Ask the Registered Dietitian Archives
Here is an archive nutrition and food-related questions and answers.
- What should my friend with prediabetes eat? Does she need to limit carbs?
- I have type 2 diabetes and am a little overweight. What are some things I could do to drop the weight without my sugar dropping too low?
- What do I eat if I am gluten sensitive and need to lose weight?
- Can you give me some guidance about what I can do to lose weight with diabetes?
- What foods will help me bring down my blood glucose when it's high?
- Is the brochure "Choose Your Foods: Exchange Lists for Diabetics" available for purchase?
- Is it okay to drink V8 with type 2 diabetes?
- Is changing from regular soda to diet better for people with type 2 diabetes?
- I have prediabetes and already eat similar to the plan you suggest (low-fat dairy, whole grains, lean meats and lots of fruits and vegetables). In the nutrition area, do you see anything I am doing wrong?
- Do you subtract the amount of fiber in a food from the Total Carbs?
- Can my husband with diabetes eat oatmeal?
- Can coffee or caffeine raise your blood glucose?
- Are dried beans, lentils, and split peas good or bad for people with diabetes?
- Why is my blood glucose high in the morning when I ate a low-carb meal the night before?
- What is a good macronutrient ratio for someone who has type 2 diabetes?
I would like to know what to eat for prediabetes to prevent full-blown diabetes. My friend was just diagnosed with pre-diabetes and thinks all she has to do is give up sugar, which I know is not the total answer. I know less fat, less red meat, and wheat bread, brown rice, foods with fiber etc., but want to know how many carbs she should eat at each meal. Is she limited like someone with diabetes?
Keeping track of carbohydrate intake for prediabetes is not recommended at this time. This is more important for people who have been diagnosed with diabetes.
Studies have shown that eating a lower-fat, reduced calorie diet not only helps with moderate weight loss, but can also help to prevent or delay diabetes. People with prediabetes who are overweight can benefit from weight loss. Losing just 10-15 pounds may improve blood glucose levels, cholesterol levels and blood pressure. Losing weight can also reduce the need for diabetes medications.
As someone with prediabetes, your friend should eat a healthy, well-balanced diet and increase the amount of physical activity she does each day. To reduce her calorie intake, she should focus on decreasing the size of her food portions and also making healthier choices within each food group.
So, cutting back on sugar is part of it. Most sweets, sugary drinks, sugary cereals, etc. are high in calories and provide minimal nutrition. Cutting back on these foods and increasing your intake of whole grains, fruits, vegetables, and other nutritious foods is a key part of eating for prediabetes and can help reduce calorie and fat intake.
Here are some additional tips for your friend:
- Use a grocery list when shopping for food to help you choose more fresh vegetables, fruits, and whole grains.
- Instead of stressing out about the foods you're trying not to eat, focus on the foods you need to eat more of. Work on including more fruits, veggies, and whole grains.
- Buy leaner meats (such as chicken, turkey, and lean cuts of pork or beef such as sirloin or chuck roast) and lower fat dairy products (like low-fat or skim milk and yogurt).
- Use healthier cooking methods without added fat (i.e. broiling, baking, microwaving, grilling, roasting, etc.). Avoid frying foods.
- Pay attention to portion sizes and use the Plate Method if needed, which can help with diabetes meal planning AND weight loss.
- Choose lower fat options. Become familiar with the different kinds of fat and the food sources we get them from at diabetes.org.
- Save money by limiting how much fast food, soda, sweets, and chips or other snack foods you buy.
- Remember that special "dietetic" or "diabetic" foods often cost extra money and may not be much healthier than simply following the suggestions given here.
You can learn more about losing weight and preventing diabetes at diabetes.org. Exercise is also a critical part of diabetes prevention. You may want to check out a few of our exercise and weight management books.
I have type 2 diabetes and am a little overweight. What are some things I could do to drop the weight without my sugar dropping too low?
If you are looking to drop some weight, there are a lot of simple changes you can make to cut calories throughout your day. Creating a calorie deficit should result in weight loss. Also, remember that healthy weight loss is a slow, gradual process – about ½-2 pounds per week. It may actually come off a little slower depending on how much extra weight you are carrying now.
Another key to losing weight and keeping it off is making changes that you know you can stick with. Instead of thinking of this as a short term “diet”, think of it as a lifestyle change. Here are a few healthy eating tips to consider:
- Control portion size. This can help you eat less calories all together, which can lead to weight loss. To keep portions in check, trying using measuring cups and spoons.
- 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 high-nutrient 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 an 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.
