Eating Well with Diabetes

Tips from a clinical nutritionist on which foods to embrace and which to avoid

By Melanie Peters   |   December 20, 2017

​More than 30 million people in the United States have diabetes and another 84 million adults are at high risk of developing type 2 diabetes. By 2050, some studies suggest more than one-quarter of Americans will have diabetes. Despite these sobering numbers, maintaining a healthy lifestyle can go a long way toward managing the condition or, as is the case with type 2 diabetes, keeping it at bay.

eating well graphic

But which foods should you consume and which should be avoided? We asked Byron Richard, a clinical nutritionist and manager of Nutrition Services at UC San Diego Health for advice on what to buy and eat  when living with a diagnosis of diabetes.

Which foods are in the “do” category?

I would say the best foods are in these six categories: berries, legumes (beans and peas), leafy greens, nuts, spices and extra virgin olive oil.

Berries: Berries have the highest antioxidant content and are rich in polyphenols. These nutrients have been shown to reduce risks associated with diabetes, like cardiac disease. Berries have a low glycemic index (GI) — the rate at which a food is digested — which may also help with weight loss and blood sugar control. Use the glycemic index as a guide in food selection. Most low GI foods are also high in fiber.

Legumes: Legumes are also high in phytonutrients. Legumes are a low-GI, high-quality protein and, since these foods do not contain cholesterol and saturated fats, make an excellent substitute for some or most of the animal proteins in your diet.

Leafy greens: Leafy greens have very high phytonutrient power. All vegetables are good sources of nutrition but dark green, leafy vegetables, like kale, spinach, bok choy, mustard greens and broccoli, provide vitamins like A, C, E, K and folate as well as fiber, iron and several minerals, like calcium. Leafy greens, as with most non-starchy vegetables, have a low GI and are low in calories and carbohydrates.

Nuts: Nuts have been shown to reduce cardiovascular disease risk. Though high in calories due to their fat content, these foods contain unsaturated fats, like omega-3s, that may benefit people with diabetes. Nuts can replace carb-heavy snacks without an increase in blood sugar and have a greater satiety point, which may lead to a decrease in calorie consumption. Nuts are also high in fiber.

Extra virgin olive oil (EVOO): If you are going to use oil, EVOO is likely the best bet. People following the Mediterranean Diet consume large quantities of EVOO and have a very low incidence of heart disease. EVOO has mostly mono-unsaturated fats, which have been shown to lower total cholesterol and LDL — the bad cholesterol. In some studies, EVOO has been shown to reduce blood sugar, too.

spices

Spices and Herbs: The research is positive toward the use of many spices because of the polyphenolic and antioxidant content. Quality common spices, like thyme, oregano, cinnamon, basil, turmeric and many others have high phytonutrient compounds that have been shown to be beneficial to health by reducing risks for some cancers and lowering diabetes risks. And using spices and herbs can help lower your sodium intake by replacing salt as a seasoning, making bland dishes more palatable.

Which foods are in the “don’t” category?

Limit highly processed foods like cereals, instant foods, frozen meals, and white foods stripped of fiber, such as white rice or bleached flour. These foods have poor nutrient content. Foods high in saturated fat, like animal fats, any trans fats and hydrogenated fats (read your nutrition label for these food nutrients) should be reduced and/or eliminated. These fats contribute to increasing risks for heart disease. High sugar content liquids, such as regular sodas and large quantities of fruit juice and sports drinks should also be reduced or avoided. Sweetened beverages deliver lots of calories and carbohydrates with little nutritional value.

All the above can lead to increased risks for cardiovascular disease, increased weight and increased blood sugar.

Are all animal fats excluded? What about fish, lean proteins and dairy?

With the exception of cold water fish, such as Atlantic mackerel, cod, haddock, herring, mahi mahi, salmon, anchovies, pollock, trout, whitefish, canned light tuna and sardines, animal fats have a larger portion of saturated fats — contributors to elevating cholesterol. Many plant oils and cold water fish also contain omega-3 fats. Omega-3 fats can lower your triglycerides and decrease your risk of heart disease, which is the number one killer of people with diabetes.

fish

Other lean fish (cod, haddock) have very little fat and are good sources of lean, high quality proteins. It is the same for lean animal proteins, like white meat chicken and turkey. There are those that would argue for lean beef and pork, but the cost of the leanest of these are higher and not the ones we typically purchase. On eggs, cardiologists limit the number of eggs eaten weekly by those with active heart disease. Eggs can be a good source of high quality protein but do deliver saturated fat in the yolk. Chickens fed special diets can have eggs with a much higher amount of omega-3, which would provide additional health benefits. If you're an egg eater, know your lipid levels and discuss with your doctor about how many to eat weekly.

When it comes to dairy, even the vegetarian-inspired, low-fat Dean Ornish cardiac program allows for non-fat dairy. Dairy products are great sources of calcium and can be obtained in various forms and fat content. Lower fat dairy is the healthier option and fermented dairy products, like yogurt, can contribute good flora (gut bacteria) and other health benefits to the diet, like protein.

Finally, are potatoes and other starchy vegetables off the table forever?

No! Many root and starchy foods like brown rice, whole wheat pasta and yams deliver many nutrients and provide greater amounts of fiber to the diet. For athletes, kids and adults needing to maintain a healthy weight, these carbohydrates and fibers are a necessity. For adults needing to lose weight, consider using less starchy food to maintain a slight caloric deficit, as these foods contribute nearly three times as many calories as non-starchy vegetables, such as broccoli, greens and green beans. Eat starchy foods that contain fiber and have a lower glycemic index. These should make you feel fuller longer.

Here are three delicious, nutritious, diabetes-friendly recipes to help keep you on track to better health.

Barley Pilaf (courtesy of Dietary Considerations)

High in fiber and bursting with omega-3s and iron, this whole grain side dish is a great accompaniment to fish or chicken.

Chicken Garbanzo Salad (courtesy of Health)

This salad is full of “dos”: legumes (chickpeas), leafy greens (spinach), fresh herbs and spices (garlic and mint or parsley) and lean protein (chicken).

Mustard-Maple Roasted Salmon (courtesy of Food Network)

Salmon is high in heart-healthy omega-3s and if cilantro isn’t to your taste, just pick a favorite herb — like tarragon, parsley or dill.


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