There’s a lot of information out there about diabetes. So much that it can leave the more than 34 million people with diabetes – and the more than 88 million people with prediabetes – scratching their heads and wondering “What do I eat?” Google searches can be helpful, but you’re just as likely to find several answers that contradict one another. In 2019, the American Diabetes Association published a report detailing its review of different eating patterns and their potential health benefits, which concluded that everything about diabetes and diet is individualized and that there truly is no one-size-fits-all approach. So, what should people do?
Blount Memorial registered dietitian Heather Pierce says the American Diabetes Association is at least open to considering several different approaches to managing diabetes to fit different lifestyles. “There are certain diets that can offer benefits to people looking to either reduce their risk of diabetes or lower blood sugar,” Pierce said. “The Mediterranean diet, for instance, is mostly plant-based, but also involves fish, seafood, olive oil, yogurt, cheese and a limited amount of eggs. This diet allows wine in moderation, but limits the intake of red meat and sweets. The benefit here is that it reduces our risk of diabetes by reducing A1C blood sugar and triglycerides. Your A1C is a measure of how well your body has controlled blood sugar for the past two to three months. Reducing A1C reduces the risk for major cardiovascular events,” she explained. “Going vegetarian or vegan has similar benefits, too, but also comes with the added benefits of lower fat, lower cholesterol and weight loss,” she added.
“Low-fat diets and low-carb diets also are popular for lowering blood sugar and can lead to weight loss,” Pierce continued. “With a low-fat diet, you want to aim for getting less than 30 percent of your diet from fats, which means relying on lean meats, low-fat dairy, and fruits and vegetables, as well as limiting all starches. As for low-carb diets, look for low-carb vegetables, such as salad greens, cucumbers or cauliflower, and use avocados, butter and oils, such as olive oil and avocado oil, to balance your fat intake. Protein should come from meat, fish, eggs, nuts and cheeses, but be sure to avoid starchy foods such as breads, pasta and cereal,” she explained.
“One aspect of a very low-carb diet that people seem to like is appetite control,” Pierce said. “‘Very low-carb’ is defined as fewer than 50 grams of non-fiber carbohydrates per day, while ‘low-carb’ is defined as less than 45 percent of total calories. If you’re not ready to ditch the carbs just yet, try an approach studied by Cornell University where you focus on ‘Food Order.’ Here, simply eating the protein and non-starchy vegetable at the beginning of the meal and saving the starchy foods for last was shown to reduce the rise in blood sugar after the meal. Protein and fiber from vegetables are filling, so you tend to eat less starchy carbohydrates,” she explained. “If you’re doing this, I would use the ‘plate method’ as a guide. This is where half your plate is non-starchy vegetables, and the other half is split equally between protein and starches, such as bread, pasta, rice or potatoes,” she added.
While each diet has its rules and restrictions, Pierce says, ultimately, both preventing diabetes and managing it are about taking control of what we’re eating each day. “Whether you’re choosing a particular diet plan to follow to control diabetes or reduce your risk, or you’re just trying to be more conscious of what you’re consuming in general, there are some common take-home messages,” she said. “Emphasize non-starchy vegetables, minimize sugars and refined grains, choose whole foods over highly processed foods, and reduce your overall carbohydrate intake. The goal of these tactics is not only to eat better and feel better, but to reduce our blood sugar levels, which is beneficial if you have diabetes already or you’re trying to reduce your risk for it,” she explained.