No, eating sugar didn’t “give” you diabetes, and yes, you can still have sugar after you’ve been diagnosed with diabetes. There are many misconceptions about what people with diabetes should, shouldn’t, can, can’t, must avoid, or absolutely have to include in their diet. The truth is you can eat anything that a person without diabetes eats, says Melissa Joy Dobbins, RDN, CDE, a registered dietitian nutritionist and certified diabetes educator. When it comes to proper diabetes nutrition, for the most part, you need to watch your portions and keep your overall diet healthy and balanced. Here, experts shed light on the truth behind some common diabetes food myths and help fix your diabetes diet mistakes.
Despite their bad rap, carbohydrates actually belong in your diet for two very big reasons: Your body needs them to function well and they serve as a main source of energy. In fact, you should include some carbs in every meal, says Dobbins. But for healthy diabetes nutrition, you do need to keep tabs on how many carbs are on your plate. “Just like you have a budget for your finances, stick to a carb budget for your meals,” says Dobbins. Generally, the recommended carb count for people with diabetes is about 30 to 45 grams per meal. Yours may be more or less, depending on your weight, activity level, and other factors. Your doctor can help figure out the right amount for you. Once you know how many carbs to eat at a meal, choose your food and the portion size to match. Here’s more info on the difference between simple and complex carbs.
What can happen is likely the opposite. “Your body requires certain amounts of vitamins, minerals, and nutrients to work properly,” explains certified diabetes educator Timika Chambers, RN, CDE. “When you skip meals, your body goes into 'starvation mode' and starts holding on to calories.” The result: extra pounds stay put. Skipping meals also messes with your blood sugar. For example, a small study published in Diabetes Care found people with diabetes who skipped breakfast had 37% higher-than-usual blood sugar levels at lunch and dinnertime. “The more consistent your meals, the steadier your blood sugar,” adds Chambers, who recommends your meals be no more than four to six hours apart. Here’s another reason feeling hungry is bad for weight loss.
First off, starchy foods can be part of your healthy meal plan, as long as you watch your portions—they may need to be a lot smaller than you’re used to—and keep tabs on your carb intake. And secondly, and perhaps even more importantly: “Managing your blood sugar isn’t the only thing you do with diabetes,” says Chambers, who also serves a health coach based in Ohio. “It’s also about managing your life.” In most cases, extreme diabetes nutrition changes won’t last. Instead, you want to do things that feel doable and sustainable for the long run, she says. Start with small changes, suggests Dobbins: If you love white pasta, have it. But find another opportunity during the day to make a healthier choice; you can switch your breakfast toast to a higher-in-fiber whole wheat slice or opt for a side of greens at lunch instead of potatoes.
Portion control is key to helping you cut calories and keep your tabs on your carbs. If you eat more food then what’s recommended for a meal, your blood sugar will likely go up. But the only way to know if you’re eating the right amount is to measure your food. You may think you know what proper portions for diabetes nutrition look like, but if you go through the measuring motions for a day or two, you might be surprised by the difference in what you’re eating vs. what you should be eating.
Start with the foods you eat most often, suggests Dobbins. If cereal is your go-to breakfast, pour your normal amount into your cereal bowl. Then get a measuring cup and see where you are in terms of portions. Maybe you’re close to the recommended ¾ cup serving size; maybe you dole out three times as much. Maybe once you see what a serving of cereal looks like in your bowl, you can aim for that on a more regular basis.
Even if it’s healthy, even if it packs in vitamins and overflow with minerals, you still have to check serving sizes, says Chambers. Case in point: fruit. It contains lots of nutrients and fiber. But you still get 15 grams of carbs in a small piece of fruit, about a cup of berries and half of a banana, so if you’re chugging a large smoothie every morning, it might taxing your blood sugar more than you think. (Follow these tips to prevent your smoothie from being a sugar bomb.) Portion control applies to all goods, regardless of the health halo.
It’s true that fats—found in oils and salad dressings—have little immediate impact on blood sugar levels. That said, eating a fatty meal can slow down digestion and make it harder for your insulin to work, which can cause a possible spike in blood sugar hours after your meal, according to the Joslin Diabetes Center in Boston.
Plus, having type 2 diabetes is a major risk factor for cardiovascular disease. In fact, two out of three people with diabetes ultimately die from heart disease or stroke. Eating saturated fats (found in butter, cheese and whole milk) can raise unhealthy cholesterol levels, increasing your risk of heart disease or stroke. Trans fats (found in some margarines and snacks) have the same effect.
If you’re feeling especially gassy or bloated, this might be why. The sugar in “sugar-free” products may be replaced with sweet-tasting substances called sugar alcohols, which are still high in carbohydrate. Overeating foods with sugar alcohols can cause digestive issues or diarrhea, says Chambers. Other “no-sugar” foods may be sweetened with substances that contain calories and carbs, and some may have artificial sweeteners, which could potentially have serious health risks.
Sometimes, if there’s less sugar in a product, it may have higher amounts of something else, such as fat or sodium. Compare food labels on sugar-free foods to their regular versions. If the sugar is only a few grams less per serving, but the saturated fat and sodium is significantly higher, go for the regular version, suggests Chambers.