In addition to healthier eating, adding exercise to your routine can also help you shed your extra pounds. Try to get at least 30 minutes of moderate-intensity exercise 5 days per week and do some type of strength training at least two days per week. If you’ve never been active before, you’ll need to work your way up slowly. If you are already active, try gradually increasing the amount of time you are exercising.
If you are looking for a sample healthy meal plan or healthy recipes to help, check out our online nutrition resource, Recipes for Healthy Living. Sign up for free today, and each month you'll receive:
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I am gluten sensitive and I am having trouble losing weight. What do I need to eat?
The calories you take in come from everything that you eat and drink. On the contrary, you burn calories when you do physical activity. You lose weight when the calories you take in are less than the calories you burn over time. This creates a calorie "deficit." The healthiest way to lose weight is to do so gradually – about ½ pound to 2 pounds per week is safest.
The Plate Method is a way of meal planning for people with diabetes that can also help with weight loss. To cut calories, start by decreasing the size of the portions you eat. Once you've changed how much are you are eating, you can start to make healthier food choices for each type of food. Reading labels can also help you identify healthier choices and keep track of the calories you eat.
In addition to changing your food habits, increasing your activity level will also help you burn more calories and create a calorie deficit. Find out more about the many activity options you have and how you can make time for activity during your day on diabetes.org.
Many people who are gluten sensitive try to avoid eating all foods that have gluten to prevent uncomfortable symptoms. Gluten is a protein found in wheat, barley, rye and all products made with these grains.
Even if you avoid foods with gluten, there are still many healthy foods that you have to choose from. Focus on eating a variety of fruits, vegetables, low-fat dairy products (those that do not have gluten-containing additives), beans, eggs, nuts and lean meat, poultry and fish. There are also some grains that are gluten-free. Check out www.diabetes.org for more healthy meal ideas and information gluten-free diets.
I am trying to lose weight to help control my diabetes. It is very hard but I don't want to quit. Can you give me some guidance about what I can do to lose weight with diabetes?
Research has shown that losing just 10-15 pounds can help you control your diabetes and improve your blood pressure and cholesterol levels. Remember that slow, gradual weight loss is safer and more effective than dropping all of it at once. In fact, ½ pound to 2 pounds per week is considered safe weight loss. You can do this by making a few small changes at a time to the way you eat and the amount of activity you do. Set a few small goals and add more as you go. Making a realistic achievable plan is important for success.
It is best to focus on making lasting lifestyle changes that you can stick with instead of short-term “dieting”. It’s also important to know that what helps you lose weight may be different from the next person. There are many different approaches to choose from. You may have to try a few things before you find something that works for you. For some, measuring portion sizes or enrolling in a structured weight loss program can help. Some people may find success by using meal replacements like a shake or bar for one or more meals each day. Others may be able to lose weight by simply switching to diet soda and cutting back on their intake of sweets.
Only you can decide what the best choice is for you based on your lifestyle and food preferences. Think about it – when could you eat a smaller portion size or switch to a lower calorie option and still feel satisfied? Here are a few ideas that you can try:
- Write down everything you eat and drink for a week. Most people underestimate their intake. Don’t guess! A food journal will help you see what you are actually eating. From there, you can see where extra calories are slipping into your day. A food journal can act as your guide for deciding what changes you’d like to make.
- Measure your food so you know exactly how much you are eating. What you thought was a ½ cup of pasta may be a whole cup. In the beginning, measuring can also help you see where extra calories are creeping into your diet.
- At mealtime, eat more non-starchy vegetables and smaller servings of starchy foods or meat. Start your meal with a side salad or a broth-based vegetable soup to help fill you up without a lot of calories.
- For salads, fill your plate with all types of vegetables but avoid macaroni or potato salads, cheese, and too much salad dressing.
- For desserts, keep your portions small or better yet, have fruit.
- For beverages, switch to diet or sugar-free beverages like water, unsweetened tea, sugar-free lemonade, or diet soda. Avoid regular soda, sports drinks, sweet tea, and fruit punch.
- Looking for a quick meal to fill you up instead of fast food? Try a meal replacement to keep your energy up. Meal replacements are a pre-packaged bar or shake that take the place of one or more of your meals. It takes the guess work out of what to eat when you are in a pinch.
For more information and tools, you can visit our weight loss section on diabetes.org.
What foods will help me bring down my blood glucose when it's high?
There is no “magic” food or drink that works to bring blood glucose down instantly and safely. To keep your blood glucose levels on target, you need to take any insulin and/or medications according to your doctor’s instructions. Medications and insulin work in your body to bring blood glucose down after eating.
