When I ask my patients about the most challenging part of managing diabetes, 99% of the time the response is related to healthy eating: “What can I eat? What should I eat? How many grams of sugar should I aim for? Should I avoid or limit carbs?” they ask.
Meal Planning Guidelines for Diabetes
What we eat has a direct effect on our health, especially for those of us who have been diagnosed with diabetes. Carbohydrates, protein and fats all play a role in managing blood sugar levels in addition to assisting with our overall health.
Following a healthy eating pattern is a key component of diabetes management. But when it comes to the long list of diets, which is the “best” choice for someone with diabetes?
The current American Diabetes Association Standards of Medical Care, which is a guide of best practices for diabetes management, states that there is no ideal distribution of calories from carbohydrates, protein and fat. The Standards of Care also recognize that eating plan recommendations for people with diabetes are not one-size-fits-all.
[READ: Healthy Carbs to Eat.]
7 tips as part of a healthy eating plan for diabetes:
— Choose fiber full food. Fiber is the undigestible portion of carbohydrate. Pick foods that are high in fiber to help blunt rises in blood sugar. Foods that contain fiber are plant based (fruits, vegetables, whole grains, beans, lentils, nuts, seeds and nut butter).
— Include lean protein with each meal. Having lean protein at each meal will help slow down the digestion of the meal, including the carbohydrate eaten, and will help you feel satisfied for longer.
— Use the plate method. Make half your plate full of non-starchy vegetables, one-quarter with lean protein and one quarter carbs. The plate method is a simple, visual way to make sure you get enough non-starchy vegetables and lean protein while limiting the amount of higher-carb foods you eat. Green beans, broccoli, cauliflower and leafy greens are examples of low-carb veggies. Healthy carbs include whole grains and yogurt.
— Make your grains whole. Choose whole grains that are higher in fiber than refined grains like oatmeal, whole grain pasta, wild rice and quinoa.
— Choose whole foods over highly processed foods. Examples of whole foods include fresh, frozen or canned produce. Make sure canned fruit is its own fruit juice and canned vegetables are labeled with no added salt if you need to watch your sodium intake.
— Spread out carbohydrates evenly over the day. When looking at a food label, focus on the total grams of carbohydrate. The grams of sugar are calculated into the total grams of carbohydrate. Foods that contain carbohydrates should be spread out throughout the day. Each person will have a different amount of carbohydrate allotment based on their personal needs. You should work with a registered dietitian and diabetes educator to help you navigate how many carbs to eat with meals. In general, 30 to 45 grams of carbs per meal is suggested.
— Plan for regular, balanced meals and snacks. Eating regular meals and snacks helps stabilize your blood sugar. Skipping meals can lead to low blood sugar. And bingeing later to make up for a missed meal can cause a high blood sugar spike.
Finding the right eating plan for diabetes
We want to find an eating plan that we can stick with. Research reveals that going on and off diets makes it that much harder to lose weight, and switching between different eating plans often can make it difficult to manage blood sugar levels.
Blood sugar likes to have consistency. So, if you are on a “diet” one week and on a different “diet” a month later, this can wreak havoc with blood sugar maintenance. Yo-yoing weight and blood sugar levels that rise and fall like a roller coaster are two issues those with diabetes should avoid.
For all people with diabetes, the diet we follow should be able to help us achieve blood sugar levels that are in target range, improve A1C and be beneficial for heart health by improving blood pressure, cholesterol and triglycerides.
We also want to make sure the plan includes some of our favorite and cultural food preferences — a plan that still allows eating to be pleasurable. A key to following any eating plan is that it is sustainable; we can follow it for a long time without feeling like we are missing out on the pleasure of eating.
Weight loss
If your goal is to lose weight, research shows positive outcomes on weight loss for people with Type 2 diabetes when following a very low-calorie eating plan. A very low-calorie eating plan is defined as a diet that allows fewer than 800 calories per day. This type of plan uses liquid meal replacements and has a transition period for re-introduction of food and an increase in calories.
