Are all white foods bad? What about sugar-free -- is it always a good choice? Should you avoid all foods that include ingredients that are unfamiliar or you can't pronounce? We take a look at 12 misleading food tips and try to set the record straight, leaving you with more options and less confusion about what to eat with diabetes.
There's good reason to keep small amounts of fat in your healthy eating plan. It tastes good, plus fat helps your body absorb fat-soluble vitamins and other important disease-fighters. For example, eat a mixed-vegetable salad without dressing and you won't absorb much of the vegetables' carotenoids such as lycopene and alpha- and beta-carotene. Scientists are interested in carotenoids for their possible roles in the prevention of heart disease, cancer, and age-related eye disease.
Expert Tip: Apply commonsense portion-control techniques to all foods. Use just a tablespoon or two of dressing on your salads, and look for more of the heart-healthy fats, such as monounsaturated and polyunsaturated fats found in foods like olive oil, salmon, avocados, peanut butter, and nuts.
The serving size on a food label is not a one-size-fits-all suggestion. It may be too big, too small, or just right. Use the listed serving size, however, to figure the calories, carbohydrate, and other nutrients into your meal plan, because all of the nutrition facts on the label are based on one serving of the size noted on the label. If you eat twice the serving size -- perhaps a full cup of peas instead of the 1/2-cup serving that's listed -- you need to double all of the numbers on the label.
Expert Tip: Visit mypyramid.gov to learn about proper portions. For an individualized plan that takes your health, lifestyle, and food preferences into consideration, meet with a registered dietitian experienced in diabetes management.
Most Americans consume too little dietary fiber, eating at best about 15 of the 21-38 grams recommended for daily intake. Naturally fiber-rich foods are brimming with vitamins, minerals, and other disease-fighters, so eat up -- just not too much. Fiber comes packed with plenty of carbohydrate in fruits, vegetables, and whole grains, so do practice portion control or your blood glucose will rise too high.
To avoid the gas, bloating, and diarrhea that sometimes accompany quickly adding a lot of high-fiber foods, gradually replace highly processed, low-fiber foods with fiber-rich ones, advises Liz Quintana, Ed.D., R.D., CDE, of the West Virginia University School of Medicine.
Expert Tip: Eat one or two high-fiber foods with each meal.
If a pantry full of junk food unleashes your inner Cookie Monster, swearing off all sweets and chips forever may seem like the only solution. Here's the problem: Once you make a food or a group of foods forbidden, it has even more appeal. Willpower works for a short while, but eventually feelings of deprivation lead to an all-out junk-food frenzy.
Expert Tip: Make moderation, not deprivation, your mantra. Keep treats out of the house or at least out of sight, but allow yourself something small and satisfying now and then. Plan for a single ice cream cone or mini bag of chips, for example. Just be sure to work it into your meal plan.
"Never judge an ingredient by the number of letters it has in its name," says New York City-based dietitian Bonnie Taub-Dix, R.D., CDN, author of Read It Before You Eat It (Plume, 2010). Some unfamiliar or intimidating ingredients are perfectly safe and are used to thicken foods or keep oil and water mixed together in salad dressings, for example. Some are essential nutrients. Even though it looks and sounds intimidating, thiamin mononitrate is just vitamin B1. "Sometimes the ingredients you can pronounce, like hydrogenated fats, are much worse," Taub-Dix says.
Expert Tip: Instead of worrying about individual ingredients, focus on your eating plan as a whole and eat a variety of foods. If you have questions about individual ingredients, get advice from a registered dietitian or other member of your health care team.
The Center for Science in the Public Interest also provides reliable information about common food additives. Visit cspinet.org for more information.
Before ripping open the package with bold letters shouting "sugar-free," take a closer look at the rest of the label. "Sugar-free does not always equal carb-free, fat-free, or calorie-free," says Jennifer Hyman, R.D., CDE, a registered dietitian and diabetes educator in Rockville Centre, New York.
The total carbohydrate from the flour and milk in some sugar-free foods such as cakes, cookies, and brownies still affects blood glucose. And the foods' calories and fat can thwart efforts to manage weight and cholesterol. With 175 calories and 7 grams of saturated fat, a sugar-free brownie is no health bargain. That's a lot of empty calories that won't really fill you up or provide much nutrition.
