Ask the Registered Dietitian Archives
Here is an archive nutrition and food-related questions and answers.
- Are nuts healthy for people with diabetes?
- What are the effects of overeating after taking insulin?
- What are effects of dark chocolate on type 2 diabetes?
- Is there an average amount of carbs you should eat with type 2 diabetes?
- Is it okay if my husband with type 2 diabetes drinks a few diet sodas each day?
- How do you change net carbs to total carbs?
- Does balsamic vinegar help lower blood glucose?
- Can you provide a list of fruits that someone with diabetes can eat?
- Can I still have turkey bacon in moderation? What about coffee?
- Are sugar-free packaged desserts and chocolates safe for me to eat?
- Are beans a good or bad food if you have diabetes?
- My friend told me that I should be eating less carbohydrates per day than my doctor told me to eat. Is that true?
- Is peanut butter okay to eat if you have diabetes?
- Is it safe for people with diabetes to have stevia? Does it affect blood sugar levels?
- I have diabetes and acid reflux. What resource would you recommend for menus, portions, etc.?
Are nuts healthy for people with diabetes?
Nuts can be a healthy food choice for people with diabetes. They are a source of healthy unsaturated fats and protein. They are also a source of fiber and some vitamins and minerals. They make a filling snack and can be added to numerous foods: yogurt parfaits, oatmeal, trailmix, pasta dishes, and more.
However, it's important to know that nuts are also dense in calories and total fat, so keeping portion sizes small is important. Nuts also have a small amount of carbohydrate, but most types have less than 5 grams in a 1-ounce serving.
We suggest buying nuts raw or dry roasted rather than oil roasted. It's a good idea to choose nuts that are unsalted or lightly salted, especially if you are trying to watch your sodium intake. Special flavorings (such as in the case of honey roasted, cinnamon-sugar, or chocolate covered nuts) can add a significant amount of extra sodium, calories, fat, and sometimes carbohydrate. So these specialty nuts are not the best foods for every day and should be considered a treat.
Though nuts are a higher fat food, they can be included as part of a healthy, balanced meal plan. Just keep the tips above in mind!
I have a family member with type 2 diabetes who constantly overeats after her insulin shot at a meal. What are the effects of overeating after taking insulin?
When we eat food that contains carbohydrates, the body breaks those carbs down into glucose, and that glucose is abosorbed into the bloodstream. There are also cells in your pancreas make the hormone insulin. Insulin is released when glucose enters the blood and it “unlocks” our cells, which allows the glucose to move from the blood into the cells where it can be used for energy.
People with 2 diabetes make insulin, but their bodies do not respond well to it. Some people with type 2, like your family member, need to take insulin shots or diabetes pills to help their bodies use glucose for energy.
The purpose of taking insulin is to help control blood glucose levels. But the insulin you take needs to be balanced with the amount of carbohydrates you eat and the activity you do to be effective. There are a lot of different types of insulin, and they vary in how quickly they work, when they peak, and how long they last.
Having the right meal plan to go with your insulin regimen is important for controlling diabetes. So, your family member's doctor may have given her some guidelines about how many carbohydrates to eat at each meal and snack. Eating more than the recommended amount will not only disrupt her blood glucose levels, but it can also cause weight gain. It may be best to talk with her to see if she has a meal plan to follow. If not, it’s important that she work with her healthcare provider to set up a meal plan soon.
You can read more about insulin routines right here on diabetes.org.
What are effects of dark chocolate on type 2 diabetes?
We recommend saving sweets like chocolate for special occasions. Having too much chocolate can add extra calories to your diet. It will also raise blood glucose because it is a significant source of carbohydrates, so it is very important to mind portion sizes. In addition, chocolate is a source of saturated fat, an unhealthy fat that can raise blood cholesterol levels if have too much.
You can still fit chocolate into your meal plan. Just use the substitution method if when you want to add a dessert or sweet to a meal. That means if you want a piece of chocolate for dessert, you should cut back on another carbohydrate food from that meal. This will help you keep the amount of carbohydrates you are eating at mealtime consistent.
