Diabetic Diet: How to Eat with Moderation.
AS A DIABETIC, FOOD CAN BECOME BORING...
As diabetics, our food choices can get a bit tedious and routine. We've all tried the extremely low carb, while some have been able to stick with it, other diabetics soon find that never eating crunchy foods again, gets old, and fast.
This may sound funny to you, but think about it, besides nuts/seeds, a couple rare low carb veggies, and overcooked bacon, the crunchy foods in life are from foods that contain carbohydrates. Yes, if you bake a low carb food long enough, you may (just maybe) get a little crunch, but naturally, the majority of low carb foods are mushy (think meat, eggs, yogurt, cottage cheese, every other kind of cheese, fish, and combinations of any of those).
I'm a texture person, so eating meal after meal of mushy foods is tiresome for me.
After trial and error (and a lot of error), my approach to food is moderation. I want to make this very clear though, as a diabetic of 23 years and a Registered Dietitian, I grealty respect and see strong benefits from restricting carbs for improved diabetes management. For some diabetics, this method works well. I also know it is possible to still manage your blood sugar and not feel that your food and routine rule your life.
It's about keeping carbs lower (not non-existent), and being smart about the carbs you do enjoy.
Granted, some days, I just don't feel like eating many carbs, so my carbs are around 40 net grams for such days. On other days, I'm hanging out with my family or friends therefore going to a restaurant, having game night, or watching a movie with popcorn. Life happens, and on these days, my total carbs are closer to 150 net grams for the day.
Guess what, when you are smart about it and give insulin correctly, you can successfully have higher carbohydrate days. It definitely can be tricky, but allowing some carbohydrates into your eating plan can help you feel more satisfied and even improve your quality of life.
Yes, again, low carb can work extremely well, but when apples and popcorn are your most favorite foods in the whole world, a low carb diet can become a life sucker, and we don't want that.
LET'S TALK MODERATION.
When you eat carbohydrates, you need to make them count!! Let me explain. Eat your source of carbs from fruits, veggies, and occasional whole grains. Also make it an effort to increase your Dietary Fiber.
(Depicted above is my Cherry Berry Ice Cream. It's packed with dark cherries, blueberries, and has a hidden source of protein, stay tuned for the full recipe - you're going to love it!)
A little bit of a cookie or a piece of cake is mentally healthy, and shows you have the ability to control yourself. BUT the majority of carbohydrate foods in your diabetic diet should come from nutrient-dense plant sources: fruits, veggies, whole grains.
To be 100% transparent here, I save all my whole grain choices specifically for popcorn (depicted above is my baby with my Protein-Packed Kettlecorn recipe, he loves it too!). Popcorn is my all-time favorite whole grain. Ever. Did you know popcorn contains 7 grams of fiber per cup?? It's so light and airy (when you air pop it) which makes it super satisfying and with only 1 or 2 servings. It's also a great food to add a heart healthy fat (by spritzing a little olive or avocado oil) and a filling protein (natural protein powders, nutritional yeast, even a little Parmesan cheese, etc). Stay tuned, I have MANY popcorn recipes, that I will be sharing with you very soon. Enough of my popcorn rant...
Why is it important to base your carbohydrate foods on nutrient-dense whole food plant sources?
According to Choose My Plate, more and more evidence shows how adding fruits, veggies, and whole grains signficantly improves your health (Nutrients & Health Benefits).
Health Benefits from eating fruits, veggies, whole grains:
Reduce risk for heart disease, including heart attack & stroke.
Protection against certain types of cancers.
Fiber-rich fruits and veggies may reduce the risk of heart disease, obesity, and T2D.
Potassium-rich fruits and veggies may lower blood pressure, and reduce kidney stones and help decrease bone loss.
Weight Loss because fruits & veggies are lower in calories compared to higher calorie junk foods.
(Nutrients & Health Benefits)
DIABETIC MODERATION APPROACH TAKEAWAY.
When you eat carbohydrates, focus on nutrient-dense plant foods because of the long list of benefits from the contained vitamins, minerals, phytonutrients, etc, but let's take a second to give a special tribute to Dietary Fiber.
For diabetics and for normal functioning pancreas individuals, Dietary Fiber should be your best friend.
WHAT IS DIETARY FIBER?
Dietary fiber is the edible parts of plants that are resistant to digestion and absorption in the human small intestine with complete or partial fermentation in the large intestine (Hollenback et al). Meaning dietary fiber is comes from plants, and is not absorbed by humans.
