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What Kind of Diet Should I Follow?

Every diabetic person’s diet must be worked out individually with a dietitian. Still, certain general principles for eating are true for everyone.

NO SKIPPING MEALS: All people with diabetes must eat three meals a day, with or without snacks; skipping meals is unacceptable. Now that you have diabetes you'll have to get away from the typical "North American" eating pattern — coffee for breakfast, a sandwich for lunch, a large supper, and eating throughout the evening. Although you should eat fewer calories, these must be spread throughout the day, so you should eat more meals and snacks. By having three small meals per day — and snacks in between — it’s easier for the pancreas to put out and use insulin. Ideally, space the main meals 4 to 6 hours apart. The snacks between the meals need not be large.

REDUCE PORTION SIZE: The vast majority of people with Type 2 diabetes (the most common form of diabetes) are overweight, and this has directly increased their blood sugars. Reducing calories will do the opposite. Your dietitian will help you with this, but there are some things you can do first (see below). About 20-30% of people with Type 2 diabetes can correct their glucose by losing weight, at least initially.

We in North America are overweight. Genetic factors (over which we have little control) are partly to blame. Apart from these, the fact is we eat portions that are too large. In this writer’s opinion, two main environmental reasons are to blame. First, our parents insisted that we clean our plates, telling us that there are starving people in the world — as if gorging ourselves was going to help them in some way. As a result we ceased to respond to our bodies’ actual needs for food, eating instead whatever food is in front of us. The second cause is restaurants, including fast food establishments. We are fed a 10-ounce steak in a restaurant, for example, and believe this is the normal portion size we should have at home. Furthermore, restaurants serve higher-fat foods, which add calories without filling us up.

There’s a few easy steps you can take to reduce portion size before seeing the dietitian:

• never have second helpings.
• use a smaller plate so that even if you fill it, you'll eat less food.
• eat ¾ of each portion of food that you have taken, and throw the rest in the garbage. You will start to train your body that your stomach is not the garbage in which you should place excess food.

REDUCE FATS: High fat diets, which are very common in North America, predispose us to obesity. The more fat we eat, the fatter we become. Fat is a highly concentrated source of energy (calories). These calories are contained in a smaller volume that doesn’t fill you up; you eat more food (and more calories), so you gain weight. By lowering the fat (specifically, eating food that has less fat, but more volume) weight loss is easier.

Furthermore, high-fat diets make it harder for insulin to work. The more fat you eat, the more difficult it is for insulin to work properly in your body. If insulin is not working well, your blood glucose level will rise.

Consider this: excess calories from the diet are stored in the body as fat. If those excess calories are from a non-fat source, they must be converted into fat in order to be stored. Your body actually requires energy for this process (via chemical reactions). The energy is actually derived from the calories to be stored, using some of them up. If the excess calories are from fat, very few are used in the storage process. Consider the following examples. To store say 100 extra calories that were eaten as starch, 25 calories may be used up simply to convert the starch into a form that can be stored as fat. Only 75 calories (100 - 25 = 75) will be ultimately stored as fat. But to store 100 extra calories eaten as fat, the body uses only about 2 calories. So 98 calories (100 - 2 = 98) get stored as body fat, compared with 75 if you had eaten the starch. This starts to add up, with huge implications. The total number of calories in the diet is not as important as what those calories are.

If I am eating too much fat, how can I cut back?

1. Follow the Canada Food Guide. Once on this healthier diet, most people complain they can’t eat all the food recommended in the guide. It's probably because they’re used to filling up on high-calorie, high-fat foods and find the more-filling, lower-fat foods take up a lot of room in their stomachs.
2. Keep track of your eating habits. Write down everything you eat for a few days, and you’ll have a good indication of how much fat you eat and where it is coming from.
3. Read the labels on the products you buy, noting the serving size. Keep an eye on the fat content.
4. Plan your meals and snacks. Before you do your shopping, jot down a menu for the week including the entree and the side dishes such as vegetables and grains. This will allow you to make a shopping list and help ensure your diet is balanced. Nothing sabotages good intentions more than lack of planning. Time put in at the beginning will save a lot in the long run.
5. If you eat at restaurants often, you’ll have more difficulty keeping your diet low in fat. Try to avoid eating out. If you can’t, ask how dishes are prepared and specify how would like them. Order salads with the dressing on the side and ask for toast that isn’t buttered.
6. Consider changing some of your favourite recipes to be lower in fat.
7. Foods such as butter, margarine and oil are pure fat. Each provides the same number of calories and grams of fat for equivalent amounts. One teaspoon of fat provides 45 calories and 5 grams of fat. It’s not hard to add hundreds of extra calories and fat to your diet without getting much more food to eat; therefore, add as little fat as possible to your foods.
8. Foods high in hidden fat — such as regular cheeses (milk- or butter-fat content of around 30%), poultry skin, bacon (crisp or not), marbled meats, sausages, sour cream, salad dressings, gravies and flaky pastries — can add significant amounts of fat to your diet. Lower-fat alternatives can often be found. Avoid chocolate, chocolate bars and ice cream, as these are also high in fat as well.

How much fat should I eat?

The bottom line is the less, the better. Be aware of the fats in food, and try to at least cut down, if not eliminate the foods with the highest fat.

The food industry is keenly aware of the desire of many people to cut their fat intake. There are now low- and no-fat salad dressings, chips, dip, cheeses, ice cream, and so on. Help should be available in your grocery store to find the lowest fat choice. Your dietitian will also be most helpful.

How can I determine how much fat I am eating?

There are a number of ways to determine how much fat you are eating. Reading the label on products that provide nutrition information is the most accurate. Remember, the serving size referred to on the label may not be the amount of food that you actually eat.