Exercise is about as close to a magic bullet as we get. Physical activity works in your body to bring blood glucose down independently of insulin. It also makes any insulin in your body at the time work better. So, taking a walk after a meal may help you stay on track.
To keep blood glucose levels on target, it’s important to follow your diabetes meal plan closely and to exercise regularly. You also need to take any insulin and/or medications according to your doctor’s instructions. If high blood glucose levels are still a problem, you should work with your healthcare team to adjust your medications and/or meal plan.
Is the brochure "Choose Your Foods: Exchange Lists for Diabetics" available for purchase? If so, where can I find it?
Yes, this brochure has been published for many years now and is updated regularly. It is available for purchase through our online store www.shopdiabetes.org. You can order a single brochure for just $3.25 here.
Is it okay to drink V8 with type 2 diabetes? I drink a 11.5 fluid ounce can once a day.
We consider 100% juice with no sugar added a healthy drink choice. Fruit and vegetable juices provide more calories and carbohydrates than water and other zero-calorie beverages, but they also provide us with important vitamins and minerals. Just remember to control portion sizes when you drink them, because the calories and carbohydrates can add up when you have too much.
Vegetable juice is actually a slightly better option than fruit juice when you consider the calories and carbs. At just 50 calories and 10 grams of carbohydrate in 1 cup, it is a great alternative! I'd suggest opting for the lower sodium variety, since V8 tends to be high in sodium. You should also note that the portion your husband currently drinks is about 1 1/2 cups, so that's closer to 15 grams of carbohdrate and 75 calories. It's fine for him to drink V8 daily, but make sure he counts it in his meal plan.
To learn more about the best beverage options for someone with type 2 diabetes, check out What Can I Drink? on diabetes.org.
Is changing from regular soda to diet better for people with type 2 diabetes?
Yes, diet soda is a much better option for someone with type 2 diabetes. Diet sodas usually have zero grams of carbohydrate per serving, so they will not raise blood glucose levels. Diet soda is different from regular soda because it is sweetened with artificial sweeteners instead of sugar or high fructose corn syrup. Removing these added sugars and replacing them with artificial sweeteners removes the calories and carbohydrates.
When choosing what to drink, always check the nutrition label to see how many grams of carbohydrate are in a serving. The American Diabetes Association recommends drinking calorie-free or very low-calorie beverages. This includes water, unsweetened teas, coffee, club soda, and diet drinks. There are other options too, such as low-calorie drinks and drink mixes which can be found in most grocery stores (for example, Crystal Light). You can also try flavoring tap or mineral water with a squeeze of lemon or lime juice for a refreshing drink with some flavor.
We advise people with diabetes to avoid sugary drinks like regular soda, fruit punch, energy drinks, sweet tea, and the like. They will raise blood glucose quickly and can easily provide over 100 calories in just one serving! So, save your calories and spare your blood glucose – choose zero-calorie beverages whenever possible.
Many people try to avoid artificial sweeteners and highly processed foods like soda – whether it is diet or not. Drinking a moderate amount of soda each day is fine but try to include water and other less-processed drinks as well.
My doctor told me that I have prediabetes. I looked at your healthy food suggestions and I already eat according to your plan (I only have low-fat dairy, whole grains, lean meats and lots of fruits and vegetables). I need to lose 10 pounds, which I am working on. I also think I need to add much more exercise to my daily routine. In the nutrition area, do you see anything I am doing wrong?
Research on prediabetes has shown that losing weight by following a reduced-calorie along with engaging in regular physical activity (at least 150 minutes/week) can help to prevent or delay diabetes. It sounds like you already follow a generally healthy meal plan. The important thing is to continue to make the best food choices, which we list out for each food group in the What Can I Eat? section on diabetes.org. Be sure that you are controlling portions as well. You may want to try using our Create Your Plate model when planning meals and portioning out foods.
Exercise is also incredibly important for preventing diabetes. We recommend hitting that mark of 150 minutes of moderate-to-high intensity per week. The more you can do – the bigger the benefits! Exercise can be key for both losing and maintaining weight loss. As you lose weight, you should see your numbers improve for blood glucose, and also your cholesterol and blood pressure if they are high.
While it sounds like you are making the right choices, eating too much of even healthy foods is not good. Measuring out your portion sizes and using the Plate Method can help. Try measuring portions out for few days and get used to how they look on a plate or in a bowl. Then, check yourself from time to time to make sure your portions haven’t slowly gotten larger.