Typically, these very low-calorie diets are only recommended for a short period of time — three months or less. Again, this isn’t for everyone, and you need to check with your health care team before starting a restrictive eating plan.
For people with Type 2 diabetes, low-carb, low-calorie or intermittent fasting are potential temporary eating plans to achieve both weight loss and blood sugar improvement. Again, the biggest issue of concern is whether it’s sustainable to follow day after day. We want stability with our blood sugar management, and this involves keeping our eating plan and exercise routine as consistent as possible — for all types of diabetes.
These short-term eating plans have been shown to be helpful for people with Type 2 diabetes due to quicker weight loss and improved hemoglobin A1C when compared with the standard eating plan for diabetes. Weight loss helps decrease insulin resistance and can potentially lead to remission of Type 2 diabetes.
[READ: Diabetes Meals for Picky Eaters.]
Best Diets for Diabetes
U.S. News & World Report publishes a review of best diets every year. These are U.S. News & World Report’s top-rated diabetes eating plans that offer opportunities for sustainable healthy eating habits and are appropriate choices for people with diabetes.
Mediterranean diet for diabetes
The Mediterranean diet is filled with powerful plant-based foods like nuts, seeds, olive oil, fruit, vegetables, whole grains, beans and legumes. As studies have demonstrated, all of these foods contain disease-fighting nutrients that can reduce your risk for heart disease, lower your cholesterol, help manage your blood sugar and improve your mood.
This eating plan also encourages exercise, which is part of the good health equation. This plan is easy to stick with because there are no bans on any food groups, and the food is very filling due to the high fiber content. An additional benefit is that the higher fiber content helps slow down the absorption of the carbohydrate you are eating. That’s a win-win.
As a starting point, consume 30 to 45 grams of carbohydrate per meal as a trial. The best way to assess your carb intake in relation to blood sugar management is to check your blood sugar before a meal and two hours after the start of eating. Remember that the target for blood sugar is 80 to130 mg/dL before eating and less than 180 mg/dL two hours after eating.
Flexitarian diet for diabetes
As a registered dietitian, I love talking to people about the flexitarian eating plan because its focus is on vegetarian eating with the flexibility to consume animal protein.
Plant-based eating has a wide spectrum of definitions. To some people, it is a vegan plan with no animal products, while for others, it is a vegetarian plan that includes dairy, eggs and/or fish. Or it may just means that you’re putting more produce on your plate and considering your diet to be plant-forward.
Studies have shown that this plan has positive outcomes for overall health. Plant-based eating plans have a higher diet quality offering more fiber, vitamins and minerals. This plant-based eating plan is also better for your heart because you’ll consume less saturated fat, cholesterol and sodium. People following a plant-based eating plan have seen improvement in their sleep, inflammation, immunity and even an increase in satiety and digestion. Red meat consumption increases insulin resistance and affects beta cell function, which have a direct influence on the risk of developing Type 2 diabetes and complicate the management of diabetes.
Studies show those who follow a vegetarian eating plan tend to feel fuller from the higher fiber food choices and lose weight because they tend to eat less overall than meat eaters.
DASH diet for diabetes
The DASH diet, like the Mediterranean and flexitarian diets, received high ratings by the U.S. News Best Diets Expert Panel as one of the best diets for overall healthy eating. The DASH diet focuses on inclusion of fruits and vegetables, whole grains, nonfat and low-fat dairy products while reducing saturated fat and salt.
The combination of reducing your sodium intake and following the DASH eating plan gives you the best benefit for lowering your blood pressure. Since two out of three people who have diabetes also have high blood pressure, this eating plan may be a good option.
Just like the other eating plans mentioned above, start with 30 to 45 grams of carbohydrate per meal and check your blood sugar before and after meals to monitor how the diet is effecting your blood sugar. If you are trying to lose weight, reduce your calorie intake by 500 to 1,000 calories.
