Living with diabetes: Better foods to choose

Recognising Diabetes Week (12th-18th June 2023)

As a charity, our heritage is steeped in offering support and education for those living with and managing variants of diabetes. We’re recognising Diabetes Week 2023, by offering a range of additional blogs and e-bulletins around this important subject.

Figuring out the best foods to eat when you have diabetes doesn’t have to be tough. To keep things simple, your main goal should be managing your blood sugar levels. It’s also important to eat foods that help prevent diabetes complications like heart disease. Your diet can have a major role in preventing and managing diabetes. Here are some great suggestions of foods for people living with diabetes, both type 1 and type 2.

Best foods for people living with diabetes:

Oily fish

Salmon, sardines, herring, anchovies, and mackerel are great sources of the omega-3 fatty acids DHA and EPA, which have major benefits for heart health. Getting enough of these fats on a regular basis is especially important for people with diabetes, who have an increased risk of heart disease and stroke.

Such healthy fats protect the cells that line your blood vessels, reduce inflammation, and may help improve the way your arteries function. Research indicates that people who eat fatty fish regularly have a lower risk of acute coronary syndromes, like heart attacks, and are less likely to die from heart disease.

Studies show that eating fatty fish may also help regulate blood sugar. A study involving 68 adults who were overweight or obese found that participants who consumed fatty fish had significant improvements in post-meal blood sugar levels than participants who consumed lean fish. Fish is also a great source of high-quality protein, which helps you feel full and helps stabilise blood sugar levels.

Leafy greens

Leafy green vegetables are full of nourishment. They’re also very low in digestible carbs, or carbs absorbed by the body, so they won’t significantly affect blood sugar levels. Spinach, kale, and other leafy greens are good sources of many vitamins and minerals, including vitamin C, which our body can’t produce on its own. Some evidence suggests that people with diabetes have lower vitamin C levels than people without diabetes, and they may have greater vitamin C requirements. Vitamin C acts as a potent antioxidant and also has anti-inflammatory qualities. Thus, reducing cellular damage.

Avocados

Avocados have less than 1 gram of sugar, few carbohydrates, a high fibre content, and healthy fats, so you don’t have to worry about them raising your blood sugar levels. Avocado consumption is also associated with improved overall diet quality and significantly lower body weight and body mass index (BMI). This makes avocados an ideal snack for people with diabetes, especially since obesity increases the chances of developing diabetes.

Avocados may have properties specific to preventing diabetes. A 2019 study in mice found that avocatin B (AvoB), a fat molecule found only in avocados, encourages greater insulin sensitivity and subsequently can be one small contributing factor to help mange diabetes. More research is needed in humans to establish the connection between avocados and diabetes prevention.

Eggs

Regular egg consumption may reduce your heart disease risk in several ways. Eggs may decrease inflammation, improve insulin sensitivity, increase your HDL (good) cholesterol levels, and modify the size and shape of your LDL (bad) cholesterol.

A 2019 study found that eating a high fat, low carb breakfast of eggs could help people with diabetes manage blood sugar levels throughout the day, ie highlighting the benefits of starting with a savoury breakfast. This can offset the risk of encouraging a day of uncontrolled blood sugar spikes if you were to start with a carb rich breakfast.

Older research has linked egg consumption with heart disease in people with diabetes. But a more recent review of controlled studies found that eating 6 to 12 eggs per week as part of a nutritious and varied diet did not increase heart disease risk factors in people with diabetes. What’s more, some research suggests that eating eggs may reduce the risk of stroke.

Chia seeds

Chia seeds are a wonderful food for people with diabetes. They’re extremely high in fibre, yet low in digestible carbs. In fact, 11 of the 12 grams of carbs in a 28-gram (1-ounce) serving of chia seeds are fibre, which doesn’t raise blood sugar. The fibre in chia seeds can actually lower your blood sugar levels by slowing down the rate at which food moves through your gut and is absorbed.

