diet for type 2 diabetes

DIET FOR TYPE 2 DIABETES
This Diet is Low in Sweets and Refined Grains, Low in Saturated Fats
and Trans Fats. It Focuses on Eating Regular Meals; Including Low
Glycemic Index Foods.
Glycemic Index (GI): The glycemic index is a scale that ranks foods by
how much they raise blood sugar levels. The higher the glycemic index
of a food, the more it raises your blood sugar levels. The goal is to
include low GI foods in your diet; the food GI should be less than 55.
Complete GI lists can be found on the internet or in book stores.
Tips To Help Keep Your Blood Sugar Levels in a
Healthy Range
1. Eat three regular meals per day, no more than six hours apart.
Include small snacks between meals.
2. Eat high fiber foods such as whole and multigrain breads,
cereals, pasta and rice; soluble fibers such as oat bran,
psyllium and barley are great. Include whole-grain starchy
foods at every meal.
3. Eat an abundance of fruits and vegetables; 2 vegetables at
lunch and 2 vegetables at supper; eat 2-3 fruits everyday; eat
fruit as a nutritious snack. Eating whole fruits is always better
than juices.
4. Drink water instead of regular sodas and fruit drinks. Tea,
coffee and low-calorie juices and beverages are great.
5. Eat lower glycemic index foods. These foods will help you:
1. keep your blood sugar levels from going up too much;
2. lose weight and be healthier; 3. lower your “bad cholesterol”
(LDL); and 4. increase your “good cholesterol” (HDL). Internet
sites: do a search for “glycemic index” and visit www.diabetes.ca.
6. Include fish, chicken, lean meats, low-fat cheese or alternate
protein choices (beans, peas, lentils, nuts, eggs, tofu) along
with milk or yogurt as part of your meal.
7. Make lower fat choices (such as skim milk or 1% milk, leaner
cuts of meat and cheeses); use unsaturated fats such as
olive/canola oils and non-hydrogenated margarine. Try not
to fry your foods.
Type 2 Diabetes FACTS – Focus on Glycemic Index, Fats
and Fiber
• In Type 2 Diabetes, the body either cannot produce enough insulin or
cannot use insulin very well. Without insulin, blood sugars (from the breakdown of foods) cannot get into cells, muscles and brain for energy.
It stays in the blood.
• Over time, high blood sugar causes damage to your blood vessels
and can result in blindness, heart disease, kidney problems, amputations,
nerve damage and erectile dysfunction.
• By eating lower glycemic index foods, low fat and high fiber foods (less
refined foods) and exercising regularly, you can avoid severe ups (spikes)
and downs (drops) in your blood sugar levels.
HEALTHIER EATING GUIDELINES
Foods and Their Glycemic Index (GI)
Try to choose foods with a GI of 55 or less. These include whole grain foods, fruits and vegetables. Hint: Try to eat as “close to
the farm” as possible; the less processed is best!
Low GI Foods (55 or less)
Choose Most Often
Medium GI Foods (56-69)
Choose Occasionally
High GI Foods (70+)
Choose Less Often
Whole grain breads
Oatmeal (slow cook oats)
All-Bran cereal
Converted or Parboiled rice
Brown rice
Pumpernickel bread
Al dente (firm) pasta
All beans, peas and lentils
Apple, orange, tomato juice
Sweet potato
Carrots, broccoli, cauliflower
Apples, peaches, pears
Grapefruits, oranges
Sweet corn
Dark leafy vegetables
Popcorn
Marmalade, jams – small amount
Skim or 1% milk
Low fat, yogurt
Soy beverage
Couscous
Basmati rice
Shredded wheat cereal
Pita bread
Rye bread
High fiber crackers
Baked snack foods (not fried)
White bread
Whole wheat pretzels
Cantaloupe
Pineapple
Raisins
Fruit cocktails
New potatoes
Beets
Cranberry juice
Ice cream – vanilla or low sugar
Instant mashed potatoes
Baked white potatoes, red potatoes
Parsnips
Rutabaga
Instant rice
Corn Flakes
Rice Krispies
Refined cereals
Bagels
Waffles/pancakes
Pretzels
Soda crackers, rice crackers
French fries
Digestive cookies, graham crackers
Dried dates, figs
Fruit bars
Sports drinks
Sweetened soft drinks
Glucose
* Adapted from the “The Glucose Revolution – The Authoritative Guide to the Glycemic Index” Jennie Brand-Miller.
