General Dietary Guidelines
Lifestyle changes of diet and exercise are extremely important for people who have pre-diabetes, or who are at high risk of developing type 2 diabetes. Lifestyle interventions can be very effective in preventing or postponing the progression to diabetes. These interventions are especially important for overweight people. Even moderate weight loss can help reduce diabetes risk.
The American Diabetes Association recommends that people at high risk for type 2 diabetes eat high-fiber (14g fiber for every 1,000 calories) and whole-grain foods. High intake of fiber, especially from whole grain cereals and breads, can help reduce type 2 diabetes risk.
Patients who are diagnosed with diabetes need to be aware of their heart health nutrition and, in particular, controlling high blood pressure and cholesterol levels. [Specific information on diet plans such as the salt-restricting Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean Diet (which is rich in fruits, vegetables, fiber, and monounsaturated fats) can be found in In-Depth Report #43: Heart-healthy diet.]
For people who have diabetes, the treatment goals for a diabetes diet are:
- Achieve near normal blood glucose levels. People with type 1 diabetes and people with type 2 diabetes who are taking insulin or oral medication must coordinate calorie intake with medication or insulin administration, exercise, and other variables to control blood glucose levels.
- Protect the heart and aim for healthy lipid (cholesterol and triglyceride) levels and control of blood pressure.
- Achieve reasonable weight. Overweight patients with type 2 diabetes who are not taking medication should aim for a diet that controls both weight and glucose. A reasonable weight is usually defined as what is achievable and sustainable, and helps achieve normal blood glucose levels. Children, pregnant women, and people recovering from illness should be sure to maintain adequate calories for health.
Overall Guidelines. There is no such thing as a single diabetes diet. Patients should meet with a professional dietitian to plan an individualized diet within the general guidelines that takes into consideration their own health needs.
For example, a patient with type 2 diabetes who is overweight and insulin-resistant may need to have a different carbohydrate-protein balance than a thin patient with type 1 diabetes in danger of kidney disease. Because regulating diabetes is an individual situation, everyone with this condition should get help from a dietary professional in selecting the diet best for them.
Several good dietary methods are available to meet the goals described above. General dietary guidelines for diabetes recommend:
- Carbohydrates should provide 45 - 65% of total daily calories. The type and amount of carbohydrate are both important. Best choices are vegetables, fruits, beans, and whole grains. These foods are also high in fiber. Patients with diabetes should monitor their carbohydrate intake either through carbohydrate counting or meal planning exchange lists.
- Fats should provide 25 - 35% of daily calories. Monounsaturated (such as olive, peanut, canola oils; and avocados and nuts) and omega-3 polyunsaturated (such as fish, flaxseed oil, and walnuts) fats are the best types. Limit saturated fat (red meat, butter) to less than 7% of daily calories. Choose nonfat or low-fat dairy instead of whole milk products. Limit trans-fats (such as hydrogenated fat found in snack foods, fried foods, and commercially baked goods) to less than 1% of total calories.
- Protein should provide 12 - 20% of daily calories, although this may vary depending on a patient’s individual health requirements. Patients with kidney disease should limit protein intake to less than 10% of calories. Fish, soy, and poultry are better protein choices than red meat.
- Lose weight if body mass index (BMI) is 25 - 29 (overweight) or higher (obese).
Several different dietary methods are available for controlling blood sugar in type 1 and insulin-dependent type 2 diabetes:
- Diabetic exchange lists (for maintaining a proper balance of carbohydrates, fats, and proteins throughout the day)
- Carbohydrate counting (for tracking the number of grams of carbohydrates consumed each day)
- Glycemic index (for tracking which carbohydrate foods increase blood sugar)