Ask the Nutrition Expert
Meet Cassie Rico MPH, RD, one of our registered dietitians, who has answered hundreds of food and nutrition questions related to living with diabetes.
Check out the archive of answered questions here.
- Can you "save" carbs from one meal for later in the day when you have prediabetes?
- What is the best thing to snack on?
- When my blood sugar goes too high what can I do to lower it?
- What is the healthiest cereal to eat?
- Is the X Factor Diet healthy for people with diabetes?
- Is it okay for me to use stevia as a sweetener?
- Is sugar-free Crystal Light safe to drink if you have diabetes?
- Is it okay to eat apples and oranges with diabetes even though they contain sugar?
- How many times per day should I be eating if I have type 2 diabetes?
- Does diet soda cause weight gain?
My cousin has borderline diabetes. If he does not eat all his carbohydrates at breakfast, can eat what he misses for lunch? In other words, can he “save” carbs for later in the day?
It sounds like your cousin has prediabetes. Prediabetes is a condition where your blood glucose levels are higher than normal, but are not yet high enough to be diagnosed as actual diabetes. Many healthy eating recommendations are the same for people with diabetes and prediabetes. However, we do not recommend counting carbohydrates if you have prediabetes. This is more important for people who have been diagnosed with diabetes.
Research has shown that eating a reduced-calorie diet along with physical activity (at least 150 minutes per week) not only helps with moderate weight loss, but can also help prevent or delay diabetes. So, when you have prediabetes, it's important to focus on eating an overall healthy diet, controlling portions (including portions of carbohydrate foods), and increasing the amount of physical activity that you do. For a list of the best food choices within each food group, visit the What Can I Eat? section on diabetes.org. These lists can serve as a guide when your cousin is shopping at the grocery store and planning meals.
Below are some additional healthy eating tips to focus on with prediabetes. You may want to share these with your cousin.
- Focus on the foods you need to eat more of like healthy sources of carbohydrate such as whole grains, fruit, low-fat dairy, beans, and starchy vegetables. Include these with a combination of lean protein sources and healthy fats. Use a grocery list when shopping for food to help you choose more of these healthier foods. Don’t shop hungry!
- Measure your food and get used to what a portion looks like in your bowls and on your plates at home. Another great way to control portions is by using the Plate Method.
- Use healthier cooking methods without added fat (i.e. broiling, baking, microwaving, grilling, roasting, etc.). Avoid frying foods.
- Limit the unhealthy saturated and trans fats you eat and make sure most of the fat you include is coming from healthy sources like nuts, seeds, fatty fish, plant oils, and avocados. Watch portion sizes with these foods as even healthy fats are dense in calories.
- Choose lean protein sources such as chicken and turkey without the skin, vegetarian protein options and lean cuts of pork or beef such as sirloin or chuck roast.
- If you drink alcohol, men should have no more than two drinks per day and women should have no more than one drink per day. Keep portion sizes under control, and choose zero-calorie mixers or lighter options such as light beer or wine spritzers.
- Save money (and calories!) by limiting how much soda, sweets and chips or other salty snacks.
What is the best thing to snack on? I like to keep a few snacks at work to have during the day.
When it comes to snacking, take the “fresh is best” approach. This means choosing opting for more fresh foods over highly processed snacks like chips, pretzels, cookies, and candy. These processed snack food are often less filling and are easy to overeat. The calories, carbohydrates, and unhealthy fats in them can also add up.
There are many snack options out there that can help curb hunger while adding a nutritious energy boost to your day – without sabotaging efforts to control your blood glucose. Choose nutritious foods like whole grains, fruits, vegetables, and healthy fats.
Below are some healthy snack ideas to get you started. All of these are easy snacks you can pack and bring with you to work. Some you can store at your desk and others may need to be stored in the office refrigerator if available. You may also want to keep a bowl, plate, and set of utensils at your desk that you can wash and reuse after snacking.
- One small banana or small apple with a tablespoon of peanut butter or almond butter
- Yogurt parfait made with 4 ounces of light yogurt, a Clementine or fresh berries, and 2 tablespoons of chopped nuts (stir these together or eat them separately if you want)
- 1/3 cup hummus with veggies for dipping. Try cucumber slices, baby carrots, cherry tomatoes, blanched green beans, broccoli florets, celery sticks, summer squash slices, jicama sticks, or sugar snap peas.