Benefits from eating a High Fiber Diet:
Lower risk for coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases
Naturally lower blood pressure and serum cholesterol levels
Improved blood sugar and insulin senstivity (in diabetic and non-diabetics)
Enhanced weight loss
Reduced inflammatory GI disorders: such as gastroesophageal reflux disease (GERD), duodenal ulcer, diverticulitis, constipation, and hemorrhoids
Enhanced Immune System to fight off colds and infections.
(Anderson et al)
HOW MUCH FIBER DO I NEED?
Well, that depends on how many calories you need for maintenance. The RDA recommends to eat 14 grams of dietary fiber for every 1000 calories (Anderson et al). This suggestion is the same for children.
For example: If your maintenance calorie needs are 2000 calories a day, you should eat 28 grams of fiber per day.
Trying to Lose Weight?
Do NOT base your fiber needs on the decreased amount of calories you are actually eating in order to lose weight. Continue to eat the amount of fiber (or more fiber) for the amount of calories your body needs to maintain.
Also, fiber promotes the feeling of fullness and keeps food in your digestive system for longer. This helps you feel more satisfied which decreases your appetite. A decreased appetite decreases the total number of calories you eat in a day.
TAKEAWAY. Fiber is a huge help in sustainable and healthy weight loss. If you want to improve your health, normalize your blood sugar, and lose weight, load up on Dietary Fiber.
IMPORTANT: When I say load up on Dietary Fiber, I mean the real stuff from actual food that you put in your mouth, chew and swallow. Do NOTwaste your time with dietary fiber supplementation. Dietary supplementation (pill form) is not nearly as effective and also you loose out on a great abundance of other vitamins, minerals, and phytonutrients for a healthier body and for better weight loss (Liu, Rui Hai). Do yourself a favor, and EAT your fiber.
When it comes to any types of supplementation, my suggestion is to look at is as insurance. It's best to EAT your nutrients, but take a multi-vitamin in case you missed a key vitamin/nutrient/mineral from your diet.
Now let's talk Type 1 Diabetes.
HOW DOES FIBER AFFECT T1DS?
Most research is conducted for T2Ds, but even still there was a recent study that looked at T1Ds specifically and their CRP levels based on their fiber intake.
Stick with me, we are about to get a bit technical.
The C-Reative Protein (CRP) level is a predictor of systic inflammation which indicates infections, cancer, and inflammation in the heart and arteries, which reveals a higher risk for heart attacks and stroke (Fernando et al). CRP is nonspecific, therefore high levels suggest that inflammation is present, but doesn't tell what source in the body is causing the inflammation. Doctors will often ask for a CRP level along with other blood work to better assess where the inflammation is coming from (C-RP Test).
When it comes to inflammation, it is well-known that T1Ds have a chronic, low-grade inflammatory status (Fernando et al). It is speculated that this low-grade and chronic inflammation is a contributor not only to insulin resistance and metabolic syndrome, but also other microvascular complications such as diabetic retinopathy, nephropathy, and neuropathy (Fernando et al).
Therefore, by looking more closer at how fiber intake may decrease the CRP levels in a T1D, can possiblly help us find ways to lower unwanted inflammatory diabetic complications such as retinopathy, nephropathy, and neuropathy (Fernando et al).
Another benefit from increasing fiber in a T1D's diet is how fiber may lower the postprandial number (your blood sugar after you eat). By lowering this postprandial blood sugar, a diabetic can lower their HbA1C and also reduce the inflammation that results from high blood sugar circulating the in the blood stream (Mainous).
To give you a visualization of sugar and how it affects your body, imagine what a single grain of sugar looks like. It is hard, course, and even spikey. When you have high levels of this spikey sugar (glucose) and in access amount, think about it scratching very tiny tunnels where there is not a lot of room to move around, like your capillaries. These course grains of sugar nick and damage your tiny capillaries. Where do these capillaries reside? Think kidneys (nephropathy), toes (neuropathy), and the backs of your eyeballs (retinopathy).
Luckily, with the great advancements of modern technology, education, and great Endocrinologists and Dietitians, as a T1D you do not have to endure any of these complications. We just need to be proactive, learn from our mistakes, and do the best we can.
REAL QUICK, FIBER SIDE EFFECTS...
It is important to note, that increasing fiber to your diet should be done gradually. Excessive fiber intake at once can cause loose stools, cramping and diarrhea, can contribute to constipation, and negatively affect certain medication interactions, therefore, consult your doctor (or dietitian) if you have questions (Side Effects of Fiber).
