About Your Diabetes > What About Nutrition?

Nutrition

The food you eat can have a dramatic impact on your diabetes. Wise food choices can prevent or slow the development of diabetes complications.

The Basics of Food

Most food is made of three basic substances: carbohydrates (or starches), protein and fat. In general, our bodies use carbohydrates for energy, protein for body structure and working tissues, and fats for insulation and energy. In addition to these major functions, our bodies use these substances for many other purposes as well.

Some foods consist almost entirely of one of these substances and therefore are called a “carbohydrate,” a “protein,” or a “fat.” For example, plain baked white potatoes are almost completely carbohydrate, containing very little protein or fat. So, baked white potatoes are considered a “starch,” or a carbohydrate. Another example is skinless chicken breast, which is considered a “protein” because it has little fat and almost no carbohydrate.

All About Energy

Our cells use fuel much like a campfire. For the “campfire” inside each cell to stay lit, it needs something to burn. Heat is a form of energy which can be measured in many different ways. The amount of energy in a food item is measured in calories. Carbohydrate is the preferred source of fuel for the campfires in our cells. It burns quickly, easily and provides a lot of energy, much like adding dry leaves to a campfire. In our cells, sugar from carbohydrate makes a nice, roaring fire. Carbohydrates provide about 4 calories per gram.

Fat can also be used for energy, although this is not our bodies’ first choice. When fuel from carbohydrate runs low, fat is broken down to keep the fire going. However, fat is very much like a large log: it takes longer to light and makes only a modest flame as compared to dry leaves. In addition, burning fat in this way can result in byproducts called ketones which “pollute” our bodies. But, like a large log, fat can “burn” much longer than carbohydrate. This is because fat packs much more energy than carbohydrate, providing about 9 calories per gram.

In a pinch, protein can be broken down for energy as well. However, this is really a last resort, because the protein must be obtained by breaking down organs and tissues. This is like tossing furniture into the fire in order to keep it lit. The energy benefits of burning protein are modest and lots of “pollution” is produced. Protein provides about 4 calories per gram.

Carbohydrate: A Double-Edged Sword?

If you recall, our bodies must break carbohydrate down into sugar before it can be used for energy. But, if people with diabetes have too much sugar in their blood already, won’t eating carbohydrate just make the situation worse? Shouldn’t diabetics just avoid carbohydrates altogether?
The answer to these very logical questions is no: persons with diabetes need carbohydrate in their diets even though it can contribute to high blood sugar. Carbohydrate is the main fuel used by the brain and body, and is a vital source of nutrients including vitamins, minerals and fiber. In addition, studies have shown that completely avoiding carbohydrate will not return blood sugar to normal in diabetes (Sheard, 2004). So, you might ask, what is a person with diabetes to do?

The Balancing Act

When making food choices, balance and moderation are essential. No foods, including sugar, are completely restricted. While you have probably been told to watch what you eat, it is really more important to watch how much you eat. So, when you are considering having a piece of cake, the question you should ask yourself is not, “should I eat this,” but rather, “how much should I eat?”
In general, the American Diabetes Association recommends a dietary pattern that includes carbohydrate from fruits, vegetables, whole grains, legumes, and low-fat milk for good health. For each day, 45–65% of your calories should come from carbohydrate, 20–35% from fat, and 10–35% from protein. It is best to get a mix of carbohydrate, protein and fat each time you eat. To help prevent eating too much carbohydrate, the American Diabetes Association recommends Carbohydrate Counting.

Carbohydrate Counting

Every person is different, and it is best to work with your health care team to set up a plan that works for you. A general starting point is 3 to 4 servings of carbohydrates with each meal and 1 to 2 servings for snacks. One carbohydrate “serving” is 15 grams of carbohydrate. The following are some foods about equal to one carbohydrate serving:

To determine how many carbohydrate servings are in a food, look at the Nutrition Facts label.

In this example, a Serving Size of 1 piece has 15 g of Total Carbohydrate. Divide the Total Carbohydrate by 15 to get the number of carbohydrate servings. In this example, each piece is one carbohydrate serving.

Let's look at another example.

For this food, there are 30 g Total Carbohydrate per 3 pieces. So, the number of carbohydrate servings is: 2

Additional Nutrition Tips

• Low-carbohydrate diets (restricting total carbohydrate to <130 g/day) are not recommended for diabetics.
• People with diabetes are encouraged to consume a variety of fiber-containing foods. Fiber helps control blood sugar by slowing digestion. It also helps people feel fuller longer.
• Limit saturated fat to <7% of total calories. For a standard 2,000 calorie diet, this means less than 140 calories or 15.5 grams of saturated fat per day. As an example, one tablespoon of regular butter has about 7.5 grams of saturated fat, which is approximately half a day’s worth.
• Limit dietary cholesterol to <200 mg/day. For example, a serving of lean, broiled steak has about 100mg of cholesterol, or half a day’s worth.
• Two or more servings of fish per week (except fried fish) are recommended as a good source of omega-3 fatty acids.
• Aim for 2 to 3 servings of lean meat and other proteins each day. Fish and lean meat portions should be about the size of a deck of cards or a hockey puck.
• Alcohol consumption should be limited to 1 to 2 drinks per day, and should be consumed with food. Drinking alcohol on an empty stomach can make your blood sugar go too low, especially at night.
• Alcohol can change the way your body responds to medication. In general, avoid mixing alcohol with medication.

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