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Type 2 Diabetes Nutrition

If you have type 2 diabetes, your main focus is often on weight control. Most people with this disease are overweight.

Often, you can improve type 2 diabetes control by losing weight (about 10 pounds) and increasing physical activity (for example, 30 minutes of walking per day). In addition to making lifestyle changes, some people will need to take pills or insulin injections to control their blood sugar.

You can improve blood sugar (glucose) levels by following a meal plan that has:

  • Fewer calories
  • An even amount of carbohydrates (30 – 45 grams per meal)
  • Healthy monounsaturated fats

Examples of foods that are high in monounsaturated fats include peanut or almond butter, almonds, and walnuts. You can substitute these foods for carbohydrates, but keep portions small because these foods are high in calories. Learn how to read nutrition labels to help you make better food choices.

A study published in the Journal of the American Medical Association found that eating nuts and peanuts may lower the risk of type 2 diabetes in women. Reduced risk was greatest in people who ate the most nuts. Those who never or almost never ate nuts had no change in risk, and those who consumed nuts five or more times a week had a 27 percent lower risk. Women who consumed peanut better five or more times per week had a 21 percent lower risk compared to women who never or almost never ate peanut butter.

CHILDREN AND TYPE 2 DIABETES

Children with type 2 diabetes present special challenges. Meal plans should consider the amount of calories children need to grow. Kids often need three smaller meals and three snacks to meet their calorie needs. The goal should be a healthy weight (most children with type 2 diabetes are obese) and increased physical activity.

Changes in eating habits and increased exercise help improve blood sugar control. When at parties or during holidays, your child may still eat sugary foods. But during other times of the day, the child should have fewer carbohydrates. Children who eat birthday cake, Halloween candy, or other sweets should NOT have the usual daily amount of potatoes, pasta, or rice. This substitution helps keep calories and carbohydrates in better balance.

MEAL PLANNING

One of the most challenging aspects of managing diabetes is meal planning. Work closely with the doctor and dietitian to design a meal plan that keeps the blood sugar (glucose) levels near normal. The meal plan should give you or your child the proper amount of calories to maintain a healthy body weight.

Having diabetes does not mean you or your child must completely give up any food, but it does change the kinds of foods your child should eat routinely. Choose foods with moderate amounts of carbohydrates (about 30 – 45 grams per meal or 45-60% of daily calories consumed) to help keep blood sugar levels under good control. Foods should also provide enough calories to maintain a healthy weight. Regular monitoring of blood sugar (glucose) at home will help you learn how different foods affect blood sugar (glucose) levels.

Recommendations

A registered dietitian can help you decide how to balance the carbohydrates, protein, and fat in your diet. Here are some general guidelines:

The amount of each type of food you eat depends on:

  • Your diet
  • Your weight
  • How often you exercise
  • Your other health risks

Everyone has individual needs. Work with your doctor, and possibly a dietitian, to develop a meal plan that works for you.

The Diabetes Food Pyramid, which resembles the old USDA food guide pyramid, splits foods into six groups in a range of serving sizes. In the Diabetes Food Pyramid, food groups are based on carbohydrate and protein content instead of their food type. A person with diabetes should eat more of the foods in the bottom of the pyramid (grains, beans, vegetables) than those on the top (fats and sweets). This diet will help keep your heart and body systems healthy.

Another method, similar to the new “plate” USDA food guide, encourages larger portions of vegetables (half the plate) and moderate portions of protein (one-quarter of the plate) and starch (one-quarter of the plate).

Glycemic Index–Some carbohydrate foods are digested and absorbed into your bloodstream quickly, while others are digested and converted to blood glucose more slowly. The glycemic index (GI) measures the effects on blood glucose of a carbohydrate food. Research has found that including foods with a low GI in the diet can improve blood sugar control in diabetics  Examples of low-GI foods are peas, beans, lentils, fruits like apples  pears and oranges, barley, bran cereals, pasta, milk and yogurt  High-GI foods include potatoes, rice cakes, cornflakes, soft drinks, watermelon, pretzels  and soda crackers. A food’s GI can vary according to the method of preparation. A baked potato, for example, has a higher GI than a boiled one.

