Tips for Healthier, Happier Eating
How to Plan Healthy Meals
Healthy meal planning is an important part of diabetes care. If you have diabetes, you should have a meal plan specifying what, when, and how much you should eat. Work with a registered dietitian to create a meal plan that is right for you. A typical meal plan covers your meals and snacks and includes a variety of foods. Here are some popular meal-planning tools:
1. An exchange list is a list of foods that are grouped together because they share similar carbohydrate, protein, and fat content. Any food on an exchange list may be substituted for any other food on the same list. A meal plan that uses exchange lists will tell you the number of exchanges (or food choices) you can eat at each meal or snack. You then choose the foods that add up to those exchanges.
2. Carbohydrate counting is useful because carbohydrates are the main nutrient in food that affects blood glucose. When you count carbohydrates, you simply count up the carbohydrates in the foods you eat, which helps you manage your blood glucose levels. To find the carbohydrate content of a food, check the Nutrition Facts label on foods or ask your dietitian for help. Carbohydrate counting is especially helpful for people with diabetes who take insulin to help manage their blood glucose.
3. The Create Your Plate method helps people with diabetes put together meals with evenly distributed carbohydrate content and correct portion sizes. This is one of the easiest meal-planning options because it does not require any special tools—all you need is a plate. Fill half of your plate with nonstarchy vegetables, such as spinach, carrots, cabbage, green beans, or broccoli. Fill one-quarter of the plate with starchy foods, such as rice, pasta, beans, or peas. Fill the final quarter of your plate with meat or a meat substitute, such as cheese with less than 3 grams of fat per ounce, cottage cheese, or egg substitute. For a balanced meal, add a serving of low-fat or nonfat milk and a serving of fruit.
No matter which tool you use to plan your meals, having a meal plan in place can help you manage your blood glucose levels, improve your cholesterol levels, and maintain a healthy blood pressure and a healthy weight. When you’re able to do that, you’re helping to control—or avoid—diabetes.
Learning Portion Control
Portion control is an important part of healthier eating. Weighing and measuring your foods helps you familiarize yourself with reasonable portions and can make a difference of several hundred calories each day. You want to frequently weigh and measure your foods when you begin following a healthy eating plan. The more you practice weighing and measuring, the easier it will become to accurately estimate portion sizes.
You’ll want to have certain portion-control tools on hand when you’re weighing and measuring your foods. Remember, the teaspoons and tablespoons in your silverware set won’t give you exact measurements. Here’s what goes into your portion-control toolbox:
• Measuring spoons for ½ teaspoon, 1 teaspoon, ½ tablespoon, and 1 tablespoon
• A see-through 1-cup measuring cup with markings at ¼, ⅓, ½, ⅔, and ¾ cup
• Measuring cups for dry ingredients, including ¼, ⅓, ½, and 1 cup.
You may already have most of these in your kitchen. Keep them on your counter—you are more likely to use these tools if you can see them. Get an inexpensive food scale ($5–15) for foods that are measured in ounces, such as fresh produce, baked goods, meats, and cheese.
When you’re weighing meat, poultry, and seafood, keep in mind that you will need more than 3 ounces of raw meat to produce a 3-ounce portion of cooked meat. For example, it takes 4 ounces of raw, boneless meat—or 5 ounces of raw meat with the bone—to produce 3 cooked ounces. About 4½ ounces of raw chicken (with the bone and skin) yields 3 ounces cooked. Remember to remove the skin from the chicken before eating it.
There are other easy ways to control your portions at home in addition to weighing and measuring:
• Eat on smaller plates and bowls so that small portions look normal, not skimpy.
• Use a measuring cup to serve food to easily determine how much you’re serving and eating.
• Measure your drinking glasses and bowls, so you know how much you’re drinking or eating when you fill them.
• Avoid serving your meals family-style because leaving large serving dishes on the table can lead to second helpings and overeating.
• Keep portion sizes in mind while shopping. When you buy meat, fish, or poultry, purchase only what you need for your meal.
