Food & Fitness

Coconut palm sugar is a sugar substitute that seems to be gaining popularity. It is made from sap that is extracted from the coconut tree. The taste of pure coconut palm sugar is similar to brown sugar. For cooking purposes, it can usually be used as a substitute for sugar in most baked goods.

Manufacturers of coconut palm sugar boast its lower glycemic index compared to regular sugar. Glycemic index (GI) is a measure of how a food raises blood glucose (or blood sugar) compared to a reference food (usually glucose or white bread). In the United States, we do not do official GI testing. So, GI numbers for the same food can differ depending on your source.

GI can also vary from person to person. It will change depending on how a food is cooked, and what the food is eaten with. In the case of coconut palm sugar, it is likely to be mixed or prepared with other ingredients that contain carbohydrates if used in baking.

It is okay for people with diabetes to use coconut palm sugar as a sweetener, but they should not treat it any differently than regular sugar. It provides just as many calories and carbohydrates: about 15 calories and 4 grams of carbohydrate per teaspoon. So, you still need to account for it when planning meals.

Also, note that some coconut palm sugar on the market may be mixed with cane sugar and other ingredients. It is important to check nutrition labels and read the ingredient list on these products.

Oatmeal is a good, whole grain breakfast choice. We recommend that everyone choose whole grain foods as much as possible over refined grains like white bread, white rice, etc. Whole grains have more vitamins, minerals, and fiber. So, oatmeal is a good choice, but it does have some carbohydrates.

It's important for people with diabetes to watch their carbohydrate intake. Having too much at once will disrupt blood glucose levels. The breakfast you described consists of several high-carbohydrate foods. So, your husband will need to consider his carbohydrate range at breakfast time and think about what portion sizes of those foods will fit with his meal plan. The following carb counts may be helpful:

• 1/2 cup of cooked oatmeal has about 15 grams of carbohydrate (if it is cooked with water, not milk)
• 1/2 of a large banana had about 15 grams of carbohydrate
• 1 cup of milk has about 12 grams of carbohydrate

This breakfast above has about 42 grams of carbohydrate. So, if he can have 30-45 grams of carbohydrate at breakfast, these serving sizes would work with his plan. If his limit is more or less, he'll want to adjust the portion sizes. 

Navigating the bread aisle at the grocery store can be tricky – there are so many options! We suggest choosing one that is a good source of whole grains. A lot of the time, bread is made with refined grains or a refined flour. “Refined” means that part of the grain has been removed, so you miss out on a lot of vitamins, minerals, and fiber.

Whole grains include the entire grain kernel and provide all of the nutrients that grains have to offer. Look for bread that is labeled "100% whole grain" or "100% whole wheat." This means that the bread is only made with whole wheat flour.  Products that say “contains whole grain” may only contain a small amount of whole wheat flour.

You can also see if your bread is a good source of whole grains is by looking at the ingredient list. Ingredients are listed in descending order by weight. That means the first ingredient on the list makes up the largest proportion of the food. The best breads will list whole wheat flour as the first ingredient and the only flour in the product. Don’t be fooled by terms like wheat flour, enriched wheat flour, multi grain, stone-ground flour, unbleached wheat flour or other similar terms. These are not whole grain flours.

Some whole wheat breads are made mostly with whole wheat flour but still have a small amount of refined flours in them. If one or two refined flours are included in the ingredient list but are farther down on the list, the bread is still a good source of whole grains.

Remember that bread is a starchy food, so it’s important to count it in your meal plan – even if you choose a whole grain option. The serving size and amount of carbohydrates can vary a lot from product to product so be sure to check nutrition labels.

There is a growing group of people out there who have a gluten intolerance. When you are gluten-intolerant, you experience uncomfortable symptoms when you eat foods that contain the protein gluten. To avoid these symptoms, it's necessary to follow a gluten-free diet.

Gluten is found in wheat, rye, and barley and any foods made with these grains. As you can imagine, eliminating gluten from your diet can be challenging. There are many foods and food additives that contain gluten or are cross-contaminated with gluten during processing. Many of these foods are things you would never think of like lunch meats, broth, salad dressing, etc.

