What to eat and what not to eat in diabetes

Many a time people worry that having diabetes means they will have to give up the foods they enjoy eating. The good news is that you can still eat your favourite foods, but you might need to eat smaller portions or enjoy them less often we can say “moderation is the key”.

The key to eating with diabetes is to eat a variety of healthy foods from all food groups:

Eat foods with heart-healthy fats which include PUFA (polyunsaturated fatty acids) like omega 3 and omega 6 and MUFA (monounsaturated fatty acids), which mainly come from these foods:

• Oils that are liquid at room temperature, such as canola oil, olive oil, sunflower oil, mustard oil and soybean oil
• Nuts and seeds such as almond, walnut, flaxseed, sunflower seed and pumpkin seed
• Fatty fish such as rohu (carpo fish), surmai (king mackerel), rawas (Indian salmon), pomfret (Indian butterfish), hilsa, bangda (Indian Mackerel) and pedvey (Indian sardines).

Carbohydrates are not bad, even if you have type 2 diabetes. Carbohydrates provide energy to your body.

But all carbohydrates are not the same. For people with diabetes, choosing whole, unprocessed carbohydrates over refined and simple carbohydrates is the key.

These carbohydrates can help to reduce the risk of diseases such as heart disease, dyslipidemia (abnormal blood lipid levels), obesity, and certain types of cancer.

For complex carbohydrates, add whole grains such as bajra (pearl millet), jowar (sorghum), ragi (finger millet), whole wheat (atta/bread/ pasta), jau (barley), rolled oats, beans or legumes such as rajma (kidney bean), chhole (chickpea), kala chana (horse gram) and green leafy vegetables in your regular diet.

Proteins are one of the main energy-providing macronutrients, along with carbohydrates and fats. They help the body to grow new tissue, therefore helping to build muscle and repair damage to the body.

Proteins are broken down into glucose less efficiently than carbohydrates and, as a result, any effect of proteins on blood glucose levels tends to occur anywhere between a few hours and several hours after eating.

Some good sources of proteins are lean meat, chicken without the skin, fish, eggs, nuts, milk, yogurt, cheese, peanuts, dried beans such as chickpeas, kidney bean, pulses, soybean and tofu.

Adding fibre in your diet slows the absorption of sugar and helps to improve blood sugar levels. For dietary fibre, take whole fruit, green salad, green leafy vegetables, whole-grain (bread/ chapati/pasta/brown or red rice), legumes with husk and sprouts.

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Fruits are a power pack of vitamins, minerals, and fibre. Take fruits as a mid-meal snack. Eat medium to low glycemic index fruits to keep your blood sugar in the target range. You can eat fruits such as:

• Apple
• Papaya
• Jamun
• Peach
• Plum
• Guava
• Sweet lime
• Oranges

Vegetables are a great way to moderate the carbs in a meal and feel full. Vegetables can be included as salad, stir fry vegetables or clear soup. Fill half your plate with non-starchy vegetables such as green leafy vegetables, cauliflower, eggplant, capsicum, gourds, cabbage and broccoli, etc.

Milk and other dairy products (curd, paneer) contain sugar in the form of lactose. But this is an important food group to include in your healthy diabetes diet because these foods provide proteins and calcium as well. Proteins offer staying power in your meals (they keep you feeling full for longer) and are necessary for muscle and metabolic health, while calcium is a critical mineral for heart, muscle, and bone health.

Many people opt for full-fat dairy, but as per several studies, we recommend low-fat milk which has 1% or 2% milkfat. Full-fat dairy contains higher levels of saturated fat, which can not only increase the risk of heart disease and inflammation, but diets rich in saturated fats have also been associated with higher levels of insulin resistance.

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Reducing your insulin resistance would naturally help to control your blood sugar and weight. There are some foods that have been scientifically proven to this, and you can easily add them in your daily diet. Examples include:

• Fenugreek seeds: Fenugreek seeds (methi dana) are high in soluble fibre, which helps lower blood sugar by slowing down digestion and absorption of carbohydrates. A research study in India found that simply adding 10 gm/day of fenugreek seeds can have a synergistic effect along with diet control and exercise on fasting blood glucose and HbA1C (HbA1C or glycosylated haemoglobin test shows average blood sugar over the last two or three months) within six months of treatment.
• Cinnamon powder: Different research studies have found that taking 500 mg cinnamon per day improves fasting glucose, blood pressure, lean body mass, and antioxidant status in people with metabolic syndrome. You can have half a teaspoon of cinnamon powder in warm water instead of or before morning tea. 
• Moringa leaves: Also known as drumstick leaves or sahjan leaves, moringa leaves are a good source of iron. But they are also good for controlling high blood insulin levels which is a marker of hyperinsulinemia and insulin resistance. You can use moringa leaves as a leafy vegetable, or add them in sambhar. They are delicious as well.

