Diabetic Diet: What to Eat with Diabetes
Basics of Healthy Eating with Diabetes
Although there isn’t a single diabetic diet that fits every person’s needs, there are general guidelines people with prediabetes or diabetes should follow to live well and thrive. Eating healthfully with diabetes is essential to helping control blood glucose (blood sugar), blood lipids (cholesterol), and blood pressure -- whether you take blood glucose-lowering medications or not. Today, following a diabetic diet means integrating smart food choices into your eating plan, which can help you manage your weight and ABCs (A1C; blood pressure; cholesterol) levels for life.
Our healthy diabetic diet guide includes:
• Healthy breakfast, lunch, dinner, and snack options
• Best foods to include in a healthy eating plan
• Foods to limit or avoid in an eating plan for diabetes
• How to fit sugary foods and sweets into your healthy meal plan
• How to successfully shop at the grocery store
• Plus information about sugar substitutes and eating out
When to Eat with Diabetes and Why
As you try to keep your blood sugar levels on an even keel, it’s beneficial to eat three meals a day and to try not to skip meals. Eating regularly has been shown to help keep blood sugar and metabolism on track.
Typically, a person needs to eat about every four to six hours during the day to maintain energy levels. "People with type 2 diabetes usually have better blood glucose control if their meals and grams of carbohydrates are spaced evenly throughout the day," says Connie Crawley, M.S., RD, LD, a nutrition and health specialist.
Since weight loss is a goal for many people with type 2 diabetes, you'll also want to keep track of how many calories you eat per day and spread them out over the meals you consume.
What to Eat for Breakfast with Diabetes
Breakfast is an important part of a healthy eating plan, especially if you need to control your weight. It jump-starts your metabolism and makes you less likely to overeat later in the day.
"Breakfast gives you energy and serves as a way to help meet your daily requirements for vitamins, minerals, and other nutrients," says dietitian Toby Smithson, RD.
It also helps to refuel your body after a number of hours without food, such as during sleep, by providing carbohydrate, which produces glucose—the main energy source for the body.
A healthy breakfast should include one or more servings of a high-fiber whole grain food, a good source of low-fat protein or dairy (such as 8 ounces of fat-free milk), and a serving of fruit. Work with a registered dietitian or diabetes educator to determine the best foods and portions for you.
What to Eat for Lunch with Diabetes
A filling and healthy lunch can help you get through the day without snacking on high-carb junk food and other empty calories. Try to eat a two to three servings of vegetables as part of your midday meal (1 cup of raw vegetables = 1 serving). Salads are a great way to include a variety of nonstarchy veggies and a lean protein—plus, you can easily sneak in whole grains or enjoy them on the side. Add a serving of fruit or low-fat dairy to round out your lunch. Again, portions and meal planning can be personalized to your specific needs by working with a diabetes educator or dietitian.
What to Eat for Dinner with Diabetes
Dinner should include a lean protein, nonstarchy vegetables, and either starchy vegetables or whole grains. Depending on your calorie and carb budgets, you can also enjoy low-fat dairy or fruit as part of your meal. Talk to a dietitian or diabetes educator about customizing meal plans for delicious and healthy dinners.
By following the plate method, you can enjoy a variety of foods while being mindful of portion sizes:
Nonstarchy vegetables: These should take up half of the 9-inch plate. Nonstarchy vegetables include:
• salad greens
• sweet peppers
• green beans
Lean protein: This should take up a quarter of the 9-inch plate. Foods with protein include:
• chicken breast
• salmon fillet
Grains or starchy vegetables: These should take up a quarter of the 9-inch plate. Grains and starchy vegetables include:
• white or sweet potatoes
• acorn or butternut squash
What to Eat for Snacks with Diabetes
You don’t have to eat snacks, but if you find that snacks help you stay on track, work them into your eating plan. If you need a pick-me-up between meals, a snack with 15-20 grams of carb can be helpful. But you'll need to count all your snacks as part of your daily carb and calorie budget.
For someone with diabetes, a fiber-filled and nutrient-rich snack can help curb appetite before the next meal, says Angela Ginn-Meadow, RD, CDE, a spokesperson for the the Academy of Nutrition and Dietetics.
Talk to your health care provider about whether a snack will work in your meal plan. You can also choose to "save" a serving of carbohydrate from your previous meal and "spend" it on a snack.
Best Foods to Include in a Diabetic Diet
Choosing extra-healthy power foods for your diabetes-friendly diet will help you meet your nutritional needs as well as lower your risk of diabetes complications such as heart disease. Of course, the foods on this list shouldn't be the only foods you eat, but incorporating some or all into your diabetes meal plan in place of less-nutritious choices will help improve your overall health.