GRAINS, BEANS, AND STARCHY VEGETABLES

(6 or more servings a day)

Foods like bread, grains, beans, rice, pasta, and starchy vegetables are at the bottom of the pyramid because they should serve as the foundation of your diet. As a group, these foods are loaded with vitamins, minerals, fiber, and healthy carbohydrates.

It is important, however, to eat foods with plenty of fiber. Soluble fiber –the kind found in oatmeal– may actually help lower blood-sugar levels (it also helps lower cholesterol). And insoluble fiber, found in whole grains and many vegetables, help you feel full on fewer calories. Choose whole-grain foods such as whole-grain bread or crackers, tortillas, bran cereal, brown rice, or beans. Use whole-wheat or other whole-grain flours in cooking and baking. Choose low-fat breads, such as bagels, tortillas, English muffins, and pita bread.

VEGETABLES

(3 – 5 servings a day)

Choose fresh or frozen vegetables without added sauces, fats, or salt. Opt for more dark green and deep yellow vegetables, such as spinach, broccoli, romaine lettuce, carrots, and peppers.

FRUITS

(2 – 4 servings a day)

Choose whole fruits more often than juices. Whole fruits have more fiber. Citrus fruits, such as oranges, grapefruits, and tangerines, are best. Drink fruit juices that do NOT have added sweeteners or syrups.

MILK

(2 – 3 servings a day)

Choose low-fat or nonfat milk or yogurt. Yogurt has natural sugar in it, but it can also contain added sugar or artificial sweeteners. Yogurt with artificial sweeteners has fewer calories than yogurt with added sugar.

MEAT AND FISH

(2 – 3 servings a day)

Choose nutritious protein sources. Eat fish and poultry more often. Remove the skin from chicken and turkey. Select lean cuts of beef, veal, pork, or wild game. Trim all visible fat from meat. Bake, roast, broil, grill, or boil instead of frying. There is no research to support either an increase or decreased protein intake for uncomplicated diabetes, so the recommended amounts for non-diabetics is also appropriate for adults with diabetes. High-quality protein foods (lean meats, meat substitutes, and lower-fat dairy foods) should supply 10 to 20 percents of daily calories.

FATS, ALCOHOL, AND SWEETS

In general, people with diabetes should follow a lower-fat diet. High-fat diets contribute to obesity and high cholesterol levels. You should limit your intake of fatty foods, especially those high in saturated fat, such as hamburgers, cheese, bacon, and butter.

Saturated fats from animal foods and hydrogenated fats in packaged foods should also be limited. On the other hand, monounsaturated and polyunsaturated fats –such as those found in vegetable oils, nuts, fish, and avocados– are good for the heart and also slow the digestion process, helping to stabilize blood-sugar levels. They may also reduce insulin resistance.

Results from some research studies suggest that people who drink light to moderate amounts of alcohol daily significantly lower their risk of diabetes. If you choose to drink alcohol, limit the amount and have it with a meal. Check with your health care provider about how alcohol will affect your blood sugar, and to determine a safe amount for you.

Sweets are high in fat and sugar, so keep portion sizes small. Here are some tips to help avoid eating too many sweets:

  • Ask for extra spoons and forks and split your dessert with others.
  • Eat sweets that are sugar-free.
  • Always ask for the small serving size.

Learn how to read food labels, and consult them when making food decisions.

Your meal plan is for you only. Each person with diabetes may have a slightly different meal plan. Talk to your Registered Dietitian or Certified Diabetes Educator to help you plan your meals. These guidelines apply to people on a fixed dose of medication or no medication for diabetes.

References

American Diabetes Association. Standards of medical care in diabetes — 2011. Diabetes Care.

American Diabetes Association. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2008;31:S61-S78.