What foods to avoid and common questions about healthy eating

Healthy eating is one of the most important areas of your comprehensive diabetes treatment plan. It is also an integral part of how we maintain the health of our bodies, in general. So, it’s no wonder that individual with type 2 diabetes have many questions about what they eat and dietary strategies that they can use to help control blood glucose and prevent common complications associated with diabetes.

In this section, we’ll address some of the common questions that people have about eating and diabetes.

Frequently asked questions about diabetes and diet

  • What foods should I avoid and what foods are healthy for me?
  • What can I do to make sure I stick to my eating plan when I eat out?
  • What should I do about eating during the holidays?
  • Is alcohol safe to drink and how much can I have?
  • What do I do if I get busy and miss a meal?
  • If I’m pregnant and have diabetes, should I change my eating plan?
  • What are “free foods”?
  • Should I do anything to change my eating plan when I’m sick?
  • Are sugar substitutes safe and do they have calories

What foods should I avoid and what foods are healthy for me?

If you have type 2 diabetes, you can still enjoy a broad range of foods. However, there are some types of foods you should limit your consumption of and others that should make up most of what you eat.

In general, you should avoid or limit consumption of snacks and desserts that are high in calories (cake, ice cream (with full fat and sugar), sodas (with sugar), fruit drinks (with sugar), and fried snacks, such as potato chips or corn chips. Also, you should reduce your consumption of red meat and make sure that you consume only low-fat or fat-free dairy products. In place of solid fats, such as butter, margarine, and shortening, use instead liquid oil, such as olive oil and canola oil. In terms of the foods that are safe for you, you should focus your eating on vegetables, fruits, and whole grains.1

Foods to avoid1

Foods that contain saturated fats
  • High-fat dairy products
  • Animal proteins (beef, hot dogs, sausage, bacon)
  • These food should make up no more than 7% of your daily caloric intake
Foods that contain trans fats
  • Found in processed snacks, baked goods, shortening, and stick margarine
  • You should avoid trans fats completely
Cholesterol
  • Sources include high-fat dairy product
  • High-fat meats
  • Egg yolks
  • Shelfish
  • Organ meats
  • You should take in no more than 300 mg of cholesterol per day
Sodium
  • Limit your daily consumption to under 2,300 mg

Foods to eat1

Healthy carbohydrates
  • Fruits, vegetables, whole grains, legumes (beans, peas, lentils)
  • Low-fat dairy products
High-fiber foods
  • Dietary fiber (the part of plant foods that you can’t digest) is useful in controlling blood glucose and reducing cardiovascular risk
  • Fruits, vegetables, whole grains (whole-wheat flour and wheat bran), legumes (beans, peas, lentils)
Heart-healthy fish
  • Enjoy fish such as cod, tuna, and halibut (they have less fat and cholesterol than meat and poultry) 2 times per week
  • Salmon, mackerel, tune, sardines, and bluefish contain omega-3 fatty acids, which promote heart health
  • Avoid fried fish and limit consumption of fish containing mercury (swordfish, tilefish, king mackerel)
“Good” fats
  • Foods that contain monounsaturated and polyunsaturated fats (avocados, almods, pecans, walnuts, olives, canola oil, olive oil, peanut oil) can reduce your blood cholesterol
  • Include these foods in your diet to get your daily fat intake, but be careful not to eat too much because all of these foods are high in fat and calories

What can I do to make sure I stick to my eating plan when I eat out?

We all love to eat out (the average American eats out 5 to 6 times a week) and if you have diabetes you don’t have to give up this pleasure. You can still go to a restaurant with friends and family and have a wonderful eating experience, but you will enjoy it all the more by sticking with your diabetes eating plan. Here are some healthy eating tips for when you eat out:2:

  1. Ask your waiter or waitress about ingredients and serving sizes of items on the menu. Many restaurants have this information readily available for health-conscious diners.
  2. Use your judgment when it comes to portion size. Having diabetes will make you an expert when it comes to nutrition and estimating calories. You never have to eat all of what is serve to you at a restaurant (typically portion sizes at restaurants are on the large size) and you can always ask for a doggy bag. Get used to taking home some of your meal. This way you’ll get to enjoy your meal out twice as much as your eating companions!
  3. Ask your waiter or waitress to prepare your meal with a minimum of high-fat products. Ask for no butter or less butter and request that sauces, sour cream, butter, salad dressings, and gravy be served on the side. Getting these high-fat items served on the side will allow you to control how much you use.
  4. Always choose broiling and baking over frying. Order meats or fish that are broiled, baked, poached, or grilled, as opposed to fried and ask for substitutions for fried side items (instead of french fries, ask for a baked potato or extra veggies).
  5. Talk to your healthcare provider about how you should adjust your insulin or medication dose when you are eating out.

What can I do to stick to my eating plan during the holidays?

