Audrey Demmitt, RN, BSN, is a nurse diabetic educator, VisionAware Peer Advisor, AFB Career Connect mentor, and author of the VisionAware multi-part blog series on diabetes and diabetes education. At age 25, Audrey was diagnosed with retinitis pigmentosa and continued to work as a nurse for 30 years with her visual impairment.
She has worked as an Adjustment to Blindness Counselor and Diabetic Educator for Vision Rehabilitation Services of Georgia and as a school nurse providing in-service training for school staff and developing care plans for newly-diagnosed students and their families.
In Part 1 of her series, Audrey discussed how diabetes education can help lower your blood sugars and reduce the risk of diabetic retinopathy. In Part 2, she emphasized the significance of the A1c test in the effective diagnosis, treatment, and management of diabetes.
In this month’s installment, Audrey discusses the importance and benefits of healthy eating as part of a comprehensive diabetes care plan. According to Audrey, “All of us can make improvements toward healthier eating. Start by setting an achievable goal and make a step-by-step plan. Your sustained efforts will pay off!”
The Benefits of Healthy Eating
Everyone benefits from healthy eating, which can sometimes be a challenge – but it does not require special foods or elaborate diet plans. Often, when someone is diagnosed with diabetes, they can feel overwhelmed by the recommended dietary changes, monitoring, and meal planning that are required. While it is very important to pay attention to what you eat, when you eat, and how much you eat, healthy eating can become a positive and enjoyable habit with many benefits.
To make healthy changes in your current eating habits, you may want to begin to record food intake in a daily log so you can see patterns and “trouble spots.” Research shows that those who do this are more successful in achieving their dietary goals. Think about what improvements you need to make and set some goals. Keep in mind that the overall goal is to eat the right types of foods at the right times and in the right amounts for you in order to maintain healthy blood sugars, a healthy heart, and optimal body weight.
Please note: For personalized instruction on setting goals and making meal plans, be sure to consult with a registered dietitian, nutritionist, or diabetic educator recommended by your doctor.
Healthy Eating: Some General Guidelines
Here are some general guidelines to help you improve your eating habits when you have diabetes:
- Eat a variety of foods from all food groups in the forms which are closest to their natural states. This ensures that you are getting the optimal nutrition and quality of nutrients. Eat whole grains and fresh fruits and vegetables for a fiber- and vitamin-rich diet. For example, choose old-fashioned oats instead of instant oatmeal, which contains extra ingredients including sugar. Eat an apple or an orange for more fiber and nutrients than you get in applesauce or orange juice. Eat a variety of “food colors” for a variety of nutrients.
- Avoid processed and packaged foods, which tend to be high in sugar, sodium, fats, and carbohydrates. Shop mainly in the outside perimeter of the grocery store where you will find fresh produce, dairy, and meats. These foods provide the best nutrition for your food dollar. Packaged foods are often more expensive and provide less nutrition than whole, fresh foods.
- When planning a meal, consider using the My Plate or Create Your Plate methods. Make ½ your plate fresh veggies, such as steamed broccoli and a salad. Choose a healthy whole grain or carbohydrate source, such as potatoes, whole wheat pasta, or quinoa for ¼ of your plate. And ¼ of your plate can be a protein source, such as lean meat, egg, or beans. To fill out your meal, add a low-fat dairy serving, such as eight ounces of skim milk and a fruit for dessert.
- Eat about the same amount of food at each meal and at the same times of the day. This helps your medications and your body regulate blood sugars more evenly. Eating regularly and in consistent amounts can also prevent severe highs and lows in blood glucose levels. Don’t skip meals.
- Remember that carbohydrates are found in starchy foods as well as sweet foods. Starchy foods include cereal, rice, tortillas, potatoes, bread, pasta, and some vegetables like corn, beans, and peas. Foods and beverages that contain natural or added sugars like fruits, juices, soft drinks, candy, and desserts are high in carbohydrates. Carbs provide fuel for energy and are necessary – but in moderation and measured amounts. Learn what foods have carbohydrates so you can monitor the amount you eat. Think of your daily intake of carbohydrates as an “allowance” and try to spend your allowance on the healthiest of foods, such as a whole grain English muffin instead of a brownie.
- Choose complex carbohydrates that are high in fiber. Starchy and sugary foods that are highly processed (white flour, pasta, rice, donuts, candy, soft drinks) break down quickly and become simple sugars, which cause blood sugars to spike. When you choose more complex carbohydrates, such as whole grains (oats, whole wheat pasta, brown rice, beans) and fiber-rich fruits, the body has to go through additional steps to break them down so they do not raise the blood sugar levels as quickly. In addition, you will get the added benefits of fiber from complex carbohydrates. There may be times when you want a fast-acting carbohydrate to raise your blood sugar quickly, but choose complex carbs most of the time.
- Choose foods with healthy fats for a healthy heart. People with diabetes are at higher risk for heart disease. Keeping your cholesterol levels down can reduce the risk of heart attacks and strokes. Eat more mono- and polyunsaturated fats, including omega-3s to protect your heart. These fats are found in foods like nuts, canola and olive oil, avocados, salmon, tuna, and peanut butter. Avoid saturated fats and trans fats found in baked goods, crackers, chips, processed meats, butter, high-fat dairy, lard, and coconut oil. These fats raise your cholesterol levels. All fats are high in calories, so be careful with the amounts you consume. When possible, substitute healthy fats for unhealthy fats. You can learn more about heart-healthy eating from the American Heart Association Nutrition Center.
- It is important to learn about portion sizes and control them. Often, our portion sensor is “out of whack” and we lose touch with healthy portion sizes. Limiting the amount you eat is a great first step toward managing blood sugars and body weight. This can be done by weighing and measuring your food, following the recommended “serving sizes” on food labels, and using a divided plate as a food guide. A simple ½ cup measuring scoop can be an invaluable tool for learning what typical portions look like on your plate. For instance, one serving of many starchy, whole grain foods is ½ cup, which contains 15 grams of carbohydrates as a rule of thumb. Portion sizes matter. You can learn more about “portion distortion” at the American Diabetes Association website.
- Smart snacking can be healthy. Snack foods are usually high in salt, sugar, and fats. Healthy snacks can curb your appetite, boost your energy, and raise your blood sugar when needed. There are many healthy snack options, such as fresh cut-up veggies with low-fat dressing; a small apple with two tablespoons of peanut butter; or two tablespoons of hummus with 10 whole wheat crackers. Healthy snacking can be a way to add additional servings of fruits and veggies or other nutrients you may be lacking. You can learn more about healthy snacks at the American Diabetes Association website.
- Learn to read food labels to guide your food choices. Food labels contain important information about serving size, calories, total carbs, total fats, and the amounts of other nutrients and additives. For example, look for whole grain cereals that have 26 or fewer total carbohydrates per serving. You can learn more about food labels at the American Diabetes Association and the American Heart Association.
- Counting carbohydrates can improve your blood sugar management. This is another meal planning technique that can help you keep tighter control on your eating, weight, and blood sugars. It requires reading food labels and learning the carbohydrate content of foods in order to balance meals with medications and physical activity. With practice, this can become second nature. Consult your health care team to learn how many carbohydrates per meal are right for you. You can learn more about carbohydrate counting at the American Diabetes Association website.
- Set yourself up for success when making changes. All of us can make improvements toward healthier eating. Start by setting an achievable goal and make a step-by-step plan. Start with small steps and reward yourself for your successes. Your sustained efforts will pay off!
Be sure to read Part 4 in this series, Exercising Safely with Diabetes.