Dining with Diabetes Down East Frequently Asked Questions

Answers to the following questions are appropriate for most people with type 2 diabetes; however, individuals may have conditions that require more personalized responses. It’s best to discuss these questions with your health care provider who knows your unique needs.

Since I have diabetes I try to stay away from sugary foods and beverages. Are there other foods that can affect my blood sugar?

The sugar in food and beverages is just one kind of dietary carbohydrate that can influence blood sugar levels. Once consumed and digested, all kinds of carbohydrates are eventually converted into blood sugar. The only exception is dietary fiber, a type of carbohydrate we can’t digest and absorb. We need some carbohydrate rich foods in order to get the nutrients our bodies require and to keep blood sugar from getting too low; however, too much carbohydrate consumed at once may result high blood sugar. Carbohydrate rich foods that should be eaten in moderation include starchy vegetables like potatoes, peas, corn, winter squash and some beans; products made from grains such as bread, rolls, cereal, crackers, pasta and rice; fruit and fruit juice; and milk and yogurt. There are several good methods to avoid excessive dietary carbohydrates including carbohydrate counting and the plate method described in the video series on this site.

I have diabetes so I watch my carbohydrate intake and my blood sugar is under good control. Is there anything else I should consider when deciding what to eat and drink?

Blood sugar control is very important, but there are other things to think about too. Foods and beverages that affect blood pressure, cholesterol and body weight should be considered as well. A well-balanced diet that limits sodium and includes plenty of vegetables, especially those that are low in carbohydrates, some fruit, some low-fat or fat-free dairy, whole grains and small servings of lean meat and poultry has been shown to lower blood pressure. Dietary fats that are solid at room temperature, saturated fat and trans fat, negatively influence cholesterol levels in the blood.

I’ve heard that butter is better for my health than margarine. Is this true?

At first, scientists thought cholesterol-free margarine would be a healthier choice than cholesterol-containing butter.  It was later discovered that dietary cholesterol isn’t the most important factor. Instead, researchers found too much saturated fat from foods such as meats, poultry, dairy, and coconut and palm oils negatively impacts blood cholesterol. Butter contains large amounts of saturated fat. They later discovered that another kind of fat, trans fat, is even worse than saturated fat. Margarine was originally made through a process called partial hydrogenation. This process turns healthful liquid oils into trans fats that are solid at room temperature. Since margarine contained trans fats, many interpreted this to mean butter was a healthier choice than margarine.

Today, many kinds of margarine are made with very little or no trans fat and contain less saturated fat than butter. Label reading is critical when selecting butter or margarine. Avoid margarines that contain trans or partially hydrogenated fats, and select those that contain the least amount of saturated fat. Better yet, use liquid vegetable or olive oil.

Why have I been told to avoid white foods?

It’s hard to tell where this belief came from, but it probably has something to do with foods like white bread, white sugar and white potatoes. Consumption of any carbohydrate rich food or beverage, regardless of color, can affect blood sugar. On the other hand, an individual with diabetes can fit any carbohydrate containing food, regardless of color, into their diet, as long as the total amount of carbohydrate consumed isn’t too great at any one time.

No doubt, whole grains are better than refined grains. But many brown colored so-called wheat breads are in fact made from refined wheat flour with some brown food coloring added, and whole grain can be white in color. When selecting wheat products like bread, look at the ingredients list to be sure the first ingredient listed is whole wheat or look for the words 100% whole wheat.

Sugar of any color contributes empty calories and little in the way of nutrients. White sugar is no worse than raw sugar, brown sugar, honey or maple syrup. When sugar of any kind is consumed, other carbohydrates in that meal or snack must be reduced or blood sugar may rise too high.

In addition to carbohydrates, white potatoes contain nutrients like fiber, vitamin C and potassium. People with diabetes may consume potatoes in moderation.

Some white foods like cauliflower, haddock and tofu contain little carbohydrate and many nutrients. Other white foods like fat free milk contain some carbohydrate along with many nutrients. The advice to avoid all white foods is a misguided oversimplification.

How can I stay on track with my diet when I eat out?

Don’t be afraid to ask questions about the ingredients used in menu items and how they are prepared. You may decide an item contains too much sugar, salt or saturated fat, or you may ask if it could be prepared differently, like broiled instead of fried. Once you figure out what to eat at a particular restaurant, it’s easy to make the same choice the next time you visit.

Ask for a to go box when the meal is served and remove some food from the plate before you begin eating. You can ask the server to put the take home food in the refrigerator until it’s time to leave. This way you won’t be tempted to eat everything that’s served. Another option is to split a meal with someone.

Buffets are just too much temptation for most of us. A little sample of everything soon adds up to be too much. It may be better to avoid buffets altogether.

What about desserts and snacks?

Fruit from a meal may be saved for dessert or a snack. Likewise, fat free or low fat milk from a meal can be used to make instant sugar-free pudding. If your blood sugar is under good control, you may occasionally substitute a sugary dessert like cake or cookies in place of other carbohydrate containing foods in a meal. Just keep in mind that these items do not contain nutrients that are in other foods and they may contain more carbohydrate and unhealthful fat than you think. For instance, a piece of cake with icing that measures 2 inches, by 2 inches, by 2 inches, contains as much carbohydrate as a whole cup of spaghetti. For most people with diabetes, snacks should contain no more than one serving of carbohydrate (15 grams).

Should I take herbal or nutrition supplements?

According to The American Diabetes Association Diabetes Standards of Care, “There is no clear evidence of benefit from herbal or nonherbal (i.e. vitamin or mineral) supplementation for people with diabetes without underlying deficiencies…. Routine supplementation with antioxidants, such as vitamins E and C and carotene, is not advised because of lack of evidence of efficacy and concern related to long-term safety. There is insufficient evidence to support the routine use of herbals and micronutrients such as cinnamon and vitamin D, to improve glycemic control in people with diabetes.”

However, people who are taking the diabetes drug Metformin, and those who regularly take antacids, may be at higher risk for vitamin B12 deficiency. In addition, people over 50 years of age, whether they have diabetes or not, may not be able to absorb enough vitamin B12 naturally occurring in food, but can still absorb vitamin B12 from supplements or fortified foods. Vitamin B12 deficiency may cause irreversible damage to nerves.

If you live at a northern latitude, like in Maine, whether you have diabetes or not, you may want to consider taking a vitamin D supplement, especially in the winter if you don’t drink much vitamin D fortified milk. When ultraviolet light from the sun hits skin, we are able to make vitamin D. However, little direct sunlight reaches the skin of people in Maine during the winter, and even if it does, the angle of the sun is too low in the sky. People with more skin pigmentation are able to make less vitamin D.