What Can I Eat Now?
Once you’ve been diagnosed with type 1 or type 2 diabetes, knowing what foods are good for you and how to incorporate them into your lifestyle is essential. In this chapter, Cooking Light and the American Diabetes Association give you meal planning and lifestyle advice, practical answers to everyday questions, and an easy-to-understand glossary of the top Power Foods.
WHEN YOU EAT A MEAL, the levels of glucose in your blood naturally rise because of the sugars and starches in the food. In response to the elevated glucose, the pancreas secretes insulin, a hormone that tells the body’s cells to absorb the extra glucose. In type 1 diabetes, an autoimmune disease that occurs most frequently in young people but can be diagnosed at any age, the cells that produce insulin are destroyed and the body stops or greatly reduces the amount of insulin produced. With type 1 diabetes, you must inject or pump insulin daily.
In type 2 diabetes, the body does not produce enough insulin, is unable to use insulin to adequately lower blood glucose, or both. Ninety to 95 percent of people with diabetes have type 2 diabetes. A healthy diet and physical activity are major components of successfully treating and managing type 2 diabetes. In addition, people with type 2 diabetes may take medications, including insulin, to lower blood glucose levels.
An eating plan that includes lean protein, fruits and vegetables, beans, healthy fats, and fat-free dairy foods—all of which are Power Foods—can help control blood glucose levels and help prevent or control other complications of diabetes, such as heart disease and eye, kidney, and nerve damage.
To get started with making healthful changes, work toward incorporating the following eight essentials for good health into your daily life. But remember to be patient with yourself. It takes time for changes to your lifestyle to become habits, so focus on achieving one objective at a time.
8 Healthy Living Basics
1 INCORPORATE POWER FOODS INTO MEALS.
Power Foods are nutrient dense, meaning they are an excellent source of nutrients such as protein, heart-healthy fats, vitamins, minerals, and antioxidants. Power Foods are natural foods that have not undergone excessive processing that removes fiber or other nutrients. Once you know what the Power Foods are, they can form the foundation of meals you prepare at home as well as those you enjoy with family and friends away from home. As with all foods, enjoy Power Foods in serving sizes that fit into your personal eating plan. With each Power Food, you’ll find a list of recipes in the book that use the ingredient in a variety of great-tasting dishes.
2 CHOOSE “SMART CARBS.”
Whole grains, beans, and sweet potatoes are all high-carb foods, but they are “smart carbs” because they contain fiber, vitamins, minerals, and phytochemicals that are beneficial to your health. “Smart carbs” are nourishing, high-carbohydrate foods that are whole foods or minimally processed.
As an example, 1/3 cup of brown rice has about the same amount of carbs and calories as 1/3 cup of white rice. But brown rice is a “smart carb” because it has more fiber and is rich in B vitamins and trace minerals contained in the outer hull, bran, and germ, which are removed when white rice is produced.
Other “smart carbs” include fresh fruits; whole grains such as oats, quinoa, and wild rice; and 100% whole-grain breads and pastas. Serving size is still important, even for “smart carbs”: 1/3 to 1/2 cup is a typical serving size, depending on the food.
3 MINIMIZE ADDED SUGARS.
Sugary foods, such as cakes, cookies, pies, and brownies, should be occasional treats when you have diabetes since they cause blood sugars to spike. In addition to sugar, desserts usually contain butter or oil as well as other carbohydrates from white flour, making them high-calorie, low-nutrient additions to your meal.
You should, of course, sometimes treat yourself to a slice of birthday cake or a piece of pie, but you’ll need to substitute the dessert for other carbohydrates in your meal. For example, if you are going to enjoy a slice of cake that has 30 grams of carbs, you’ll need to eliminate a slice of bread from lunch (make your sandwich open-faced) to cut 15 grams of carbs and skip the potatoes at dinner to cut an additional 15 grams of carbs.
If sugars were only in desserts, it would be easy to track them, but they are also in many processed foods. Check labels on tomato sauce and pasta sauce, baked beans, frozen dinners, flavored instant oatmeal, flavored yogurt, and non-dairy milk (like soy milk). Sugar lurks in ingredients with names other than “sugar.” Look for honey, maple syrup, agave, molasses, high fructose corn syrup (sometimes called corn sugar), and turbinado (raw) sugar in the ingredient list on labels.
Avoid sugar-sweetened beverages. They have been linked to developing type 2 diabetes and worsening cardiovascular risk factors. Plus, they offer no nutritional value other than extra calories. Instead of drinking sugar-sweetened soft drinks, energy drinks, tea, and sports beverages, opt for artificially sweetened or unsweetened beverages or water.
4 BOOST FIBER.
Fiber is the indigestible part of fruits, vegetables, beans, and grains. All dietary fibers are either soluble or insoluble, and both are important for digestion, health, and preventing conditions such as heart disease, diabetes, and obesity. The difference is that soluble fiber dissolves in water, while insoluble does not. This affects how each benefits your health. Soluble fiber, found in beans, lentils, oats, apples, oranges, cucumbers, and carrots, attracts water, which slows digestion. Slow stomach emptying helps you feel full longer and may also have a beneficial effect on blood sugar levels. Insoluble fiber, found in whole grains, seeds, nuts, and vegetables, doesn’t dissolve in water, so it passes through the intestinal tract almost intact. This added bulk is beneficial for intestinal health.
