7 Ways to Maintain a Healthy Type 2 Diabetes Diet

A study finds that many type 2 diabetics don't follow nutrition guidelines. Here's how to do better

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.



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Brown rice

Healthy eating plays a major role in diabetes prevention and management, as demonstrated by a new study published online by the Archives of Internal Medicine, suggesting that choosing brown rice over white rice may help reduce the risk of type 2 diabetes. But selecting the right type of rice isn't the only food choice you can make to help avoid the disease. To ward off diabetes—or keep it in check if you've already been diagnosed—consider adding the foods on the following pictures to your diet.

Nut

Nuts help dampen hunger and provide healthy fats, magnesium, and fiber. Peanuts and other varieties are thought to help reduce the risk of heart disease and help improve cholesterol levels. Some research suggests that eating nuts may reduce the risk of diabetes. Because of this, people with diabetes should consume nuts to help reduce their cardiovascular risk, according to a study published in 2008 in the Journal of Nutrition. A common myth is that nuts should be avoided by those who want to lose weight because they're thought to be fattening. Not so, according to the National Institute of Diabetes and Digestive and Kidney Disease, which suggests consuming nuts, which are high in calories, in small portion sizes—say, a half-ounce of mixed nuts, totaling about 84 calories.

Green leafy vegetables

A 2008 Diabetes Care study found that women who ate more green, leafy vegetables in addition to fruit had a lower risk of developing type 2 diabetes. Eating lots of veggies such as spinach, kale, and collards, which are low in calories and carbohydrates, may also help accomplish a key goal of weight loss: Consuming less calories than one expends, says dietitian Elizabeth Mayer-Davis, president-elect for healthcare and education at the American Diabetes Association.

Fish

Choose fish high in omega-3 fatty acids, such as salmon, Mayer-Davis recommends. But shy away from fish that is deep fried or breaded, the ADA suggests. A study published this month in Diabetes Educator found that people with diabetes who consume more fish may have a reduced risk of cardiovascular disease, as well as improved cholesterol levels and a lower risk of cardiac death.

Fat-free milk and dairy products

A 2005 Archives of Internal Medicine study found that men who consumed more dairy products, particularly those low in fat, had a reduced risk of type 2 diabetes. Other research suggests that dairy products may help ward off insulin resistance, which leads to type 2 diabetes. When shopping, select dairy products that are fortified with vitamin D and calcium, Mayer-Davis suggests, since research shows that low levels of vitamin D may be tied to poor health outcomes.

Exercise is key, too

Losing 7 to 10 percent of your body weight if you're overweight is the ideal goal to help ward off type 2 diabetes, Mayer-Davis says. Because of this, both a healthy diet and regular physical activity are important for preventing and managing the disease. Regular exercise also "improves the way in which insulin works in the body to control glucose levels," another key benefit, she says.

The commitment to a healthy lifestyle should be lifelong and it should also influence your family members, says Mayer-Davis. "When you're thinking about a healthful diet for yourself, if you're a parent, this is something you're modeling for your children as well. Whole families should adopt healthful habits."


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