Chia seeds may help you achieve a moderate weight because fibre reduces hunger and makes you feel full. Chia seeds may also help maintain glycaemic management in people with diabetes.

A study involving 77 adults with overweight, or obesity and a diagnosis of type 2 diabetes found that eating chia seeds supports weight loss and helps maintain good glycaemic control. Additionally, chia seeds have been shown to help reduce blood pressure and inflammation in the body.

Beans or Pulses

Beans are affordable, nutritious, and super healthy. Beans are a type of legume rich in B vitamins, beneficial minerals (calcium, potassium, and magnesium), and fibre. They also have a very low glycaemic index, which is important for managing diabetes.

Beans may also help prevent diabetes. In a study involving more than 3,000 participants at high risk of cardiovascular disease, those who had a higher consumption of legumes had a reduced chance of developing type 2 diabetes.

Greek yogurt

A long-term study involving health data from more than 100,000 participants found that a daily serving of yogurt was linked to an 18 percent lower risk of developing type 2 diabetes. It may also help you lose weight if that’s a personal goal. 

Studies show yogurt and other dairy foods may lead to weight loss and improved body composition in people with type 2 diabetes. The high levels of calcium, protein, and a special type of fat called conjugated linoleic acid (CLA) found in yogurt may help keep you full for longer. 

What’s more, Greek yogurt contains only 6–8 grams of carbs per serving, which is lower than conventional yogurt. It’s also higher in protein, which may promote weight loss by reducing appetite and thus decreasing intake of ultraprocessed calorie dense foods.

Nuts

Nuts are delicious and nutritious. Most types of nuts contain fibre and are low in net carbs, although some have more than others. Research on a variety of different nuts has shown that regular consumption may reduce inflammation and lower blood sugar, HbA1c (a marker for long-term blood sugar management), and LDL (bad) cholesterol levels.

Nuts may also help people with diabetes improve their heart health. A 2019 study involving more than 16,000 participants with type 2 diabetes found that eating tree nuts — such as walnuts, almonds, hazelnuts, and pistachios — lowered their risk of heart disease and death.

Research also indicates that nuts can improve blood glucose levels. A study with people with type 2 diabetes found that eating walnut oil daily improved blood glucose levels. This finding is important because people with type 2 diabetes often have elevated levels of insulin, which are linked to obesity. (Please be aware that nut consumption is strongly not advised should you have any form of nut allergy).

Broccoli

Broccoli is one of the most nutritious vegetables around. A half cup of cooked broccoli contains only 27 calories and 3 grams of digestible carbs, along with important nutrients like vitamin C and magnesium. Broccoli may also help manage your blood sugar levels.

One study found that consuming broccoli sprouts led to a reduction in blood glucose in people with diabetes. This reduction in blood glucose levels is likely due to sulforaphane, a chemical in cruciferous vegetables like broccoli and sprouts.

Extra-virgin olive oil

Extra-virgin olive oil contains oleic acid, a type of monounsaturated fat that may improve glycaemic management, reduce fasting and post-meal triglyceride levels, and has antioxidant properties. (In other words, reduce sugar spikes and offset too much fat in your blood stream. Whilst preventing you ageing prematurely - both inside and out).

This is important because people with diabetes tend to have trouble managing blood sugar levels and have high triglyceride levels. In a large analysis of 32 studies looking at different types of fat, olive oil was the only one shown to reduce heart disease risk.

Olive oil also contains antioxidants called polyphenols (you’ll have heard these also related to the likes of dark chocolate, green tea and red wine). Polyphenols reduce inflammation, protect the cells lining your blood vessels, keep oxidation from damaging your LDL (bad) cholesterol, and decrease blood pressure.

Extra-virgin olive oil is unrefined, so it retains antioxidants and other properties that make it so healthy. Be sure to choose extra-virgin olive oil from a reputable source, since many olive oils are mixed with cheaper oils like corn and soy.

