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Healthy Eating for People with Diabetes Mellitus

Dietary management is important for people with Diabetes Mellitus (DM) for blood glucose control and the prevention or delay of the onset of complications. Some people may have mistaken dietary management as dieting. Instead, the diet for people with DM is based on a balanced diet, which if coupled with the proper modifications, can be full of variety in food selections.

Key to Healthy Eating

1. Eat Regular Meals and Consistent Portions

Eating regular meals and consistent portions of carbohydrates at each meal and snack can help people with DM to maintain their blood glucose levels at more desirable levels. Excessive food intakes should be avoided as they can lead to hyperglycemia (high blood glucose) and complications associated with elevated blood glucose levels. On the other hand, eating too little can lead to hypoglycemia (low blood glucose) and cause harmful effects on health.

2. Follow a Balanced Diet

Eating a balanced diet means selecting a variety of foods from different food groups, namely grains, vegetables, fruits, meat and beans, and dairy products every day in appropriate portions, and reducing the intakes of fat, sugar, and sodium, as recommended by the Healthy Eating Food Pyramid.

3. Eat More Fibre-Rich Foods

People with DM should select more fibre-rich foods according to the principle of healthy eating. Dietary fibre can be in the forms of soluble and insoluble fibre. Foods which are rich in soluble fibre include oatmeal, fruits, and dried beans; foods rich in insoluble fibre include whole wheat bread, vegetables, and fruits.

4. Use Healthy Cooking Methods

Using healthy cooking methods can cut down the amount of fat, sugar, and sodium in the diet:

  • Use vegetable oils, such as peanut oil, canola oil, etc. Avoid using animal fats, such as lard, butter, etc.
  • Use low-fat cooking methods including blanching, steaming, stewing, baking, and stir-frying with little oil, etc. Avoid using high-fat cooking methods, such as pan-frying and deep-frying.
  • Remove the fat and skin of meat and poultry prior to cooking to reduce the intake of fat.
  • Reduce the use of sugary seasoning, such as honey, ketchup, etc.
  • Use more natural, low-sugar and low-sodium seasonings, such as ginger, green onions, garlic, pepper powder, lemon juice, vinegar, etc.
  • Avoid using a lot of cornstarch and flour, which are high in carbohydrates, in preparing sauces or gravies.

5. Follow Own Meal Plan

  • People with DM should not follow others' meal plans as different people have different nutritional needs. They should consult their doctor or dietitian concerning their own meal plan.
  • Weight loss in obese people with DM can help to improve blood glucose control. They should follow the advice of medical professionals on portion control and exercise for weight management.

Meal Planning Approachess

All kinds of carbohydrates, including starch, fructose, and lactose, can affect blood glucose levels and should be evenly distributed in meals and snacks for blood glucose control. The common meal planning approaches are as follows:

Carbohydrate Exchange System

People with DM can incorporate different kinds of carbohydrate-rich foods into their meal plan using the "Carbohyrate Exchange System". The system emphasizes the importance of the overall nutritional content of foods and encourages consistency in the timing and amount of the meals and snacks. There is the need to understand the concept of "exchanging foods". The advice of dietitians can be sought on ways to use this system. The following examples show how different foods of similar carbohydrate content can be exchanged:

Example 1:
If 10g of carbohydrate is eaten as snack, each of the following
that contains 10 g of carbohydrate can be exchanged:

1 slice of wheat bread (thin cut, crust trimmed)
= 4 soda crackers
= 1 small fruit (e.g. 1 small orange, small pear, kiwifruit)

Example 2:
If 50g of carbohydrate is eaten for a meal, each of the following
that contains 50g of carbohydrate can be exchanged:

1 bowl* of rice, cooked (about 5 Tbsp)
= 12/3 bowl* of spaghetti, cooked
= 1 baked potato, medium (about 240 g)

*1 bowl =300 ml

The following foods are high in carbohydrates and may require the use of carbohydrate exchanges:

  • Vegetables and dried beans
    Starchy vegetables, such as potatoes, yams, etc. and beans, such as black-eyed peas, kidney beans, green peas, etc. contain higher amount of carbohydrates than leafy vegetables. Using the carbohydrate exchange system can help to keep the intakes of carbohydrates consistent.
  • Fruits
    • Some people with DM are avoiding fruits as they worry that the fructose in them can affect their blood glucose levels. Fruits are rich in vitamins, minerals, anti-oxidants, and dietary fibre, which are essential for a balanced diet.
    • Using the carbohydrate exchange system can make enjoying about 2 fruit exchanges daily possible. For example, 1 small orange can be exchanged with 1 small pear or 1 kiwifruit.
  • Desserts
    • Using the carbohydrate exchange system and nonnutritive sweetener when preparing desserts can help to satisfy the sweet tooth without adding any extra carbohydrates and energy to the meal plan.
    • The carbohydrate exchange system can also be used when eating desserts that contain starchy ingredients, such as sweet potatoes, kidney beans, etc.

Carbohydrate Counting System

The "Carbohydrate Counting System" is another way of incorporating different kinds of carbohydrate-rich foods into the meal plan. To use this system, people with DM need to become familiar with the carbohydrate content of foods. The total carbohydrate allotment for the day must also be known. It is important not to lose sight of the overall nutritional quality of foods when counting the carbohydrates in foods. If no attention is paid to the overall nutritional quality of foods, the diet may end up being high in fat or sodium. People with DM should follow a balanced diet which is low in fat, sugar, sodium, and high in dietary fibre. The advice of dietitians can be sought on ways to use this system.

References:

  • American Diabetes Association. www.diabetes.org
  • The American Dietetic Association. www.eatright.org