Nutrition plays a big role in preventing and managing diabetes. Usually discussions about food and diabetes focus on carbs, and with good reason. Carbohydrates impact blood sugar (unlike the other two macro nutrients- protein and fat. More on them in the pairing section below.
Here is how it works:
Carbs are eaten–>carbs are digested/broken down into sugar–> sugar is absorbed into the bloodstream–>blood glucose levels rise. At this point, our bodies produce a hormone called insulin that lowers blood glucose levels and maintains them in a healthy range.
For people with type 2 diabetes or pre-diabetes, this process doesn’t function properly and blood glucose levels stay high. If uncontrolled, this can lead to long-term consequences such as nerve damage, kidney damage, vision impairment, heart disease, and stroke.
For a more comprehensive explanation of insulin’s role in blood glucose regulation, check out the American Diabetes Association website.
Given how carbs affect blood sugar, a common misconception is that people with diabetes need to eliminate carbs completely. This is not the case. Carbs are an essential energy source for our bodies, and the preferred fuel for our brains and working muscles. It’s not about cutting out carbs, it’s about controlling them.
Particularly, people with diabetes need to pay attention to the TYPE, AMOUNT, TIMING, and PAIRING of the carbs they eat:
What is TTAP?
• TYPE: High-fiber, nutrient-dense carbs are digested more slowly, have less impact on blood sugar, help you stay fuller longer, and offer other health benefits (i.e. vitamins, minerals, antioxidants, phytochemicals, and protein.) Examples of what are sometimes affectionately called “good” carbs are fruit, starchy veggies such as corn, potatoes and peas, beans/legumes, oats, whole wheat bread and pasta, quinoa, and whole grains like farro and brown rice. These are the carbs you want to focus on. Refined grains and foods with lots of added sugar but little nutritional benefits such as pastries, cookies, donuts, candy and soft drinks are best enjoyed as occasional treats. Keep in mind that honey, maple syrup, agave, raw sugar and coconut sugar affect your body just like regular sugar – so use in moderation!
• AMOUNT: Consuming more carbs means a greater rise in blood sugar, so it’s important to pay attention to the amount you eat at one time. The exchange system is a way to classify serving sizes of foods that contain carbs and guide your intake, where 1 exchange = 15 grams of carbs. But you don’t necessarily need to “count carbs” in order to control your blood sugar, as long as you’re mindful of portion sizes. Since many of us are victims of the “portion distortion” in our current food environment, here are some visual tools to help guide how much you should be eating at one time.
• 1 medium piece of fruit or 1 cup of berries, melon etc = 1 baseball
• 1 slice of bread = 1 cassette
• 1/2 cup of beans or potatoes = light bulb
• 1/3 cup of pasta or rice = hockey puck
• TIMING: Spreading your carb intake throughout the day, ideally eating every 3-4 hours, promotes stable blood sugar and energy levels. This is not the same thing as grazing mindlessly. In fact, when it comes to meal and snack timing, planning ahead is key. When you eat is nearly as important as what you eat. Treat your snacks as a noun, not a verb (i.e. “I am having a snack” versus “snacking.”) Include a carbohydrate-rich food at breakfast, lunch, dinner, and snacks. For example, eat oats with breakfast, whole wheat bread at lunch, brown rice with dinner and include fruit with snacks.
• PAIRING: Unlike carbs, the other two macronutrients, protein and fat, don’t affect blood sugar. They take longer to digest, so they keep you full longer. Pair carbs with lean protein such as skinless chicken or fish, and/or healthy fats such as olive oil, nuts or avocado for more stable blood sugar control, and greater satiety.
• For snacks, try an apple + string cheese, banana + peanut butter, berries + Greek yogurt, whole grain crackers + tuna or turkey, or carrots with hummus.
• For meals, pair your carb (such as a sweet potato, quinoa, pasta or bread) with a lean protein source. Balance out your meal by filling at least half your plate with greens and other non-starchy veggies such as broccoli, squash, asparagus, cauliflower and string beans. (Note that corn and potatoes, while they are awesome for you, count as your carb, not your veggie.) Eating more non-starchy veggies not only boosts the nutritional value of your meal, but also adds volume to keep you full.
When eating out, instead of avoiding carbs completely, I often encourage clients to choose ONE per meal. If you want a burger, have the bun OR the fries, and get a green salad. At a cookout, choose corn on the cob, potato salad OR mac and cheese- not all three. Then balance out your plate with protein and grilled veggies or salad. This is what we like to call the “ plate method” and works in virtually any setting, whether at home, a party or a restaurant.
With all of this said, hopefully you can now see that carbs don’t have to be your enemy and you can TTAP this!
Alissa Palladino is a Registered Dietitian and certified personal trainer born and raised in NYC. She is a graduate of Yale University and New York University. At Good Measure Meals, Alissa helps people achieve and maintain their health goals by empowering them to make sustainable diet and lifestyle changes. A veggie lover and avid runner with a number of half and full marathons under her belt, Alissa believes the best form of exercise is the one you enjoy and the best nutrition plan is one that fits into your lifestyle. Read more about Alissa & Good Measure Meals.
If you want to check-in about your health goals, you can reach out to Alissa at firstname.lastname@example.org or schedule a complimentary nutrition consultation.
Learn more about Good Measure Meals, a local social enterprise dedicated to nutrition science here.