High protein foods (ie. meat, poultry, fish, eggs, peanut butter, nuts) have a low GI; choose low fat/lean protein foods.
Canada’s Guidelines for Healthy Eating (1991) recommend that you eat more whole grain products, vegetables and fruit, and
less fat, salt, alcohol, and caffeine. The Guidelines encourage the choice of lower fat dairy foods, leaner meat, and foods
prepared with little or no added fat.
Sugar and Refined Foods – 1 teaspoon = 5g sugar
• The more sugar you eat, the higher your blood sugar will be! Always read food labels carefully.
• Limit sugars within your diet! These include sweets, candy, sugar, jam, honey, syrup, regular soft drinks and sweetened fruit
drinks.
• Avoid foods that contain a lot of sugar such as cakes, pies, cookies and many pre-packaged foods.
• Avoid adding sugar during cooking.
• Avoid refined (“white”) foods such as white sugar, white flour, white bread, pastries etc. These have a high glycemic index
and will cause your blood sugar levels to spike.
The sugar content on the food label should be less than 10 grams per serving. When reading “carbohydrates” on the food label,
remember that whole grains are best. Always see the fiber content, which should be subtracted from the total “carbs” as fiber is
not digested.
General Healthier Eating Guidelines (To Avoid Complications With Diabetes)
• Your breakfast plate should be 1/3 fruit, 1/3 starchy fiber foods (multigrain bread and cereal products) and 1/3 protein (nuts,
eggs, tofu, beans, lentils, low-fat dairy products). Your lunch and dinner plates should be 1/2 vegetables, 1/4 starchy fiber
foods and 1/4 protein.
• Choose whole grains, such as whole wheat pasta, whole wheat bread and brown rice to increase fiber intake. Most of these
are low in fat.
• Choose only lean meat and poultry. Remove skin and trim fat before cooking. Your meat portion should be about the size of
a deck of cards (50-100g or 2-4oz).
• See the milk fat (MF) of all dairy products. Use skim or 1% milk products and low-fat cheese (less than 20% MF), or choose
fortified soy products.
• Reduce your total fat intake (less than 25%-35% of your daily calories). To achieve this, always try to choose low fat foods
and avoid fried foods. Read labels!
• Limit saturated and trans fats to less than 10% of your daily calories. Try to always choose unsaturated fats such as olive
and canola oils and non-hydrogenated margarine (in moderation). Saturated and trans fats raise blood cholesterol levels, while
unsaturated fats lower blood cholesterol. Saturated fats are solid at room temperature and are usually of animal origin. They
are found in meats, whole milk, dairy products, butter and hard margarines. Trans fats are found in baked and pre-packaged
foods. Hydrogenation is a process that changes liquid vegetable oil into a solid fat such as hard margarine. The hydrogenation
process changes some of the good fats into cholesterol-raising saturated and trans fats. (People with diabetes are at a
greater risk of developing or have already high levels of fats in their heart and blood vessels.)
• Omega-3 fatty acids are found in cold water fish such as herring, mackerel, salmon, trout, sardines and tuna, and in
flaxseeds (2 tbsp per day, freshly ground). Three to four servings of fish per week is recommended as part of a healthy, balanced
diet. Omega-enriched foods are also available in supermarkets such as omega-3 eggs and omega-3 enriched dairy products.
• Omega-3 supplements: always look for the active ingredients DHA and EPA. Recommendations are 600-900mg/day.
Always check with your doctor or registered dietitian before taking any supplements.
Food Labels
• Read food labels carefully. Try to reduce your fat intake and your sugar intake.
• Remember that labels list ingredients in descending order by weight.
• Avoid products listing enriched wheat (white) flour, sugar, glucose, fructose or any other form of sugar as one of the first 3
ingredients.
Fibre
• Increase fiber in your diet by eating more whole grain foods, vegetables, fruits and legumes. These foods also contain
vitamins, minerals and antioxidants and have a lower glycemic index. Low glycemic index foods will help to keep your blood
sugar levels in the target range. They will also make you feel fuller faster and longer and will help to lower cholesterol levels.