- A serving of fresh fruit (such as grapes, a peach, pear, nectarine, orange, or grapefruit) with a piece of string cheese
A small bowl of whole grain or bran cereal with ½ cup low-fat milk
- 1/4 cup homemade trail mix with any combination of nuts (such as walnuts, pecans, almonds, pistachios, peanuts) mixed with a tablespoon of dried fruit
One packet of sugar-free instant oatmeal
- ½ of a whole wheat pita toasted and topped with mashed avocado and tomato slices
- ½ cup of cottage cheese mixed with ½ cup of canned pineapple or peaches (choose those that have been canned in juice, not light syrup)
- 3 cups light popcorn (or buy the 100-calorie bags)
These are just a few ideas. Check out our Snacking page on diabetes.org for even more ideas broken down by the amount of carbohydrate they contain. If you have diabetes, you may need to adjust the portions of the snack ideas above to fit your meal plan.
If you are interested in learning more about planning meals and snacks, you might be interested in our new nutrition resource: Recipes for Healthy Living. Register for free today, and each month you’ll receive a new set of diabetes-friendly recipes, a one-day meal plan, and other healthy meal ideas.
When my blood sugar goes too high what can I do to lower it?
There is no “magic” food or drink that works to bring blood glucose down. To avoid high blood glucose levels, make sure you take any medications as prescribed by your doctor. Following your meal plan is also important and can help to keep blood glucose levels on target.
When you have diabetes, exercise can help to lower blood glucose. This is as close to a magic bullet as we have. So, if you find that your blood glucose levels are high after a meal, try going for a brisk walk or do something active. This may help bring blood glucose levels down.
If you still continue to have chronically high blood glucose, make an appointment with your doctor to discuss it. There’s a chance he or she may need to adjust your treatment plan in some way.
What is the best cereal to eat? I usually have multi grain cheerios. Are there healthier options?
Cereal is a quick and easy meal in the morning. However, navigating the cereal aisle and picking out the healthiest choice can be tricky – there are so many options! Not to mention, some cereals that are marketed as “healthy” can also be loaded with added sugars.
So – what can you do? A good place to start is to look at the nutrition facts label. The best cereals will be made mostly with whole grains. Check to see if a whole grain, like whole wheat flour or whole oats, is listed as the first ingredient.
Also, check the nutrition label for the amount of fiber. While not whole grain, unsweetened bran cereals are a good choice because of their high fiber content. Look for whole grain or bran cereals that have 3 or more grams of fiber per serving. If you can find a cereal with 5 or more grams of fiber per serving, that is considered an excellent source of fiber and is likely a good choice!
Refrain from buying sugary cereals – they are usually less nutritious and will raise blood glucose quickly. This includes cereals that are marketed to children and also less conspicuous brands. Pass on anything that contains sugary ingredients like chocolate, frosting, marshmallows, and other ingredients that add extra calories, carbohydrates, and fat. Granola-based cereals are also usually loaded with added sugars and contain a large amount of carbohydrates and calories in a small portion.
The cereals lowest in added sugars will usually be the “original” versions of a cereal, like plain oatmeal or original Total, Wheaties, or Cheerios. Unless the cereal you buy has fruit in it, (which will add natural sugars) look for those that are lower in sugar – around 6 grams or less per serving. Multi-Grain Cheerios actually fit this criteria and list several different whole grains in the ingredient list.
So, the best cereals are a good source of whole grains and fiber, while also being low in added sugars. Even if you buy a healthier cereal, it is still important to watch portion size and consider carbohydrates if you have diabetes. All cereals (and milk) contain carbohydrates and can raise blood glucose, so pay attention to the nutrition facts label.
Here are a few more pointers:
- Opt to use skim, ½%, 1% milk in your cereal. Plain soymilk is also a good choice. 1 cup of milk has about 12 grams of carbohydrate. Some cereal boxes include nutrition information with the nutrition facts for a serving of cereal plus ½ cup of milk. This is usually shown in a separate column and may make meal planning easier. You may want to measure the milk out before pouring it over your cereal to keep portions in check. It can be hard to know how much you are actually using when you pour it straight from the carton.
- Whole grain hot cereals are another option. Whether you prefer instant, quick-cooking oats, or old fashioned oats, oatmeal is whole grain in all of these forms. Note that grits and cream of wheat are not usually whole grain. Oatmeal also comes in instant packets so you can make it easily with hot water in the office or at home.
- Get familiar with the size of your cereal bowl. Research has shown that the bigger the bowl or plate we have, the more we will serve ourselves and eat. Try measuring out portions for a week and taking note of what a portion of cereal and milk looks like in the bowls you have at home. You don’t have to measure every day, but it may be a good idea to check yourself and re-measure once in a while. Use the nutrition facts label to look up a serving size of cereal and the amount of carbohydrate grams in a serving.
I looked into the X Factor Diet and they mainly say to eat a lot of meat and non-starchy vegetables. You cannot have any starchy vegetables, whole grains, sweets or legumes. Is this a healthy diet or not?
