Ask the Registered Dietitian Archives
Here is an archive nutrition and food-related questions and answers.
- Is it safe to go on a low carbohydrate diet when you have diabetes?
- Is cheese counted as a complex carbohydrate, a simple carbohydrate or a protein?
- How many net carbs per meal should you have with type 2?
- Can you give me some ideas for breakfast, lunch, and dinner (a day's menu)?
- Can blood sugar rise without eating anything with type 1 diabetes?
- Are green smoothies good for a person with type 2 diabetes?
- Is it okay for my son with type 1 to eat potato chips?
- If you lose weight will the diabetes go away?
- I work in construction, and it is often difficult to find good fast food and snack options. Do you have any ideas?
- I have prediabetes. What changes can I make to my diet that will bring my blood sugar levels down?
- How many grams of carbohydrates am I allowed each day with diabetes?
- Can my husband with diabetes eat fried foods?
- Are Glucerna meal replacements an appropriate breakfast choice to get me through until lunch or a mid morning snack?
- I have type 2. Is Cream of Wheat a good breakfast choice?
- How many carbohydrates can a person have in a day with type 2 diabetes?
Is it safe to go on a low carbohydrate diet when you have diabetes?
The American Diabetes Association recommends following a meal plan is individualized for you to help you meet your own health goals. These goals could be anything: losing weight, improving A1C, lowering blood pressure and/or lowering cholesterol levels.
Restrictive diets and low-carb diets are not necessarily the answer for diabetes. Cutting out entire food groups may cause you to miss out on important vitamins, minerals, and fiber. In addition, the Institute of Medicine recommends having a minimum of 130 grams of carbohydrate per day.
This recommendation exists because glucose is your brain’s preferred fuel source. Your body can run with less carbohydrate than this, but things like being physically active are more difficult when you don’t have glucose for your muscle cells. Because your brain is fueled by glucose, many people report headaches upon starting truly low-carb diets (about 20 grams of carb per day) as well as GI side effects like constipation.
Research has shown that many diets can be effective for managing diabetes. The LookAhead trial used low-fat diets and meal replacements and results showed that people still have improved A1Cs at 4 years. Low-fat vegan diets have shown that people can lose weight and manage their diabetes very well on high carbohydrate diets. Still, some research has shown that a more moderate-carbohydrate diet is helpful for many people.
The answer is not to eliminate all carbs, but to find the right balance while including healthy carbs and physical activity. Spacing out the carbohydrates you eat throughout the day, not skipping meals, and choosing healthy sources of carbohydrate like vegetables, fruits, beans, low-fat dairy and whole grains cis important for diabetes management and for general health.
Is cheese counted as a complex carbohydrate, a simple carbohydrate or a protein?
Cheese is actually very low in carbohydrates. Most cheeses have 1 gram of carbohydrate or less per serving, so you probably don’t need to count it in your meal plan. Cheese also has some protein but it is a significant source of fat, particularly saturated fat.
We call saturated fat an “unhealthy fat” because too much of it can raise your cholesterol levels and increase your risk for heart disease. You don't have to avoid cheese, but it is very important to watch your portion size. Choose cheeses from the best choices list below as often as possible.
One ounce of cheese is considered a serving, which is about the size of your thumb or a pair of large dice. Usually, 1 slice of cheese or ¼ cup shredded cheese is also about an ounce. Keep in mind that one ounce of regular cheese (such as cheddar, American, blue, brie, Monterey jack, Colby, or Swiss) can have over 100 calories and almost half of the saturated fat you need for the entire day.
The best cheese choices are:
- Those with 3 grams of fat or less per ounce
- Cottage cheese
If you cannot find a cheese that you like with 3 grams of fat or less per ounce, opt for one with 4-7 grams of fat per ounce, such as:
- Reduced-fat cheeses which are lower in total fat, saturated fat, calories, and cholesterol
- Pasteurized processed cheese product/spread
- String cheese
- Ricotta cheese
How many net carbs per meal should you have with type 2?
Actually, we do not recommend using “net carbs” for meal planning. The Food and Drug Administration (FDA) does not have a legal definition for it, which means that there are no regulations for how manufacturers can use it on food labels. So, the meaning of net carbs can actually differ between food products.