For example, let’s say you want a small piece of brownie after dinner. A few things you could do to sub in the brownie would be:
- have a side of steamed broccoli (a low-carb, non-starchy vegetable) instead of a baked potato side
- omit your usual dinner roll
You can learn more about eating sweets and desserts with diabetes right here on diabetes.org. Remember, working a treat into your meal plan a few times a week is fine, but make sure you are still including a balance of nutritious foods in your meals and snacks.
I am not sure how many carbs I can have each day. Is there a standard average for a person with type 2 diabetes?
This is a very common question among people with diabetes. The truth is, there is not a standard amount of carbohydrates that will work for everyone with type 2 diabetes. If you have diabetes, we recommend following an individualized 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.
Since it sounds like you 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.
Find a time to work with your healthcare provider to set up a meal plan that takes your preferences into account and can help you achieve your diabetes goals. Ask about how many carbohydrates to include at each meal and whether or not to include snacks. Your provider may suggest using the diabetes plate method to start or they may have you try carbohydrate counting. It may also be helpful to work with a registered dietitian (RD) when learning to plan meals.
My husband was recently diagnosed with type 2 diabetes. He is taking metformin and trying to change his diet. Is it okay if he drinks a few diet sodas each day?
Diet sodas do not provide calories or carbohydrates, so they are a much better option than regular soda or other sugary drinks like fruit punch, sweet tea, lemonade, energy drinks, and juice drinks. These drinks will raise blood glucose quickly and provide several hundred calories in just one serving!
The American Diabetes Association recommends drinking calorie-free or very low-calorie beverages. The best choices are:
- Water (tap water, mineral water, or sparkling water)
- Unsweetened teas (could be black tea, green tea, herbal, decaf, etc. - hot or cold)
- Coffee (black or sweetened with low-calorie sweetener)
- Diet soda and other diet drinks
- Low-calorie drinks and drink mixes (for example, Crystal Light)
- Water flavored with a squeeze of fresh lemon or lime juice
The drinks listed above all provide minimal calories and carbohydrates. Diet drinks and low-calorie drink mixes are usually available in several flavors, so they are a good option for those who get tired of water easily. Still, it’s best to have everything in moderation. One or two diet sodas a day is probably fine, but I would still encourage your husband to vary his low-calorie drink choices during the day.
There are also a few healthy drinks that provide some calories and carbohydrates like low-fat milk and 100% fruit juice. Though these drinks provide calories, they also contribute important vitamins and minerals. Just remember check labels when you choose them and mind portion sizes.
How do you change net carbs to total carbs?
Usually, calculating net carbs involves subtracting the grams of sugar alcohols and/or dietary fiber from the total carbohydrates in a serving. However, the U.S. Food and Drug Administration (FDA) has not set a legal definition for the term "net carbs". This means there are no regulations for how companies use it on food labels, and the meaning of it can differ between food products.
The American Diabetes Association does not recommend using “net carbs” for meal planning purposes. Instead, you should continue to use the standard information on the nutrition facts label. This information is regulated by the FDA.
The grams of total carbohydrate listed on the nutrition facts label is the number you should use when planning meals with diabetes. The total carbohydrate includes all of the different types of carbs that can raise blood glucose – starch, sugars, dietary fiber and sugar alcohols.
It is true that sugar alcohols and some types of fiber do not raise blood glucose to the same extent that starches and sugar raise it. Here are a few rules to help adjust for fiber and sugar alcohols. We only suggest using these adjustments if you are managing your diabetes intensively with insulin or if you 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
Does balsamic vinegar help lower blood glucose?
Just a few small studies have explored the effect of vinegar on post-meal blood glucose levels and insulin sensitivity in type 1 and type 2 diabetes. Some of these studies did show a positive effect. However, there is not enough research at this time to recommend a regular dose of vinegar (or a specific type of vinegar) for the purpose of controlling blood glucose levels. Larger, more robust studies are needed before making a recommendation like this.
As of now, we know that if you have diabetes, controlled carbohydrate intake, regular physical activity, stress management, and taking any medications as prescribed by your health care provider are all important for blood glucose control. To learn more, the following information from diabetes.org may be helpful:
I am looking for a list of fruits that someone with diabetes can eat. Can you provide one?
A lot of people with diabetes ask if they can eat fruit, and the answer is yes. Fruit is a healthy choice and should be included as part of a balanced diet. It’s packed with antioxidants, vitamins, minerals and fiber. It makes a great snack, and can also be a great substitute for high-fat desserts when you need to satisfy your sweet tooth.
