Diabetes Diet and Guidelines

What is a diabetic diet? Is there only one or many? What does a diabetic diet consist of? All these questions and more will be answered in this article.

A diabetic diet is an eating plan or diet recommended for people with diabetes mellitus to assist them in controlling their blood sugar.

A diabetes diet is medically known as Medical Nutrition Therapy. It is rich in nutrients, low in fat and calories and high in vegetables, fruits and whole grains. In such a diet, individuals are encouraged to eat moderate amounts of food and stick to regular mealtimes.

The importance of eating dietary fiber is emphasized in such diets and it is even said that carbohydrates eaten with dietary fiber results in a lower glycemic status (level of sugar in the blood) than the same amount of carbohydrates otherwise consumed alone.

It has been recommended that between 40 to 65% of calories should be obtained from carbohydrates, although the American Diabetes Association in 1994 recommended 60 to 70%.

This latter recommendation has been criticized by various individuals who rather canvassed a low carbohydrate diet. Richard K Bernstein is one of such individuals. His own diet limits carbohydrate intake to just 30 grams per day along with strenuous muscle building exercise and frequent blood glucose monitoring.

Futurologist Ray Kurzweil who was previously diagnosed with diabetes likewise advocates a carbohydrate intake of one sixth of total daily caloric load.

Taking a cue from the fact that a diet high in dietary fiber has been shown to be very beneficial, studies have been made on vegan diets (diets of vegetarians). These studies show that such diet not only also help to lower hemoglobin A1C and LDL levels but also advanced glycation end products. Glycated end products are proteins or lipids which having been exposed to sugars become glycated (covalently bonded with a sugar molecule without the controlling action of an enzyme).

In the United Kingdom though, there is the Eat Well plate which is the national food guide designed to help UK citizens have a healthy balanced diet. It is based on the basic five food groups and the guide stipulates the percentage of a person's plate that should be made up of each food group.

Thus Fruits and vegetables - 33%, Bread, rice, potatoes, pasta and other starchy foods - 33%, Milk and other dairy products - 15%, Meat, fish, egg, beans and other non-dairy sources of protein - 12% and foods and drinks high in fat or sugar - 7%.

It is noteworthy that the second group though should be whole grain-that is whole wheat bread, brown rice etc. and not refined grains like white bread and white rice. Where this is so and bearing in mind that the diet falls within the bounds of the recommended stipulation of between 40 to 65% calorie to be obtained from carbohydrates, it can be said that it is also a good diet for diabetics.

Likewise the United States Department of Agriculture (USDA) have the MyPlate nutrition guide which replaced the USDA's pyramid guide on June 2, 2011. It is basically a plate plan requiring that 30 percent of a meal be grains, 40 percent vegetables, 10 percent fruits, and 20 percent protein. A small amount of dairy (product), such as a glass of milk or a yogurt cup is also included.

This plan was revised by the Harvard School of Public Health in their Harvard Healthy Eating Plate. Their revision features an additional percentage increase of vegetables over fruits whilst at the same time balancing healthy protein and whole grains as equal quarters of the plate.

On the other hand the American Diabetic Association recommends that you create your own plate by following these simple steps;

"Using your dinner plate, put a line down the middle of the plate. Then on one side, cut it again so you will have three sections on your plate.

1. Fill the largest section with non-starchy vegetables such as:

spinach, carrots, lettuce, greens, cabbage, bok choy
green beans, broccoli, cauliflower, tomatoes,
vegetable juice, salsa, onion, cucumber, beets, okra,
mushrooms, peppers, turnips

2. Now in one of the small sections, put grains and starchy foods such as:

whole grain breads, such as whole wheat or rye
whole grain, high-fiber cereal
cooked cereal such as oatmeal, grits, hominy or cream of wheat
rice, pasta, dal, tortillas
cooked beans and peas, such as pinto beans or black-eyed peas
potatoes, green peas, corn, lima beans, sweet potatoes, winter squash
low-fat crackers, snack chips, pretzels and light popcorn

3. Then in the other small section, put your protein such as:

chicken or turkey without the skin
fish such as tuna, salmon, cod or catfish
other seafood such as shrimp, clams, oysters, crab or mussels
lean cuts of beef and pork such as sirloin or pork loin
tofu, eggs, low-fat cheese

Add a serving of fruit, a serving of dairy or both as your meal plan allows.

