read labels of packaged foods to find out the total carbohydrate per recommended serving size. Counting carbs can be a rigorous practice. To do it correctly, you’ll need a calculator, a food scale, measuring cups, and measuring spoons.

Carbohydrates make up anywhere from 40-65% of daily food intake. The typical diabetic diet allows for up to 250 grams of carbohydrate each day. Diabetics are to eat three meals every day and one snack. A typical carbohydrate allotment per meal is between 45-65 grams per meal.

This method works for people who want to continue eating the standard American diet. This diabetic eating meal plan does not require dropping any one food group. Instead, diabetics can eat the same foods they’re accustomed to eating. It’s important to count and track carbohydrates from every source. Remember that on a diabetic diet, dairy counts as carbohydrates, too, because lactose is a sugar.

Apps make the tracking and calculations much easier for those who might be intimidated by the math involved. For more advanced carb counters, there is the option of tracking fiber as well. Carbohydrate counting can be tough in the beginning, but in time it becomes second nature like any new skill. It’s also vital to remember that even though counting carbohydrates is the focus of this approach, you should keep track of how much you eat from all food groups. Anything consumed in excess can lead to weight gain and complications later on. (UCSF, Clinical Diabetes)

Exchange Lists

Like counting carbs, the diabetic exchange list approach is a tried and true method of managing blood sugar levels for diabetics. This method is a simplified way to count carbohydrates. Food choices are pretty much limited to what is on your list. Most diabetic diet exchange lists tend to feature typical American fare. Food is categorized into six groups:

• Starches/breads
• Meats & meat substitutes
• Vegetables
• Fruit
• Milk
• Fat

Each category on the list has different options that though the serving size may vary, have roughly the same amount of calories, carbs, and other nutrients. A serving from any category is called a “choice.” For example, under the starches/bread list, two taco shells, three cups of microwave popcorn, and 16-25 French fries can all be equally exchanged. The lists make meal planning much easier. The choice of foods is limited to what is on the diabetic diet exchange lists. A challenge of exchange lists is that it is based on the food pyramid. It recommends foods that are considered potentially unhelpful in a diabetic diet.

For example, on the exchange lists, fat-free cream cheese, and fat-free sour cream are considered free foods. That means that you’re allowed to eat as much as you like of them. Fat free versions of full fat foods tend to have added sugar to replace the fat. It seems counterintuitive to recommend that diabetics eat with no limits foods that are laden with sugar. 

Another way that exchange lists seem to be out of touch with current knowledge about nutrition is the fact that the approach allows for liberal amounts of refined carbohydrates and artificial sweeteners. Multiple studies show a link between consumption of diet beverages and weight gain. Artificial sweeteners have been linked to lessening the body’s ability to metabolize sugar. For diabetics, this has problematic implications that need further study before the drinks are commonly recommended as diabetic diet drinks that can be consumed in large quantities. (University of Arkansas, Mayo Clinic, Nutrition, and Diabetes)

Glycemic Index

Glycemic index measures how much a carbohydrate affects blood glucose levels. Carbs that have higher levels of fat, fiber, and protein have lower glycemic indexes. Processed, enriched grains have some of the highest glycemic indexes. The scale goes from 0 to 100. A cucumber, for example, has a glycemic index of 0. Pure glucose has a glycemic index of 100. A low glycemic index does not necessarily translate into being low carb. It just means that the carbohydrates in the food take longer to be absorbed into the blood. This slower breakdown means that the food doesn’t raise blood sugar levels.

Diabetes-friendly foods with a glycemic index of 55 and below include whole grains like barley, bulgur, quinoa; vegetables like carrots and artichokes; cereal grains like oatmeal; and most fruits and non-starchy vegetables. These should make up the bulk of your carbohydrate intake if you’re following a low glycemic diabetic eating plan. 

The medium glycemic index range is 56-69. Foods like whole-grain bread, whole-grain pasta, and couscous and dried fruits like raisins have medium glycemic indexes. These foods are fine in moderation. High glycemic index (70+) are nearly all processed carbohydrates and simple sugars. These foods should be eaten rarely or not at all as part of a healthy diabetic eating plan.

Tracking the glycemic index is ultimately a more advanced way of counting carbs. It leads people to choose complex carbohydrates that take longer to digest. It causes people to reject highly processed foods. Of all the ways to keep track of carbos, glycemic index lets you know how your body will respond to the carb you’re about to eat. This is a great tool for meal planning. (American Diabetes Association, MedlinePlus.gov, Diabetes Care, Heart.org)

There are thousands of foods and meals with low-glycemic foods on Noom. The app is clinically-proven to help you lose weight. If carbohydrates control is important, your coach can help personalize your plan.

Diabetic Diet Tips

To successfully bring your blood sugar under control with type 2 diabetes, permanent, sustainable lifestyle changes are necessary. There is definitely a learning curve, and to assist in incorporating these changes into your lifestyle diabetic diet, here are some tips to help maximize the benefits of your lifestyle change. These diabetic tips can make a difference in how you can care for yourself as a diabetic.

Low-fat Dairy to Save Bone Mass

Incorporating low-fat dairy into a diabetic diet reduces the risk of bone mass loss. Three servings each day are recommended. Dairy protein, potassium, and vitamin D contribute to the bone-strengthening benefit. In a diabetic diet, all dairy counts as carbohydrates. It’s better to choose low-fat dairy over nonfat because low-fat dairy has lower glycemic indexes than skim dairy. (Journal of the American College of Nutrition, JBMR, Calcified Tissue International)

Limit Alcohol

Diabetics should limit alcohol consumption. Moderate consumption of alcohol raises blood glucose levels, but excessive drinking can cause blood sugar to plummet. Carbohydrate-heavy drinks like beer and sweet wines raise blood sugar. Many cocktails have excess calories that lead to weight gain. Alcohol interferes with insulin and other diabetic medications. Excess alcohol consumption taxes the liver and can increase blood lipids and raise cholesterol. Alcohol consumption contributes to hypertension. Signs of drunkenness: slurred speech, blurred vision, flushing, nausea, increased heart rate, and slower cognitive function resemble symptoms of hypoglycemia. This can cause someone to disregard serious, potentially life-threatening symptoms. (American Diabetes Association, Healthline, Beyond Type 1)

Limit Salt

Excess sodium intake can be very dangerous to diabetics. Diabetics already have a greater risk of high blood pressure. A diet high in sodium increases that risk. The American Heart Association recommends that diabetics take in no more than 1500 mg of sodium each day. This a drastic cut from the average American sodium intake, which is between 6 and 8 grams daily. Processed, packaged foods are the primary sources of excess sodium. Meats like bacon are also high sodium items that should be eaten sparingly or better yet avoided altogether. Food can be seasoned with herbs, lemon juice or zest, lime juice or zest, and kinds of vinegar. (Diabetes UK, Diabetes Care, University of Rochester Medical Center) 

How to Count Carbohydrates

The first step in mastering how to count carbohydrates is to understand the nutritional labels of the foo