Diabetes Diet Principles
One of the common errors dietitian Diane Rachac sees people make when they get a diabetes diagnosis is that they stop eating. They figure if they don’t eat, they can’t make their blood sugar get too high. “But that’s just about the worst thing they can do,” says Rachac. “We need glucose (sugar) for our body to function properly. Eating regularly, about every four to six hours, is a good goal.”
Aside from eating regularly, what are some other sound dietary principles to follow if you have diabetes?
“Another common misperception people with diabetes have is that they can’t eat sugar,” continues Rachac. “Blood sugar goes up the same when you eat any high carbohydrate food. Rice, bread, pasta—all of these have a lot of carbohydrates. Sugars are part of carbohydrates, and we recommend looking at the total amount of carbohydrates you eat. That’s why people need to talk with a dietitian. They can set a goal for a healthy amount of carbohydrate (often called “carb counting”) to eat at each meal.”
What about fats in the diet?
“Fat causes insulin resistance,” says Rachac. When you have insulin resistance, your body uses insulin less efficiently. “People tend to eat more fat than they realize. I talk to people all the time who tell me they often eat a bag of microwave popcorn in one sitting. They somehow have the impression that they’re not getting much fat from that. But one bag of popcorn might have 40 grams of fat. That’s way too much for one snack.
“Another thing people do that they think is healthy is order a grilled chicken sandwich when they go out for fast food. But those sandwiches have mayonnaise on them, and one tablespoon of mayonnaise alone has 10 grams of fat. A better choice would be a veggie sub—with no mayo.
“People need to limit saturated fats, and they should severely limit or eliminate trans fats, which are found in most snack foods. Trans fats aren’t listed on the food labels, but saturated fats are. Read the labels. Look at what it says under ‘total fat.’ Only one third of that should be saturated fat. For example, if there are 4 grams of fat and 3 grams of saturated fat, that’s not a good choice.”
Should people limit salt?
“We need salt to keep our electrolytes balanced,” says Rachac. “We should get about 30 to 40 milligrams of sodium per day. But most people get about 5,000 to 6,000 per day, when really we should be limiting it to about 2,000 milligrams.”
Create meals that fall within guidelines
“People often ask me to write them a menu, but I don’t like to do that. I give them guidelines, show them how much carbohydrate they should have in each meal and snack, how much fat. Then they can create meals of their own choosing that fall within the guidelines. Or they can bring me a list of foods they commonly eat, and we can take a look at that and see what kinds of modifications they need to make.
“People with diabetes should meet with their dietitian at least once a year, even if things are going well,” says Rachac. “It’s the best way to keep on top of things. Your diabetes status changes over time, so we can help people make adjustments along the way.”
Diane Rachac, RD, LD, CDE, Allina Hospitals and Clinics