"You don't need to buy special foods,” advises Sue Tocher, MS, RD, dietitian and diabetes clinical program coordinator at Children's Healthcare of Atlanta. “You should prepare the same healthy foods that would be recommended for someone without diabetes. That means plenty of whole grains, fruits, vegetables, and a low concentration of fats and sweets."
Diabetes: Food and Blood Glucose Levels
It's important for diabetics to keep their glucose from getting too low or too high. This is achieved by regularly checking blood glucose levels and regulating insulin dosage and carbohydrate intake. It's best to eat about the same amount of carbohydrates each day, eat and snack at regular hours, and avoid skipping meals.
"Carbohydrates are the most important food group for diabetics,” says Tocher. “These are the foods that impact glucose levels. Fats and proteins supply calories but have little effect on blood glucose."
Foods that contain lots of carbs include bagels, crackers, dried beans and peas, fruit, pasta and rice, and of course, sweets.
Diabetes: The Food Pyramid
The diabetes food pyramid illustrates how to make the best food choices. The pyramid has six color-coded categories, each representing a different food group.
"The idea of the food pyramid is to get you to eat from a variety of food groups,” says Tocher. “The foods closest to the bottom are the foods that are closest to their natural state, such as whole grains, fresh vegetables, beans, and fresh fruit. You want to get your calories from the bottom up." Foods from the bottom also provide vitamins, minerals, and fiber.
Moving up the pyramid, as the category sections narrow, are milk products, meat, and meat substitutes like eggs, fish, and tofu, and then fats and sweets.
Foods that contain refined sugars and fats are empty calories and have the least amount of nutrients. They also tend to have more saturated fats and cholesterol.
Diabetes: The Right Foods in the Right Amounts
Tocher says it is important to pay attention to serving sizes. “Americans have a tendency to supersize their portions. A normal portion of pasta for an older child or adult is one cup, which is equal to three servings of starch,” she explains. “A typical portion you might see in a restaurant could be five times what is normal.”
- Fruits. You should provide at least five servings of fruit each day. "One medium apple or banana is equal to two servings," notes Tocher.
- Fish. Fish like salmon and tuna are high in fatty acids that are heart-protective. Try to serve fish two to three times per week.
- Grains and starches. Choose 4 to 11 servings a day, depending on calorie needs. Look for foods that list whole grains as their first ingredient, like whole-grain bread or pasta, brown rice, beans, corn, and potatoes.
- Vegetables. You should provide five servings a day.
- Dairy. Offer low- or non-fat milk two to three times per day.
- Meat protein. Limit meat to four to six ounces a day. Proteins that can substitute for meat include tofu, eggs, beans, or cheese.
Diabetes: Cooking Tips
How food is cooked is also important. Using high-fat dressing or sauces on low-fat foods, for instance, is not a healthy way to cook. If you use oils to cook, use canola or olive oil.
Other smart cooking tips:
- Broiling, grilling, roasting, and steaming are better than frying.
- Use low-fat or fat-free salad dressing.
- Steam vegetables in water or low-fat broth.
- In place of salt, try lemon or lime juice.
- Try a piece of lean ham or smoked turkey instead of butter for flavoring vegetables.
- Eat fruits raw or cooked without adding sugar.
- Use low-fat or non-fat yogurt as a substitute for sour cream.
- Trim all the fat off meat before cooking.
- Take the skin off chicken and turkey before cooking.
Diabetes: Special Tips for Children
"I remind parents that eating habits formed in childhood can last a lifetime, and diabetes is a lifetime disease," Tocher notes.
- Vitamin D is especially important in children. "I recommend parents limit drinks at mealtime and snacks to either milk or water," says Tocher.
- Children can get their whole grains and dairy from cereal, but make sure that there are less than 10 grams of sugar per serving.
- Limit fruit juice to eight ounces per day. Even 100 percent unsweetened juice has too much concentrated sugar. "It's better to eat your carbohydrates than to drink them," advises Tocher.
- Non-diet colas and sodas should be eliminated completely. "One 22-ounce cola contains the same amount of carbohydrate as an entire meal — and it is all empty calories," warns Tocher.
- Children like to snack, but this can increase insulin requirements. Always allow two hours between meals and snacks.
Preparing the right meals for someone with diabetes is an important part of diabetes management that requires education and preparation. You can get help from your loved one’s doctor and diabetes educator. Many diabetes clinics offer classes for caregivers.
To find a diabetes educator near you, go to the Web site of the American Association of Diabetes Educators. To learn more about the diabetes food pyramid, go to mypyramid.gov or www.diabetes.niddk.nih.gov.