Instead of net carbs, use the standard information on the Nutrition Facts Panel. This information is regulated by the FDA. When carb counting, focus on the grams of total carbohydrate listed. That number includes all different types of carbohydrates that can raise blood glucose – starch, sugars, dietary fiber, sugar alcohols, etc.
We recommend following a meal plan that works for you and helps you meet your diabetes goals. Your healthcare provider can help you set these goals, which might include losing weight, improving your A1C, lowering your blood pressure and/or cholesterol levels.
Once your goals are set, work with your provider to set up a meal plan that can help you achieve them and takes your preferences into account. Discuss how many carbohydrates to include at each meal and whether or not to include snacks.
If you haven’t set up an individualized meal plan yet, we suggest including about 45-60 grams of carbohydrate per meal to start. It is important to spread out your carbohydrate intake throughout the day and try to keep it as consistent as possible from day to day. Some people may need more and some people may need less than the above recommendation, so set up a plan that works for you soon!
Another note about net carbs:
Usually, using “net carbs” involves subtracting the grams of sugar alcohols and/or dietary fiber from the total carbohydrates in a serving. Most sugar alcohols and most types of fiber do not raise blood glucose to the same extent that starches and sugar raise it. There are a few rules for fiber and sugar alcohols that you may want to follow if you have type 1 diabetes or are an advanced carbohydrate counter:
If a food has more than 5 grams of sugar alcohols per serving:
- Subtract ½ the grams of sugar alcohol from the amount of total carbohydrate in a serving of that food.
- Count the remaining grams of carbohydrate in your meal plan
If a serving of food has 5 or more grams of dietary fiber per serving:
- Subtract half the grams of dietary fiber from the total grams of carbohydrate in a serving of that food.
- Count the remaining grams of carbohydrate in your meal plan
Can you give me some ideas for breakfast, lunch, and dinner (a day's menu)?
If you are looking for a sample meal plan, you might want to check out our website, Recipes for Healthy Living. You can find several one-day meal plans plus lots of healthy meal ideas for breakfast, lunch, and dinner!
Recipes for Healthy Living is our online nutrition resource where we post free meal plans and diabetes-friendly recipes each month. On the site, you can also find nutrition articles complete with additional meal ideas, on-the-go tips, and cooking videos. It’s great if you are looking for quick and simple meal ideas!
Sign up to receive the Recipes for Healthy Living e-newsletter and we’ll let you know when new information is available each month. Whether you have diabetes, prediabetes, or are just trying to eat healthier, you’ll find recipes you love and useful tips for healthier cooking and meal planning.
Can blood sugar rise without eating anything with type 1 diabetes?
Hyperglycemia occurs when your blood glucose gets higher than your target range. Basically, it means there is too much glucose in your blood and not enough insulin.
A number of things can cause hyperglycemia:
- If you have type 1, you may not have given yourself enough insulin.
- If you are on an insulin pump, your pump or pump supplies could be malfunctioning or you may need to change your pump site.
- You ate more than planned or exercised less than planned.
- You have stress from an illness, such as a cold or flu.
- You have other stress, such as family conflicts or school or dating problems.
The signs and symptoms of hyperglycemia include the following:
- Peeing a lot
- Extreme thirst
- Feeling tired
- Feeling weak
- Blurry vision or can’t see clearly
- Feeling hungry even if you just ate
If your blood glucose is running unusually high, be sure to check for ketones. If your blood glucose is running high regularly, talk with your healthcare team about adjusting your insulin, meal or exercise plan.
Is a green smoothie good for a person with type 2 diabetes? The recipe I have is made with 3 ounces of water, 2 large peaches, 2 frozen bananas (sliced), 3 cups baby spinach and 1/2 teaspoon vanilla extract.
Smoothies are a great on-the-go choice and are an easy way to get more servings of fruit and vegetables into your day. However, the carbohydrates in smoothies can add up quickly, so you’ll need to make sure your smoothie recipe will work with your meal plan. Many smoothies are made with a good amount milk, fruit, and/or yogurt, all of which are sources of carbohydrate.