Complex carbs are often referred to as starchy foods. Though you need to avoid gluten, you still have a lot of options. The following is a list of starchy foods that are also gluten-free:

• Amaranth
• Arrowroot
• Beans (kidney, black, soy, navy, pinto, etc.)
• Buckwheat
• Corn (look for pure corn tortillas)
• Flax
• Gluten-free baked products (made from corn, rice, soy, nut, teff and/or potatoflour)
• Kasha
• Millet
• Potatoes (sweet potatoes are best)
• Quinoa
• Rice (brown or wild rice is best)
• Sorghum
• Tapioca
• Soy
• Black-eyed peas
• Lentils
• Acorn Squash
• Butternut Squash
• Parsnips
• Pumpkin
• Sweet Potatoes

You can also choose to buy gluten-free crackers or bread. Just be aware that most gluten-free products usually differ in taste and texture than their wheat-based counterparts. They may also differ in the amount of carbohydrate grams per serving, which can make a difference when you are carbohydrate counting and meal planning. For example, gluten-free bread can have twice as many carbohydrate grams as whole wheat bread. So, always check labels when you choose to buy these products.

This is a very common question among people with diabetes. If you have diabetes, we recommend following a meal plan that will help you meet your diabetes goals. First, you’ll need to work with your healthcare provider to set these goals, which might include losing weight, improving your A1C, lowering your blood pressure and/or lowering cholesterol levels.

Once your goals are set, work with your provider to set up a meal plan that takes your preferences into account and can help you achieve those goals. Discuss 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. A registered dietitian (RD) or certified diabetes educator (CDE) can be especially helpful when you are first learning to plan meals.

It sounds like you haven’t set up an individualized meal plan yet, so 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 about 135-180 grams of carbohydrate per day. Remember, some people may need more and some people may need less than the recommendation above, so talk to your healthcare team about setting a plan soon!

A few smaller studies have explored the effect of vinegar on blood glucose levels in type 1 and type 2 diabetes. Some of the studies have shown positive results, however, there is not enough research at this time to recommend a regular dose of vinegar for the purpose of controlling blood glucose levels. More larger, robust studies are needed before making a recommendation like this.

Right now, the best way to control blood glucose levels is by eating well, being physically active and taking any medications and/or insulin as prescribed by your doctor. Space the carbohydrates you eat throughout the day and pay attention to portion sizes. If you are overweight, losing about 10-15 pounds can make it easier to manage your blood glucose.

You may want to check out additional information on our site about weight loss and physical activity.

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 evidence that artificial sweeteners cause weight gain.

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. There are many options for you besides diet soda and artificially sweetened drinks including:

• Water (tap, sparkling, or mineral)
• Unsweetened tea (black, green, herbal, iced, or hot)
• Coffee (regular or decaf)
• Water flavored with a spritz of citrus juice

To learn more, you may want to visit Artificial Sweeteners and What Can I Drink? right here on diabetes.org.

Eating on the road can be tough – especially when you are trying to follow a diabetes-friendly diet. But fast food is not the only option. Try packing some of your own homemade meals or snacks. You have a lot of options, especially if you have a cooler or a small refrigerator in the cabin of your truck. Here are some healthy foods to try packing:

• Hummus and pre-cut vegetables like carrots, broccoli, celery, cauliflower, sugar snap peas, or cherry tomatoes
• Fresh fruit like berries, grapes, precut melon or precut apples
• Sandwiches made with 100% whole wheat bread, lettuce, tomato, and lean meats like low-sodium turkey breast or grilled chicken breast
• Wraps – wrap a combo of meat and non-starchy vegetables and add some mustard or cheese in a whole wheat tortilla
• Single servings of light yogurt
• Low-fat milk
• Low-fat cheese sticks or string cheese
• Hard-boiled eggs

Even if you don’t have a refrigerator, there are plenty of healthy foods that you can keep on hand:

• Unsalted nuts or nut mixes (dry roasted almonds, raw cashews, walnuts). 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.
• 100% whole wheat bread and peanut butter so you can make half of a sandwich for a snack.
• Granola bars.
• Whole fruit such as oranges, apples, bananas, nectarines, pears, or peaches.
• Small containers of Clementine pieces or fruit cocktail.
• Tuna snack packs.
• Instant oatmeal packets or quick-oats. When you stop at a truck stop, use the hot water spicket on a coffee machine to heat your oats. Stir in some nuts, fruit, or sugar substitute to add flavor if you want. 