When you’re away from home, your eyes and hands become your portion-control tools. You can use your hand to estimate teaspoons, tablespoons, ounces, and cups. The tip of your thumb is about 1 teaspoon; your whole thumb equals roughly 1 tablespoon. Two fingers lengthwise are about an ounce, and 3 ounces is about the size of a palm. You can use your fist to measure in cups. A tight fist is about half a cup, whereas a loose fist or cupped hand is closer to a cup.
These guidelines are true for most women’s hands, but some men’s hands are much larger.
The palm of a man’s hand is often the equivalent of about 5 ounces. Check the size of your hand in relation to various portions.
Remember that the more you weigh and measure your foods at home, the easier it will be to estimate portions on the road.
Controlling your portions when you eat at a restaurant can be difficult. Try to stay away from menu items with portion descriptors that are large, such as “giant,” “supreme,” “extra-large,” “double,” “triple,” “king-size,” and “super.” Don’t fall for deals in which the “value” is to serve you more food so that you can save money. Avoid all-you-can-eat restaurants and buffets.
You can split, share, or mix and match menu items to get what you want to eat in the correct portions. If you know that the portions you’ll be served will be too large, ask for a take-home container when you place your order and put half of your food away before you start eating.
Gradually, as you become better at portion control, you can weigh and measure your foods less frequently. If you feel like you are correctly estimating your portions, just weigh and measure once a week, or even once a month, to check that your portions are still accurate. A good habit to get into is to “calibrate” your portion control memory at least once a month, so you don’t start overestimating your portion sizes. Always weigh and measure new foods and foods that you tend to overestimate.
Frequently Asked Questions about Diabetes and Food
1. Do people with diabetes have to eat a special diet?
No, they should eat the same foods that are healthy for everyone – whole grains, vegetables, fruit, and small portions of lean meat. Like everyone else, people with diabetes should eat breakfast, lunch, and dinner and not put off eating until dinnertime. By then, you are ravenous and will eat too much. This sends blood sugar levels soaring in people with diabetes, and doesn’t allow them to feel hungry for breakfast the next morning.
2. Can people with diabetes eat sugar?
Yes, they can. Sugar is just another carbohydrate to the body. All carbohydrates, whether they come from dessert, breads, or carrots, raise blood sugar. An equal serving of brownie and of baked potato raise your blood sugar the same amount. If you know that a rise in blood sugar is coming, it is wise to focus on the size of the serving.
The question of “how much sugar is too much?” has to be answered by each one of us. No one who wants to be healthy eats a lot of sugar.
3. What natural substances are good sugar substitutes? Are artificial sweeteners safe for people with diabetes?
Honey, agave nectar, maple syrup, brown sugar, and white sugar all contain about the same amount of calories and have a similar effect on your blood glucose levels. All of these sweeteners are a source of carbohydrates and will raise blood glucose quickly.
If you have diabetes, you can use these sweeteners sparingly if you work them into your meal plan. Be aware of portion sizes and the carbohydrate content of each sweetener:
• 1 tablespoon honey = about 64 calories, 17 grams of carbohydrate
• 1 tablespoon brown sugar = about 52 calories, 13 grams of carbohydrate
• 1 tablespoon white sugar = about 48 calories, 13 grams of carbohydrate
• 1 tablespoon agave nectar = about 45 calories, 12 grams of carbohydrate
• 1 tablespoon maple syrup = about 52 calories, 13 grams of carbohydrate
• 1 packet of artificial sweetener = about 4 calories, <1 gram of carbohydrate
Artificial sweeteners are a low-calorie, low-carb option. Because they are chemically modified to be sweeter than regular sugar, only a small amount is needed to sweeten foods and drinks. There are several different artificial sweeteners available under various brand names: stevia, aspartame, acesulfame-K, saccharin, or sucralose. These are safe for people with diabetes when used in moderate amounts.