Though spinach is considered a free food, with 2 bananas and 2 whole peaches, the smoothie you described above has easily over 60 grams of carbohydrate. For a lot of people with diabetes, that is more than what they have at mealtime. So when making smoothies, remember to keep carb counts and portion sizes in check. If the smoothie above makes two portions, it may be easier to make it work with your meal plan.
Here are some ideas to to thry that can help you make better smoothies that will fit with your meal plan:
- Instead of milk or yogurt as a base, use water and ice. This can help you cut back on the amount of carbohydrates in your drink and it still tastes great!
- You can also try replacing regular milk with almond milk to save on a few calories and grams of carbohydrate.
- If you want to add dairy, choose non-fat milk or yogurt.
- Avoid adding ice cream and other high-fat frozen dairy products.
- Add non-starchy veggies, like spinach or other greens. These add very few calories and carbohydrates while packing in extra nutrition.
- Sprinkle in some ground flaxseed for a nutty flavor and some extra healthy fats.
- If you use frozen or canned fruit, buy products without added sugar. (Canned fruit should be canned in water or juice.)
- Remember that each cup of berries and each small (4 ounce) piece of fruit has about 15 grams of carbohydrate. A small 6-inch banana has about 20 grams of carbohydrate.
- Avoid adding extra sugar, honey, or other sweeteners that provide calories. Most smoothies have enough natural sweetness from the fruit. If you must add some extra, go with Splenda or another zero-calorie sweetener.
Visit Recipes for Healthy Living for some diabetes-friendly smoothie recipes:
Like these recipes? Sign up for the monthly Recipes for Healthy Living E-Newsletter and you’ll receive a new set of diabetes-friendly recipes, a meal plan, and other healthy tips and videos each month.
My son with type 1 likes to pack potato chips with his lunch sometimes. Is it okay for him to eat potato chips?
Yes, your son can still enjoy potato chips in his lunch sometimes just like any other child. As you probably know, children with type 1 diabetes learn how to adjust their insulin (in this case use their pump) to compensate for the amount of carbohydrate they eat. Potato chips contain carbohydrate, so just make sure your son is familiar with how to count the carbs from his chips.
Just like people without diabetes, people with diabetes need to eat healthy. Obviously, potato chips are not the most nutritious snack, so they may not be the best choice for every day. Encourage your son to make healthy choices when putting his lunch together. Some good examples are using whole wheat bread on his sandwiches, including some fruits and vegetables like an apple or banana with peanut butter and carrots with ranch. He can also pack other healthy snacks like yogurt, string cheese with whole wheat crackers, or trail mix. If you want some other healthy snack ideas broken down by carbohydrate amount, you can visit our Snacking page.
If you lose weight will the diabetes go away?
Unfortunately, there is no cure for type 2 diabetes at this time. The good news is that it can be managed. For weight loss and diabetes management, the American Diabetes Association recommends following a healthy balanced diet in addition to increasing your level of physical activity.
Making lasting lifestyle changes that you can stick to is the best route to go, but it takes time and willpower. Even those who are able to bring their blood glucose levels down to normal and no longer need medication should continue to exercise and be mindful of the food they eat.
I work in construction, and it is often difficult to find good fast food and snack options. Do you have any ideas?
A lot of fast food menus tend to be high in unhealthy fats and sodium, while being low in the important nutrients we need to keep ourselves healthy. Our advice? Pack your lunch as often as you can and bring healthy foods from home. Buy yourself a small cooler and pack it with ice so you can keep your food fresh during the day or use a communal refrigerator if there is one available at your site.