Flaxseeds

Also known as common flax or linseeds, flaxseeds have a high content of heart-healthy omega-3 fats, fibre, and other unique plant compounds. A portion of their insoluble fibre is made up of lignans, which may help decrease heart disease risk and improve blood sugar management. A review analysing 25 randomised clinical trials found a significant association between whole flaxseed supplementation and a reduction in blood glucose.

Flaxseeds may also help lower blood pressure. A 2016 study involving participants with prediabetes found that a daily intake of flaxseed powder lowered blood pressure — but it did not improve glycaemic management or insulin resistance. More research is needed to investigate how flaxseed can help prevent or manage diabetes. But overall, flaxseed is beneficial for your heart and gut health. So will have an indirect but positive knock on effect in managing metabolic syndrome conditions such as diabetes. Furthermore, flaxseeds are very high in viscous fibre, which improves gut health, insulin sensitivity, and feelings of fullness.

Apple cider vinegar and vinegar

Apple cider vinegar and plain vinegar have many health benefits. Although it’s made from apples, the sugar in the fruit is fermented into acetic acid. The resulting product contains less than 1 gram of carbs per tablespoon. According to a meta-analysis of six studies, including 317 people with type 2 diabetes, vinegar has beneficial effects on fasting blood sugar levels and HbA1c. Apple cider vinegar may have many other healthful properties, including antimicrobial and antioxidant effects. But more studies are needed to confirm its health benefits.

Strawberries

Strawberries are high in antioxidants known as anthocyanins, which give them their red colour. They also contain polyphenols, which are beneficial plant compounds with antioxidant properties. 

A 2017 study found that a 6-week consumption of polyphenols from strawberries and cranberries improved insulin sensitivity in adults who were overweight or obese and who didn’t have diabetes.

This is important because low insulin sensitivity can cause blood sugar levels to become too high. A 1-cup serving of strawberries contains about 53.1 calories and 12.7 grams of carbs, three of which are fibre. This serving also provides more than 100% of the reference daily intake (RDI) for vitamin C, which provides additional anti-inflammatory benefits for heart health.

Garlic

For its tiny size and low-calorie count, garlic is incredibly nutritious. Research indicates that garlic contributes to improved blood glucose management and can help regulate cholesterol. Although many studies that determine garlic is a proven healthy option for people living with diabetes include abnormal dietary amounts of garlic, the meta-analysis cited above only included servings from 0.05–1.5 grams. For context, one clove of garlic is around 3 grams. Research also indicates that garlic can help reduce blood pressure and regulate cholesterol levels.

Squash

Squash, which has many varieties, is one of the healthiest vegetables around. The dense, filling food is fairly low in calories and has a low glycaemic index. Winter varieties have a hard shell and include pumpkin and butternut. Summer squash has a soft peel that can be eaten. The most common types are courgette and squash.

Like most vegetables, squash contains beneficial antioxidants. Squash also has less sugar than sweet potatoes, making it a great alternative. Research shows that pumpkin polysaccharides, which are also found in squash, improved insulin sensitivity in rats.

Although there’s very little research on humans, a small study in humans found that squash decreased high blood glucose levels quickly and effectively in people with diabetes who were critically ill. More studies with humans are needed to confirm the health benefits of squash. But the health benefits of squash make it a great addition to any meal.

Foods to avoid

Just as important as figuring out which foods you should include in a diet for diabetes is understanding which foods you should limit. This is because many foods and drinks are high in carbs and added sugar, which can cause blood sugar levels to spike. Other foods could negatively impact heart health or contribute to weight gain. Here are a few foods that you should limit or avoid if you have diabetes.

Refined grains

Refined grains like white bread, pasta, and rice are high in carbs but low in fibre, which can increase blood sugar levels more quickly than their whole grain counterparts. According to one research review, whole grain rice was significantly more effective at stabilising blood sugar levels after eating than white rice.