Foods to Avoid on a Diabetic Diet
Eating healthfully doesn't have to mean deprivation, starvation, or bland and boring meals. However, that doesn't mean anything goes. Some foods are best left off the table or on the grocery shelf. Everyone—with or without diabetes—would be wise to limit the foods in this list. They are high in saturated fat and trans fat, which contribute to heart disease risk. They can also be high in added sugars, an empty calorie source that can lead to weight gain.
How Veggies Fit Into a Diabetic Diet
Vegetables supply excellent benefits to a diabetic diet. "They provide vitamins, minerals, and fiber, and they're relatively low in calories," says Madhu Gadia, RD, CDE, a nutrition and diabetes educator.
The Dietary Guidelines for Americans recommend that everyone, including people with diabetes, eat 2-1/2 cups of vegetables per day. If your blood sugar rises after you eat vegetables, check your portion sizes:
• One serving of nonstarchy vegetables (1/2 cup cooked) has about 5 grams of carbohydrate and 25 calories.
• One serving of starchy vegetables (1/2 cup cooked) contains about 15 grams of carbohydrate and 80 calories.
Fresh, frozen, or canned vegetables are all good choices as long as they are low in sodium and come without sauces that can add calories and fat.
How Fruits Fit Into a Diabetic Diet
Whether fresh, canned, frozen, or packaged with no sugar added, fruits should be part of a healthful eating plan. Fruits are natural sources of energy, vitamins, minerals, and fiber. Be mindful that juice does not have the fiber content of whole fruits.
The American Diabetes Association (ADA) recommends following the Dietary Guidelines for Americans for a healthful eating plan, which is 2 cups of fruit each day. Keep portion sizes in mind: One serving (1 small piece or 1/2 large piece) of fruit has about 15 grams of carbohydrate and 60 calories.
How Dairy Fits Into a Diabetic Diet
When buying milk, yogurt, cottage cheese, and other dairy products, be sure to choose reduced-fat or fat-free versions. Regular dairy products can contain unwanted saturated fat (the type that can lead to heart disease). Also limit sweetened dairy foods, like chocolate milk or yogurt with fruit, unless it’s sweetened with a low-calorie sweetener.
Aim to get three servings of dairy products a day. Try 1 cup or 1/2 cup of fat-free milk over your cereal, a stick of low-fat string cheese for a snack, and 6 ounces of plain fat-free or light yogurt for dessert. If you're lactose-intolerant, look for calcium-fortified soymilk. Hard cheeses and yogurt are low in lactose, making them options for people who have mild to moderate lactose intolerance.
How Protein Fits Into a Diabetic Diet
Protein is an important part of a diabetic diet. It's vital to keep your body working properly, but it's also helpful for people with diabetes who are trying to lose weight because it provides satiety.
People with diabetes have a higher risk of heart disease, so choose protein-rich foods that are low in fat. Lean protein options include poultry, fish, and lean cuts of beef, veal, and pork. If you're not sure which cuts of meat are lean, look for the words "loin" or "round," such as pork tenderloin or eye of round beef. The ADA recommends a serving size of 2-5 ounces of meat per meal. Talk to your health care provider about how best to include lean protein in your meal planning.
Try including some meatless meals that contain nuts, legumes, or soy products, such as tofu. These foods can lower cholesterol due to their combination of fiber, heart-healthy fat, and phytochemicals.
How Whole Grains Fit Into a Diabetic Diet
Replacing refined grains with whole grains in your diabetic diet can help improve your blood sugar control, reduce total cholesterol, and manage your weight.
Experts recommend that everyone, including people with diabetes, make at least half of grains consumed daily whole grains -- so make sure some of the starches you choose to eat contain whole grains. Look for the Whole Grain Stamp on products to ensure you’re reaping the awards of whole grains, such as increasing fiber intake.
How to add whole grains to a diabetic diet: Toss out white rice, white bread, and white pasta. Replace them with brown rice and whole wheat breads and pastas. Consider trying whole grains like quinoa, millet, barley, oats, or farro. Visit wholegrainscouncil.org for more information.
How Fats Fit Into a Diabetic Diet
Fats and fat in foods can have a place in a diabetic diet.
Healthy fats are unsaturated. Unsaturated fats don't increase your risk of heart disease. Monounsaturated fats, found in olive oil and avocados, and omega-3 fats, found in salmon and walnuts, are especially good for heart health. For everyday cooking, use canola and olive oils.
Unhealthy fats include trans fats and the overconsumption of saturated fats, which can increase your risk of heart disease. Found in red meats, full-fat dairy products, and baked goods, these fats can cause LDL (bad) cholesterol and triglyceride levels to go up.
Shopping tip: A food label may say "zero trans fat," but the product may still have small amounts. Check the ingredients list before buying—if you see "partially hydrogenated oil" or "vegetable shortening" on the label, put the product back on the shelf. Also watch out for "palm kernel oil"—one of the few oils high in saturated fat.
