Food and Diabetes: Common Dietary Concepts
An excerpt from the book, “A Guide to Complimentary Treatments for Diabetes: Using Natural Supplements, Nutrition, and Alternative Therapies to Better Manage Your Diabetes” by Gene Bruno, MS, MHS. Read additional excerpts or buy the whole book.
The power of food over diabetes is amazing. What you eat and how much you eat can make all the difference in the world regarding the stability of your glucose levels. Consequently, it is no surprise that a change in diet is the primary means for helping a diabetic to control his or her blood glucose levels and diabetes.
Presumably, if you are a diabetic, you’ve likely already received instruction on the importance of a good nutrition and diet plan. If you haven’t, stop everything! You should contact your doctor, dietician, or nutritionist to make an appointment to obtain a personalized diet and exercise plan. The reason for this is that changing your diet is the first thing you need to do when you are diagnosed with diabetes. You may also want to sign up for a diabetic education program that will teach you what you need to do to care for your diabetes. Research has shown that early referral into this type of program can minimize the progression of type-2 diabetes. Specifically, patients should be educated about the progressive nature of diabetes and the importance of glucose control, with a focus on appropriate food choices and physical activity in conjunction with their anti-diabetes medication. The proof, of course, is in the pudding. In study after study, nutrition therapy in patients with diabetes has been shown to reduce A1C levels, which, as stated in Chapter 1, are the most accurate reflection of long-term blood glucose control.
You should focus on making dietary and physical activity changes before you start taking dietary supplements. As the name suggests, a dietary supplement is just that: a supplement to the diet, not a proper substitute for eating a poor diet.
COMMON DIETARY CONCEPTS
There are a number of diet plans that can address diabetes and blood glucose control in a healthy manner. Additionally, there are diets that are not recommended for this purpose. This section includes an overview of some of the most well-known diet plans and their potential—or lack thereof—for helping you to achieve blood glucose control. A case will also be made for the consumption of organic foods.
Before jumping into an explanation of the diet plans, it is important to first ensure that you understand a couple of dietary concepts that find their way into more than one of these plans. The first concept is glycemic index, and the second is the type of dietary fat.
Glycemic Index (GI)
Glycemic index (GI) is a numerical system of measuring how fast a carbohydrate triggers a rise in circulating blood glucose—the higher the number, the faster the blood glucose response. A low GI food will cause a slow, small rise, while a high GI food will quickly trigger a dramatic spike (clearly not a good thing for a diabetic). In general, a GI of seventy or greater is considered high, a GI of fifty-six to sixty-nine is classified as medium, and a GI of fifty-five or less is considered low. With regard to carbohydrate foods, those with more fiber are likely to have a lower GI. This is because fiber causes food to break down more slowly in the digestive system, which also slows the absorption of any sugars the food contains. The result is a slower increase in blood glucose levels, which makes it easier for the body to metabolize since it doesn’t require large amounts of insulin all at once. On the contrary, simple or refined carbohydrates—like most desserts or white bread and white pasta—break down rapidly and yield their sugars quickly, meaning they will generally be higher on the GI ranking. Table 2.1 contains approximate GI values for some popular foods. Additionally, there are a number of guide-books that can help you identify the GI of various foods.
What is most significant is the effect that a low-GI diet has on diabetics. In a review assessing the effects of low-GI diets on glucose control in people with diabetes, researchers examined 11 clinical studies involving 402 type-1 or type-2 diabetics whose diabetes were not already optimally controlled. When these diabetics followed a low-GI diet, results showed a statistically significant decrease in A1C levels. Additionally, there were significantly fewer episodes of hypoglycemia (low blood sugar) in diabetics following a low-GI diet compared to those on a high-GI diet. Furthermore, the proportion of participants reporting more than fifteen episodes of hyperglycemia (high blood sugar) per month was significantly lower for those fol- lowing a low-GI diet. The researchers in this review concluded that a low-GI diet can improve glucose control in diabetics without causing additional hypoglycemic episodes.
Similarly, other studies have shown that fiber-rich foods and other foods with low GIs can help keep post-meal glucose levels lower than would otherwise be the case. These foods may also improve insulin resistance and blood fat levels—an important goal for diabetics.
The importance of a low-GI diet for glucose control is further validated by population studies that showed high-GI and low-fiber diets are associated with a potential risk for developing diabetes. Conversely, the available evidence suggests that eating a diet rich in whole grain cereals and vegetables and low in refined grains, sucrose, and fructose contents (which is, essentially, a low-GI diet) is beneficial in the prevention of diabetes.