Between commercials, advertisements and magazine articles for different weight loss diets and diet plans, it’s hard to determine what is safe and what works. Many very-low calorie diets and detox diets are unsafe and they can disrupt your metabolism and also your blood glucose levels. Some diets, such as the X Factor Diet, call for eliminating entire food groups and can be difficult to keep up for a long period of time. Even if you lose weight on this diet initially, returning to old eating habits later can cause you to regain weight.
Many weight loss plans have been studied by researchers to see which works best for long term weight loss. The results are mixed, and likely the answer will be different for each individual. For some, cutting out highly processed carbohydrates like cookies, chips, and soda may be the answer. For others, following a Mediterranean eating plan may be the answer. Still, a lower-carbohydrate diet similar to the X-Factor diet could help you as well. You may have to try a few different things before you figure out what works for you.
If you want to lose weight, just make sure you go the safe route – make lasting lifestyle changes that will take the weight off for good and will help with your diabetes control. Losing ½-2 pounds per week is a gradual, but safe, rate at which to lose weight. You should also talk to your doctor if you have diabetes and are planning to start a weight loss plan. As people with diabetes lose weight, they often need their dotocr to make adjustments to their medications and/or insulin if prescribed.
A good weight loss program will focus on decreasing portion sizes, making healthier food choices, and increasing the amount of physical activity you do each week. Completely eliminating a certain food group or nutrient is not necessarily the way to go.
Below are a few healthy eating tips that may help with weight loss:
- Control portion size. This can help you eat fewer calories all together, which can lead to weight loss. To keep portions in check, trying using measuring cups and spoons or use the Plate Method.
- Write down what you eat. Tracking your food intake can make you more accountable for your choices. After tracking what you eat for a few weeks, review your records and find places where you could improve.
- Incorporate more non-starchy vegetables into your diet. They are fat-free and very low in calories. Make an effort to have a vegetable side with dinner, a salad once a day, or make a veggie soup that you can pack for lunch for the week.
- Focus on including nutrient-rich sources of carbohydrate such as whole grains, fruit, low-fat dairy, beans, and starchy vegetables. Choose these over less nutritious foods such as products made with refined grains, sweets, and salty snacks.
- Choose lean protein sources such as chicken breast, lean deli turkey, beans, tofu, and lean cuts of pork or beef such as sirloin or chuck roast.
- Use healthier cooking methods without added fat (i.e. broiling, baking, microwaving, grilling, roasting, etc.). Avoid frying foods.
- If you do add fat in cooking, do so in moderation and use oil that is high in healthy fats such as canola, olive, peanut, corn, or safflower.
- If you drink alcohol, stick to the following guideline: men should have no more than two drinks per day and women should have no more than one drink per day. Choose lighter drinks like wine spritzers or light beer.
- Cut out soda and other sugar-sweetened drinks and choose zero-calorie drinks like water, unsweetened tea, or sugar-free lemonade.
- Want more ideas for small changes you can make? Check out our list of Ways to Cut 100 Calories.
I have type 2 diabetes. Is it okay for me to use stevia as a sweetener?
Yes, stevia is an option for people with diabetes. Stevia is also referred to as Rebaudioside A, Reb-A, or rebiana. Technically, Reb-A is a highly purified product that comes from the stevia plant and is several hundred times sweeter than sugar. Reb-A is used to make the stevia products that we see in the store and on nutrition labels such as Stevia in the Raw, Steviva, SweetLeaf, Domino Light, Truvia, or Purevia.
According to the U.S. Food and Drug Administration (FDA), Reb-A is generally recognized as safe (GRAS) as a food additive and table top sweetener. When something is generally recognized as safe by the FDA, it means that experts have agreed that it is safe for use by the public in appropriate amounts. For more information on the safety of Reb-A, visit the Food and Drug Administration website: www.fda.gov.
Most stevia sweeteners are very low in calories and do not have a significant effect on blood glucose levels, unlike sugar. Stevia is similar to other artificial sweeteners, in that it can be a good option for people who have diabetes who are trying to cut calories and still enjoy a sweet taste. However, some stevia brands are mixed with sugar to enhance the taste, so be sure to read the package carefully.
Is sugar-free Crystal Light safe to drink if you have diabetes?
Yes, it is okay to drink Crystal Light. The American Diabetes Association recommends drinking calorie-free or very low-calorie beverages. This includes water, unsweetened teas, coffee, diet soda, and low-calorie drinks and drink mixes (including Crystal Light). You can also try flavoring your water with a squeeze of lemon or lime juice for a refreshing drink with a slight flavor. These drinks are all great thirst-quenchers and provide minimal calories and carbohydrates.
One good thing about low-calorie drinks and drink mixes like Crystal Light is that they are available in several flavors. They may be a good option for those who get tired of water easily, or those who are looking for an alternative to regular lemonade, iced tea, fruit punch, etc. These drink mixes are artificially sweetened so they will not cause a significant rise in blood glucose. They are usually very low in calories (about 5-10 calories per 8 fluid ounces) and have less than 5 grams of carbohydrate per serving.
