Understanding what is in your food and how it can affect your blood sugar levels can seem like a daunting task. But it’s important to first learn which foods are mostly carbohydrates, mostly protein, and mostly fat so you can learn the best foods to choose, the appropriate amounts, and the best times to eat them. Having a good grasp of diabetes nutrition basics will help you make the best decisions in any setting-and you will be surprised to discover that if s a lot less complicated than it may seem.


Food is one of the oldest forms of medicine, and that is especially true when it comes to living with diabetes. Taking control of what you eat will have immediate benefits to your health. As mentioned in the previous chapter, research has shown that MNT provided by a registered dietitian can decrease hemoglobin AlC levels by up to 2 percent, so it’s definitely worth the effort to learn about and implement the strategies in this chapter and to seek additional help as needed.


Nutrients and the Newly Diagnosed

You do not need to follow one specific eating plan to be successful. In fact, research has shown that there are many different nutrition plans that can help you manage your diabetes. What is important is to learn some key principles that you can implement in a way that works for you. Individualizing your plan to meet your budget, food preferences, scheduling demands, and family needs will make all the difference.


I focus on what to include in your meals, rather than simply what to avoid, and I hope you will find my approach refreshing. Too often, diets teach us to restrict certain foods entirely, leaving us with more questions than answers. When we are told that we can’t eat something, we end up craving those off-limits foods more than we would otherwise. There is a better way.


This chapter will give you a deeper look at exactly what foods to add to your daily meals and teach you why they are important, so you will be empowered to make better choices in any situation you may find yourself.


At the end of the day, eating well with diabetes is simply following a healthy nutrition plan-one than anyone could benefit from eating. So please don’t be discouraged and feel as if you need to eat completely differently than everyone else around you. You can and should enjoy your food! So with that, lets dive a little deeper.




Macronutrients are essential nutrients the body requires for growth, metabolism, and other vital functions. They provide energy in the form of calories and are classified into three main groups: Carbohydrates, protein, and fat. Let’s take a closer look at each.



Perhaps the nutrient most perceived as a villain, carbohydrates often get an unnecessarily bad rap. But let’s be clear, you do not have to completely eliminate or avoid carbohydrates to control your blood sugar levels. In fact, carbohydrates are an important energy source that helps your cells function optimally. What you have to pay attention to is the type of carbohydrates you choose and how much of them you eat.


Starches, sugars, and fiber are all considered carbohydrates (aka carbs). Starches and fiber are complex carbs, meaning they are made of long chains of multiple sugar molecules. Sugars are simple carbs, which means your body will digest them more quickly, so they have the potential to raise your blood sugar levels faster than starches and fiber.


Some simple carbohydrates are very healthy and beneficial to your overall health, so they do not need to be omitted from your eating plans. Examples include full-fat dairy products and fruit. The latest research points to the benefits of choosing organic, grass-fed,full-fat dairy products, such as kefir, yogurt, and whole milk, for people with type 2 diabetes. You do not need to eliminate fruit, but do be mindful of the amount and frequency in your meals. As a general rule, I tell my clients to make sure they are eating more vegetables than fruits throughout the day and to choose the highest-fiber fruits, like berries, most often.


It’s important to note that most of the simple carbs in a typical American diet are added to foods, often without our being aware of them, so it’s important to read labels for added sugar, like high-fructose com syrup, fruit juice concentrate, brown sugar, and cane sugar. These types of added sugars are digested within five minutes and quickly raise blood sugar levels. One of the best health decisions anyone can make is to commit to identifying and eliminating as much added sugar as possible, to avoid the multitude of complications it can create.


Complex carbohydrates are best for blood sugar control because they are higher in fiber, are digested more slowly (taking up to 90 minutes), and contain more nutrients. Since they are digested more slowly, they will also keep you satisfied for longer compared with simple sugars.


Starches are what people typically think of when they say “carbs.” These include cereals, breads, pastas, peas, bagels, and rice. While you can still eat these foods, you should limit the portion size and the frequency, and choose whole-grain options. If you choose refined white starches, they will offer little nutritional value, be digested quickly, and subsequently raise your blood sugar levels. Additionally, they won’t keep you full for very long, so while they have the same number of calories per gram as protein (4 calories per gram), it’s easy to overeat them.


If s important to include adequate amounts of fiber in your diet every day, and you may find that challenging. The goal is 25 grams per day for women and 38 grams per day for men. Fiber occurs naturally in the cell walls of plant foods, so including more vegetables, whole grains, beans, nuts, seeds, and high-fiber fruits (such as berries and apples) will ensure better health.


Quick recap: Dairy products, fruit, whole grains, beans, starchy vegetables (such as potatoes, peas, winter squash, and com), and added sugar in all its forms all contain carbohydrates. Limit the simple sugars, check labels for added sugars, and start to notice how big your portion sizes of carbohydrates are. (Later in this chapter I’ll talk about how carbs fit into the whole diet, servings, and the Complete the Plate method.)