High-fiber meals usually require a lot of chewing, which slows you down and makes you more attuned to when you’ve had enough to eat. Fiber adds no calories to your diet, yet it bulks up meals, making you feel full for a longer time.
The American Diabetes Association recommends a minimum of 25 grams of fiber a day for women and 38 grams for men. Most Americans consume only about half this amount. To incorporate more fiber into your everyday meals, choose a high-fiber breakfast cereal with no added sugars; add beans or lentils to soups and top your salads with seeds, nuts, and a variety of vegetables; choose 100% whole-grain breads and pastas; and enjoy whole fruits for snacks and desserts.
5 CHOOSE HEALTHY FATS.
All fats are high in calories—there are about 120 calories in a tablespoon of any type of oil—so you’ll want to keep portions small even for healthy fats. Fat is a vital component of your diet. You need fat for energy; absorption of vitamins A, D, E, and K; and for healthy hair and skin.
But for heart health, it’s important to make smart choices about the fats you do include in your meals. The key is to substitute mono- and polyunsaturated fats for trans and saturated fats. (Your diabetes educator or registered dietitian will help you learn to substitute healthy for unhealthy fats.) Saturated fats and trans fats raise your cholesterol levels and having high cholesterol is a key risk factor for heart disease. Limiting these fats is particularly important for people with diabetes, since having diabetes already puts you at high risk for heart disease.
Saturated fat is found in foods such as fatty meats, chicken and turkey skin, butter, cheese, whole-milk dairy products, lard, coconut oil, palm oil, and chocolate. Trans fat is produced when liquid oil is processed to turn it into a solid fat. It’s found in margarine, shortening, snack chips and crackers, commercially made cookies and cakes, and French fries. Read labels carefully. Avoid foods with the word “hydrogenated” in the ingredient list. Hydrogenated oil contains trans fat and manufacturers are allowed to list trans fat at 0 grams if the product contains less than 0.5 grams of trans fat per serving.
While cutting back on saturated and trans fat, you can substitute heart-healthy monounsaturated and polyunsaturated fats, and omega-3 fatty acids. For cooking oils, these include canola, olive, corn, cottonseed, safflower, sunflower, and soybean oils. They’re also found in avocados, nuts, sunflower seeds and pumpkinseeds, and fatty fish. Tuna, trout, sardines, and salmon are also excellent sources of omega-3 fatty acids.
6 LIMIT SODIUM.
Eating too much sodium can raise blood pressure, which increases the risk for heart attack or stroke. In people with type 2 diabetes, the risk for heart attack and dying from heart disease is the same as in people who have already had heart attacks, so keeping blood pressure in check is vital. Aim for 2,300 milligrams or less of sodium each day. If you have high blood pressure, talk to your health-care provider about the right amount for you.
You may be surprised to find out that it’s the salt found in processed foods that is the biggest source of sodium for most people. Reading labels is crucial. It’s important to choose products with the least amount of sodium—the amount can vary widely between different brands of the same type of product—or, even better, make your own versions at home. Soups, broths, soy sauce, packaged seasoning mixes, and snack foods are high in sodium, but other foods you wouldn’t think of as containing excess sodium can contain a surprisingly high amount, including bread, breakfast cereals, pre-marinated meats, condiments, and pasta sauces.
Cooking at home is one way to control everything that goes into your meals, but even then, it’s important to be mindful of how much salt (and high-sodium foods) you’re adding to your diet. If you often reach for the salt shaker to season food, try stirring in a pinch of grated lemon zest, a splash of lime juice or vinegar, or a spoonful of chopped fresh herbs to add lots of flavor and cut the amount of salt you need. When you begin to cut back on sodium, things may initially taste blander, but your taste buds will adjust, and over time, you’ll need less salt in your food.
7 WORK TOWARD AND MAINTAIN A HEALTHY WEIGHT.
Being overweight is strongly correlated with having type 2 diabetes—almost 90% of people with type 2 diabetes are overweight. If you weigh more than you should, losing 7% of your body weight can reduce your risk of developing type 2 diabetes. For example, if you weigh 200 pounds, losing 15 pounds, 7% of your body weight, can help control blood glucose, improve blood pressure and cholesterol levels, and give you more energy. Losing weight is most likely to help blood glucose if you have not had diabetes for a long time.
Talk with your registered dietitian who will personalize your weight-loss goals and eating plans to help you take off pounds sensibly and safely. When you change your eating and exercise patterns, you may need an adjustment in your insulin or other diabetes medications, so involving your health-care team is essential. Your dietitian can guide you to take small, easy-to-incorporate steps toward being more active and eating fewer calories, making it more likely that the changes will become an enjoyable part of daily life.
8 GET SOME EXERCISE.
Being physically active can help lower your blood glucose, keep you at a healthy weight, and help maintain a healthy heart. Health experts recommend 30 minutes of exercise at least five days a week. If this sounds like it’s more than you have time for, break it up into two 15-minute sessions when it fits into your schedule. You can do jumping jacks or jump rope while you watch TV, go for a walk, ride a bike, swim, take an exercise class, dance, or do an online workout at home.
If you have not been active, check with your health-care team before starting any strenuous exercises to make sure you’re choosing activities that are safe for you. Your insulin or other diabetes medications and your food intake may need to be adjusted when you start working exercise into your daily routine. Your diabetes educator or your physician will explain what you need to do to get fit while keeping your blood glucose at a steady level.