You can also try keeping a food diary for a week. Write down everything you eat and drink and record portion sizes, calorie intake, and even how you felt at the time. After the week is over, use it to see where extra calories could be slipping into your day. From there, you can think of a strategy to help you avoid the situations that trigger you to eat extra calories. It could be as simple as not buying a certain food from the store or measuring snacks out beforehand. These are all important strategies that can help for weight loss and ultimately, diabetes prevention.
My daughter is 14 and was diagnosed with type 1 last May. Do you subtract the amount of fiber in a food from the Total Carbs? Or do you just subtract half of the fiber when calculating her total carbs and how much insulin to give her?
For people intensively managing their diabetes with insulin or those who are advanced carbohydrate counters, subtract half of the total dietary fiber from the total carbohydrates if a food has 5 or more grams of dietary fiber per serving. The remaining number should be counted in the meal plan.
Fiber is found naturally in all plant foods - whole grains, fruits, nuts, beans, and vegetables. Soluble and insoluble fibers are two types of fibers that occur naturally in these foods. Sometimes, companies also add more fiber to foods during processing.
As you can see, there are several different types of fiber, but not all fibers raise blood glucose to the same extent. Some are partially absorbed while others are not absorbed at all and have no effect on blood glucose.
Food companies are not required to list out the amount of each type of fiber on the nutrition label. Usually, just the total grams of dietary fiber per serving are given. Due to these labeling rules and the different blood glucose responses from the various types of fiber, the best we can do is estimate.
The recommendation above is used to account for the fiber that does not affect blood glucose. Below are a few examples of how this rule might be used.
Example 1: A piece of whole wheat bread has 6 grams of fiber and 20 grams of total carbohydrate per serving. So, (20 total grams of carbohydrate) - (3 grams of fiber) = 17 grams of carbohydrate to count in your meal plan
Example 2: A granola bar has 3 grams of fiber per serving and 25 grams of total carbohydrate per serving. In this case, you would not subtract anything and use the 25 grams because there are less than 5 grams of fiber per serving.
Can my husband with diabetes eat oatmeal? If so, what kind?
You can still eat oatmeal, even if you have diabetes. Oatmeal is a whole grain and is high in soluble fiber. It also provides several vitamins and minerals and it is a fat-free, sodium-free and cholesterol-free food. However, it is also high in carbohydrates and will raise blood glucose. The key is to fit healthy carbohydrate foods like oatmeal into your meal plan by controlling portion sizes.
Not only is oatmeal healthy but it is also a filling breakfast option. There are several types of oats to choose from – quick cooking oats, old fashioned oats, and steel cut oats. The best thing about oatmeal is that all of these types are whole grain and high in fiber. Typically, one-half cup of cooked quick oats made with water has about 15 grams of carbohydrate and 80 calories. (¼ cup of quick oats yields about ½ cup of cooked oatmeal.) However, this could vary depending on the type of oatmeal you buy. Always double check the Nutrition Facts Label when counting carbs and measuring portion sizes. The amount of oatmeal you can eat at breakfast will depend on your meal plan.
Making your oatmeal with water will not add any calories or carbohydrates. If you prefer to make it with milk, be sure to account for the extra carbohydrates in your meal plan (about 6 grams for every ½ cup of milk) and use low-fat or skim milk.
Be aware that pre-packaged instant oatmeal products have added ingredients for sweetness and flavor. These are convenient because they are already portioned out for you, but check the nutrition facts label to see how many grams of carbohydrate and calories are in a serving. Some brands may offer a sugar-free version. When you can, choose plain old-fashioned oats, steel cut oats or quick oats, which usually have less additives and sodium than instant varieties.
Most of us like to add some flavor to our oatmeal. Here are some healthy ways to do it:
- Stir in 2 tablespoons of chopped walnuts, almonds, or pecans. You can toast the nuts before adding them in for an even stronger flavor.
- Sprinkle on some cinnamon or nutmeg. These give off a natural sweetness without adding extra carbs and calories.
- Add a packet of sugar substitute or some brown sugar substitute for sweetness.
- Add a tablespoon of chopped dried fruit like dried cranberries, raisins (regular or golden), blueberries, currants, or apricots.
- You could also opt to add fresh fruit like sliced strawberries, bananas, or blueberries.
Note that adding fruit will add carbohydrates, so make sure it fits with your meal plan.
If you’re looking for even more breakfast ideas, visit our Breakfast On-The-Go page.
Can coffee or caffeine raise your blood glucose? I’ve noticed a rise in my blood glucose after I drink it.