4. How many grams of carbohydrates should someone with diabetes eat per day? How many at each meal?
This is a very common question. About 45–60 grams of carbohydrates per meal is a good starting point when you are carb-counting. If you follow that recommendation, you will be eating a total of 135–180 grams of carbohydrates per day. However, some people may need more, and some may need less. Talk with your health care team to create an individualized meal plan to help you meet your health goals.
5. What types of fruit can I eat? Is canned or fresh fruit better for people with diabetes?
You can eat any type of fruit if you work it into your meal plan. Fruits are loaded with vitamins, minerals, and fiber. Fresh, canned, or frozen fruit without added sugars are all good options. You get a similar amount of nutrients from each. When you buy canned fruit, be sure the fruit has been canned in water or juice—not in syrup.
Fruit is nutritious, but it is not a “free food.” The following portions have about 15 grams of carbohydrates:
• 1 small piece of whole fruit such as a small apple, small orange, or kiwifruit
• ½ cup of frozen or canned fruit
• ¾–1 cup of fresh berries or melon
• ⅓–½ cup 100% no-sugar-added fruit juice
• 2 tablespoons of dried fruit
6. Besides meat, what can I eat to make sure I get enough protein?
There are many protein sources. Proteins that are low in saturated and trans fats are the best options. Choose lean sources of protein like these:
• Eggs, egg whites, and egg substitutes
• Vegetarian proteins: beans, soy products, veggie burgers, nuts, and seeds
• Low-fat or nonfat dairy products
• Fish and shellfish
• Poultry without the skin
• Cheeses with 3 grams of fat or less per ounce
• When you do eat meat, choose lean cuts
People with diabetes can follow a vegetarian or vegan diet. Plant-based diets that include some animal products like eggs and milk can be a healthy option. However, animal products are not necessary. A mix of soy products, vegetables, fruits, beans, and whole grains provides plenty of protein and nutrients.
7. Why should I eat whole grains instead of refined grains?
Even a food made with 100% whole-wheat flour will raise your blood glucose levels. All grains—whole or not—affect blood glucose because they contain carbohydrates. However, you shouldn’t completely avoid starchy foods. People with diabetes need some carbohydrates in their diet.
Whole grains are a healthy starch option because they contain fiber, vitamins, and minerals. Choose whole-wheat or whole-grain foods over those made with refined grains, but watch your portion sizes.
8. Can people with diabetes eat potatoes and sweet potatoes?
Yes! Starchy vegetables are healthy sources of carbohydrates. They also provide you with important nutrients like potassium, fiber, and vitamin C. You can include them in your meal plan as part of a balanced meal. Just pay attention to portion sizes and avoid unhealthy toppings. If you are carb counting, remember that there are about 15 grams of carbohydrates in:
• ½ cup of mashed potatoes
• ½ cup of boiled potatoes
• ¼ of a large baked potato with the skin
9. Without salt and fat, food tastes bland. What can I do?
When you are preparing healthy foods, try to limit added fats and extra salt. Look for recipes that use herbs (fresh or dried) and spices for flavor instead. There are many spice blends available in the baking aisle at the grocery store—choose salt-free blends. Other healthy ways to flavor your foods include:
• Squeezing lemon or lime juice on vegetables, fish, rice, or pasta
• Using onion and garlic to flavor dishes
• Baking meats with sugar-free barbecue sauce or any low-fat marinade
• Adding low-fat, low-calorie condiments, such as mustard, salsa, balsamic vinegar, or hot sauce
10. Are gluten-free products okay for people with diabetes to eat?
About 1% of the total population has celiac disease, which is an allergy to gluten—a protein found in wheat, rye, and barley. About 10% of people with type 1 diabetes also have celiac disease. People with celiac disease or gluten intolerance should follow a gluten-free diet.
However, unless you have one of these conditions, following a gluten-free diet is unnecessary and can make meal planning more difficult. Gluten-free products may contain more grams of carbohydrates per serving than regular products. For example, gluten-free bread can have twice as many grams of carbohydrates as whole-wheat bread. You can use gluten-free products and recipes, but just be sure to check the carbohydrate content and calories.