Sugar-sweetened beverages

Not only are sugar-sweetened beverages like soda, sweet tea, and energy drinks lacking important nutrients, but they also contain a concentrated amount of sugar in each serving, which can cause blood sugar levels to spike.

Fried foods

Fried foods have a lot of bad fat, that has been linked to a higher risk of heart disease. What’s more, fried foods like crisps, french fries, and mozzarella sticks are also typically high in calories, which could contribute to weight gain.

Alcohol

People with diabetes are generally advised to limit their alcohol intake. This is because alcohol can increase the risk of low blood sugar, especially if consumed on an empty stomach.

Breakfast cereal

Most varieties of breakfast cereal are very high in added sugar. Some brands pack as much sugar into a single serving as some desserts. When shopping for cereal, be sure to check the nutrition label carefully and select a variety that is low in sugar. Alternatively, opt for oatmeal and sweeten it naturally with a bit of fresh fruit, such as berries.

Sweets & Candies

Candy contains a high amount of sugar in each serving. It typically has a high glycaemic index, meaning it’s likely to cause spikes and crashes in blood sugar levels after you eat.

Processed meats

Processed meats like bacon, hot dogs, salami, and cold cuts are high in sodium, preservatives, and other harmful compounds. Furthermore, processed meats have been associated with a higher risk of heart disease.

Fruit juice

Although 100% fruit juice can be enjoyed from time to time in moderation, it’s best to stick to whole fruit whenever possible if you have diabetes. This is because fruit juice contains all the carbs and sugar found in fresh fruit, but it’s lacking the fibre needed to help stabilise blood sugar levels.

Creating a plan

There are several strategies you can use to plan a healthy, well-rounded diet for diabetes.

Plate method

The plate method is a simple and effective way to support healthy blood sugar levels without tracking or measuring your food. It requires you to adjust your portions of certain food groups on your plate to create a nutritionally balanced meal.

To get started, simply fill half your plate with non-starchy vegetables, such as leafy greens, broccoli, squash, or cauliflower. One-quarter of your plate should consist of proteins, like chicken, turkey, eggs, fish, tofu, and lean cuts of beef or pork. The remaining quarter of the plate should contain a good source of carbohydrates, including whole grains, legumes, starchy vegetables, fruit, or dairy products.

Food ordering is important. Starting with your beg/salad; followed by your protein and fat; and leaving your carbs until the end of the meal. It’s suggested, this simple task can reduce sugar spikes by up to 75%.

Carb counting

Carb counting is a popular method used to manage blood sugar levels by monitoring the amount of carbohydrates you consume throughout the day. It involves tracking the grams of carbs in the foods you eat. In some cases, you may also need to adjust your dosage of insulin based on the amount of carbs you consume.

The number of carbs you should eat for each meal and snack can vary quite a bit depending on factors like your age, size, and activity level. Therefore, a registered dietitian or doctor can help you create a customised plan for carb counting based on your needs.

Sample menu

Eating healthy with diabetes doesn’t have to be difficult or time consuming. Here’s a 1-day sample menu with some easy meal ideas to help get you started:

·       Breakfast: omelette with broccoli, mushrooms, and peppers

·       Morning snack: handful of almonds

·       Lunch: grilled chicken salad with spinach, tomatoes, avocado, onions, cucumber, and balsamic vinaigrette

·       Afternoon snack: Greek yogurt with sliced strawberries and walnuts

·       Dinner: baked salmon with herb quinoa and asparagus

·       Evening snack: sliced veggies and hummus

When diabetes is not well managed, it increases your risk of several serious diseases. But eating foods that help keep blood sugar, insulin, and inflammation in check can dramatically reduce your risk of complications. Just remember, although these foods may help manage blood sugar, the most important factor in healthy blood sugar management is following an overall nutritious, balanced diet.

Extracts taken from Erin Kelly from https://www.healthline.com