Salt – Tips to reduce salt (“Sodium”) in your diet
High blood pressure may also be present with your diabetes. Limiting how much salt you eat can help keep your blood pressure low.
• Decrease the amount of salt you add during cooking and reduce salt in recipes.
• Before adding salt at the table, taste first.
• Try seasoning your food with (salt-free) herbs, spices and garlic. Lemon juice brings out the natural saltiness of foods.
• Avoid processed foods that are high in salt (sodium chloride) such as canned or packaged foods and condiments such as
mustard.
• Watch for “Na” (sodium) on food labels. Chips, pretzels, and other such snacks are very high in salt.
• Avoid cured meats such as ham, bacon, bologna and salami.
• Check with your physician before using salt substitutes.
Alcohol
• Limit alcohol to less than 2 drinks per day (1 drink=12 oz beer=1.5 oz liquor=4oz wine)
• Drinking alcohol is not recommended if you:
- have high triglycerides (blood fats)
- have high blood pressure
- have liver problems
- are pregnant or breastfeeding.
• If you choose to drink alcohol, remember:
- to drink with your meal or snack (not on an empty stomach!)
- to drink slowly or dilute with water or diet soda
- that liqueurs, sweet wines and dessert wines have a lot of sugar
- to wear your MedicAlert (Alcohol can cause hypoglycemia/low blood glucose)
Reducing alcohol can promote weight loss and help you lower your blood pressure.
Caffeine
• Drink no more than four (4) cups of coffee or caffeine-containing beverages per day.
Supplements – Ask your Doctor or Registered Dietitian before taking
Recommendations:
• Heart healthy mixture = 1/3 ground flax, 1/3 oat bran and 1/3 psyllium – take 2 tbsp/day
Food Preparation
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Avoid adding sugar during cooking. Use Splenda (sucralose) instead of sugar if baking or cooking.
Use low-fat and low sugar sauces and marinades.
Use reduced-fat cooking methods such as barbecuing, broiling, roasting and steaming.
Avoid frying and deep-fat frying.
Exercise
• Achieve and maintain a healthy body weight by exercising daily and eating healthy
• Aim to be active for 150 minutes per week. Start with brisk walking for 10 minutes a few times per day and increase
gradually from there. Endurance exercise will help to increase your heart and lung capacity.
• Also include flexibility exercises (gentle stretching) to keep your muscles and joints relaxed. Aim for at least 4
stretching sessions per week.
• You can also do strength exercises 2-4 times per week to strengthen muscles and help your bones.
• Remember to start slowly and consult your physician before engaging in a new exercise program!
• Also, remember to measure your blood sugar levels before and after exercise.
• Bring some food (a fruit or high fiber breakfast bar) or glucose tablets with you while exercising in case your blood
sugar drops too low. Stop if you feel tired or pain.
Keeping active can lower your blood sugar, lower your blood pressure, help you lose
weight, help you feel better, reduce the amount of medication you need, relieve tension
or stress, improve your heart and lung function and improve your muscle tone! Look at all
those benefits!
To help reduce your weight:
• Eat smaller portions of foods and remember that your lunch and dinner plate should be 1/4 protein, 1/4 starch
(including potatoes) and 1/2 vegetables.
• Eat 3 balanced meals per day (no more than 6 hours apart), and don’t skip meals; snack with fruit between meals.
• Choose foods lower in FAT and SUGAR; choose LOW GLYCEMIC INDEX foods whenever possible; avoid “white”
foods (white flour and white sugar).
• Aim for a maximum weight loss goal of 1-2 lb (0.5-1 kg) per week.
DIET FOR TYPE 2 DIABETES
Choose Low Glycemic Index Foods Whenever Possible!
FOODS TO ALWAYS CHOOSE
FOODS TO AVOID
Whole Grain Products
• Whole and multi grain breads, whole wheat pasta,
brown rice
• Low-fat and multigrain crackers
• Low-sugar, whole-grain cereals
• Oatmeal, bran, bulgur, buckwheat
• Low-fat, whole grain baked goods with added bran
or oat bran
• White breads, croissants, sweet rolls, high-fat white
crackers, waffles
• Short-grain and minute rice – white rice
• Sweetened refined cereals
• Commercial muffins, cakes, doughnuts, Danish pastries, high-fat cookies
• Avoid “white” foods (white flour, white sugar)
Vegetables and Fruits – with lots of colour!