Types of Dietary Fat
There are three types of dietary fat: saturated, polyunsaturated, and monounsaturated.
Chemically, a fat receives one of these three designations based upon the number of double bonds it possesses, and whether or not it is “saturated” with hydrogen atoms. However, the chemical way of explaining this can get complicated and isn’t necessary for this book. To make things simpler, we will focus on the health-related features of these fats rather than their chemical attributes.
Saturated fats are primarily found in animal foods, such as beef, pork, and dairy products. A vast number of studies have demonstrated that diets high in saturated fat are correlated with an increased incidence of atherosclerosis and coronary heart disease, as well as stroke. Research has also shown that that people who consume diets high in saturated fats experi- ence increases in their LDL cholesterol (bad cholesterol) and total cholesterol levels. Since diabetics are already at higher risk for heart disease (see Chapter 6), limiting your saturated fat intake can help lower your risk of having a heart attack or stroke. This can be done by making better, more appropriate food choices. Choosing leaner cuts of red or white meat rather than dark meat when eating poultry and choosing low or no fat dairy products are all good ways to do this.
Limiting your saturated fat intake is one of the single most important steps you can take to reduce your risk of cardiovascular disease. Of course, this applies to everyone—but especially to diabetics.
|Table 2.1 GIycemic Index of Popular Foods|
|Apple||38||1 medium (138 grams)|
|Baked potato||85||1 medium (173 grams)|
|Banana||52||1 large (156 grams)|
|Bean sprouts||25||1 cup (104 grams)|
|Bread, white||70||1 slice (30 gram|
|Brown rice||55||1 cup (195 grams)|
|Carrot||47||1 large (72 grams)|
|Grapefruit||25||1/2 large (166 grams)|
|Honey||55||1 tablespoon (21 grams)|
|Ice cream||61||1 cup (72 grams)|
|Macaroni and cheese||64||1 serving (166 grams)|
|Oatmeal||58||cup (234 grams)|
|Orange||48||1 medium (131 grams)|
|Peanuts||14||4 ounces (113 grams)|
|Pizza||30||2 slices (260 grams)|
|Popcorn||72||2 cups (16 grams)|
|Potato chips||54||4 ounces (113 grams)|
|Raisins||64||1 small box (43 grams)|
|Rice, white||64||1 cup (186 grams)|
|Snickers candy bar||55||1 bar (113 grams)|
|Spaghetti||42||1 cup (140 grams)|
|Table sugar (sucrose)||68||1 tablespoon (12 grams)|
|Yogurt, lowfat||33||1 cup (245 grams)|
|Watermelon||72||1 cup (154 grams)|
|*GI values can be classified into three levels—low (ranging from 1 to 55), medium (ranging from 56 to 69), and high (ranging from 70 to 100).|
Polyunsaturated fat can be found mostly in grain products, fish and seafood (herring, salmon, mackerel, and halibut), soybeans, and fish oil. Heart-healthy omega-3 fatty acids are types of polyunsaturated fats. Omega-3 fatty acids have been shown to lower the risk of heart attacks.
Polyunsaturated fats are also protective against insulin resistance.10In fact, omega-3 polyunsaturated fats have clinical significance in the prevention and reversal of insulin resistance. Furthermore, a diet high in polyunsaturated oleic acid, which can be easily achieved through consumption of peanuts and olive oil, can have a beneficial effect in type-2 diabetes and ultimately reverse the negative effects of inflammation observed in obesity and non-insulin dependent diabetes mellitus.
Typically, polyunsaturated fats are liquid at room temperature, while saturated fats are solid (think of vegetable oil and butter, respectively). Polyunsaturated fats can be made solid, however, by forcing hydrogen atoms into them. That’s exactly how margarine is made, and it is also where the term “hydrogenated fats” comes from. Unfortunately, during the hydrogenation process polyunsaturated fats are turned into trans fats (the term “trans” refers to a certain arrangement of atoms in the fat). Like saturated fats, trans fats can increase cholesterol levels and increase a diabetic’s risk of developing cardio- vascular disease. Additionally, trans fats increase the risk of certain types of cancer.
Monounsaturated fats are found in foods such as nuts and avocados. They are the main component of tea seed oil, olive oil, and canola oil. Monounsaturated fats are called “good” or “healthy” fats because they can lower your bad (LDL) cholesterol. The American Diabetes Association recommends eating more monounsaturated fats than saturated or trans fats in your diet.
Furthermore, a lower-carbohydrate/higher-monounsaturated fat diet resulted in lower plasma triglyceride (common blood fats) levels in type-1 diabetics than a higher-carbohydrate/lower-fat diet.
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