Healthy nutrition for people with type 2 diabetes

Getting proper nutrition is an important part of healthy living for any person. However, this is especially true for people with type 2 diabetes, because diabetes is a disorder of metabolism, a word that means how our body uses the food you digest for growth and energy. With diabetes something goes wrong with the way our body processes the food we take in, interfering with our ability to use that food for energy and to maintain our health. So, a healthy eating plan that supplies the proper nutrients (carbohydrates, fat, protein, and vitamins and minerals) and works to control the elevated blood glucose, as well as blood pressure and lipids, is not just optional, but is a necessary part of any diabetes treatment plan.

It’s important to make good decisions when it comes to putting together healthy meals. This includes selecting foods according to their nutrient content (how much and what kinds of carbohydrates, fat, and protein a food contains).

In general, you a healthy pattern of eating should focus on getting1:
Carbohydrates from fruits, vegetables, whole grains, legumes, and low-fat milk, rather than other carbohydrate sources, such as those containing fats, sugars, and sodium.
Protein from leaner meats and other sources of protein, including meat alternatives.
Fat from sources of polyunsaturated (eg, fish, olive oil, nuts) and monounsaturated fats (eg, nuts, vegetable oils, canola oil, olive oil, avocado), limiting saturated fats (red meats, butter, cheese, margarine, and shortening) and trans fats (processed and fried foods) to no more than 10% of daily calorie intake.

In this section, we’ll make some specific recommendations for meal planning based on how specific groups of foods, including:

  • Starches (bread, grains, cereals, starchy vegetables)
  • Fruits
  • Vegetables
  • Milk and dairy products
  • Meats (including fish) and meat substitutes
  • Fats and sweets

Total calories per day

One of the first things that you’ll do when you work with your dietitian to put together a diabetes eating plan will be to determine a daily calorie target that is right for you. Your total daily calorie target will depend on many different personal factors, including your blood glucose level, whether you rely on medications or insulin to control your blood glucose, your body size, whether you are overweight (and how much), how active you are (this will determine how many calories you burn during a day), and if you have other medical conditions that affect your dietary needs.

Here are some examples of ranges of total daily calorie intake that take into account some of the personal factors that determine calorie needs. (We give examples of what constitutes a serving below.)

Total daily calorie range: 1,200-1,600 calories per day. This range would be appropriate for a small woman who is active, small-to-medium sized women who need to lose some weight, or a medium-sized woman who is not active (does not exercise regularly).2

Here’s an example of a meal plan that would allow you to reach this goal of 1,200-1,600 calories per day. Your meals (and snacks) during a typical day might include:

  • 6 servings of starches
  • 2 servings of milk
  • 3 servings of vegetables
  • 4 to 6 ounces of meat or meat substitutes
  • 2 servings of fruits
  • 3 fats

Total daily calorie range: 1,600-2,000 calories per day. This range would be appropriate for a large woman who needs to lose some weight, a small man who is at a healthy weight, a medium-sized man who is not very active, or a medium- or large-sized man who needs to lose some weight.2

Here’s an example of a meal plan that would allow you to reach this goal of 1,600-2,000 calories per day. Your meals (and snacks) during a typical day might include:

  • 8 servings of starches
  • 2 servings of milk
  •  4 servings of vegetables
  • 4 to 6 ounces of meat or meat substitutes
  • 3 servings of fruits
  • 4 fats

Total daily calorie range: 2,000-2,400 calories per day. This range would be appropriate for a medium- or large-sized man who is very active (either exercises a lot or has a job that requires a high level of physical activity), a large-sized man who is at a healthy weight, or a medium- or large-sized woman who is very active.2

Here’s an example of a meal plan that would allow you to reach this goal of 1,600-2,000 calories per day. Your meals (and snacks) during a typical day might include:

  •  10 servings of starches
  • 2 servings of milk
  • 4 servings of vegetables
  • 5 to 7 ounces of meat or meat substitutes
  • 4 servings of fruits
  • 5 fats

Selecting foods for your meal plan

Let’s select from our major food groups (starches, fruits, vegetables, milk and dairy products, meats and meat substitutes, and fats and sweets) to practice putting together some sample meal plans.