3 Ways to Manage Your Meals
There are three methods to choose from when planning what you eat each day. Meal planning is critical for people with diabetes to help improve blood glucose levels, balance food intake with insulin or other diabetes medications (if medications are prescribed), and help you maintain or lose weight and eat heart-healthy foods.
The method you use is up to you and your health-care team based on your individual needs. Whichever plan you choose, your registered dietitian will personalize the plan taking into account your food likes and dislikes, exercise level, daily work and activity schedule, and the diabetes medications you take.
1 CREATE YOUR PLATE
This is the easiest method for meal planning for people with diabetes. You simply use a dinner plate to decide how much to eat. One caveat: Use a 9-inch plate with this method, not an oversized one, to help keep portions in check.
Fill half your plate with colorful vegetables, such as green beans, carrots, broccoli, spinach, or salad greens. Fill one-fourth of your plate with a carbohydrate-containing food such as 100% whole-grain pasta or bread, brown rice, or sweet potatoes. Fill the remaining one-fourth with a protein-rich food, such as 3 ounces of chicken, lean beef or pork, fish, or tofu.
To round out your meal, enjoy a serving of milk or yogurt or a piece of fruit for dessert, or both, if your eating plan allows. Your registered dietitian will help you determine what’s right for your meals as well as snacks, based on your personal needs.
2 CARB COUNTING
Carb counting is a bit more complicated than the “create your plate” method. Your registered dietitian will tell you how many carbs you can have at each meal and for snacks if you enjoy eating between meals. Then, you decide which foods you will have based on the number of carbs they contain. Typically, the amount of carbs for meals will be somewhere between 45 and 60 grams and 15 grams for a snack.
For this method, you need to know how many carbs foods contain. You can look at the label, or if the food doesn’t have a label, use a carb-counting book, website, or app. At first, it may seem time consuming, but once you learn the carb count of the foods you commonly eat, you won’t have to look them up every time. Keep in mind that you need to match your serving size to the serving size on the label or in the book or app. It’s easy to focus only on carbs using this method, but you’ll also need to include lean protein in your meals, use heart-healthy fats, and watch calories if you are trying to maintain or lose weight.
3 FOOD CHOICES
The food choices system, previously called the exchange system, groups foods together based on their carbohydrate, protein, fat, and calorie levels. For example, starchy vegetables are grouped together, and the serving size of each one varies so that the carb, protein, fat, and calorie level for a serving is the same for the entire food list of starchy vegetables. In this category, a serving of corn is 1/2 cup, a serving of hominy is 3/4 cup, and a serving of winter squash is 1 cup. You can make “choices” for each meal from the food lists, using the serving sizes provided.
This method is more complicated to learn, but it helps with weight control because foods are grouped not only by the amount of carbs they contain, but also by the calories they have. In addition, serving sizes for each food are given within the food lists. The food choices method also helps with heart-healthy eating, since milk and yogurt are grouped as fat-free, reduced-fat, and whole milk choices, and protein foods are grouped as lean, medium-fat, and high-fat choices.
Your registered dietitian will work with you to set up an eating plan with the number of choices from each food list for each meal and snacks if you enjoy having them.
Real-Life Questions
SHOULD I CONSIDER THE GLYCEMIC INDEX OF FOODS?
The glycemic index (GI) is a measure of the rise in blood glucose after eating a serving of food that contains 50 grams of carbohydrate compared to the rise in blood glucose after eating pure glucose (sugar) or white bread. Foods with high GI raise blood glucose more than foods with low GI. Once you have mastered carb counting, choosing foods with lower GI/more fiber may be helpful in keeping your blood glucose in control.
One of the pitfalls of using GI as a method for choosing foods to eat when you have diabetes is that serving size is not taken into account. Split peas have a medium GI of 25. If you eat 1/3 cup, that’s only 14 grams of carbs, but if you eat 1 cup of them, it’s a whopping 42 grams of carbs.
Another problem with using GI is that the number the food is assigned is based on a serving size that contains 50 grams of carbohydrate, which may not be a typical serving size. For example, broccoli has a very low GI of 10. But, to get 50 grams of carbohydrate from broccoli florets, you would need to eat more than 13 cups.
Yet another issue with this method is that it’s based on eating single foods, not as in real life where you eat a combination of foods at once. You may know the GI of each particular food, but you don’t know what the GI would be of all the foods combined in your meal in the serving sizes you consume.
In general, though not always, low-GI foods are less processed, more wholesome foods. But don’t use GI as your only consideration in meal planning—you still need to take into account the grams of carbohydrate and serving sizes.
WHAT ABOUT NATURAL SWEETENERS LIKE AGAVE AND HONEY?
All added sugars (table sugar, agave, honey, brown sugar, syrup, molasses), no matter if they’re natural or not, should be used sparingly. Once any of these sugars are ingested, the body digests and absorbs them the same way and they have the same effect on blood sugar levels. However, some natural sweeteners, specifically agave and honey, are inherently sweeter than cane sugar and therefore smaller amounts can produce the same sweet taste.
WILL ARTIFICIAL SWEETENERS HELP ME CONTROL MY BLOOD SUGAR LEVELS?
Foods and beverages that use artificial sweeteners may help you control your sweet tooth. These sweeteners, also known as sugar substitutes or low-calorie sweeteners, have far fewer calories and carbohydrates and are also about 100 times more intense than regular sugar, which means you can use less while still satisfying your cravings for something sweet. Here are the sugar substitutes you’ll find in stores:
•Acesulfame potassium (brand names: Sunett, Sweet One)
•Aspartame (NutraSweet, Equal)
•Neotame
•Saccharin (Sweet ‘N Low, Sugar Twin)
•Sucralose (Splenda)
•Stevia/Rebaudioside A (SweetLeaf, Sun Crystals, Steviva, Truvia, Pure Via)
WHAT IS A SERVING?