Holidays can turn out to be eating-intensive occasions and can be a train wreck for any eating plan. One strategy you can use during holidays is to divide your total food into smaller meals or snacks that can be spread out over the course of the day. Since you’ll be around food all day, this will allow you to partake, without exceeding your daily calorie totals too much.

Is alcohol safe to drink and how much can I have?

If you have diabetes, you can still enjoy drinking alcohol. However, the key is to drink in moderation. Since alcohol contains calories (but no nutrients), you’ll need to include the alcohol you consume along with all of the other foods that you eat to come up with your total daily calorie intake. In figuring out total calories for alcoholic drinks, substitute alcohol for fat calories, with 1 drink equal to 2 fat servings (90 calories).2

Alcohol, especially when it is consumed on an empty stomach, can result in a decrease in your blood glucose if you are being treated with insulin or diabetes medications that increase insulin secretion (called secretatogues), including sulfonylureas and glinides (repaglinide and nateglinide). So, when you drink alcohol you should eat something along with it to avoid getting hypoglycemia.2

Learn more about hypoglycemia.

What do I do if I get busy and miss a meal or change the timing of my eating?

One thing you should do if you have diabetes, is get into the habit of taking small, healthy snacks along with you wherever you go. If you miss a meal (you may get stuck in traffic or get busy at work), you can always have your snack and avoid getting hypoglycemic.

If you have diabetes, you will need to get in the habit of thinking through your daily eating and anticipating potential problems. In terms of the timing of meals, if you are making a departure from the usual timing of your meals (say you are having brunch over the weekend or having a late dinner), make sure that you have a snack at the appropriate time before to keep your blood glucose at a predictable level. This is especially important if you have a regular dosing schedule for insulin or oral diabetes medications.

If I’m pregnant and have diabetes, should I change my eating plan?

If you are pregnant or planning to become pregnant, you should speak to your healthcare provider about how this will affect your diabetes eating plan. You will want to work with your healthcare provider and obstetrician and dietitian to change your plan to make sure that you get the extra calories and nutrients that your baby will require for healthy growth. For instance, chances are, you will need to increase how much protein, calcium, iron, and vitamins you get during your pregnancy.

Some important things to consider when revising your dietary plan for pregnancy include2:

  • How much you should increase your total daily calorie intake
  • Whether a prenatal vitamin supplement is necessary
  • How you should spread out your total calories in meals and snacks over the course of the day
  • Whether you should monitor your blood glucose during the day and how often

What are “free foods”?

Certain sugar-free foods, including sugar-free gelatin, diet soda, and sugar-free gum, contain a minimal amount of calories or carbohydrates. “Free food” is defined as food containing less than 20 calories and less than 5 grams of carbohydrates. These foods can be consumed without concern for weight gain or the need for additional insulin.

Should I do anything to change my eating plan when I’m sick?

When you’re sick it is difficult to stick to your diabetes eating plan. You may not be able to keep foods down. This can result in a loss of control of blood glucose. If you are sick you should check your blood glucose periodically (every 4 hours) and keep track of the results. If you take diabetes medications, continue to take them, even if you are having a hard time keeping foods down. Make sure you drink at least 1 cup of water or another calorie-free liquid per hour during waking hours. Even if you can’t eat the foods you typically eat, try eating crackers, popsicles, soup, or drinking juice. If you are having a hard time keeping foods down, try drinking something with sugar in it (ginger ale or another clear liquid or a cracker) so that you still get the calories you need. When you’re sick your risk for becoming hypoglycemic increases. Symptoms of hypoglycemia vary from person to person, but may include sweating, trembling, feeling anxious, feeling weak, having difficulty with vision, and becoming confused. If unaddressed, hypoglycemia may also lead to unconsciousness or seizure.3

Are sugar substitutes safe and do they have calories

There are six noncaloric sweeteners approved by the FDA (aspartame, saccharin, acesulfame-K, neotame, stevia, and sucralose). These are safe for most people. There are two exceptions to this. Women who are pregnant or breastfeeding should not consume products sweetened with saccharin and people who have a condition called phenylketonuria (a type of inherited disorder affecting metabolism) should not consume foods with aspartame.2

Another group of sweeteners called polyols includes sorbitol, xylitol, lactitol, mannitol, and maltitol. These are low-digestible carbohydrates that have on average 2 calories per gram. These are often found in ice cream, baked goods, chocolate, and chewing gum and will increase blood glucose after eating, but to a less extent than sugar. Polyols may potentially reduce overall blood glucose levels and may also be useful in reducing caloric intake. So, these sweeteners are a potentially valuable tool in both glycemic control and weight loss. In some individuals, polyols may cause gastrointestinal symptoms, including gas and diarrhea. In calculating total carbohydrates, one-half of the sugar alcohol content should be counted.4

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Written by: Jonathan Simmons | Last reviewed: May 2014.