Fast food tends to be high in unhealthy fats and sodium and low in nutrients. But sometimes, there is no choice but to stop. Here are some tips to help you choose healthier menu items:

• Choose the smaller, simpler sandwiches. There’s no need to supersize your meal. Stick to grilled chicken sandwiches or regular hamburgers instead of the double bacon cheeseburger.
• Think about how your choices will work with your meal plan. Buns and tortilla wraps will have at least 30 grams of carbohydrate. 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 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.
• Look for vegetarian options. While grilled chicken is better than fried chicken, any meat from a fast food restaurant will usually add several hundred milligrams of sodium to your meal. If you choose to eat one meal at a fast food restaurant, make sure the rest of your day is filled with fresh, healthy foods.
• 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 several hundred calories to your meal. Yellow mustard is a better low-calorie option and a little bit goes a long way.
• Choose restaurants that have menu items that are clearly marked as healthier choices. For example, Taco Bell has their “Fresco” menu items and Dunkin Donuts has their “DDSMART menu”.
• Look for restaurants that offer fresh ingredients and give you several vegetable 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 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. 

Although the items above are healthier options, it is important not to go overboard on the carbs with diabetes. These foods still need to be worked into a diabetes meal plan. If counting carbohydrates, it might be helpful to ask to see the nutrition information for the menu. Most establishments should have this for you on-hand.

Often, carbohydrates get all the attention when it comes to managing diabetes. But it is also important to make good protein choices. High protein foods like meat and meat substitutes can vary in the amount of fat they contain.

The best meat choices are those that are lower in saturated fat such as vegetarian sources, fish, lean meats, and poultry without the skin. The following is a more detailed list of the best choices in this food group:

• Vegetarian protein, which includes beans, tofu, veggie burgers, and other soy products
• Eggs, egg whites and egg substitutes
• Fish and shellfish (fatty fish such as salmon, herring, mackerel, rainbow trout, albacore tuna, and sardines contain heart-healthy omega-3 fatty acids)
• Poultry such as chicken, turkey, or Cornish hen without the skin (white breast meat is lower in fat than the darker meat in the thigh and leg pieces)
• Lean cuts of beef including round, sirloin, and flank steak; tenderloin; rib, chuck, or rump roast; T-bone, porterhouse, or cubed steak.
• Ground beef or turkey that is at least 93% lean. (Opt for more than 93% lean if it is available.)
• Lean types of pork including ham, Canadian bacon, pork loin, and center loin chops.

We do not have a specific recommendation when it comes to red meat, but we do suggest choosing one of the leaner cuts mentioned above. It’s also helpful to vary your choices. Having lean red meat for dinner once in a while is fine, but try to focus on including some fish and vegetarian sources of protein. Try cooking vegetarian meals a few days each week.

If you’re husband needs to lose weight, our Weight Loss section may be helpful. If you are interested in learning more about heart-healthy eating with diabetes, check out our article from Recipes for Healthy Living: Diabetes and Heart Health – What’s the Connection?

High fructose corn syrup is made by chemically changing corn starch. It is considered a form of sugar. It is different from actual fructose – which is the natural sugar found in fruit. High fructose corn syrup does not occur naturally in foods.

Table sugar is naturally made up of two smaller sugars; it is 50% glucose and 50% fructose. High fructose corn syrup is sweeter than table sugar, and is also made up of glucose and fructose, but the proportions are different. (It's not half and half like naturally occurring sugar).

It is very inexpensive to make high fructose corn syrup so it is added to many processed foods and sugary drinks instead of actual table sugar. It is most prevalent in sugar-sweetened beverages, which have been linked to obesity and diabetes. It can also be found in the ingredient lists of breads, yogurts, sweets, and many snack foods found at the grocery store.

High fructose corn syrup is included in the grams of sugars on the nutrition facts label. It does not add any nutritional value to our foods, but it does add calories – just like other added sugars. ADA recommends limiting the amount of added sugar in your diet. This includes table sugar, honey, high fructose corn syrup, and other forms of added sugar.

We also recommend avoiding sugar-sweetened beverages. Extra calories from added sugars such as high fructose corn syrup can contribute to weight gain in the long run, and carrying extra weight can put you at higher risk for developing diabetes and certain diabetes complications.

When you have prediabetes, your main goal should be to prevent or delay diabetes. Research has shown that moderate weight loss (about 7% of your body weight) through increased physical activity (at least 30 minutes moderate intensity exercise, 5 days a week) and eating a healthy, reduced calorie diet can help.