No matter which method you use for meal planning, you must pay attention to serving sizes in order to help with blood glucose levels, calorie intake, and heart health. If you’re eating a packaged food with a label, the serving size is listed on the label with the nutrition information given for the serving. If you eat more or less of the food, account for the carbs and other nutrients accordingly.
Use books, websites, or apps to look up the nutrition information for foods without labels and enjoy the serving size given, or account for a larger or smaller portion in your meal plan. A typical diabetes-friendly serving of starchy foods such as brown rice, whole-wheat pasta, or stuffing is 1/3 cup, which has about 15 grams of carbohydrate. Examples of typical serving sizes of fruit are 1 cup of diced honeydew, a small banana (4 ounces), or 1/2 of a large pear (4 ounces). You can have a larger serving, but you have to count the total number of carbs in all the foods in your meal.
A heart-healthy serving of cooked meat, poultry, or fish is 3 ounces, about the size of a deck of cards. A serving of salad dressing or mayonnaise is 1 tablespoon; for an avocado, it’s 2 tablespoons; and for olive oil, it’s 1 teaspoon. These are much smaller servings than you are probably used to, especially when eating out.
Train your eye to estimate serving sizes by measuring or weighing servings of foods you frequently eat at home. Put the food in your plates and bowls, and after measuring foods a few times, you’ll be able to estimate the correct serving size just by looking. (If you change your dinnerware, you should remeasure since amounts can look different on plates that are different sizes or shapes.) You’ll soon become adept at estimating serving sizes, which can help determine how much food to eat when you are in a restaurant or in someone’s home.
HOW DO I MAKE SENSE OF A FOOD LABEL?
Food labels are a wonderful resource, but they can be puzzling. Next time you check one out, use this guide to help you decipher the numbers:
• The serving size indicates how much food is recommended for one portion. If you eat more or less than this amount, you’ll need to adjust the nutrients accordingly. (Pay special attention to the carbs!)
• Need to know how many single portions are in one jar, can, or package? Check the servings per container—you might be surprised at how often packages contain more than one serving.
• Food labels divide fats into total fat, saturated fat, and trans fat categories, but you’ll want to focus on the latter two. Always stay away from trans fats—those can be harmful to your health. (They’ve been found to raise “bad” LDL cholesterol and lower “good” HDL cholesterol.) As for saturated fats, the American Diabetes Association recommends a daily intake of less than 10 percent of total calories. This translates to 20 grams or less for a 2,000-calorie diet and 15 grams for a 1,500-calorie diet. And lastly, you’ll sometimes see monounsaturated and polyunsaturated fats’ names on the label too. These are good, heart-healthy fats that should be substituted for saturated and trans fats.
• Total carbohydrate, dietary fiber, and sugars are listed together, but the key player in this section is total carbohydrate. This number indicates the grams of carbohydrate in one serving, including fiber and sugars. You want the fiber number to be high—aim for a total of 25 grams per day for women and 38 grams per day for men. Sugars can include naturally occurring sugars (like lactose in yogurt), but also could indicate high levels of added sugars (like high fructose corn syrup).
• Protein is a daily essential that doesn’t affect your blood sugar much. According to experts, women need 46 grams a day and men need 56 grams. Most Americans easily exceed these amounts, but it’s a good idea to make sure you’re getting enough. If you’re a vegetarian (or an occasional one), don’t worry about eating certain foods together to create “complete” proteins—your body will make its own if you eat a variety of foods and a sufficient number of calories.
• Vitamin and mineral amounts for vitamins A and C, calcium, and iron are also noted on food labels. They usually appear as percentages, which are linked to the Recommended Daily Intake for each nutrient. Percent daily values indicate how much of a daily recommended vitamin or mineral you are consuming in a certain food. Most percent daily values are for a 2,000-calorie diet, though larger food packages often provide amounts for a 2,500-calorie diet. Keep in mind that the calorie level your health-care team recommends may be less than 2,000 calories.
WHAT SHOULD I ORDER IN A RESTAURANT?
Diabetes doesn’t mean your social life is over. Dining at restaurants is a normal part of life that you can enjoy; however, being prepared is key. Knowing how to order will help you dine healthfully and confidently and keep you from derailing your diet. Choose restaurants that offer a variety of dishes containing fresh fruits and vegetables and lean meats. Even many fast food establishments now offer healthier choices, so you can still make good decisions when you’re on the go. Once you’ve wisely chosen where to eat, these tips will help you order:
• Opt for appetizers that aren’t loaded with salt or fat. Veggies and hummus or a shrimp cocktail are better choices than chips and queso or French fries. If you’re trying to cut down on bread or eliminate it entirely from your diet, tell your waiter upfront not to bring it to your table. If you do eat bread, plain breads are best. Watch out for cornbread, biscuits, muffins, and other breads that are high in fat, sodium, and added sugar.