BACK TO THE MODERATION APPROACH.
That was a long tangent about fiber, but it was necessary to better explain why a moderation approach to your diabetes eating plan can be beneficial. When you greatly restrict your carbs, you will most likely restrict sources that contain critical vitamins, minerals, phytonutrients, wonderful dietary fiber and all the fantastic benefits that come with it all. In this post, we only scratched the surface by looking at just 2 benefits that come from Dietary Fiber. Even more specifically, we addressed how Dietary Fiber can lower inflammation and postprandial blood sugars for T1Ds.
THE MODERATION DIABETIC DIET TAKEAWAY.
A lower carb and more moderate approach for a Diabetic's diet can be exceptionally helpful for blood sugar management and a healthy weight. However, the suggestion for the amount of carbs a T1D may benefit from, greatly depends on the individual.
If you are younger and/or athletic:
Meals: 30 - 60 grams
Snacks: 0 - 30 grams
If you are older, more metabolically disadvantaged, or sedentary
Meals: 15 - 30 grams
Snacks 0 - 15 grams
When you do eat carbohydrates, make sure to prioritize whole food and nutrient-dense plant sources such as fruits, vegetables, and occasional whole grains.
Along with adding healthy carbohydrate choices to increase necessary vitamins, minerals, phytonutrients, and dietary fiber, it is critical to add lean sources of protein and heart healthy fats (think nuts, seeds, avocados, etc).
Stay tuned, we will talk about how to add healthy protein and fats by using a more moderate diabetic diet approach. Such an approach can help you lower your HbA1c, feel more satisfied, increase your energy, and help with weight loss that stays off.
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As always, if you are having trouble with your diabetes and/or weight loss, email me, so we can figure out a customized game plan based entirely on you. I'm 100% here for you and understand all your frustrations because I am a T1D and a Registered Dietitian.
When we talk, I will look in detail at what, when, and the amount you are eating, along with what you are doing for exercise (or not doing, we'll be honest with each other). Together we will analyze your blood sugar (use your Dexcom Clarity reports if you have a Dexcom) and together we will decipher why you are getting your frustrating highs and lows. After a single session, you will have answers and a much better clarity of why your blood sugars react they way they do to your food, exercise, and lifestyle.
After talking, we will stay in touch, and you will have direct access to me for any questions. I deeply care about each and everyone of my clients.
If you just have a general question, send me an email and I will get back to you ASAP.
Your friend & Dietitian,
Ariel Warren, RD, CD, T1D
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For more articles from me and other health professionals, check out HapiBody.com. On HapiBody, you can always ask ANY health question and be answered by a professional. HapiBody also has great healthy recipes for you and your whole family and effective at-home workouts for weight loss and full body toning.
“C-Reactive Protein Test: Purpose, Procedure, and Results.” Edited by Judith Marcin, Healthline, Healthline Media, 22 May 2017, www.healthline.com/health/c-reactive-protein#high-crp-levels.
Fernanda S R Bernaud, Mileni Vanti Beretta, Cigléa do Nascimento, Fabrícia Escobar, Jorge L Gross, Mirela J Azevedo, Ticiana C Rodrigues. "Fiber Intake and Inflammation in Type 1 Diabetes." Diabetes & Metab Syndr, 2014, 6(1): 1-22.
Hollenbeck, and Schatzkin. “Dietary Fiber Intake and Mortality in the NIH-AARP Diet and Health Study.” Archives of Internal Medicine, Arch Intern Med, 3 Dec. 2012, europepmc.org/articles/PMC3513325.
James W. Anderson, Pat Baird, Richard H. Davis, Jr, Stefanie Ferreri, Mary Knudtson, Ashraf Koraym, Valerie Waters, Christine L. Williams. "Health benefits of dietary fiber."
Nutr Rev. 2009 Apr; 67(4): 188–205. doi: 10.1111/j.1753-4887.2009.00189.x
Liu, Rui Hai. “Health-Promoting Components of Fruits and Vegetables in the Diet.” Advances in Nutrition 4.3 (2013): 384S–392S. PMC. Web. 10 Apr. 2018.
Mainous AG 3rd, King DE, Simpson KN. Dietary fiber for the treatment of type 2 diabetes mellitus: a meta-analysis. J Am Board Fam Med 2012;25:16–23
“What Are the Side Effects of Fiber?” Reference, IAC Publishing, www.reference.com/health/side-effects-fiber-ec96916eb5625506?qo=contentSimilarQuestions#.
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