Some sugar-free foods are with made with sugar alcohols, such as sorbitol or xylitol. Most people can tolerate sugar alcohols in portion-controlled amounts. However, if you overeat on foods with sugar alcohols or are just starting to eat foods that contain them, you may notice some increased gas, a bloated feeling, cramps, or diarrhea.
Even though fat doesn't spike blood glucose, it contains about 120 calories per tablespoon, so it can foil your weight-control efforts, says Liz Quintana, Ed.D., R.D., CDE. And that makes controlling blood glucose more challenging as well.
The type of fat you eat matters, too. Studies suggest that saturated fats decrease your body's sensitivity to insulin, and both saturated and trans fats contribute to high cholesterol.
Expert Tip: Apply commonsense portion-control techniques to all foods, not just carbohydrate-rich foods. Avoid unhealthy fats by limiting solid fats (stick margarine and shortening), fried foods, poultry skin, animal fats, and packaged foods with partially hydrogenated oils.
While nutrient-packed foods like brown rice and barley are good for you, Goliath-size servings of healthy foods can even pack on the pounds and spike blood glucose. In fact, white rice and brown rice have similar amounts of carbohydrate and calories, says Jennifer Hyman, R.D., CDE. Most people need just one to two servings of whole wheat pasta, brown rice, or all-natural fruit smoothies for a healthy portion.
Expert Tip: Portion, portion, portion! Portion size matters, regardless of the nutrient value of the food.
Some people in the hospital "get very upset when we send a dinner roll, white rice, mashed potatoes, or pasta, even though the portion is controlled and within their carbohydrate allotment for the meal," says Virginia-based dietitian Deb Indorato, associate director of Food and Nutrition Services with Morrison Management Specialists. What they are misunderstanding is that the portion of the food affects their blood glucose more than the type of rice or bread.
This faulty food rule also has some people fearing unprocessed or minimally processed white foods like cauliflower, radishes, onions, cottage cheese, and fat-free milk.
Expert Tip: Choose unprocessed foods such as quinoa, minimally processed foods such as whole wheat bread, or whole grain options more often than highly processed foods such as white rice, white bread, or sugary cereals.
It's true that eating bumps up metabolic rate because digesting food and absorbing and storing the nutrients uses calories, but the amount of calories burned doesn't have to do with the number of times you eat. Rather, the boost in metabolic rate from eating depends on the amount of calories you eat, says Susan B. Roberts, Ph.D., director of the Energy Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. For example, if you eat a balanced, 1,200-calorie meal plan, the metabolic rate is approximately the same whether you eat small meals every three to four hours or simply consume the traditional breakfast, lunch, and dinner.
For some people, snacking backfires: More opportunities to eat mean more opportunities to overeat. Yet for others, snacks between meals help them prevent hunger and overeating when they do sit down to eat.
Expert Tip: Don't be a slave to someone else's idea of the proper times to eat. Spread your food out over your day in a fashion that manages hunger, controls blood glucose, and fits into your daily routine.
Drinking water may temporarily fill your stomach, but the water empties quickly and has no lasting effect on hunger or fullness, according to researchers at The Pennsylvania State University. When 24 women drank a glass of water and ate casserole before lunch, they were less full and consumed more calories than when they ate the same casserole combined with the water to make a soup, suggesting that water incorporated into food is more filling.
Expert Tip: Curb your appetite and cut calories by filling up on foods with a high water content such as broth-base soups, salads, fruits, and vegetables.
With some of the older blood glucose-lowering medicines, a bite before bed was necessary to prevent low blood glucose (hypoglycemia) during the night. That's no longer the case because of newer blood glucose-lowering treatment options, says Liz Quintana, Ed.D., R.D., CDE. Today we have insulins, other injectable medications, and pills that lower blood glucose in ways that are unlikely to cause hypoglycemia. Plus, unnecessary snacking at bedtime or other times can cause weight gain.
This doesn't mean that snacks are a bad idea for everyone. For some people with diabetes, a small bedtime snack that contains some carbohydrate, such as fruit or light yogurt, can actually help tame high fasting glucose levels in the morning by preventing the liver from producing excess glucose while they sleep.
Expert Tip: Check with your health care provider about your need for bedtime eating. If your blood glucose-lowering medicines require you to snack but you'd rather not, ask if there are other treatment options for you.
Reviewed by Hope S. Warshaw, R.D., CDE, BC-ADM, 2011.