Start by changing a few things about the way you eat. To find healthy meal plans and recipes, visit our new nutrition resource, Recipes for Healthy Living. Sign up for free today, and each month you’ll receive:

• A new set of healthy recipes
• A healthy one-day meal plan with tips for adjusting carbohydrates and calories plus a grocery list
• Cooking videos
• Other healthy tips and meal planning advice

Recipes for Healthy Living is a great resource if you have prediabetes and are trying to lose weight. You’ll find dozens of tips and ideas for cooking healthier in your own kitchen, adding more fruits and vegetables to your diet, and you’ll see how to put together an entire day of healthy meals from our sample meal plans. 

Here are just a few basic guidelines for healthier eating with prediabetes:

• Use a grocery list when shopping for food. The bulk of the list should include a variety of fruit, whole grains, and vegetables (both starchy and non-starchy). 
• Buy leaner meats such as fish, shellfish, chicken or turkey breast (without the skin) and lean cuts of pork or beef such as sirloin or chuck roast. Be open to trying vegetarian meals that include sources of plant-based protein.
• Choose lower fat dairy products like skim or 1% milk, non-fat or light yogurt, and reduced-fat cheese.
• Instead of stressing out about the foods you're trying not to eat, focus on the foods you need to eat more of (fruits, vegetables, beans, whole grains, low-fat dairy, and lean protein).
• Use healthier cooking methods that don’t require added fat (i.e. broiling, baking, microwaving, grilling, roasting, etc.). Avoid frying foods.
• Limit foods that are high in saturated fat and trans fat. Even when you choose healthy fats like nuts, vegetable oils, and avocados, remember to keep portions small. These foods are good choices, but are also dense in calories.
• Save money and calories by limiting the amoutn of sweets, chips, and other snack foods you buy.
• Choose zero-calorie drinks. Limit sugary beverages like soda, energy drinks, and juice drinks.
• Remember that portion size is still important, even if you are eating healthy foods. If you need help controlling portions, try using our plate method or even measuring out your foods with measuring cups and spoons.
• Have a small portion of fruit for dessert instead of cookies, candy, or other baked goods. If you are out to eat, split one dessert among the whole table.

Healthy eating is just one important lifestyle change that you can make to reduce your risk for developing diabetes. It is also important to be active on a regular basis. If you have never been active or have not been active for a while, you will need to start slowly and work your way up. Thirty minutes of moderate-intensity activity, 5 days per week is a good goal to start with.

Some other online resources that can help include:

Losing Weight, Fitness, and What Can I Eat?

If you have further questions or would like to recieve a free copy of booklets on weight loss or the top ways to stop diabetes, contact our Center for Information and Community Support. Our reps are standing by to answer your questions Monday through Friday, 8:30 am- 8 pm EST. Just call 1-800-DIABETES.

It’s obviously very important to take cultural preferences into account when helping patients with meal planning for their diabetes. Rice is a staple food in Hispanic culture, and it wouldn’t be fair to ask one of these patients stop eating rice all together.

The good news – having diabetes doesn’t mean that your patients have to give up high carbohydrate foods like rice. People with diabetes can still enjoy rice and other staple foods like beans, corn, and tortillas in small portions.

It’s important to teach them how to make these foods fit with their meal plan. For example, if their carb limit for lunch is 45 grams of carbohydrate, they can choose to get some of those carbs from a serving of rice.

Below is a list of serving sizes that have approximately 15 grams of carbohydrate:

• 1/3 cup rice (white or brown)
• 1/2 cup wild rice
• 1, 6-inch tortilla (flour or corn)
• ½ cup corn
• ½ cup beans

You will probably find that most of these patients prefer to eat white rice, which is a refined grain. We recommend that people with diabetes choose whole grain foods most of the time because they provide more fiber, vitamins, and minerals than refined grains. Both brown and wild rice are whole grains and make great substitutes for white rice.

If a patient is hesitant to stop eating white rice, it may help to start by asking them to start by substituting in brown rice just a few times each week. Brown and white rice have the same amount of carbs in a serving, which makes it an easy switch!

