May 16, 2002
Diet for diabetics
People diagnosed with diabetes often believe that they must say goodbye to all of their favorite foods. However, new nutritional recommendations from the American Diabetes Association (ADA) published in January 2002 say that all foods can be included in a diabetic diet, as long as you follow some general guidelines.
The ADA says that the strongest evidence from studies supports the importance of including carbohydrate-containing foods like whole grains, fruits, vegetables and low-fat milk in a diabetic diet. This is true regardless of the food’s effect on your body’s blood sugar, which is often called the glycemic index. The glycemic index of foods has recently received a lot of attention from diet book authors claiming that foods with a high glycemic index promote insulin release and the storage of fat.
However, the ADA says that the total amount of carbohydrate in meals or snacks is more important for diabetics than the glycemic index. Therefore, total carbohydrate grams from a banana, a cookie or a carrot would have equal effects on blood sugar. Alcohol can also be included in the diabetic diet if desired but should be limited to one drink per day for adult women and two drinks per day for adult men; alcohol should be consumed with food to reduce the risk of causing low blood sugar.
“I try to emphasize foods that are nutrient dense, low in fat, and high in fiber for overall good health,” says Doris Piccinin, registered dietitian and certified diabetes educator at Seattle’s Harborview Medical Center. She reports that many people with diabetes are pleasantly surprised when they learn that they don’t have to give up all of their favorite foods in exchange for good health.
With regard to fat, the ADA concluded that diabetics with normal LDL-cholesterol levels and no history of heart disease should follow the same recommendations established for all Americans. These recommendations include low intake of saturated fats, accounting for less than 10 percent of total calories, and fewer than 300 milligrams of cholesterol a day. If LDL cholesterol is high, there is some evidence that saturated fat intake can be replaced by either monounsaturated fat, found in olive and canola oil, or carbohydrate to improve LDL cholesterol. However, like all fats, monounsaturated fat is high in calories, so it should be limited if weight loss is a goal. The ADA concluded that there is no clear evidence of benefit from vitamin or mineral supplementation in diabetics who do not have any existing deficiency.