• Dark green leafy vegetables
• Eat an abundance fresh/frozen vegetables
• Unsweetened, fresh, frozen or canned fruits
• Parsnip, pumpkin, white potatoes (high GI)
• Dried fruits and fruits in heavy syrup
• Sweetened fruit juices
Milk/Dairy Products
• Dairy products with less than 1% fat
• Cheese should be 10-20% MF
• Milk products higher than 1% fat
• Cheese higher than 21% MF and creams
Meat and Alternatives
• Fish with butter or breading
• Fried chicken, poultry with skin, wings
• Fatty marbled meats, ribs, regular ground meats, organ
meats
• High fat processed and canned meats: bacon,
sausages, patés, bologna, salami, wieners
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Fish (canned in water, fresh, frozen), seafood
Skinless chicken and turkey
Lean meats with fat trimmed, wild game
Lean cold cuts (but watch the salt content)
Legumes, tofu
Eggs (up to eight per week)
Other Foods and Fats
• Olive, canola, soybean, sesame, sunflower oils (3 tsp
or less per day)
• Non-hydrogenated soft margarines
• Low-calorie dressings and mayonnaise
• Light peanut butter, nuts (watch salt and calories)
• Unsalted seeds: flax, pumpkin, sunflower
• Defatted gravy and low-sugar condiments
• Cocoa powder or a small piece of dark chocolate
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Hydrogenated oils, coconut and palm oils
Shortening, butter, lard, hard margarines
Peanut butter with palm or hydrogenated fat
No more than 1/4 cup nuts per day (high calories)
Heavy gravy, cream sauces, high-sugar condiments
Chocolate and carob
Sweets (in very small amounts)
• Sugar substitutes and artificial sweeteners, low sugar
jams/jellies/syrups
• Sugar-free candies, gelatins, gum
• Low-sugar and high fiber baked goods
• Low-fat and low-sugar frozen dessert
• Sugar and regular jams, jellies, syrups, candies,
gelatins, gum, honey
• Regular cakes, pies, cookies
• No “white” foods (white flour, white sugar)
• Regular frozen desserts
Snack Foods
• Popcorn without salt, butter, or hydrogenated oils
• Choose low fat, low sugar snack foods
• Regular popcorn, chips, pretzels, cheesies, corn chips
CANADIAN DIABETES ASSOCIATION GUIDELINES
Canadian Diabetes Association Guidelines
The Canadian Diabetes Association also recommends that, when choosing carbohydrate-rich foods (or “carbs”), try to choose
foods with a Low GI.
(Examples of carbohydrate-rich foods are starchy foods such as cereals, breads, pasta, rice, legumes, fruits, sweet vegetables
and dairy products. Always choose whole grains and lots of fiber.)
Blood Sugar Target Ranges
Fasting: First thing in the morning and before each meal as long as no food has been taken
for 3 hours. Range = 4.0-7.0
2 Hour PC: 2 hours after a meal. These will be higher: Range = close to 10.0
Portions to Live By !
Starchy
Fiber
Protein
Fruit
Protein
Starchy
Fiber
Vegetables
Breakfast Plate
Lunch and Dinner Plates
• Your breakfast plate should be 1/3 fruit,
1/3 starchy fiber foods and 1/3 protein.
• Your lunch and dinner plates should be 1/2
vegetables, 1/4 starchy fiber foods and 1/4 protein.
Other Diet Sheets Available:
• Diet for Congestive Heart Failure
• Diet for High Cholesterol
• Diet for Hypertension
• Potassium Replacement Diet
• Weight Management
Please visit www.ottawacvcentre.com for
more information.
Ottawa Cardiovascular Centre
502-1355 Bank Street
Ottawa, ON K1H 8K7
Phone: (613) 738-1584
Email: [email protected]
Diet for Type 2 Diabetes December 2005
Prepared by Helene Charlebois, B.Sc., R.D.
With Dietetic Intern Jasna Robinson
www.cvtoolbox.com
© Continuing Medical Implementation ® Inc.