(this article refers to Type 2 Diabetes)

According to the American Diabetes Association, nearly 10% of the US population has diabetes. What’s even more shocking is that 37% of Americans aged 20 or older have prediabetes. Due to genetic differences, the risk of developing diabetes is highest among Asian Americans, Hispanics and African Americans. If left untreated or if poorly controlled, diabetes increases the risk of experiencing the following:

• heart attack and stroke
• hyperglycemic coma and death (extremely high blood sugars that cause severe dehydration -> coma)
• retinopathy (progressive damage to the retina causing difficulty seeing and eventually, blindness)
• kidney failure and the need for life-long dialysis and/or transplant

As a former kidney transplant dietitian, I can’t tell you how many diabetic-renal diet educations I have provided and let me just say - that diet is NOT. FUN. It is very difficult to follow and can really take the joy out of eating.

By making the choice to eat healthfully and get a little exercise each day, you can prevent the development of diabetes. Already have diabetes? Although you cannot erase the damage that has already been done, you can use diet and exercise as tools to come off of medications and to prevent the above co-morbidities that come along with uncontrolled diabetes. Not only will you feel and look better, you’ll save yourself a ton of money in medical bills.

WHAT CAUSES DIABETES?

When we eat, our body converts carbohydrates (CHO) into glucose. The glucose is then rapidly absorbed into the bloodstream and delivered to all of our cells for energy. This rise in blood glucose signals insulin to be released by the pancreas and allows the glucose to enter the cells, removing it from the bloodstream.

But in type 2 diabetics, the cells become resistant to insulin, not allowing the glucose in, and instead leaving it to float around in the blood causing hyperglycemia. Initially, this state of hyperglycemia signals your pancreas to secret more insulin in hopes of getting that sugar into cells and out of the blood stream. But overtime, the pancreas will burns out and can no longer produce enough insulin to meet the body’s demands (in this case, one would need exogenous insulin, as do Type 1 diabetics). Furthermore, this state of hyperinsulinemia (high insulin levels in the blood) is also detrimental to health, directly damaging blood vessels and increasing the risk for heart disease and stroke, among other things.

It is not clear what causes insulin resistance in the first place, but exercise has shown to improve insulin sensitivity, and should be done on a daily basis to help control blood sugars. Likewise, following a balanced diet - aka the “diabetic diet” - can help prevent drastic spikes in blood sugars, both preventing and controlling diabetes.

THE DIABETIC DIET

The diabetic diet limits sugary, refined foods and red meat, and encourages whole grains, healthy fats, fruits and vegetables, and lean proteins. Sounds like a regular ole healthy diet right? That’s because it is! The diabetic diet is comprised of components from which everyone can benefit:

EAT WHOLE GRAIN FOODS VS. REFINED ONES

Fiber allows glucose to be more slowly absorbed, causing lower glucose levels and therefore, creating less stress on the pancreas to produce insulin. However, when grains are highly processed (like in sugary cereal, white breads and pastas, pastries, packaged snack products, etc), their bran and fiber have been removed, and so these foods cause tremendous spikes in blood sugars. In addition to fiber, whole grains also contain a wide variety of health protecting vitamins, minerals and phytonutrients that refined products lack.

EAT CHO IN MODERATION

Eating the right amount of CHO is just as important as eating the right kind. But the amount needed is very individual and depends on how active you are and what medications you take, if any. In order to truly know how your body uses specific amounts of CHO, you would need to use a glucometer before and after you eat. Unless you are diabetic, you probably don’t have access to this. [You could however, buy one online; the glucometer itself is affordable but the test strips are pricey.] If you’re not diabetic then using a glucometer isn’t practical; but avoiding the overconsumption of CHO is. Check it:

Women: 30-45 g CHO per meal, 15-30 g CHO per snack
Men: 45-60 g CHO per meal, 15-30 g CHO per snack

Because athletes require more CHO to recover from workouts, the above recommendation does not apply to them. If you are an athlete and are curious about the amounts of CHO you need pre- and post-workout, contact me and I can help you determine whats best for you.

These CHO amounts are based on the diabetic exchange list. Although you may not have diabetes, it’s a reliable and easy system to use in order to eyeball the amounts of CHO you are about to eat. It’s a healthy tool for everyone to use; whether or not you have diabetes. Although brands vary, here are the basics:

15g CHO of Starch
3/4 cup cereal
1/2 cup oats
1/2 cup rice, pasta, barley, cous cous, quinoa, etc.
1 slice bread
1/2 english muffin

15g CHO of Veggies
1/2 cup cooked (carrots, broccoli, cabbage, onion, etc.)
1 cup raw (including salad greens)
1/2 cup starchy veggies (corn, potatoes, beans/legumes, okra

15g CHO of Fruit
1 small apple, orange, peach, pear, banana etc.
1 cup fresh berries, grapes
1/2 grapefruit
1 kiwi
1 cup melon

Eat a lot of packaged foods? Check the label to see your CHO count. Especially on sugary drinks like soda, energy drinks, sports drinks, teas, lemonades, fruit juices and fruit flavored drinks, which often times have upwards of 60-70 grams of CHO per bottle! These drinks can really do some damage on your blood sugar and are best avoided or at least consumed in moderation (like once a week moderation) and per appropriate portion size.

EAT THE RIGHT KIND OF FAT

Polyunsaturated and monounsaturated fats found in plant foods like nuts and seeds, avocados, and olive oils are beneficial in preventing diabetes and contain other health-promoting nutrients. Avoid trans fats which are labeled as partially or fully hydrogenated oils on food labels, and can be found in fried foods, packaged baked goods and margarines. Omega-3 fats found in cold water fatty fish like salmon, mackerel and tuna, haven’t been shown to reduce the risk of developing diabetes but do confer other noteworthy health benefits like reducing inflammation, improving mood and mental health.

LIMIT RED MEAT & HIGHLY PROCESSED MEATS

The literature shows that eating red meat and highly processed meats (like bacon, hot dogs, packaged deli meats) on a daily basis raises the risk for developing diabetes. That same study showed that replacing red/processed meat with nuts, low fat dairy or other lean protein like chicken or pork greatly reduced the risk of developing diabetes. Balance and moderation are the keys to health.

The diabetic diet should be looked at as a general healthy way of eating that improves the health of most anyone. You don’t need to have a diagnosis to reap the benefits of this way of eating.

If you need more guidance in putting these recommendations into practice, contact me and we can work one on one in person, or via the web.