Starches. You will want to include some starches, such as bread, grains, pasta and vegetables, such as corn and potatoes, with every meal. These foods are a good source of carbohydrates, as well as vitamins, minerals, and fiber. However, all starches are not equal in their nutritional value, so here are some rules of thumb to follow to make sure that you select the best options among starches. You should always eat whole grain cereals and breads, when possible, and limit fried and high-fat starchy foods, such as fried tortilla chips or potato chips, french fries, pastries, or biscuits. Select alternatives to fried snack foods that are baked (many are available nowadays!), including pretzels, fat-free popcorn, baked potato chips, low-fat muffins, and baked tortilla chips. Also watch what you put on top of starches like baked potatoes. Try mustard instead of mayo, low-fat or fat-free sour cream, and light margarine, and fat-free (skim) or low-fat milk with cereal.

Examples of Starches

Bread Pasta
Corn Pretzels
Potatoes Rice
Crackers Cereal
Tortillas Beans
Yams Lentils

If you are eating packaged foods, the serving size is shown on the Nutrition Facts label.

Learn more about reading food labels

For foods that may not have Nutrition Facts labels, you can use some rules of thumb to determine how much makes up a single serving. For instance, single servings of some common starches include:

  • 1 standard slice of bread
  • 1 small potato
  • 1/2 cup of cooked cereal
  • 3/4 cup of dry cereal flakes
  • 1 6-inch tortilla
  • 1 small ear of corn
  • 1 small roll
  • 1/2 cup of peas
  • 1/3 cup of rice

Vegetables. Vegetables should be an important part of your meal plan and a source of essential vitamins, minerals, and other nutrients. As with starches, try to eat your vegetables with a minimum of fat-containing sauces or dressings (many low-fat or fat-free dressings are available). The best way to prepare many vegetables is to lightly steam them (steaming them for too long can remove valuable nutrients). Avoid using fat to cook your vegetables and make sure that you use olive oil, canola oil, or soft margarines, instead of fat from meat (shortening) or dairy fat (butter). Instead, try cooking vegetables with some lean meat, such as lean ham or smoked turkey. Experiment with herbs and spices to add flavor to your vegetable dishes.

Examples of vegetables

Lettuce Peppers
Celery Broccoli
Carrots Chilies
Vegetable juice Green beans
Greens (eg, collards, mustard) Spinach
Tomatoes Cabbage

Fresh vegetables typically don’t have Nutrition Fact labels. You can use some rules of thumb to determine how much makes up a single serving. For instance, single servings of some common vegetables include:

  • 1/2 cup of cooked carrots
  • 1/2 cup of cooked green beans
  • 1 cup of salad (mixed salad greens or iceberg lettuce)
  • 1/2 cup of vegetable juice
  • 1 small tomato
  • 1/2 cup of broccoli
  • 1/2 cup of tomato sauce

Fruits

Fruits are an important source of carbohydrates, vitamins, and minerals, as well as fiber and should be a part of your everyday meal plan. You may eat fruits raw or cooked, but avoid adding sugar. Also, for canned fruits, read the label and avoid products with added sugar. Instead, make sure that they are canned only in their own juice. Since single servings of raw fruit tend to be on the small size, when you get fresh fruit, buy small pieces of fruit. Whole pieces of fruit are generally a better choice than fruit juices, because whole fruit has more fiber and is more filling. Reserve high-sugar fruit desserts only for special occasions.

Examples of Fruits

Apples Bananas
Mango Fruit juice (no added sugar)
Raisins Guava
Strawberries Oranges
Papaya Dried fruit (no added sugar)
Watermelon Blue berries
Grapefruit Peaches
Canned fruit (no added sugar) Pears

Examples of single servings of some common fruits include:

  • 1 small apple
  • 1/2 cup fruit juice
  • 1/2 grapefruit
  • 1 banana
  • 1/2 cup orange juice
  • 1 and 1/4 cup whole strawberries

Milk and yogurt

Milk and dairy products are an important source of vitamins and minerals, such as calcium, as well as carbohydrates and protein. Milk and dairy products also contain dairy fat, which you should try to limit your consumption of. So, select fat-free or low-fat milk or yogurt (without sugar or with a low-calorie sweetener). Plain yogurt (low-fat or fat-free) is a good substitute for sour cream. Single servings of fat-free or low-fat milk and yogurt are typically 1 cup.