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There are certain foods and nutrients which are essential for our body but we have to watch the quantity to avoid complications. These foods include salt, nuts and seeds, oil, sweet fruits such as mango, banana and litchi and starchy vegetables such as potato and yam.

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Foods and drinks to limit in diabetes include:

• Fried foods and other foods high in saturated fats and trans fats, such as butter, cream, red meat, organ meat, Dalda ghee, chips, french fries, samosas, namkeen, kachori, pizza, burger.
• High GI foods like white rice, white bread, potatoes, all-purpose flour. High GI (glycaemic index) foods are those that cause a sudden spike in blood sugar levels soon after eating.
• Foods high in salt, such as pickle, papad, ketchup, jam, jelly, ham, bacon.
• Sweets, such as barfi, mithai, cake, pastry, cookie, biscuits.
• Beverages with added sugars, such as juice, regular sodas, sports or energy drinks and carbonated drinks like Coke, Pepsi, Limca.
• Drink water instead of sweetened beverages. Avoid using sugar or sugar substitutes in your coffee or tea.
• Avoid alcoholic beverages to avoid hypoglycemia.

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Here are some tried-and-tested tips people living with diabetes—and even prediabetes—can try to control their blood sugar levels:

• Follow the food plate method: The plate method helps you control your portion sizes, by showing the amount of each food group you should eat. This method works best for lunch and dinner. Here's how you can follow it
  • Use a 9-inch plate.
  • Put non-starchy vegetables on half the plate
  • A piece of meat, egg, pulses, paneer, soya or other protein should cover one-fourth of the plate
  • And a grain, such as bread, chapati, pasta, or other starch should be on the last one-fourth of the plate.
  • As a drink, a small glass of water is included in your meal plan.
• Carbohydrate counting: Carbohydrate counting means keeping track of the carbohydrates you eat and drink each day. Because carbohydrates turn into glucose in your body, they affect your blood glucose level more than other foods. Carb counting can help you manage your blood glucose level.
  Carbohydrate counting is a meal planning tool for people with diabetes who take insulin, but not all people with diabetes need to count carbohydrates. You can ask your dietitian or doctor to plan your meal with the daily requirements.
• Read the nutrition labels: Whenever you are buying a packaged product, read the nutrition label carefully. Understanding the nutrition facts label on food items can help you make healthier choices. The label breaks down the number of calories, carbs, fat, fibre, protein, sodium and vitamins per serving of the food, making it easier to compare the nutrition of similar products. Avoid anything that contains high-fructose corn syrup.
• If you drink alcohol: If you are managing your blood sugars very well, you can drink moderately—no more than one drink a day if you’re a woman or two drinks a day if you’re a man. If you use insulin or diabetes medicines that increase the amount of insulin your body makes, alcohol can make your blood glucose level drop too low. This is especially true if you haven’t eaten in a while. It’s best to avoid the drink alcohol.
• Choose your snacks wisely: People with diabetes are always advised to have “small and frequent meals” to avoid any fluctuations (sudden spike or drop) in blood sugar profile.
  So, apart from the three major meals, one needs to have small snacks in-between to prevent low blood sugar or hypoglycemia or overeating later.
  Rather than having an unhealthy snack (this includes aerated drinks, juices, sugary foods, fried snacks, ready-to-eat processed food, fast or street food, or simply any food high in sugar, fat, simple carbs and preservatives) which may disturb sugar values and glycemic control, include healthier snacks like a glass of apple milkshake (without sugar, of course).

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Replace high-calorie and oily foods with these snacks:

• 1 bowl steamed/raw sprouted moong dal/chana with vegetables
• 1 grilled vegetable/low fat paneer or chicken sandwich with whole wheat bread
• 1 small besan cheela with vegetables
•  Dhokla without sugar syrup
• 1-2 oats and vegetable dosa
• 2 handful roasted chana+murmura
• 1-2 handful of home-made roasted namkeen (made with healthy nuts like almonds, walnuts, pistachio + roasted chana or soy)
• 1 cup milk + fruit (100 gms)
• 8-10 almonds or 2-3 walnuts
• 1 glass plain buttermilk / skimmed milk with kesar (saffron) or cardamom
• 1 cup low fat curd / vegetable raita / fruit curd

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