Protein is also considered an energy nutrient —like carbs, it provides energy in the form of calories. Almost everything in your body requires protein, and protein is found in every cell in your body. Protein supplies the same number of calories per gram as carbohydrates (4 calories), but it takes a lot longer to digest (around two or three hours). This is an important difference, because eating protein with carbohydrates can help stabilize blood sugar levels, since protein does not affect blood sugar levels as much as carbohydrates. For this reason, I recommend including a protein-rich food every time you eat. A study published in 2015 in Diabetes Care showed that the order in which we eat foods can be helpful, so eating a protein before a carbohydrate in the same meal may have even better blood sugar results.
When it comes to protein, there are two primary categories: animal-based and plant-based. Examples of healthy animal-based protein include fish, poultry, grass-fed red meats, pork tenderloin, eggs, and cheese. Healthy plant-based protein includes nuts, seeds, beans, tofu, lentils, nut and seed butters, and quinoa. Remember that plant-based foods, which include plant protein, also contain fiber, while animal protein does not, so you can see that including plant-based protein more often in your diet will give you the best results. It’s also important to note that plant-based protein is easier on the kidneys than animal-based protein.

Studies, including a study published in 2017 in the Journal of Geriatric Cardiology, have found that ensuring you are primarily eating plant-based foods, including plant-based protein, is highly beneficial for treating type 2 diabetes. This does not mean you need to become vegan or vegetarian; it simply means you should aim to eat more plant protein than animal protein overall. We live in a society that has access to cheap, low-quality protein sources (think Quarter Pounders with Cheese), so most of us are eating enough protein; it’s the quality and type of protein that will make all the difference.


The final type of macronutrient that supplies energy is fat. Fat takes longer to digest than carbohydrates or protein, so it will help keep you satisfied for hours after meals. Fat helps your immune system function properly, helps your body absorb certain vitamins A, D, E, and K efficiently; provides structure for cell membranes; and regulates body temperature. As you can see, fat is an essential component of your diet. Fat provides a more concentrated fuel source, having 9 calories per gram. As with the other macronutrients, it’s all about the amount and type of fat that you are consuming.


Fat is either saturated or unsaturated, having to do with its chemical structure. Saturated fats are solid at room temperature, and unsaturated fats are liquid at room temperature.


The unsaturated fats are further broken down into polyunsaturated and monounsaturated fats, again having to do with their chemical

When it comes to the type of fat you are consuming, unsaturated fats are the best Examples of foods that contain monounsaturated fats include olive oil, avocados, nuts, and nut “butters. (Pro tip: Look for nut butters that have oil on the top; this is actually a sign that it’s a better choice.)
Polyunsaturated fats are essential fats, meaning your body can’t produce them, so
you must get them from food. The best types of polyunsaturated fats are omega-3 fatty acids, because they have been shown to have powerful benefits in reducing the risk of heart disease and stroke. Examples of foods that contain omega-3 fatty acids include salmon, sardines, ground flaxseed, walnuts, mackerel, oysters, halibut, and fresh tuna.
Saturated fats have been the subject of much debate and recently have become more accepted than in previous years as the science of nutrition has advanced. However, they should still be consumed in moderate amounts, and their health benefits do not outweigh those of omega-3 fats and monounsaturated fats. Examples include coconut oil, ghee, butter, whole dairy products, and meat.
The most harmful type of fat is a type of saturated fat called trans fat. It is created when a manufacturer adds an extra hydrogen molecule to a saturated fat in a process called hydrogenation. Trans fat offers no dietary benefits and should be completely eliminated. Trans fat will both raise your LDL (bad) cholesterol and lower your HDL (good) cholesterol, thus damaging your heart health in multiple ways. Check food ingredient lists and avoid anything that has the word hydrogenated. Examples of foods that could potentially have trans fats include coffee creamer; peanut butter made with hydrogenated oil; commercially prepared cookies, cakes, and crackers; biscuits; and stick margarines.
Again, fat is a necessary macronutrient that your body requires, and if s a good idea to include a healthy source of fat every time you eat. The ultimate goal is to eliminate all trans fat and switch to mostly monounsaturated and omega-3 fats.
Using all of this information about macronutrients, I like to point out to my clients that eating something with quickly digested, refined carbs combined with a high-fat food will likely keep blood sugar levels elevated for longer periods of time. Examples of this type of meal include traditional pepperoni pizza, meat lasagna, and macaroni and cheese. Each of these foods can be made healthier and create less of a blood sugar spike, though. For example, thin-crust whole-wheat veggie pizza, vegetarian lasagna made with zucchini instead of pasta, and macaroni and cheese made with whole-wheat macaroni and with veggies added are all better alternatives.

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