Meat and meat substitutes

This group of foods is high on the Diabetes Food Pyramid. Therefore, you should generally limit your consumption from this group. The group includes meats, such as poultry (chicken, turkey), eggs, cheese, fish, and tofu (soy protein). These foods are a good source of protein, vitamins, and minerals. Meats (especially red meat) generally contain a good bit of fat. To reduce the fat content of meats try purchasing lean cuts of beef, pork, ham, and lamb, and trim excess fat of what you purchase. Also remove the skin from chicken and turkey. Always cook your meats in a low-fat way, using broiling, grilling, roasting, steaming, and stir-frying, instead of deep-frying. To add flavor to your meats, try using herbs and spices, lemon juice, vinegar, or low-sugar sauces. When you cook eggs, use a cooking spray instead of butter or oil. Generally, limit your consumption of fried foods. Also, since nuts contain high amounts of fat, you should be careful how much eat. If you eat cheese, select low-fat or fat-free cheeses.

Examples of meats and meat substitutes

Chicken Eggs
Cheese Beef
Peanut butter Pork
Fish Tofu
Lamb Canned tuna or other fish
Cottage cheese Turkey

Measurements (servings) of meat and meat substitutes are made in ounces. Examples of servings of some meat and meat substitutes include:

  • 1 egg = 1 ounces
  • 2 tablespoons of peanut butter = 1 ounces
  • 1 slice of turkey = 2 ounces
  • 1 slice of low-fat cheese = 2 ounces
  • a small to medium piece of fish or meat (about the size of deck of cards after cooking) = 3 ounces

Fats and sweets

Fats and sweets contain a lot of calories (high in carbohydrates) and not much nutritional value. You can still enjoy foods from this group, but you should limit the amounts you eat. Not all fats are the same, so learn about what foods contain saturated fats, trans fats, and cholesterol. These types of fats contribute to risk for heart disease and should be avoided.

Learn more about nutrition and different kinds of dietary fat.

Examples of fats and sweets

Fats

Salad dressing Butter
Oil Avocado
Margarine Olives
Cream cheese Mayo
Bacon Shortening

Sweets

Cake Pie
Ice cream Cookies
Syrup Doughnuts

Tips for satisfying your sweet tooth, while limiting the amount of sugar you take in include purchasing sugar-free desserts and treats (sugar-free popsicles, soda, ice cream or frozen yogurt), sharing desserts in restaurants, ordering off the child’s menu at your favorite ice cream shop, and dividing home-made desserts into small servings. Keep in mind that fat-free or sugar-free desserts still have calories. So, you will need to count these as part of your meal plan.

Examples of single servings of sweets include:

  • 1 3-inch cookie
  • 1 plain cake doughnut
  • 1 tablespoon of maple syrup

Examples of single servings of fats include:

  • 1 strip of bacon (well cooked)
  • 1 teaspoon of oil (olive, canola)
  • 1/2 tablespoon of regular salad dressing
  • 2 tablespoons of reduced-fat salad dressing
  • 1 tablespoon of reduced-fat mayo

Alcohol

Alcohol contains calories, but by itself (not including other ingredients found in many alcoholic drinks) it doesn’t contain nutrients. If you have diabetes, you should consume alcohol in moderation. When you consume moderate amounts of alcohol with food during a meal, the alcohol does not have a significant impact on your blood glucose. However, if you drink alcohol without also eating and you are being treated with insulin or diabetes medications that increase insulin secretion (called secretatogues), including sulfonylureas and glinides (repaglinide and nateglinide) it may put you at risk for hypoglycemia. If you have type 2 diabetes and want to drink alcohol, you should learn to recognize and manage delayed hypoglycemia, including the need for increased self-monitoring of blood glucose after alcohol consumption. Additionally, alcoholic drinks may increase your blood lipids (cholesterol).2,3

Although alcohol by itself does not contain carbohydrates, beware of ingredients other than alcohol in mixed drinks or other types of alcoholic beverages (such as beer). These other ingredients may raise blood glucose significantly. As a rule of thumb, if you are an adult male, you should limit your alcohol consumption to 2 drinks (24 oz beer, 10 oz wine, or 3 oz 80-proof whiskey) per day. If you are an adult female (or a lighter weight individual), you should limit your alcohol consumption to 1 drink per day. Talk to your doctor or dietitian about how many drinks of alcohol you should have as part of your dietary plan.2.3

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