It is easy to say what a diabetic should not eat: sugars, simple carbohydrates, alcoholic beverages. Sometimes it seems that all tasty foods are forbidden: pizza, donuts, cakes, ice cream, brownies, etc.

Is a diabetic condemned to a broccoli and grilled fish diet?

Not at all. For the most part, people can eat normal foods, but wisely.

The biggest problem diabetics have is consuming too many calories. Simply limiting caloric intake to 1500-1800 calories would stabilize blood sugar levels for many patients. Not only that, but they would also lower body weight and serum cholesterol. If you are diabetic and only make one change in your diet, choose to eat less.

Problem foods for diabetics are those that quickly raise blood glucose levels. Sugar, of course, but also simple carbohydrates and alcohol. It doesn’t mean that you can’t eat even a bite of these foods, but rather that you should use discretion and limit your portion sizes to just 100-200 calories per day. Avoiding “white” foods is a good idea: white flour, white rice, white potatoes, white pasta. All of these are converted to glucose in the bloodstream almost as fast as the sugar itself.

Beyond that, what should a diabetic eat? And because?

Some of the best foods for diabetics are fruits and vegetables, which are rich in soluble fiber. These promote a feeling of fullness, help the intestines to clear properly, add potassium, vitamins, and antioxidants to the diet, and are generally low in calories. Try to eat 5 servings of fruits and vegetables a day.

Among fruits, those that are less sweet are desirable, such as apples, berries, and cantaloupe. Very sweet fruits like watermelon and pineapple can be eaten, but in limited quantities. A full cup of watermelon has about the same number of calories as a 7 cup and can raise your blood sugar just as much. A large slice of watermelon can have as many calories as a hot fudge ice cream.

Vegetables tend to have more fiber and fewer calories. You can eat lettuce, spinach, celery, cucumbers, cabbage, radishes, onions, leeks, kale, and other vegetables as you like. Carrots have a higher glycemic index, but it is difficult to eat too many carrots. Green beans and pea pods are good as they include the low calorie pod. Beans and peas are high in fiber, a good source of protein, but more calories than salad-type vegetables. Corn is actually a grain, not a vegetable, but it is preferable to a processed grain such as white flour or cereal.

If it weren’t for the ingredients, a diabetic could eat an unlimited amount of salad. The dressing can add hundreds of calories, as can other toppings like eggs, croutons, seeds, and bits of bacon. Tasty low calorie dressings are an option, or use a small amount of regular dressing. Again, serving size is vital. A serving of regular restaurant dressing for a large salad is easily 500 calories, while a large serving of diet dressing can be less than 100 calories.

Most diabetics love carbohydrates, but limiting them to whole grains is a good idea. And while oatmeal has been touted as a health food, processed oatmeal metabolizes almost as quickly as sugar-coated cereal. If you like oats, choose raw steel cut oats (but keep in mind that they take much longer to cook).

We all need protein in our diet to keep our muscles strong and healthy. While it is possible to consume enough protein from a vegetarian diet, most people prefer to add animal products such as fish, chicken, eggs, or meat. Many diabetics have high cholesterol levels and therefore should avoid red meat and excess eggs. Lean meat such as chicken, fish, or turkey is preferable, but be careful with salty lunch meat, which can raise your blood pressure.

Five daily servings of foods with calcium (1500 mg) in the form of green leafy vegetables or dairy products should be included in the diet. Skim milk, low-fat cheese, and artificially sweetened yogurt are good options.

Lastly, what about dessert? Today, many desserts are available in varieties with no added sugar, including ice cream, cookies, and cakes. These are sweetened with alcoholic sugars, which do not raise blood glucose as quickly as regular sugar, but are just as high in calories. A bowl of berries with some unsweetened ice cream is a reasonable option.

Copyright 2010 Cynthia J. Koelker, MD

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