[READ: Best Meal Delivery Services for Diabetes.]
Food List for a Diabetes-Friendly Meal Plan
The great news is that all foods can fit into a healthy eating plan. Here is a sampling of some foods that fit into a healthy eating plan:
Proteins
— Beans, lentils.
— Chicken or turkey without the skin.
— Lean beef or pork (limit to twice per week).
— Low-fat cheese.
— Nuts and nut butters (choose nut butters that only contain nuts or nuts and salt).
Fruits (quantity noted in parentheses is equal to 15 grams of carbohydrate)
— Berries: strawberries (1 ¼ cup whole), raspberries (1 cup), blueberries (3/4 cup).
— Canned fruit packed in its own juice (1/2 cup).
— Cherries (12).
— Grapes (17).
— Kiwi (1).
— Mango (1/2 cup).
— Melon: watermelon (1 ¼ cups cubed), cantaloupe or honeydew (1 cup cubed).
— Pineapple (¾ cup fresh or ½ cup canned in its own juice).
— Small apple, nectarine, orange, banana (4 ounces).
— Plums (2).
— Tangerines (2).
— Pear (4 ounce).
Vegetables (serving is ½ cup cooked or 1 cup raw= 5 grams carbohydrate)
Choose non-starchy vegetables, which are most vegetables except for potato, corn, winter squash and peas.
Whole grains that are higher in fiber
— Bulgur.
— Oatmeal.
— Peas.
— Popcorn.
— Quinoa.
— Winter squash.
— Whole-grain breads and crackers.
Milks and yogurts
— Low-fat milk.
— Greek yogurt.
Heart-healthy fats
— Avocado.
— Nuts and nut butters (choose nut butters that only contain nuts or nuts and salt).
— Olive oil.
[READ: How to Meal Prep Diabetes-Friendly Meals. ]
Easy Meal Prep Tips
Now that you have a basic list of foods that you can include in your eating plan, you are ready to start prepping the menu for the week. Start your meal prep by planning your meals for the week. You can use the seven-day meal plan below to get you started.
Next, based on your meals for the week, write your grocery list and then head to the store to pick up the needed ingredients.
Once you have all the ingredients for your week of menus in your home, see if there’s any pre-prep you can do on the weekend. For example, on the Monday menu listed below, you can prepare the tuna salad and the chicken dish the day before.
When preparing meals for diabetes management, it’s important to balance the amount of carbohydrate, protein and fats in each meal. You can use this as a checklist to see if you are planning a balanced meal:
— Does your meal have a source of protein?
— If you are using fat at your meal, is it a heart-healthy fat choice?
— Does the meal use higher fiber grains, fruits and vegetables?
— Remember to include several servings of vegetables at mealtime to help keep the carbohydrate lower and your stomach fuller for the meal.
7-Day Diabetes Meal Plan
Here is a sample healthy menu for people with diabetes calculated with 45 grams of carbohydrate per meal. Note that healthy carbohydrate foods are spread evenly throughout the day.
For recipes of many of the meals below, check out “Diabetes Meal Planning and Nutrition for Dummies,” which I co-authored with Dr. Alan Rubin in 2013 with help from Lindsey Singleton, a registered dietitian nutritionist.
Monday
— Breakfast: Egg white omelet with bell pepper, tomatoes and spinach; two slices of rye toast with margarine; 1 cup cubed cantaloupe; coffee or tea.
— Lunch: Tuna salad on a slice of sourdough bread with sliced tomato and romaine; 3 cups popped popcorn; 3/4 cup blueberries; iced tea.
— Snack: Cheese stick and five whole-wheat crackers.
— Dinner: Chicken with lemon; 3/4 cup rice pilaf with currants; steamed green beans with roasted red bell pepper; whole-grain roll with margarine; iced tea.
Tuesday
— Breakfast: One 6-ounce serving of plain Greek yogurt topped with sliced almonds, cinnamon and a 1/2 cup raspberries; 1 cup cooked oatmeal; coffee or tea.
