Clarifying Some Common Diabetes Questions by Cari Culp, RD
When you have diabetes, thinking about nutrition can seem very overwhelming. Often times it seems as though everyone has advice for you. When clients come to me for diabetes counseling, it’s not uncommon to hear “I was told not to eat anything white” or “I was told to avoid carbohydrates” along with a lot of other confusing advice. With diabetes, there is enough to worry about without taking the joy out of eating! So, in honor of National Diabetes Awareness Month, I’d like to take a moment to address some of the common questions and myths surrounding nutrition for diabetes.
1. I was told not to eat anything white, is that true?
I commonly hear, “I was told to stay away from anything white.” The problem with this concept is that, there are many white foods that are full of health benefits. While some white foods such as white bread, white rice, pastries, cookies, biscuits and other processed floury foods are not great choices, cauliflower, apples, milk, unsweetened yogurt and yes, even potatoes provide many beneficial nutrients. In fact, a potato, although a starch, is rich in vitamin C, potassium, B vitamins and has some fiber. In the case of white bread versus wheat bread, they are both carbohydrates and will both raise blood sugar, however a whole grain bread has more nutrients and fiber which slows digestion of the carbohydrates resulting in a more stable blood sugar. When choosing bread, look for 100% whole grain or 100% whole wheat as the first ingredient and opt for the higher fiber item. Now, we can always get too much of a good thing so the key with any carbohydrate is portion control.
2. Should I choose sugar free foods?
Although sugar raises blood sugar, so do other carbohydrates like grains and milk. Many sugar free foods may be lower in carbohydrate but still contain some carbs in addition to added fats, chemical sweeteners and some other undesirable ingredients. Although anyone, whether they have diabetes or not, should limit foods with added sugar, it is okay to have them occasionally. The key here is to limit the portion, have them with a meal and count them as part of your carb allotment for that meal. Think of it as having a specific amount of carbohydrate dollars in your bank at each meal. How do you want to spend them? Do you want that baked potato or would you rather have a small piece of cake? A registered dietitian can help you understand what a portion of carbohydrate looks like for each food group and the amount that is most appropriate for you at each meal.
3. Should you drink orange juice if you feel like you are having a low blood sugar?
Having a low blood sugar can be very acutely dangerous. If you have diabetes, it is important to have a balanced snack with you anytime you are away from home to avoid this, however if you do feel like blood sugar is getting low, the first thing you want to do is test it. If your reading is 70 or below, 4 oz of liquid sugar, like orange juice or any other type of sugary beverage, is the best way to bring it up. This is really the only time a sugary beverage is recommended. The reason, is that liquid sugar is typically lacking in other macronutrients and fiber so your body metabolizes it very quickly therefore bringing blood sugar up very quickly. The key here is only having 4 oz. You want to avoid drinking too much and putting yourself on a blood sugar roller coaster of highs and lows. Other items appropriate for bringing up a low blood sugar include about 6 pieces of hard candy, 1-2 glucose tablets or 1 tablespoon of honey. Always check blood sugar again 15-30 minutes after treating a low to be sure it is coming up. If it is, it’s important to have a balanced snack or meal at that point to keep it up.
4. I hear cinnamon is good for blood sugar, is that true?
There is substantial research indicating that cinnamon contains certain phytonutrients which are beneficial for increasing insulin sensitivity and improving glucose metabolism therefore lowering blood sugar and hemoglobin A1c. Cinnamon is considered beneficial for diabetes across much of the world, however more research needs to be done before cinnamon could be considered a replacement for other diabetes treatments. Certainly adding it in abundance to your diet can do no harm and even taking it as a supplement is probably safe for most people. The problem with supplements is that they are not regulated by the FDA so it is important to select a brand with good quality standards. If you are unsure, your registered dietitian could recommend one for you.
5. I was told I need 3 meals and 3 snacks daily. Is that true?
I commonly hear this question when counseling people with diabetes. This recommendation was more applicable years ago when there were more diabetes medications that contributed to hypoglycemia. The goal with snacks is to keep blood sugar stable throughout the day and stay ahead of hunger so that you are not overeating at the next meal. If you are feeling satiated from meal-to-meal however, you may not need a snack. In fact, having snacks when you are not hungry could inhibit your ability to maintain a healthy weight and improve blood sugar numbers. The bottom line here… if you are not hungry or having low blood sugar, you probably don’t need a snack. If you are unsure about this or any other diabetes questions, let us help you understand what works best for your body!