There is not a list of “good fruits” and “bad fruits” for people with diabetes. You can choose from the many options – from apples to kiwi to cherries and more. The most important thing is to choose either fresh, frozen, or canned fruit without added sugars. For canned fruit, make sure it is canned in juice rather than syrup. Dried fruit and 100% fruit juice are also nutritious choices, but the portions are small and are not as filling.
For some people, certain types of fruit may affect blood glucose levels differently than others. For example, some people with diabetes report greater blood glucose spikes when they eat pineapple. If that is the case, you can try decreasing your portion size or choosing another fruit you like that does not usually cause issues with your blood glucose.
All fruit contains carbohydrate, so you’ll need to count it in your meal plan. The following portions of fruit have about 15 grams of carbohydrate:
- 1 small piece of whole fruit (about 4 oz)
- ½ cup of frozen or canned fruit
- ¾ - 1 cup of fresh berries or melon
- 3 ounces or about 17 small grapes
- 2 tablespoons of dried fruit
- 4-6 ounces of 100% fruit juice
I was recently diagnosed with type2 diabetes. I’ve been told not to eat turkey bacon… this is the only processed meat I eat. I’ve also been told I should give up coffee. Is this true? Are both okay if I have them in moderation?
A lot of people want a list of foods that they can and cannot eat with diabetes. It turns out you can fit most foods into your meal plan. The key is moderation and controlling portion sizes.
Often, carbohydrates get all the attention when it comes to managing diabetes, but it is also important to make good protein choices. We advise choosing lean meats that are lower in saturated fat like fish, poultry without the skin, lean cuts of pork or beef, and vegetarian protein like tofu and beans.
Processed meats like sausage and bacon can be very high saturated fat and high in calories, so they may not be the best food for every day. But, like you said, it’s okay to enjoy some turkey bacon once in a while. Just be mindful of the portion size you eat.
When choosing processed meats, it’s best to buy products that have 3 grams of fat or less per ounce. If you cannot find turkey bacon that meets that guideline, look for one with less than 7 grams of fat per ounce. Packages marked as lean and/or lower sodium are usually good choices. But sometimes, the best you can do is compare the nutrition labels on different products to make the best choice.
You also asked about coffee. Coffee is actually one of the drinks we recommend since it is very low in calories and does not provide extra carbohydrates.
A lot of people prefer to have their coffee with sugar, milk, or cream. Remember that once you start adding these, you will start increasing the calories and carbs in your drink.
If you want to avoid adding extra carbs, very low-calorie sweeteners (like Splenda or Stevia), are a good alternative to sugar. A packet of these sweeteners has minimal calories and carbohydrates, and should not affect blood glucose levels.
Pouring on full-fat creamer or half-and-half will also add extra calories and saturated fat. To keep the calories in your drink low, try fat free half-and-half, or better yet, try a few tablespoons of soy milk, 1% milk, or 2% milk instead. (These will add just a few grams of carbohydrate if you keep portions small.)
I was just diagnosed with type 2 diabetes. Are sugar-free packaged desserts and chocolates safe for me to eat?
Sugar-free desserts and sugar-free candy can be an option for people with diabetes. Often times sugar-free foods have fewer calories and carbohydrates per serving. Many use artificial sweeteners, sugar alcohols, or a combination of the two to replace the sugar but still keep a sweet taste.
Still, you should be cautious when you see “sugar-free” on a package. Claims like “reduced sugar”, “no added sugar”, or “sugar-free” do not mean that these foods are also “carbohydrate free”.
Want our advice? Always check the total carbohydrate listed on the nutrition label when deciding how sugar-free foods fit into your meal plan. Many sugar-free foods are still a significant source of carbohydrate, calories, and fat. It’s also important to consider the cost and taste of these products as well. Some people may prefer to have the original version of a dessert and just cut back on portion size.
You should also be aware that sugar alcohols, a common ingredient in sugar-free foods, can cause a laxative effect or other gastric symptoms in some people, especially in children. If you experience uncomfortable symptoms after eating foods that contain sugar alcohols, it may be best to avoid them.
I’m confused about beans. I read that they are considered high in starch, but ADA also lists them as a good source of fiber. Are they a good or bad food if you have diabetes?