Coffee is a very low-calorie, carbohydrate-free drink, so having a cup in the morning should not result in a rise in blood glucose. In fact, an 8 fluid ounce cup of black coffee is considered a “free food” and is a good drink choice when you have it in moderation. However, coffee will provide carbohydrates and more calories when you add extra ingredients like milk or sugar.
Caffeine is the stimulant found in regular coffee and tea. It is what causes many people to feel jittery, restless, or irritable after drinking caffeinated drinks. It is also a diuretic, which means it helps your body get rid of fluids which can cause dehydration.
There is some research that has linked caffeine intake to higher blood glucose levels in people with diabetes after meals and throughout the day. However, these studies were all very small and more research is needed before recommending a “safe” amount of caffeine for someone with diabetes. If you think coffee may be elevating your blood glucose, you can try switching to decaf coffee, which has minimal caffeine, to see if it makes a difference for you.
We do know that caffeine can cause a rise in blood pressure, so those with high blood pressure or heart conditions should limit their intake of caffeinated drinks or switch to decaf. Decaf teas and caffeine-free herbal teas are also great options if you’re looking for a hot beverage.
I am confused about dried beans, lentils, and split peas. One place it says that they are considered high in starch and should be avoided. However, they are also considered a super food for people with diabetes. Can you clarify which is true?
Beans and legumes are a great food choice. They are a good source of vitamins, minerals, and lean protein. They are also a great source of soluble fiber, which can help protect your heart by lowering cholesterol. You can get almost 25% of the fiber you need in a day from just 1/2 cup of beans!
It’s true - beans are also a starchy food, and starch is a type of carbohydrate. However, we consider beans a good carbohydrate choice because they are also packed with so many important nutrients. It’s great if you want to include beans in your diet, just make sure you count the carbohydrates in your plan and keep portion sizes under control.
Most beans have about 20 grams of carbohydrate in ½ cup. However, this can vary depending on the type of beans you choose. Always read nutrition labels and check portion sizes for a closer estimate.
You have the option to buy beans canned or dried. Both are similar in terms of nutrition. The major difference is that dried beans are almost completely sodium-free. Canned varieties usually have several hundred milligrams of sodium per serving. You can still buy canned beans if you prefer convenience, but opt for products that say “reduced sodium” or “low sodium” on the can. If you can find a product that says “no salt added”, that is even better. In addition, always drain and thoroughly rinse canned beans to lower the sodium content even more.
Why would I have a high fasting blood glucose reading in the morning if I ate a high protein, low-carb meal in the early evening the night before?
It seems logical to think that your blood glucose level would decrease throughout the night and that it would be lower in the morning due to your low-carb dinner. However, there are other mechanisms working in your body during the night that can cause blood glucose to rise. Many people struggle to control high morning glucose levels. There are a few things that could be at play that you should know about.
During the very early morning hours, natural changes occur in your body’s hormone levels, which cause blood glucose to rise. This is called the Dawn Phenomenon. These hormonal changes happen in both people with and without diabetes. When it happens in someone without diabetes, their body is able to make insulin and use it to regulate their blood glucose level. People who have diabetes do not make enough insulin or their body does not use it properly, thus causing high blood glucose levels in the morning.
The Dawn Phenomenon is just one issue, but there are several other reasons why you're seeing those readings in the morning. The Somogyi Effect occurs when your body responds to a low at night by pumping out hormones that increase blood glucose. If you take insulin, these highs could also be a result of your insulin waring off in the early morning hours. For more details, you may want to check out our Diabetes Forecast article Rocky Morning Highs.
If your blood glucose is frequently high in the morning, you should talk to your doctor. He or she can work with you to set up a plan to manage it. Continue to check your blood glucose in the morning as prescribed and record your reading. Those readings will help your health care team adjust your medication or insulin if needed. They may need to make adjustments your meal plan as well.
What is a good macronutrient ratio for someone who has type 2 diabetes? I’ve been looking online at different weight loss plans and I found 50% carbs, 30% protein, and 20% fats. Also found 30% carbs, 40% protein, and 30% fats. I could not find anything on ADA site about this.
Over the years, researchers have explored whether one eating pattern or macronutrient distribution was better than another. However, as more research has been published, it appears that there is not likely one superior plan that will work for all people with diabetes. That is why we currently recommend an individualized meal plan that is designed to help the person with diabetes meet their health goals. It's also important that the meal plan be adjusted for the individual's preferences, culture, and lifestyle.
If you are interested in learning more about the research that has explored different eating patterns and macronutrient ratios, you may want to check out the 2011 systematic review published in Diabetes Care: Macronutrients, Food Groups, and Eating Patterns in the Management of Type 2 Diabetes.
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