Is it okay to eat apples and oranges with diabetes even though they contain sugar?
A lot of people with diabetes wonder if they can eat fruit and the answer is yes! Fruit naturally contains carbohydrates in the form of fructose (a type of simple sugar). So, it is very important to watch portion sizes when you choose to include any type of fruit in your meal plan.
But, fruit is also loaded with important nutrients such as fiber and an assortment of vitamins and minerals. Oranges in particular are a good source of vitamin C and fiber. Apples are also a great source of fiber – just make sure you leave the peel on! In addition, fruit typically has little-to-no saturated fat, sodium, or cholesterol.
Even if you have diabetes, you can still eat most types of fruit as long as you work them into your meal plan. We consider fruit a healthy carbohydrate choice, so choose it over less healthy carbohydrates like refined grains, cookies, cakes, pastries, processed snack foods, and candy. A serving of fruit actually makes a tasty and healthy dessert when you need to satisfy a sweet craving.
In order to work fruit into your meal plan, it’s important to be familiar with portion sizes. We’ve listed some basic fruit portions below that have about 15 grams of carbohydrate:
- 1 small apple (about 4 oz)
- 1 small orange (about 6 ½ oz)
- 1 extra small banana (about 4 oz)
- ½ of a large grapefruit
- ½ cup of canned fruit or fruit cocktail (choose those that have been canned in water, not syrup)
- ¾ cup blueberries or blackberries
- ¾ cup of fresh pineapple
- 1 cup of raspberries
- 1 cup cubed cantaloupe or honeydew
- 1 ¼ cup whole strawberries
- 1/3-1/2 cup fruit juice
- 2 tablespoons of dried fruit
Fresh, canned, or frozen fruit without added sugars are nutritionally similar, so choose what is best for your budget. Dried fruit and fruit juice are also nutritious choices, but the portion sizes are small and they may not be as filling.
When you choose to buy canned fruit, check labels to be sure the fruit is canned in its own juice – not in light or heavy syrup. Fruit is already a source of carbohydrates, so when it is canned in syrup, the carbohydrate content goes up and so do the calories per serving.
How many times per day should I be eating if I have type 2 diabetes? Is three meals and one snack okay? Or should I be eating 5-6 small meals per day?
The number of meals and snacks you should eat throughout the day will depend on your own preferences and the meal plan that you’ve worked out with your health care team. If you are on certain diabetes medications, this will also play into when and how often you should eat.
Your meal plan should be designed to help you reach your diabetes goals. First, work with your healthcare provider to set these goals. Goals might include losing weight, improving A1C, lowering blood pressure and/or lowering cholesterol levels. Then, work with him or her to set up a meal plan that will help you achieve those goals.
Ask about how often you should eat and how many carbohydrates to include at each meal and snack. For those who haven’t set up an individualized meal plan yet, we suggest starting with about 45-60 grams of carbohydrate per meal. However, some people may need more and some people may need less. So, visit your healthcare provider soon and set up an individualized plan!
For many people, spreading your carbohydrate intake throughout the day and eating regular meals can help keep your blood glucose under control. Different types of plans work for different people, and you need to do what works for you. It’s also a good idea to work with a registered dietitian (if available) to learn more about how different foods affect your blood glucose and how to plan meals.
Does diet soda cause weight gain?
A few research studies have found that people who drink artificially sweetened beverages may gain more weight than those who don’t. However, there are many reasons that these trends could have been observed. It could be that those who drink diet soda tend to have poor eating habits. Remember that there are many other lifestyle choices, such as the foods you choose to eat and your physical activity level that also affect your weight.
There is also research being done on the metabolic effects of artificial sweeteners and how our sweet taste receptors interpret them. Some people suspect that using artificial sweeteners can increase your preference for sweets and may increase your appetite. However, this is a new area of research and there is still no clear answer to whether or not artificial sweeteners trigger us to eat more and gain weight.
What we do know is that artificial sweeteners have little-to-no calories and they do not contain carbohydrates. Research has shown that they have the potential to reduce overall calorie intake when used in place of regular sugar. Switching from regular soda (about 140 calories in a 12-ounce portion) to diet soda (zero calories in a 12-ounce portion), can save you a significant amount of calories - especially if you drink more than one soda per day. Of course if you compensate by eating additional food, then you won’t see a calorie deficit.
We recommend avoiding sugary beverages like soda and choosing zero-calorie beverages as much as possible. If you would prefer to stay away from artificial sweeteners and diet drinks, you still have many options including:
- Water (tap, sparkling, or mineral)
- Unsweetened tea (black, green, herbal, iced, or hot)
- Coffee (regular or decaf)
- Water flavored with some freshly squeezed citrus juice
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