• When ordering meat, poultry, or fish, choose a baked, broiled, or grilled preparation, rather than fried or breaded. Salads and sides of fresh nonstarchy vegetables are better choices than starchy foods like potatoes and white rice. However, if you opt for the latter, choose brown rice or a sweet potato and keep the portion small. Be cautious of the dressings, sauces, and gravies that might come with veggies and meats and the sour cream, butter, and cheese that come on loaded potatoes. These supplements are often heavy on sodium, fat, and calories, so ask your waiter to serve them on the side.
• A serving of fresh fruit is a smart option for dessert. Even if it’s not listed on the menu, ask your waiter for a small bowl of sliced melon, berries, or citrus. If there’s another dessert on the menu you’d like, order one for the table and split it. Never hesitate to ask your server questions about the menu or be afraid to ask for a substitute side that’s better for your eating plan. Restaurants are generally happy to accommodate requests like preparing foods without salt as long as you ask.
Asparagus
Health Benefits
These elegant stalks do more than dress up a dinner plate. Asparagus has the highest level of any vegetable of glutathione, a powerful antioxidant that helps detoxify and maintain a healthy immune system. It is a good source of folate, which is vital for making new cells, especially during pregnancy; potassium, which helps control blood pressure; and vitamin K, which helps make proteins required for proper clotting of blood. Asparagus is very low in carbohydrates, so it will not cause blood sugar to rise.
Did You Know?
Asparagus takes three years to mature from planting to the first harvest; the spears are harvested individually by hand. Because the tips are so delicate, great care must be taken to transport asparagus from the field to the packinghouse, and damaged spears must be sorted out individually. For these reasons, asparagus is one of the most expensive—yet, most delicious—vegetables.
Serving size: 1 cup raw or 1/2 cup cooked
Carb counting: 5 grams
Food Choice: 1 Nonstarchy Vegetable
Recipes
Asparagus and Spring Greens Salad with Gorgonzola Vinaigrette
White Bean Salad with Shrimp and Asparagus
Asparagus-and-Spinach Toasts with Fontina Cheese
Asparagus with Balsamic Tomatoes
Avocados
Health Benefits
Given their buttery texture, it’s not surprising that avocados are high in fat, but the fat they primarily contain is monounsaturated fat, which helps lower cholesterol and decreases the risk of heart disease. Use avocado in place of sat fat–loaded butter on toast. Studies have shown that people who eat more unsaturated fat are less likely to develop type 2 diabetes. Avocados are a good source of fiber and vitamins C and E, as well as the antioxidant lutein.
Did You Know?
Ninety percent of America’s avocados come from southern California, where they grow year round; a single tree can yield up to 500 avocados. Hass avocados, with their dark green bumpy skins and creamy flesh are the most popular variety. Botanically, avocados are a fruit, but because of their high fat content, the American Diabetes Association counts them as a fat.
Serving size: 2 tablespoons
Carb counting: 2 grams
Food Choice: 1 Fat
Recipes
Grilled Salmon and Avocado Pitas
Chipotle Grilled Pork Tenderloin with Strawberry-Avocado Salsa
Beans (black, garbanzo, kidney, pinto, white)
Health Benefits
Not only are beans an excellent source of protein and fiber, but they are particularly important for people with diabetes because they have been shown to lower blood glucose levels, reduce cholesterol, and help with weight loss. Dried beans are a good source of minerals including potassium and calcium as well as folate and other B vitamins.
Did You Know?
Eating beans is one of the best ways to meet the daily fiber goal of 25 grams for women and 38 grams for men. Depending on the variety, 1/2 cup of beans provides 6 to 10 grams of fiber. Use them in soups, stews, and casseroles, add them to salads, or turn them into dips. When buying canned beans, choose unsalted beans, or, if you’re using regular canned beans, rinse them before using to remove about 40 percent of the sodium.
Serving size: 1/2 cup cooked
Carb counting: 24 grams
Food Choices: 1 Starch, 1 Lean Protein
Recipes
Rosemary-Garlic White Bean Spread
Spicy Bean and Quinoa Salad with “Mole” Vinaigrette
Coriander-Crusted Beef Salad with Black Bean Salsa
Southwestern White Bean Pita Pockets
Berries (blueberries, raspberries, strawberries)
Health Benefits
All varieties of berries are a rich source of antioxidants, which may reduce the risk of cancer, improve heart health, and aid memory. Raspberries are particularly high in fiber, with 8 grams in a 1-cup serving. Blueberries are ranked highest in antioxidants among 43 fruits and vegetables tested by the U.S. Department of Agriculture and, in one study, were found to improve insulin sensitivity. Just 8 strawberries contain more vitamin C than a medium orange. To reap the benefits of berries, include a variety of them in your meals and snacks.
Did You Know?
Berries are the perfect healthy snack or dessert for people with diabetes. They’re naturally sweet, almost effortless to prepare (they just need a quick rinse under the faucet), and absolutely delicious.
Serving size: 11/4 cups whole strawberries, 1 cup raspberries, or 3/4 cup blueberries
Carb counting: 15 grams
Food Choice: 1 Fruit
Recipes
Chile-Spiced Fruit Salad with Queso Fresco
Crunchy Noodles and Greens Salad
Creamy Blueberry-Chicken Salad
Strawberry, Pistachio, and Goat Cheese Pizza
Broccoli
Health Benefits
This deep green vegetable may be one of the world’s healthiest—especially for people with diabetes. With very few calories and few carbohydrates to affect blood sugar, broccoli packs in the nutrients with a good amount of vitamin C, antioxidants, folate, and fiber. It contains a high amount of glucosinolates, compounds that may fight against cancer and play a role in reducing heart disease risk.