— Lunch: Four slices of fresh turkey on two slices of rye bread with 1 tablespoon ajvar (a red pepper spread); fresh orange sections; baby sweet bell peppers; water with sliced lime.
— Snack: Small apple with almonds.
— Dinner: One 5-ounce serving of teriyaki salmon with ginger and orange juice; 1 cup spaghetti squash with margarine; roasted asparagus; one whole-grain dinner roll with 1 teaspoon margarine; one sliced kiwi; flavored sparkling water.
Wednesday
— Breakfast: Black bean breakfast bowl topped with sliced avocado; sliced fresh peach; coffee or tea.
— Lunch: Natural peanut butter spread on two slices of whole-wheat bread; 1/2 cup raspberries with a dollop of whipped cream; celery sticks; one serving of dark (72% cacao) chocolate.
— Snack: Cubed cheese and 17 frozen grapes (tastes like ice cream!).
— Dinner: Grilled chicken; 1 cup baked acorn squash; roasted cauliflower; dinner roll with margarine; scoop of ice cream with chopped nuts.
Thursday
— Breakfast: One 6-ounce serving of low-fat, fruited yogurt; two servings of “cheese Danish” made with 1/4 cup cottage cheese sprinkled with cinnamon and low-calorie sweetener on a slice of pumpernickel bread; almonds; coffee or tea.
— Lunch: Egg salad with sliced tomato on two slices of rye bread; fresh baby bell peppers; 1 cup vegetable soup; water with lemon slice.
— Snack: 1 1/2 graham crackers with peanuts.
— Dinner: Spiced pork tenderloin with gala apples; medium sweet potato with margarine; cornbread; sauteed spinach and roasted garlic; water.
Friday
— Breakfast: Whole English muffin topped with two egg whites and a slice of cheese; sliced tomato; baked pear; coffee or tea.
— Lunch: Hamburger on a bun with lettuce and tomato; 1 cup baked fries; tossed salad with dressing; iced tea.
— Snack: Three-quarters cup fresh pineapple with almonds.
— Dinner: Flatbread cheese and vegetable pizza; tossed salad loaded with vegetables and topped with salad dressing; flavored sparkling water.
Saturday
— Breakfast: Whole-grain tortilla spread with peanut butter and wrapped around a small banana; 1 cup milk; coffee or tea.
— Lunch: Vegetarian chili; creamy coleslaw; 1/2 cup applesauce; sparkling lemon water.
— Snack: Pistachios and an orange.
— Dinner: Panko chicken tenders; roasted Brussels sprouts; 3/4 cup quinoa salad; 1/2 cup cantaloupe; sparkling water.
Sunday
— Breakfast: A half-cup of cooked oatmeal; one whole sliced mango; soy sausage; tea or coffee.
— Lunch: Chipotle beef tacos; tossed salad with jicama and salad dressing; sliced apple; iced tea.
— Snack: Tuna salad with crackers.
— Dinner: Baked polenta with turkey sausage ragu; steamed broccoli with margarine; flavored sparkling water.
[READ: How Much Sugar Can I Eat If I Have Diabetes?]
Foods to Avoid or Limit on a Diet for Diabetes
When my patients want to know, down to the bite, what they should — and shouldn’t — eat, I always say, “a balance of everything. And yes, that includes carbs like fruit, starchy vegetables, beans and legumes, whole grains, milk and yogurt, and even some sweets.
There is a category of food that should be avoided or limited as these types of foods can spike blood sugar. These are foods that we refer to as simple sugars, which include:
— Table sugar.
— Coconut sugar.
— Agave.
— Honey.
— Jams and jellies.
— Sweetened beverages like soda and fruit juice.
— Maple syrup.
More from U.S. News
The Best Mediterranean Diet Recipes
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Meal Plans for People With Diabetes originally appeared on usnews.com
