Diet plays a key role in the balance of diabetes and it is a major issue in the management of the disease. Managing diabetes is about knowing your disease and its treatment, but it is almost as well being an expert on nutrition.
Why should you pay attention to your diet when you have diabetes?
When we eat, the level of sugar in the blood (glycemia) increases. The sugars, or “carbohydrates”, are then transformed essentially into “glucose”. The “beta cells of the pancreas” normally secrete “insulin” which allows glucose to enter the body’s cells: muscles, adipose tissue, etc. Thus, blood sugar may increase slightly and transiently, then return to a normal level and glucose can be converted into energy and reserves. In people with diabetes, this system does not work.
In type 1 diabetes, dietary differences are very bad for blood sugar control and require insulin injections to be adjusted.
In type 2 diabetes, being overweight, associated with heredity factors, plays a major role in the occurrence of the sugar regulation disorder: the more fat there is in the body, especially in the belly, the more insulin has trouble getting sugar into the cells–insulin resistance. The sugar therefore remains in the blood, leading to diabetes. About 70% of type 2 diabetics are overweight. To improve your blood sugar, losing 10% of your weight is beneficial.
How do you know if you are overweight?
The body mass index (BMI) is used to estimate the distribution of weight based on height. Validated by the World Health Organization (WHO), this index is reliable for adults, men and women, between 18 and 65 years old.
BMI is calculated by dividing youe weight in kilograms by the square of your height in meter. BMI = Weight / Height^2.
When the BMI is over 25, it means the person is overweight. When the BMI is over 30, the person is considered obese. For example, a person of 1.65 m in height and a weight of 70 kg would have a BMI of 25,71, which is slight above normal.
You can use to this tool to automatically calculate your BMI.
How to lose or maintain weight when you have diabetes?
So that type 2 diabetics can lose weight permanently, diabetologists recommend balanced diets with moderate calorie restriction. The goal is to achieve a rate of weight loss of between 1 and 3 kg per month. In type 1 diabetes, it is important to maintain your weight to avoid increasing your cardiovascular risk.
But losing weight does not necessarily rhyme with draconian diet. By changing the way you eat a little, it is possible to lose a few pounds, which is often an encouragement to keep on exerting yourself. The best is to take it slow. In type 2 diabetes, even moderate weight loss can reduce or even eliminate certain manifestations of insulin resistance such as hypertension and abnormalities in blood fats. .
Dos and don’ts to lose weight or to not gain weight during diabetes?
To balance diabetes in the long term, it is essential to eat better, every day. It is the repeated excesses during the week that prevent you from losing weight or make you fat. Calorie restriction is quite difficult to maintain in the long term, so you should focus on a modest calorie restriction and focus on the quality of the diet.
The rules can be summarized as follows:
- You must get help from a diabetologist or a dietitian.
- You must eat enough protein (meat, fish, dairy products, etc.).
- You must eat enough carbohydrates (starches, fruits, pulses), in divided amounts during the day.
- Eat as little animal fat as possible.
- It is better not to skip meals.
- We can occasionally (emphasis on occasionally) allow ourselves a deviation (pastry)
- You must have daily physical activity adapted to your age and condition.
What should a diabetic eat?
In theory, a person with diabetes should compose their diet with 55% of the total energy intake in the form of carbohydrates, 30% in the form of fat and 15% in the form of protein. This is indeed the recommended balanced diet whether you have diabetes or not.
But it is not about doing complicated calculations at each meal, it is above all about checking that each menu, each food group is represented:
- Group 1 — Drinks: This group provides minerals and trace elements. Recommended consumption: 1 to 1.5 liters of drink per day. It should be increased in the event of extreme heat or prolonged physical activity. Only water is essential. Calorie-free, it can be consumed in pure form, in coffee, tea, herbal tea, broth, soup, flavored, etc. Certain “light” drinks can be consumed. They contain sweeteners and provide little (or no) calories. Avoid sugary drinks high in sugar and hyperglycemic.
- Group 2 — Fruits and vegetables: They provide mainly carbohydrates and are rich in vitamins, minerals and fibers. Source of fiber, green vegetables allow satiation and slow digestion. The recommended consumption is 5 portions of fruits and vegetables per day including 2 to 3 fruits, but it is possible to vary the nature of the fruits consumed in all forms (raw, cooked, plain or prepared, fresh, frozen or canned).
- Group 3 — Starches, Beans and bread: They provide carbohydrates, vegetable proteins, fiber and provide most of the energy that the body needs. They calm hunger. You can eat some at each meal according to your appetite, favoring whole grain foods or brown bread.