Did You Know?
Broccoli is a member of the cruciferous vegetable family that includes cabbage, Brussels sprouts, cauliflower, kale, and collards. This entire family of vegetables is associated with health benefits, but overcooking can destroy the health-promoting components of these veggies. For the most health benefits and the best flavor, lightly steam broccoli and other cruciferous vegetables just until crisp-tender.
Serving size: 1 cup raw broccoli or 1/2 cup cooked
Carb counting: 5 grams
Food Choice: 1 Nonstarchy Vegetable
Recipes
Broccoli-Quinoa Casserole with Chicken and Cheddar
Broccoli with Quinoa and Bacon
Citrus (grapefruit, lemons, limes, oranges)
Health Benefits
Of course they have vitamin C, but citrus fruits also have other antioxidants that protect the heart by reducing inflammation in the arteries and lowering cholesterol. They’re also a good source of potassium, magnesium, and folate. Citrus fruits contain a moderate amount of carbohydrates, few calories, no sodium, and plenty of fiber making them an optimal choice for people with diabetes and heart disease.
Did You Know?
Oranges and grapefruit are a good source of fiber and will help you feel full longer. They are perfect for adding to salads to boost flavor and nutrients and they make an excellent diabetes-friendly snack any time of day. One word of caution: Grapefruit can interact with some heart medications, so check with your doctor about the safety of consuming the fruit. Lemons and limes are another source for a bit of citrus juice and flavor.
Serving size: 1 medium orange or 1/2 of a large grapefruit
Carb counting: 15 grams
Food Choice: 1 Fruit
Recipes
Tomato-and-Mango Salad with Curry-Orange Vinaigrette
Orange Salad with Arugula and Oil-Cured Olives
Orange and Mustard–Glazed Pork Chops
Fresh Fruit with Strawberry Sauce
Fatty fish (arctic char, salmon, tuna)
Health Benefits
Salmon and albacore tuna are some of the best sources of heart-healthy omega-3 fatty acids, which may decrease abnormal heartbeats, decrease triglyceride levels, slow the growth of atherosclerotic plaque, and lower blood pressure. They are excellent sources of protein and good-for-you unsaturated fat. Fish contains no carbohydrate, so it will not cause a rise in blood glucose.
Did You Know?
Mercury in fish is a concern for women who are pregnant or breastfeeding. The Food and Drug Administration recommends women in this group should limit their intake of albacore tuna to 6 ounces each week. However, salmon and canned light tuna are two of the fish recommended by the FDA for having the lowest amount of mercury. Check FDA.gov for updated information regarding fish safety.
Serving size: 3 ounces cooked
Carb counting: 0 grams
Food Choices: 3 Lean Proteins
Recipes
Grilled Salmon and Spinach Salad
Open-Faced Salmon Sandwiches with Tomato and Avocado
Broiled Salmon with Marmalade-Dijon Glaze
Flaxseed
Health Benefits
Flaxseed contains alpha-linolenic acid, a type of omega-3 fatty acid that boosts heart health. It is an excellent source of soluble fiber, which is thought to bind with cholesterol in the intestine to prevent it from being absorbed. It also makes blood cells less sticky, which may lower the risk of atherosclerosis.
Did You Know?
Flaxseed is better digested if ground before eating. If eaten whole, it may pass through the intestine undigested and you will not get its nutritional benefits. You can buy flaxseed already ground, or grind your own in a coffee grinder at home. Because of its high fat content, it will stay fresh longer if stored in the refrigerator or freezer.
Serving size: 11/2 tablespoons
Carb counting: 1 gram
Food Choice: 1 Fat
Recipes
Parmesan-Rosemary Flatbread Crackers
Confetti Rice Pilaf with Toasted Flaxseed
Mixed Berry, Flaxseed, and Yogurt Parfaits
Greens (kale, leafy greens, spinach)
Health Benefits
Rich in omega-3 fatty acids; antioxidants; calcium; vitamins A, B, C, and K; and fiber, leafy greens are a nutritional powerhouse for people with diabetes. One study found that consumption of these healthful greens may help lower the risk of type 2 diabetes and may protect against several kinds of cancer.
Did You Know?
Kale chips are increasingly popular, and they make a terrific low-carb snack for people with diabetes. It’s best to make your own kale chips by simply tossing 2-inch pieces of kale leaves very lightly in olive oil and baking at 350° for 15 minutes. If you buy them already made, check the label first. Some varieties are fried, making them high in calories, and some brands are high in sodium.
Serving size: 1 cup raw or 1/2 cup cooked
Carb counting: 5 grams
Food Choice: 1 Nonstarchy Vegetable
Recipes
Kale Salad with Apple and Cheddar
Quinoa-Stuffed Kale Rolls with Goat Cheese
Melon (cantaloupe, honeydew)
Health Benefits
Cantaloupe is a great source of vitamins A and C as well as potassium and B vitamins. It’s also a good source of fiber and contains antioxidants, which may help prevent cancer and heart disease, conditions that occur more often in people with diabetes. Cantaloupe may help lower inflammation, which can play a part in developing diseases such as cancer. Honeydew melon has less vitamin C than cantaloupe but has similar levels of other nutrients.
Did You Know?
Simple slices or cubes of cantaloupe and honeydew make healthy, delicious summertime snacks and desserts. As a precaution, always wash the skin of melons in warm soapy water before cutting them. This removes any dirt or debris that might transfer to the flesh when you cut the melon with a knife.