Here are some healthy meals and snacks to try packing:
- Hummus and pre-cut vegetables like carrots, broccoli, celery, cauliflower, sugar snap peas, or cherry tomatoes
- Fresh fruit like berries, grapes, or precut melon
- Sandwiches made with 100% whole wheat bread, lettuce, tomato, and lean meats like turkey breast or grilled chicken breast
- Whole wheat tortilla wraps – wrap a combo of lean meat and non-starchy vegetables and add some mustard or a slice of reduced-fat cheese
- Low-fat cheese sticks or string cheese
- Hard-boiled eggs
- Single servings of non-fat regular yogurt or Greek yogurt
- Low-fat milk
If you don’t have a way to keep perishable foods cool until lunch, there are still plenty of healthy foods you can pack:
- Unsalted nuts or nut mixes (these could also have some dried fruit in them, but remember that 2 tablespoons of dried fruit adds about 15 grams of carbohydrate to your snack)
- A peanut butter sandwich made with 100% whole wheat bread
- Granola bars
- Whole fruit such as oranges, apples, bananas, nectarines, pears, or peaches.
- Prepackaged fruit cocktail or clementines
- Tuna snack packs
- Instant oatmeal packets or quick-oats. If you have access to a coffee machine, use the hot water spicket to heat your oats. Then heat for a few extra seconds in a microwave. Stir in some nuts, milk, or fruit to add extra flavor.
Sometimes you don’t have time to pack your lunch and fast food will be your only option. Here are some tips to help you choose healthier menu items:
- Choose the smaller, more simple sandwiches. No need to supersize your meal. Stick to grilled chicken sandwiches or regular hamburgers instead of the double bacon cheeseburger.
- If you have diabetes, think about how your choices will work with your meal plan. Buns and tortilla wraps will have at least 30 grams of carbohydrate. Check the nutrition facts beforehand if you can!
- On sandwiches and wraps, ask for extra non-starchy vegetables like tomatoes, onions, cucumbers, or lettuce.
- When you can, choose a lean meat like turkey, chicken breast, or fish that has not been fried. Avoid deep fried meats and sides like chicken fingers, chicken nuggets, crispy chicken sandwiches, onion rings, or french fries.
- Order healthier side items like fresh fruit, side salads, vegetables, or soups.
- Choose salads without fatty meats like bacon or fried chicken. Remember, a little dressing goes a long way, and often dressing packets have more than one serving in them. Use a little bit at a time so you don’t use more than you need.
- Use sauces sparingly. Ketchup, honey mustard, and other sauces are fine to use, but don’t go overboard. If you use too much, they could end up adding a good amount of calories to your meal. Yellow mustard is a better low-calorie option and just a little bit goes a long way.
- Look for restaurants that have “fresh menus” or menu items that are clearly marked as healthier choices. For example, Taco Bell has their “Fresco” menu and Dunkin Donuts has their “DDSMART menu”.
- Look for restaurants that offer fresh ingredients and give you several vegetarain options. Subway is a good example.
- Avoid ordering regular soda or specialty coffee drinks. Stick to water, diet drinks, or unsweetened tea. Order regular or decaf coffee and ask for low-fat milk and artificial sweetener to add to it instead of getting an extra large, sweetened latte.
- In the mornings, stick to egg-white sandwiches, yogurt parfaits, fruit, and/or oatmeal. Many fast food chains offer these healthier options now. Half of a whole wheat bagel with low-fat cream cheese is also an option that you may be able to work into your meal plan if the options above are not available.
If you have diabetes, these foods are good choices but they still need to be worked into your usual meal plan. If counting carbohydrates, it might be helpful to ask to see the nutrition information for the menu. Most chain establishments should have this for you on-hand.
I have been diagnosed with prediabetes. What kinds of changes can I make in my diet that will help bring my sugar levels back to normal?
It is great that you are ready to make some changes to your diet! Prediabetes is a condition where your blood glucose levels are higher than normal but not quite high enough to be diagnosed as diabetes.
The good news is research has shown that losing weight by following a balanced, reduced-calorie diet and increasing your physical activity level can help you prevent or delay diabetes.
Reducing calories usually means decreasing the size of your food portions and also making healthier choices within each food group. For example, instead of having a huge plate of pasta with creamy, high-fat alfredo sauce, you might choose to have a salad made with lots of non-starchy vegetables and low-fat dressing, along with a side of whole wheat pasta and tomato sauce.
You can read more about portion sizes and what the best choices are from each food group in the What Can I Eat? section here on diabetes.org. You might also want to check out Ways to Cut 100 Calories to learn a few simple ways you can cut calories throughout the day.
