Q:
I've heard there are healthy and unhealthy carbohydrates. What should I eat more of, and what do I need to limit?
A:
Foods that contain carbohydrates are starches, grains, fruit, vegetables, and dairy foods. The healthiest sources of carbohydrates provide plenty of vitamins and minerals per calorie—they are nutrient-dense. Everyone should eat more fiber-rich carbohydrates, such as whole grains, fruits, vegetables, and beans (legumes). You should try to eat at least three servings or half your servings of starches as whole grains each day. Less healthy carbohydrates like candy, sweetened beverages, and ice cream pack little nutritional punch but contain plenty of calories; keep them to a minimum.
Q:
What are the most important factors I need to consider about the types and amounts of fats I eat?
A:
You should consume no less than 25%, and no more than 35%, of your calories from fat. For example, if you eat 1,600 calories daily, this translates to 400 to 560 calories from fat. Each gram of fat contains nine calories, so you should aim for 44 to 62 grams of fat daily.
Focus on getting most of your fat in polyunsaturated or unsaturated form. Some of these healthier fats help bring down your total and LDL (lousy) cholesterol levels, while boosting HDL (healthy) cholesterol. Polyunsaturated fats include omega-3 fats, found in fish, canola oil, walnuts, flax seeds, and flax seed oil; and omega-6 fats, contained in corn oil, sunflower oil, and other liquid vegetable oils. Nuts, olive oil, canola oil, and avocados are good monounsaturated fat sources.
Limit saturated and trans fats, which increase both total and LDL cholesterol. Saturated fats are found in meats and dairy foods, as well as the coconut oil, palm oils, and palm kernel oils often used to make store-bought cookies, snacks, and other processed foods. Trans fats have no nutritional value and should be limited as much as possible. Partially hydrogenated oils used to make some baked goods, prepared snacks, and deep-fried fast foods are the main source of trans fats in the U.S. food supply. Nutrition Facts labels generally include information on a food's saturated and trans fat content.
Q:
Is it OK for me to consume alcohol in moderation? What caveats should I follow, and are some types of alcohol better than others?
A:
Moderate alcohol consumption—one drink a day for women, two a day for men—is fine for everyone, including people with diabetes. Drinking lightly can actually have health benefits, for example, reducing the risk of heart and blood vessel disease. But don't start drinking to get these benefits if you don't already. Sip alcoholic beverages slowly, and consume them with meals. Be aware that alcohol can cause blood glucose to go too low for people who take insulin or certain diabetes pills (ones that can cause low blood glucose or hypoglycemia), while alcohol can also cause hyperglycemia due to its carbohydrate content. The health benefits for all types of alcohol are the same. If you choose to drink, you can keep the amount of carbohydrates in drinks down by avoiding drinks mixed with juice or soda and using low-calorie mixers like club soda and tomato juice.
Q:
Should people with diabetes eat snacks?
A:
Years ago, health-care providers would advise people with diabetes to eat three meals a day and three snacks to keep their blood glucose levels up. But today, there are several blood-glucose-lowering medications that don't cause hypoglycemia and types of insulin (long-acting and rapid-acting) that cause fewer problems with low blood glucose. Some people may not initially need to take any blood-glucose-lowering medication. So the recommendation to eat several snacks a day is considered old-school. Today's advice is: Include snacks in your eating plan if you want them, if your blood glucose still tends to drop below normal even after you've worked with your health-care provider to adjust your medications, or if you need snacks to get the calories or nutrients you require.
As with all the foods you eat, choose foods for snacks that contain healthy sources of carbohydrates and trim fat content. A few healthy and portable snacks are: fresh or dried fruit; individual containers of fruit packed without added sugar; a handful of nuts; low-fat, high-fiber crackers with peanut butter, reduced-fat cheese, or part-skim cheese; raw vegetables; or reduced sugar yogurt.
Q:
Which sugar substitutes are best for a person with diabetes?
A:
Aspartame (NutraSweet) and sucralose (Splenda), the sugar substitutes most commonly used in the U.S., are virtually carbohydrate free and will not increase your blood glucose levels. Three other no-calorie sweeteners that won't affect blood glucose have been approved as food additives by the FDA: acesulfame potassium (Sunette and other brands), neotame (which currently isn't in a tabletop sweetener or in many foods), and saccharin (Sweet n' Low and other brands). According to the American Diabetes Association and the FDA, these are all safe for people with diabetes and the general public to use. Extracts of stevia, a South American plant with very sweet leaves, have not been approved by the FDA as a food additive, although stevia is available as a dietary supplement.
Type 2 Diabetes:Eating Healthy
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