Serving size: 1 cup diced melon
Carb counting: 15 grams
Food Choice: 1 Fruit
Recipes
Minty Cucumber and Honeydew Salad
Milk, fat-free
Health Benefits
As an excellent source of calcium, vitamin D, and protein, fat-free milk is a great choice for people with diabetes. Having diabetes can increase the chance of bone fracture, and calcium in milk can help keep your bones strong and guard against osteoporosis, which can lead to broken bones in older adults. Including milk and dairy foods in meals can help lower blood pressure and reduce the risk of type 2 diabetes and cardiovascular disease.
Did You Know?
Surprisingly, milk contains a significant amount of carbohydrate. The carbohydrate comes from lactose, the naturally occurring sugar found in milk, and should be counted toward the carb choices for your meal or snack. Even if you choose lactose-free milk, it still contains lactose; it just has an enzyme added to help those with lactose intolerance digest the milk.
Serving size: 1 cup
Carb counting: 12 grams
Food Choice: 1 Fat-Free Milk
Recipes
Nuts
Health Benefits
Tree nuts, such as almonds, pecans, pistachios, and walnuts, contain monounsaturated fat, a heart-healthy unsaturated fat that can help lower the risk for type 2 diabetes and help lower blood cholesterol. A serving of tree nuts is a healthy alternative to chips when you’re craving a crunchy snack. Walnuts are the superstars of the nut family; they are the only type that contains significant amounts of alpha-linolenic acid, the plant source of omega-3 fatty acids. Walnuts may also have a helpful effect on metabolic syndrome, a group of risk factors including obesity, high blood pressure, and high blood glucose levels that increase the risk for developing type 2 diabetes and liver, kidney, and heart diseases.
Did You Know?
Although nuts are high in calories and should be enjoyed in small amounts, they are an excellent snack for people with diabetes. A few nuts in addition to a small piece of fruit in the afternoon will provide you with the energy you need to keep you going until dinner. The fat from the nuts will help you feel full, and the carbohydrate from the fruit will give you energy. Pine nuts, which are seeds and not true nuts, also offer similar benefits.
Serving size: 4 walnut halves, 6 almonds, 4 pecan halves, or 16 pistachios
Carb counting: 5 grams
Food Choice: 1 Fat
Recipes
Cinnamon-Raisin Waffle Sandwich
Baby Arugula, Pear, and Gorgonzola Salad
Raspberry and Blue Cheese Salad
Kale and Beet Salad with Blue Cheese and Walnuts
Sautéed Spinach with Raisins and Pine Nuts
Oats
Health Benefits
Oats are known for their cholesterol-lowering abilities, but some studies have shown that they may also help reduce the risk of type 2 diabetes, control blood pressure, improve the immune system, and increase levels of appetite control hormones. Oats contain a group of antioxidants called avenanthramides, which protect blood vessels from the harmful effects of LDL (“bad”) cholesterol. And they are an excellent source of beta-glucan, a soluble fiber that can help lower blood glucose levels.
Did You Know?
It’s healthier if you use rolled oats or steel-cut oats instead of using pre-sweetened packages, which contain a lot of added sugar. Prepare your own oatmeal and top it with a handful of berries, a small chopped apple, or half a sliced banana to lend natural sweetness. You can also add rolled oats to dishes such as meatloaf and pancakes to add texture and fiber.
Serving size: 1/4 cup dry oats or 1/2 cup plain cooked oatmeal
Carb counting: 14 grams
Food Choice: 1 Starch
Recipes
Peanut butter
Health Benefits
A smear of peanut butter on your sandwich will not only taste great, but it’s also an excellent source of protein, fiber, vitamin E, potassium, magnesium, and cancer-fighting antioxidants. Consuming peanuts or peanut butter, which contain unsaturated fat, has been shown to lower cholesterol and triglycerides, which reduces the risk of heart disease. Use peanut butter in place of butter on toast or in place of chocolate for a snack.
Did You Know?
Peanuts are not a true nut but legumes that grow in their shells underground; their nutritional profile is similar to that of nuts that grow on trees. When choosing peanut butter, select a “natural” brand without added sugars. Skip “reduced-fat” brands, which include sugars and other additives. You’ll only save about 5 calories in a tablespoon, and you’ll take in more carbs. Peanut butter is the perfect snack for people with diabetes because it contains protein and fat, which take longer to digest and help you feel full longer.
Serving size: 1 tablespoon
Carb counting: 4 grams
Food Choice: 1 High-Fat Protein
Recipes
Curried Beef with Peanut-Coconut Sauce
Peanut Butter Ice Cream Sandwiches
Peanut Butter-and-Jelly Sandwich Cookies
Quinoa
Health Benefits
Quinoa is one of the few grains that contain all nine essential amino acids that are needed by the body. Compared to other grains, quinoa has a higher amount of protein, antioxidants, and vitamin E. With 2 grams of fiber in 1/3 cup of cooked quinoa, it is an excellent source of fiber. Fiber is important for people with diabetes because it may help improve blood glucose control, helps lower cholesterol, and makes you feel full.
Did You Know?
Quinoa was grown as long as 4,000 years ago in the Andes, where this drought-resistant plant still flourishes. White and red quinoa are the most common varieties, but there are more than 120 different types. Not a true “grain,” quinoa is a relative of Swiss chard and beets. Quinoa leaves, though they are not marketed in the U.S., are edible.