The tips below can also help:
- Use a grocery list when shopping for food. Make sure your list is mostly made up of fruits and vegetables, along with some whole grains, low-fat dairy, lean meats, and healthy fats (like nuts, avocado, or olive oil).
- Eat more fruits and vegetables. Try having a side salad or a broth-based soup filled with veggies before your main course to help fill you up before the higher-calorie dishes come out.
- Use our diabetes plate method as a meal planning guide. It’s a great way to keep your portions in check and make sure you are eating the right foods. You can use it at home, when you are out to eat, or anywhere else!
- Stick to zero-calorie drinks like water, unsweetened iced tea, sugar-free lemonade, or diet sodas. Avoid sugary drinks like regular soda, fruit punch, juice drinks, and energy drinks.
- Save money by limiting how much fast food, soda, sweets, chips and other snack foods you buy. Opt for healthier snacks like an fruit, carrots with low-fat ranch dressing, a handful of nuts, or unbuttered popcorn.
- Keep desserts to just a bite or two – enough to curb your sweet tooth. Better yet, have fruit for dessert. If you are out to eat, split one dessert for the whole table.
- Avoid frying foods in your own kitchen or ordering them when eating out. Use healthier cooking methods that don’t require adding a lot of extra fat like steaming, baking, roasting, microwaving, or grilling.
- Choose lean meats such as fish, chicken or turkey without the skin, and lean cuts of pork or beef such as sirloin or chuck roast. Incorporate vegetarian protein options instead of meat when you can like beans, tofu, and veggie burgers.
- Remember that physical activity is also a critical part of diabetes prevention.
I was just diagnosed with diabetes. How many grams of carbohydrates am I allowed each day? Where can I go to figure my number out?
This is a very common question among people with diabetes. The American Diabetes Association recommends following a meal plan that works for you and helps you meet your diabetes goals. Your healthcare provider can help you set these goals, which might include losing weight, improving your A1C, lowering your blood pressure and/or cholesterol levels.
Once your goals are set, work with your provider to set up a meal plan that can help you achieve them and takes your preferences into account. Discuss how many carbohydrates to include at each meal and whether or not to include snacks. Your provider may suggest just using the diabetes plate method to start or they may have you try carbohydrate counting. A registered dietitian (RD) or certified diabetes educator (CDE) can be especially helpful when you are first learning to plan meals.
Since you haven’t set up an individualized meal plan yet, we suggest including about 45-60 grams of carbohydrate per meal to start. It is important to spread out your carbohydrate intake throughout the day and try to keep it as consistent as possible. Still, some people may need more and some people may need less than that recommendation, so set up a plan that works for you soon!
There is a lot of information to learn about diabetes management. Sometimes, it can be overwhelming. Since you were recently diagnosed, you may be interested in our program Living with Type 2 Diabetes. This free, 12-month program offers timely information to help you learn how to live well with diabetes over your first year after diagnosis. You can learn more about this program and enroll on diabetes.org
My husband just found out he has diabetes. Can he have fried foods? (We are arguing over this one...)
Fried foods are a source of both saturated and trans fats. These are considered “unhealthy fats” because having too much in your diet can lead to an increase in cholesterol levels. High cholesterol levels put you at a higher risk for heart disease. People with diabetes need to be especially careful about their cholesterol levels since having diabetes already puts you at a higher risk for heart attack and stroke.
Whether you have diabetes or not, it is best to limit the amount of fried foods in your diet. Not only do these foods contribute unhealthy fats to your diet, but they are also high in calories. Did you know that a small order of French fries from McDonalds has 230 calories? That’s a lot for such a small amount of food!
Having extra calories in your diet will add up over time and can lead to weight gain. Carrying extra weight also raises your risk for diabetes complications and other diseases like heart disease and some cancers.
So, if you want to enjoy fried foods here and there, consider them a “treat”. They are probably not the best foods for every day, but you can definitely enjoy them in smaller portions once in a while and should work them into your meal plan. Be sure to choose a portion that works with your meal plan. Also, remember that fried foods with any type of crispy breading on the outside have extra carbohydrate.
