A diagnosis of type 2 diabetes means lifestyle changes that can be frustrating but are important for a long, healthy life. At the top of the list is adjusting to a type 2 diabetes diet, but a new study of overweight and obese diabetics, published in August in Journal of the American Dietetic Association, suggests that diabetics often don't follow recommended nutrition guidelines. Ninety-three percent of participants consumed more calories from fat than they should, 85 percent consumed too much saturated fat, and 92 percent took in too much sodium. Researchers compared what study participants reported eating to the recommendations in the Dietary Guidelines for Americans and the Institute of Medicine's Dietary Reference Intakes. These guidelines call for no more than 30 percent of a person's daily calories to come from fat, for example, and no more than 10 percent from saturated fat.
"You displace other healthy foods if you consume high levels of fat, [and] fat is high in calories," cautions Mara Vitolins, the study's lead author. Vitolins is an associate professor and vice chair of the department of epidemiology and prevention at Wake Forest University's School of Medicine. The research serves as a heads-up to all type 2 diabetics—not just the newly diagnosed—since it found that people who had lived with diabetes for the longest periods of time were no more likely to maintain a healthy diet than people who'd had the disease for shorter periods. Whether you were diagnosed many years ago or only recently, here are seven tips for starting and maintaining a healthy type 2 diabetes diet:
Figure out what you're eating. To replace high-fat foods in your diet with low-fat foods, first write down everything you eat and then analyze your list, advises Sue McLaughlin, president for healthcare and education at the American Diabetes Association. Some online tools, such as the ADA's My Food Advisor, can help you determine what your actual intake is and where you are lacking in nutrients. As you analyze your food intake, "choose one or two of the highest fat-content foods and replace them with a colorful serving of fresh fruit or vegetables," says McLaughlin. By doing this, she says, "you have decreased your fat and calorie intake and increased your intake of fiber and vitamins and minerals and moved one step closer to improving blood pressure, blood cholesterol, and overall health."
Get serious about your fruits and vegetables. Strive for two servings of fruits and three servings of vegetables per day, Vitolins suggests, and two servings of dairy and six servings of grains. And try to stick with low-fat dairy products and grains. The study showed that less than half of study participants took in the minimum recommended daily servings of fruits, vegetables, dairy, and grains.
Plan your meals. Careful planning can prevent mindless eating. Adults should get 45 to 65 percent of their calories from carbohydrates, 10 to 35 percent from protein, and 20 to 30 percent from fat, Vitolins says. For some people, diabetic diet planning tools, such as counting carbohydrates and the create-your-plate method (which involves drawing imaginary lines on your plate to divide it into three sections, then putting nonstarchy vegetables in one section and starchy foods and meat/protein in the other sections), may be useful for meal planning.
Don't assume you know everything. Just because you've been diabetic for a long time doesn't mean that nutrition education won't help you. "In my opinion, people with type 2 diabetes may not be getting the amount of nutrition education they need to consume a healthful diet," Vitolins says. "I think people with type 2 diabetes need nutrition education 'boosters' or continual re-evaluations of their food intake over time." Ask your doctor for a referral to a dietitian or nutritionist if you think you could use a refresher.
Develop a support system. Identifying a person who McLaughlin calls a "champion"—someone who will listen and provide support for the healthy changes that you are trying to make—can be beneficial for diabetics. Ask this person to encourage you to consume healthy foods and engage in physical activity as a part of your daily life.
Be picky about where you eat. Select restaurants that specialize in healthy foods or that are willing to substitute high-fat foods for healthier ones.
Find advice online. There is a wealth of nutritional advice online for type 2 diabetics. Among McLaughlin's favorites: the ADA's My Food Advisor, a calorie and carbohydrate counting tool, the American Dietetic Association's Web site, MyPyramid.gov, and the National Diabetes Education Program.
Along with refining your dietary habits, it's important to take stock of your physical activity. You should "do something that requires you to move the large muscles in the body [arms and legs] for a goal of 30 minutes or more, five days a week or more," McLaughlin recommends. Research shows that restricting calories alone will result in loss of lean muscle mass and body fat, while a program of both exercise and calorie restriction should lead to a loss that is primarily body fat.