Beans and legumes are actually a very nutritious 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. In fact, you can get almost 25% of the fiber you need in a day from just 1/2 cup of beans!
As you said, beans are considered 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. So, it’s great if you want to include beans in a meal, but take note of portion sizes and be sure to count the carbohdyrates in your meal plan.
Most beans have about 20 grams of carbohydrate in ½ cup. This can vary depending on the type of bean you choose, so always read nutrition labels for a closer estimate.
You have the option of buying either canned or dried beans. Both are similar in terms of nutrition. The only major difference is the amount of sodium they have. Dried beans are almost completely sodium-free if you don’t add extra salt when cooking them. On the other hand, most canned varieties 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.
I have type 2 diabetes. I was told to limit my carbohydrates to between 60-75 grams per meal. The other day, I was told by a friend that I was mistaken: that I should be eating less. My last A1C was 5.3. Which is correct?
It is most important to follow the individual treatment plan that you have worked out with your health care team. Individual needs can vary greatly. So, eating less carbohdyrates per day may work well for your friend, but that does not mean it will also work best for you. It sounds like your A1C is in the normal range, so it’s likely that your current plan is working well. If you have other concerns or issues with your current plan, be sure to talk to your doctor before making any changes.
Is peanut butter okay to eat if you have diabetes?
Peanut butter provides some protein and is a good source of healthy unsaturated fats. Peanut butter can vary in how many grams carbohydrate it has per serving, so make sure you check the nutrition label on the brand that you buy. That will help you in determining how to count it in your meal plan.
Regardless of the type of peanut butter you buy, portion control is extremely important since all peanut butter high in calories. There are almost 200 calories in just 2 tablespoons! The calories can add up quickly if you’re not careful. So, be conscious of portion sizes and be sure to check nutrition labels when you choose this food.
Is stevia safe for consumption by people with diabetes? Does it affect blood sugar levels?
Most stevia sweeteners are very low in calories and should not have a significant effect on blood glucose levels. Stevia is similar to other artificial sweeteners in that it can be a good option for people who are trying to cut calories and still enjoy a sweet taste. Be aware that some stevia products contain a mix of sugar and stevia to enhance the taste, so read labels carefully.
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. It is several hundred times sweeter than sugar. 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. Some of the brand names for stevia or Reb-A products that you may be familiar with are: Stevia in the Raw, Steviva, SweetLeaf, Domino Light, Truvia or Purevia.
For more information on the safety of stevia and other artificial sweeteners, visit the Food and Drug Administration website at www.fda.gov. For more information on using low calorie sweeteners with diabetes, visit our Artificial Sweeteners page.
I have type 2 diabetes but am not on medication. I also have acid reflux and the doctor has told me no tomatoes or citrus. (I think yellow tomatoes are okay though). What resource would you recommend for menus, portions etc.?
I suggest visiting our online nutrition resource, Recipes for Healthy Living. You can sign up for access to Recipes for Healthy Living today, and each month you’ll receive a new set of diabetes-friendly recipes, a one-day meal plan with tips for adjusting carbohydrates and calories, cooking videos, and other healthy tips – all for free.
Another free resource that may be helpful for planning meals is the MyFoodAdvisor tool. You can use it to track your meals and to look up the nutrition information for different foods. It also allows you to explore healthier alternatives to the foods you are currently eating.
Another helpful nutrition resource is our What can I Eat? booklet. This booklet is a basic yet complete guide that covers the best choices from each food group. It also covers portions sizes, The Plate Method and carbohydrate counting - some of the main meal planning techniques that people with diabetes can use to help control blood glucose levels. Two sample diabetes meal plans are also included. You can receive a free copy of this booklet from our Center for Information and Community Support. Just call 1-800-DIABETES and talk to one of our reps today.
You might also be interested in our book, The Month of Meals Diabetes Meal Planner. This is another great resource complete with recipes and a variety of meal plans.
Of course, you are bound to come across meal plans that include citrus, tomatoes, and other foods that trigger your acid reflux. When you come across those foods, simply substitute them for another similar food that does not cause reflux issues. For example, if a meal plan calls for an orange, substitute a serving of non-citrus fruit in its place like a banana or a peach. Over time, you’ll get used to making these substitutions within your diabetes meal plan.
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