How to Enjoy Sugary Foods and Sweets on a Diabetic Diet
The ADA says people with diabetes may consume sugar (sucrose) as part of their total carbohydrate count. The current ADA guidelines suggest that people with diabetes should be more concerned about the total amount of carbohydrate, which should be individualized.
However, nutrient-rich sources of carbohydrate (such as fruit, vegetables, and low-fat dairy products) are preferred over nutrient-poor foods with refined grains and added sugars.
Sugar tip: To aid in weight loss or eat more healthfully, consume only small amounts of foods containing added sugar, because they’re likely also high in calories and fat.
How to Enjoy Sugar-Free Foods on a Diabetic Diet
When people discover you have diabetes, they may proudly offer you sugar-free versions of favorite treats or beverages. Sugar-free claims may mean that foods are calorie-free, or they could contain carbs and calories, like cookies and candy. Read the ingredients and the Nutrition Facts label to know for sure.
In some cases, sugar-free and no-sugar-added foods offer carb and calorie savings, making them smart choices for a diabetic diet. But sometimes these foods cut your carb intake only slightly and may cost more, too. It’s important to be aware of the fat content in these foods as well.
Sugar-free tip: If you simply prefer the taste of the regular version of a food, you may find a smaller portion of it is just as satisfying as a full serving of the sugar-free option.
How to Enjoy Sugar Substitutes on a Diabetic Diet
Thanks to low-calorie sweeteners, having diabetes and satisfying a sweet tooth has become a lot easier.
Sugar substitutes are safe to include in a diabetic diet. The U.S. Food and Drug Administration has approved sucralose, saccharin, aspartame, acesulfame potassium, neotame, steviol glycosides, and luo han guo as food additives.
You can find an array of sugar substitutes to use in cooking and baking. Choose sugar substitute packets to sweeten coffee or tea.
How to Enjoy Alcohol on a Diabetic Diet
Adults with diabetes can drink alcohol and should follow the same guidelines as the general public—an average of up to one drink per day for women and up to two drinks per day for men, with no more than three or four drinks in any single day for women and men, respectively. “Research shows moderate alcohol consumption has minimal short- or long-term effects on glucose levels in people with type 1 or 2 diabetes,” says Marion Franz, RD, CDE.
For people who take insulin or another blood glucose-lowering medication that can cause hypoglycemia, eat some food when drinking alcohol. A cautionary note to people with type 1 diabetes: Significant alcohol intake can cause hypoglycemia a number of hours later, so regularly check blood sugar levels when you drink.
How to Enjoy Restaurant Foods on a Diabetic Diet
Dining out with diabetes is possible! Refer to a restaurant's menu or website, or carry a reference guide to help you determine nutrition information for a dish before you go. For lunch or dinner, opt for the following and you'll gain a nutritional bargain:
Best fast-food picks:
• Pizza loaded with veggies rather than high-fat meats and cheeses. Limit yourself to one large or two small slices. Thin crust also keeps the carbs down.
• 6-inch sub with turkey, lean ham, or roast beef on whole grain bread. Pile on the vegetables—lettuce, tomatoes, peppers (green and hot), onions—and other low-fat toppers. Request mustard and vinegar on the side, but skip the oil and mayonnaise altogether.
• Grilled chicken sandwich with a garden salad.
Best restaurant picks:
• Main-dish salad with a low-calorie dressing on the side. Then go light on the dressing.
• Roasted chicken quarter with whole grain and steamed-vegetable side dishes.
• Vegetable plate or stir-fry with brown rice.
• Baked potato stuffed with broccoli or chili and a little cheese.
Top tips for dining out:
Before you go: If a restaurant's nutrition information isn't available online, ask the staff about lighter menu options.
When you order: Ask for dressings and sauces on the side.
When your meal comes: Measure out the proper portion for your meal, and put the rest immediately into a to-go box to save for another meal.
What to Look For in the Grocery Store
"The most important tool for shopping is the nutrition label," says Susan Weiner, RD, CDE. "Practice label-reading at home so that you don't have to spend 10 minutes per food item when you're in the market."
Weiner suggests looking first at suggested serving size and number of servings per container, keeping in mind that the serving size may be different from diabetes exchanges or your dietitian's recommendations.
Next, read down the label, which is always in the same order according to federal guidelines:
• Calories: Be sure to find the calories per serving if you're managing your weight.
• Protein: Consider the grams of protein you need for a balanced diet.
• Carbohydrate: Look at total carbohydrate grams to figure out how the food fits into your meal plan.
• Fats: Look for fat count per serving; fat is a concentrated source of calories. If the food contains saturated and trans fats, it can raise LDL (bad) cholesterol and increase heart disease risk.
• Sodium: If you have high blood pressure, pay special attention to sodium.