Choose healthy fats in small amounts. For cooking, use oils. For salads, some healthy additions are nuts, seeds, avocado and vinaigrette.

To complete your meal, add a low-calorie drink like water, unsweetened tea or coffee".

With regards to meal times, as a diabetic, it has been said in Sons ken, Fox and Judd that the length of time before a meal that one should inject insulin would depend on the type of insulin one is injecting. Whether it is long, medium, or quick acting insulin. 

For instance where a low blood glucose reading just before bedtime of below 6 milimoles per liter (108 mg/dL) is evidenced, it is suggested that the patient should take some long acting carbohydrate before retiring to bed to prevent night time hypoglycemia (abnormally low levels of blood sugar).

Now as far as the don'ts go, as concerns alcohol, it is recommended that people with diabetes who take insulin or other medication such as sulphonylureas should not take alcohol on an empty stomach. The reason for this is that alcohol interferes with glycogenesis (the process of storing glucose in the form of the polysacharride called glycogen) in the liver and some drugs inhibit hunger pangs. This in addition to impaired memory, judgement and concentration caused by some drugs can lead to hypoglycemia.

Let us now consider some specific diets. There are several and all have at one time or another been very popular. These still enjoy varying degrees of patronage, though some more than others.

The low Carb diet

This diet advocates that the removal of carbohydrates from the standard diet may help reverse diabetes. Following this removal, the diet would consist of fatty foods such as nuts, seeds, meats, fish, oils, eggs, avocados, olives and vegetables. Fat would become the main energy source and insulin resistance related complications would greatly reduce.

The high Fiber diet

Showing better results than the American Diabetes Association recommended diet, this diet is said to control blood sugar levels with the same efficacy as oral diabetes drugs.

The Paleolithic diet

Premised on what our ancient human ancestors likely ate during the Paleolithic age and as a result of which they enjoyed diabetes (among other diseases) free good health, the Paleolithic diet consists mostly of lean meat, nuts and berries. Tests show that this diet improves glucose tolerance in humans with diabetes and in humans with ischemic heart disease and glucose intolerance.

The Pritkin diet

Is made up mostly of fruit, whole grains, vegetables and the like. It is high in dietary fiber and carbohydrates. It balances its high carbohydrate content however by including exercise as part of its stipulated regimen.

The G.I. diet

Aims at lowering the glycemic index of a persons diet with a view to assist the user in the control of his/her diabetes. Here multi-grain and sourdoughs, legumes and whole grains- foods that are converted more slowly to glucose in the blood stream serve as replacement for others like white bread and potatoes cooked a certain way.

One should not also forget the vegan diet which has an ability to improve glycemic control similar to the ADA diet.

The Newcastle Diet

Lastly it is worth mentioning the Newcastle diet. Although strictly speaking, it may not be the sort of diet one continues with once the initial objective has been met, it is worth mentioning.

The diet is geared towards people who seek to bring their blood sugar levels back to normal and so technically, "cure" their diabetes. The diet is a liquid one containing carbohydrate, protein, fat, vitamins, minerals and trace elements. It provides 600 calories a day and is supplemented by 3 portions of non-starchy vegetables, thereby bringing total calories to 800 a day.

The diabetes fighting aspect of the diet is premised on the fact that its low calorie base, results in the individual losing weight. At the abdomen, this means that the liver and pancreas are less clogged with fat and as such the pancreas is more effective in producing insulin whilst the liver is better able to react to it.

And so bearing in mind that diet forms an essential part of managing diabetes, it is important that a diabetic takes his diet seriously. Usually his doctor and or other healthcare professional will ensure this as well as advise him on a general diet to follow.

However, where he seeks a specific diet, he should endeavor to stay not only informed on the types available, the relative advantage each confers, but also seek his doctors advise so as to make an informed decision. When this is done and done aright, there is no doubt that for a diabetic, diet can serve as a veritable tool in the fight against diabetes.