Other whole grains to encourage are:

• Bulgur (cracked wheat)
• Whole wheat flour
• Whole oats/oatmeal
• Whole grain corn/corn meal
• Popcorn
• Brown rice
• Whole rye
• Whole grain barley
• Wild rice
• Buckwheat
• Buckwheat flour
• Triticale
• Millet
• Quinoa
• Sorghum

Be sure to tell your patients to look for products that list whole wheat flour or another whole grain as the first ingredient when buying foods like bread, crackers, or tortillas.

This is a very common question among people with diabetes. If he hasn't already, your dad should work with his healthcare provider to set some diabetes goals. Goals might include losing weight, improving his A1C, lowering his blood pressure and/or lowering cholesterol levels.

Once his goals are set, he can then work with his provider to set up a meal plan that aims to achieve those goals. This plan should also account for his preferences and lifestyle. The plan should include how many carbohydrates to have at each meal and whether or not to include snacks. His provider may suggest using the diabetes plate method to plan meals or they may suggest carbohydrate counting. A registered dietitian (RD) can be especially helpful when learning about meal plannign for diabetes.

For those with type 2 diabetes who haven’t set up an individualized meal plan, we suggest including about 45-60 grams of carbohydrate per meal to start. However, some people may need more and some people may need less. It sounds like your father is very active, so if he has type 2 diabetes, he would probably want to shoot for the higher end of that recommendation. He may actually need more than that, so encourage him to see his provider soon!

One of the simplest methods you can use to plan diabetes-friendly meals is the Plate Method, which we also call “Create your Plate”. This method is helpful for controlling portion sizes. Once you get used to smaller portions on your plate, you can work toward filling each section of the plate with healthier options. Here are the basics:

1. Divide your plate in half down the middle.Then on one side, cut it again so you will have 3 sections on your plate.
2. Fill the largest section with non-starchy vegetables such as:
• spinach, carrots, lettuce, greens, cabbage, bok choy 
• green beans, broccoli, cauliflower, tomatoes, 
• vegetable juice, salsa, onion, cucumber, beets, okra, 
• mushrooms, peppers, turnip 
3. Now in one of the small sections, put starchy foods such as: 
• whole grain breads, such as whole wheat or rye 
• whole grain, high-fiber cereal 
• cooked cereal such as oatmeal, grits, hominy, or cream of wheat 
• rice, pasta, dal, tortillas 
• cooked beans and peas, such as pinto beans or black-eyed peas 
• potatoes, green peas, corn, lima beans, sweet potatoes, winter squash 
• low-fat crackers and snack chips, pretzels, and fat-free popcorn 
4. And then on the other small section, put your lean meat or meat substitutes such as:
• chicken or turkey without the skin
• fish such as tuna, salmon, cod, or catfish
• other seafood such as shrimp, clams, oysters, crab, or mussels
• lean cuts of beef and pork such as sirloin or pork loin
• tofu, eggs, low-fat cheese 
5. Add an 8 oz glass of non-fat or low-fat milk. If you don’t drink milk, you can add another small serving of carb such as a 6 oz. container of light yogurt or a small roll.
6. And a piece of fruit or a 1/2 cup fruit salad and you have your meal planned. Examples are fresh, frozen, or canned in juice or frozen in light syrup or fresh fruit.

You may also be interested in our free meal planning resource Recipes for Healthy Living. All it takes is a quick sign-up and you’ll receive a new set of diabetes-friendly recipes, a one-day meal plan, and cooking tips each month. Recipes for Healthy Living may be especially helpful for finding healthy meal ideas that are diabetes-friendly.

Since your husband has high cholesterol, he should also work on lowering the amount of trans fat, saturated fat, and cholesterol in his diet. He can do this by choosing from the healthy choices listed above. He should also become familiar with the different types of fat and the foods that we get them from. A few foods that contain unhealthy fats to watch out for are highly processed meats, highly processed snack foods, fried foods, chocolate, cream, butter, full-fat dairy products, and poultry with the skin.

In addition to changing his eating habits, he should refrain from smoking and increase his activity level. Losing weight if he is overweight can also help.

When you look at a nutrition label, you’ll notice that the grams of total carbohydrate are bolded. That number includes all types of carbohydrate: starches, sugars, dietary fiber, and sugar alcohols. Since almost all types of carbohydrate raise blood glucose, we recommend using the grams of total carbohydrate listed when counting carbohydrates.

The sugars are listed out on the label but there is no need to subtract the grams of sugar. Sugars will raise blood glucose but they are already accounted for in the total carbohydrate grams.