Serving size: 1/3 cup cooked
Carb counting: 13 grams Food Choice: 1 Starch
Recipes
Curried Quinoa Salad with Cucumber-Mint Raita
Chicken and Asparagus in White Wine Sauce
Quinoa with Roasted Garlic, Tomatoes, and Spinach
Red bell peppers
Health Benefits
Low calorie and low carb, red bell peppers are an exceptional choice for people with diabetes. They are an excellent source of vitamins A and C, potassium, folate, and fiber. A medium-sized red bell pepper has double the amount of vitamin C as a medium orange, and a 1/2-cup serving of red bell pepper gives you almost half the vitamin A you need for the day. Bell peppers contain some of the same health-promoting sulfur-containing compounds associated with cruciferous vegetables such as broccoli and Brussels sprouts.
Did You Know?
Red peppers are nutritionally superior to green or yellow bell peppers because they are riper, so they develop more vitamins and antioxidants as they mature. This also means they are more expensive than other colors, since they stay on the plant longer to develop their bright red color.
Serving size: 1 cup raw or 1/2 cup cooked
Carb counting: 5 grams
Food Choice: 1 Nonstarchy Vegetable
Recipes
Goat Cheese and Roasted Pepper Panini
Speedy Chicken and Cheese Enchiladas
Roasted Peppers and Tomatoes with Herbs and Capers
Soy
Health Benefits
Soy foods such as tofu, edamame, and soy milk are linked with lower risks of breast and endometrial cancer and may help women under 65 with cognitive function. Studies on soy are inconclusive, but some researchers have found that soy may have cholesterol-lowering abilities and protective effects against obesity, diabetes, and bone and kidney diseases. Soy products supply a generous amount of protein for few calories and a modest amount of fat.
Did You Know?
Unsweetened soy milk has 7 grams less carbohydrate in a 1-cup serving than regular fat-free dairy milk. When choosing soy milk for a beverage or for cooking, choose an unsweetened variety with added calcium and vitamin D. Check the ingredients list on the package to find out if your favorite brand is fortified with these important nutrients.
Serving size: 1 cup regular plain soy milk
Carb counting: 8 grams
Food Choices: 1/2 Carbohydrate, 1 Fat
Serving size: 4 ounces tofu
Carb counting: 3 grams
Food Choice: 1 Medium-Fat Protein
Recipes
Chicken, Edamame, and Rice Salad
Flank Steak and Edamame with Wasabi Dressing
Tomatoes
Health Benefits
Tomatoes are an excellent source of many antioxidants, including lycopene, which help eliminate free radicals that cause damage to DNA. Lycopene is associated with decreasing cancer risk and protecting against stroke. Tomatoes contain good amounts of vitamins A and C, potassium, and fiber. They are an excellent vegetable for people with diabetes because one cup of red tomato contains only about 32 calories and 7 carbohydrates.
Did You Know?
A study from Marseille, France, found that most of the antioxidants in tomatoes are found in their skins, so don’t bother peeling tomatoes. When they are sliced or chopped to put on a sandwich or use in a salad, the skins are barely noticeable anyway, so keep the nutrients and the skin intact.
Serving size: 1 cup raw or 1/2 cup cooked
Carb counting: 7 grams
Food Choice: 1 Nonstarchy Vegetable
Recipes
Thai Basil Beef with Rice Noodles
Speedy Chicken and Cheese Enchiladas
Scallops with Capers and Tomatoes
Whole grains (barley, brown rice, bulgur, wheat)
Health Benefits
Whole grains contain the bran, germ, and endosperm—the parts of the grain that provide essential nutrients such as fiber, folate and other B vitamins, magnesium, and chromium. The fiber in whole grains is a carbohydrate, but it is not digested, so it does not raise your blood sugar. For this reason, whole grains are a superior choice over products made from processed grains, such as white flour or white rice, for people with diabetes. The extra fiber also helps you feel full longer after you eat, aids in digestion, and helps keep blood cholesterol in check.
Did You Know?
Breads, cereals, and crackers made with processed grains lose most of their nutrients during manufacturing. Food companies add back or “fortify” processed grains with vitamins including iron, folate, and other B vitamins to replace what was removed in processing.
Serving size: 1/2 cup cooked bulgur, 1/3 cup cooked barley, brown rice, or whole-wheat pasta; 1 slice whole-wheat bread
Carb counting: 15 grams
Food Choice: 1 Starch
Recipes
Curry Chicken Wraps with Nectarine Chutney
Yogurt, fat-free
Health Benefits
Yogurt is an excellent source of protein, calcium, potassium, and vitamin D. It is also a great source of probiotics, the “good” bacteria that may have health benefits ranging from boosting the immune system to helping with irritable bowel syndrome. Studies have found a link between eating yogurt and reduced risk of type 2 diabetes and high blood pressure.
Did You Know?
Greek yogurt is regular yogurt with some of the liquid whey or protein strained off. Because it is more concentrated, it has twice the protein of regular yogurt and makes a healthy snack or a rich-tasting sour cream substitute. Just be sure to read the label carefully and choose a plain fat-free yogurt with no added sugars and fortified with vitamin D.
Serving size: 1 cup plain fat-free yogurt
Carb counting: 18 grams
Food Choice: 1 Fat-Free Milk
Recipes
Curried Quinoa Salad with Cucumber-Mint Raita
Turkey Pitas with Tahini-Yogurt Sauce