I have been doing low-impact activities like water aerobics/walking because of my severe knee pain from osteoarthritis. Now my work schedule has changed. In order to get to the swim center before work I must skip breakfast at home and take it with me. Are Glucerna meal replacement shakes and bars an appropriate choice to get me through until lunch or a mid morning snack?
Eating breakfast regularly will help boost your energy for the day and keep your blood glucose steady. It’s also very important that you follow your meal plan and keep your carbohydrate intake consistent – especially if you are on diabetes pills or insulin.
So, you should eat something for breakfast that fits with your plan. The good news is there are a lot of on-the-go breakfast options, so you can get in your morning swim and still eat well.
A meal replacement is a pre-packaged shake or bar that takes the place of one or more of your meals. Meal replacements have a set number of calories so they help to take the guesswork out of meal planning, and are a good option if you are trying to lose weight. If you want to use them to replace breakfast, make sure that they have about the same amount of carbs that you would normally eat at that time.
Here are some other on-the-go options to consider for breakfast:
- Make some high-fiber bran muffins or whole grain muffins on the weekend and freeze them. Put one in the fridge the night before so it thaws and you can eat it on your way to the pool in the morning with a piece of fruit.
- Try whole wheat toast, a whole wheat bagel, or a whole wheat English muffin with 2 tablespoons of natural peanut butter spread on top, plus a small piece of fruit like an apple, banana, or nectarine.
- Make scrambled eggs in the microwave (it only takes a minute!). Sprinkle some low-fat cheese and salsa on top of the cooked eggs and wrap it all in a small whole wheat tortilla. Wrap the tortilla in foil and bring it in the car with you. (You can also use egg whites or egg substitute for less fat and cholesterol.)
- Make a quick breakfast shake or smoothie with 1 cup fat free milk or plain non fat yogurt, blended with 1/2 cup fruit, 1 tsp. wheat germ and add 1 tsp. nuts or nut butter, ice and whirl!
If you’re crunched for time, the most important thing is to plan ahead and be sure you have all of your ingredients ready. You may need to adjust the portion sizes of the options above to fit with your plan.
I have type 2. Is Cream of Wheat a good breakfast choice?
Cream of Wheat is a grain-based food, usually made using farina which is a fine meal or flour. Usually the bran and most of the germ is removed to make farina, so it is not considered a whole grain.
We recommend choosing whole grain foods over processed refined grains whenever possible. Some other ideas are oatmeal (old-fashioned, quick, and steel cut oats are all whole grain) or cold cereals that have a whole grain listed as the first ingredient and are low in added sugars. Cream of wheat also offers their Healthy Grain variety now, which includes all parts of the grain.
Here are some guidelines for what to look for when you are navigating the cereal aisle:
- Refrain from buying cereals with ingredients like chocolate, frosting, marshmallows, honey, and other ingredients that add extra calories, carbohydrates, and fat. 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 5 grams or less per serving).
- Look at the nutrition facts label. Make sure a whole grain or wheat bran is listed as the first ingredient.
- Also, check the nutrition label for the grams of dietary fiber. Look for whole grain or bran cereals that have 2.5 or more grams of fiber per serving. If you can find a cereal with 5 or more grams per serving, that is considered an excellent source of fiber and is probably a good choice!
How many carbohydrates can a person have in a day if they have type 2 diabetes?
This is a very common question among people with diabetes. The American Diabetes Association recommends following a meal plan that works for you and helps you meet your diabetes goals. Your healthcare provider can help you set these goals, which might include losing weight, improving your A1C, lowering your blood pressure and/or lowering cholesterol levels.
From there, work with your provider to set up a meal plan that takes your goals and preferences into account. Discuss how many carbohydrates to include at each meal and whether or not to include snacks. Your provider may suggest just using the diabetes plate method to start or they may have you try carbohydrate counting. A registered dietitian or certified diabetes educator can be especially helpful when you are first learning to plan meals.
If you haven’t set up an individualized meal plan yet, we suggest including about 45-60 grams of carbohydrate per meal to start. If you follow that recommendation, you would be eating a total of 135-180 grams of carbohydrate throughout the day. However, some people may need more and some people may need less, so set up a plan that works for you soon!
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