- Group 4 — Milk and dairy products: These foods provide animal proteins and fats. They are very important on a daily basis for their richness in calcium. The recommended consumption is: with each meal, or 3 to 4 times a day. We, however, must limit the consumption of excessively fatty products such as cheese and whole milk dairy products and instead favor low-fat products, such as semi-skimmed milk, 0% yogurts and white cheeses with 20% fat.
- Group 5 — Meat, fish and eggs: These foods provide mainly animal proteins, but also fats, iron and group B vitamins including vitamin B12 (little or not present in other food groups. Consumption recommended is 1 to 2 times a day. Regarding meats, you must vary the species and favor less fatty pieces. Be careful with cold cuts, meats in sauce and breaded products. Fish must be eaten at least twice a week, including once a week oily fish (salmon, sardines, tuna, mackerel) for their richness in essential fatty acids.
- Group 6 — Fats: Fats are mainly composed of lipids, they provide essential fatty acids and vitamins A and E. Very rich in energy, they must be limited and the recommended consumption is maximum 1 to 2 tablespoons per meal. Only eat one high fat food from the same menu. Among the fats, preference should be given to those of vegetable origin, for example olive, rapeseed, soya or walnut oil. It is necessary to limit fats of animal origin (butter, crème fraîche) and preferably use them raw because they are more digestible.
- Group 7 — Sweet products: They mainly provide sugar which is not essential from a nutritional point of view. In addition, many foods classified in this group provide a significant amount of fat: cookies, pastries, chocolate, etc… Very dense in energy, they are therefore to be consumed occasionally and always as part of a meal to limit the immediate hyperglycemic effect.
Can diabetics eat pastries?
Carbohydrates are not prohibited for diabetics. They are, on the contrary, recommended in controlled amounts: they should represent between 50 and 55% of the total energy intake provided by daily foods. But if you can avoid as much as possible sweet products (pastries, candies, sodas), that would be the ideal decision.
Carbohydrates are found in different food groups: bread and its equivalents, starchy foods (pasta, rice, cereals, etc.), beans, fresh vegetables, fruits and their derivatives, dairy products, sweets, sugary drinks. Eating a balanced diet means varying your diet. We must therefore learn to estimate the amount of carbohydrates provided by each food to adapt.
How to adapt the diet of a diabetic to public catering?
One in four adults eats their meals away from home because of their work. When you have diabetes, eating out in restaurants, cafes or fast food restaurants is not always easy. The dishes offered can be mouth-watering, the portions generous, but the menus offered are seldom well balanced.
Eating in a restaurant once in a while does not pose any particular problems. But you just have to compensate for this outing with one or more lighter meals at home. On the other hand, if the restaurant or the café are part of everyday life from a professional point of view, it will be necessary to be more attentive and to have some simple reflexes to limit the damage:
- It is better to avoid appetizers because they are often very high in sugar and calories. Also avoid fatty side meals such as peanuts or chips (vegetables should be preferred).
- You should opt for simple formulas such as “main course + dessert” or “starter + main course” and do not hesitate to share a dish with a friend if the restaurant is known for its generous portions.
- Drink water before the meal and, if necessary, request a second glass.
- It is very important to eat slowly, as this promotes satiety and allows you to taste and discuss with your friends at the table.
- Avoid the complementary piece of bread often given before the meal.
- Try to return regularly to the same place to be a regular and ask the staff to respect your needs (no added sugar, sauce on the side…).
- Be wary of “inexpensive” restaurants where dishes are often enriched with fat in order to mask an average taste quality.
- You have to decipher the menus and identify the terms that imply a large quantity of fat: fried, marinated, breaded, sautéed, creamy, puffed
- Do not hesitate to ask the server what the dishes are specifically made of, then choose accordingly.
Associate physical activity with your diet
Physical activity, or sport, lowers blood sugar levels, blood fat levels and blood pressure, three major contributors to the cardiovascular complications of type 2 diabetes.
Physical activity or sport is therefore one of the best allies of type 2 diabetics. Of course, at 50, 60, 70 years old, it is not always easy to restart playing sports. But it doesn’t have to be intense; physical activity at any pace such as walking will be beneficial. On the other hand, if you are resuming exercise, it is advisable to have a cardiologist monitor you, who will take a stress test to assess the health of the heart.
All physical activities are good and there is no ideal sport, apart from the one that appeals to the person: swimming, walking, dancing… On the other hand, the more it is an endurance sport, the better it is.
After 30 minutes of exercise, the blood sugar level drops. And this drop in blood sugar can last for a few hours after exercise. You should know that taking sulfonylureas may expose you to hypoglycaemia during activity: you should therefore seek advice from your doctor.
Cassidy is a certified dietician with a focus on patients suffering with diabetes. She has more than 10 years of experience, working with patients of different background. She writes health-related article for the Scientific Origin.