Health & Fitness

The best and worst foods for a diabetic

Executive Chef John Pereira teaches how to prepare low-calorie, healthier foods for diabetes patients at Memorial Hospital in Pembroke Pines on Wednesday, Nov. 15, 2017.
Executive Chef John Pereira teaches how to prepare low-calorie, healthier foods for diabetes patients at Memorial Hospital in Pembroke Pines on Wednesday, Nov. 15, 2017. sballestas@miamiherald.com

We all tend to overeat sugary and fattening foods during the holiday season.

But for many, particularly those with dietary challenges like diabetes, it’s an everyday struggle.

The prevalence of diabetes in the U.S. climbed to a new high of 11.6 percent of Americans in 2016, up from 10.6 percent in 2008, according to a new report by Gallup and Sharecare, titled “The Face of Diabetes in the United States.”

About 1.5 million Americans are diagnosed with diabetes every year, estimates the American Diabetes Association. Roughly 95 percent have Type 2, the result of the nation’s obesity epidemic, a by-product of too little exercise and too much bad food.

In Type 2, the pancreas produces insulin, but the body doesn’t use it properly, which can wreck havoc with blood-sugar levels.

“Researchers have found over 60 different causes for Type 2 diabetes,” said Natalia Torres-Negron, a registered dietitian in Cleveland Clinic’s endocrinology department and patient educator at the Weston hospital. But lifestyle does “play a huge role” in preventing or improving the disease, she added.

Diet, weight and sedentary behavior are “part of the whole package,” added Randy Kaplan, clinical dietitian at Memorial Hospital Pembroke. “It’s important to look at the big picture.”

One strategy is to ask patients about their current typical diet and “together we choose one thing to change,” Torres-Negron said. “One patient had juice or soda with every single meal. He switched to water and didn’t make any other change in his diet. He was able to lose 10 pounds in a month just by doing that.”

“Patients often think that certain foods are their enemy,” said Carla Duenas, a dietitian at Baptist Health. “Nothing is off-limits, but some options are better than others, based on how quickly they break down to glucose in the body. Nutrition is extremely important in managing blood sugar.”

Diabetes can increase the risk of heart disease and stroke through clogged and hardened arteries, so much attention is paid to carbohydrates and fat, particularly in high-caloric food like cookies, cake, pastries, etc.

“We’re not demonizing rice or potatoes,” said registered nurse Della Matheson, director of education at the Diabetes Research Institute, part of the University of Miami Health System.. “It’s more about portion control and eating normal, healthy, balanced meals. Eat three good meals a day.”

That means healthy foods in small portions and regular mealtimes.

Foods to eat

Choose lean proteins like chicken, turkey, fish or lean cuts of beef. The American Diabetes Association recommends eating fish at least two times a week. Some types of fish, including cod, tuna and halibut, have less total fat, saturated fat and cholesterol than meat and poultry.

Eat healthy carbs. Brown rice and whole wheat pasta are two picks with fiber and antioxidants. Complex carbohydrates are starches but they’re the least processed or refined. They take longer to digest so they don’t raise blood sugar as quickly as simple carbohydrates. “Beans are a great food and have a low-glycemic index,” said Matheson. Other good choices include quinoa, barley, bulgur wheat, oatmeal, farro and chickpeas. Starchy vegetables such as potatoes, sweet potatoes, corn, and pumpkin are complex carbs. Plantains, yuca and potatoes are fine options, “but you still need to be careful” about the portions, said Duenas. Foods with fiber can also help you feel full and you’re not as likely to snack.

Best dairy choices are low-fat milk and unsweetened or plain products like milk alternatives, yogurt and cheese, said Duenas. “Buy plain, unsweetened yogurt and add fruit.”

Look for a rainbow of vegetables. Green vegetables like spinach, kale, broccoli, collard greens and cabbage are among the top nutritional powerhouses. But other veggie rock stars include beets, cauliflower, bell peppers, Swiss chard and Brussels sprouts.

Eat, don’t drink, your fruit. Fruit juice may seem healthy but it contains a lot of sugar. Get your vitamins from a whole piece instead of fruit juice or a smoothie. Smoothie shops “may throw in a handful of kale to make it sound healthy,” but these drinks can be loaded with sugar, Matheson said. Skip fruits canned with syrups. If you must drink juice, dilute it with water or switch to unsweetened tea or fruit-infused water. Consider black, green and herbal teas, served hot or cold.

"Good" fats like nuts (especially walnuts and raw almonds) and seeds (pumpkin, sunflower seeds) are good in moderation, said Kaplan. “Don’t eat a whole jar of cashews.” Good fats can help protect your body against heart disease by lowering your blood cholesterol levels, but don’t overdo it because all fats are high in calories. Some other good choices are avocados, olives and olive oil. Include fatty fish that are high in omega-3 fatty acids like salmon, mackerel, herring, albacore tuna, bluefish and sardines.

Foods to avoid

Skip bad starch choices: Refined grains like pasta or white rice, cereals or bars with added sugars, candy and desserts. Limit or avoid chips or fries. “It really is hard to just eat one chip or one French fry,” said Kaplan.

Processed foods: “Stay away from processed foods and empty calories,” said Matheson. Processed foods can lack nutrients and be high in unhealthy trans fats, which can clog arteries, raise cholesterol and increase the risk of heart disease. Watch for products with partially hydrogenated oils. Even a half-gram of trans fat indicates the presence of partially hydrogenated oil even if it’s not on the ingredients list. Snacks, cookies, icings and other desserts can be trans fat culprits. “Foods in the frozen section, even meals with lower calories, can be packed with sodium,” said Torres-Negron.

Fast food: These foods can be high in sodium, calories and possibly trans fats. When nothing else but fast food is available, consider grilled chicken.

Eating sugar: Portion control plays a big factor here. “A small piece of cookie might be OK but you wouldn’t want to be eating cookies as part of your daily habit,” said Duenas. Even products that are labeled sugar-free are likely made with milk and flour and may have higher calories than other choices, said Torres-Negron. Check the label of any item for sugar, sugar cane syrup, maple syrup, honey, molasses and high fructose corn syrup

Sweet drinks: Avoid sugary drinks like soda, fruit punch, fruit drinks, energy drinks, sports drinks and sweet tea. These sweet drinks will raise blood glucose and have lots of calories. One 12-ounce can of regular soda has about 150 calories and 40 grams of carbohydrates, about the same amount of carbohydrates as 10 teaspoons of sugar, according to the American Diabetes Association.

Classes/support groups

Area hospitals offer diabetes educational programs and support groups. Check online or contact the medical facilities for updates.

Baptist Health South Florida is offering a “Take Control Diabetes Prevention Program” beginning in January. Registration closes Dec. 22. For information, contact Christine Mendez at 786-527-9433 or ChristineMe@BaptistHealth.net

Cleveland Clinic offers three support groups: The Type 1 group meets at 6 p.m. every second Tuesday. The Type 2 evening support group meets at 6 p.m. every third Tuesday. And the Type 2 daytime group meets at 10 a.m. every fourth Tuesday. The groups meet at the Weston campus, 2950 Cleveland Clinic Blvd., in Jagelman Room 4.

Memorial Hospital Pembroke offers a free lecture series conducted in Spanish and English twice a month and cooking demonstrations twice a year. Classes are held at the hospital, 7800 Sheridan St., Room 366 (third floor). Register online at MHS.net or call 954-883-7513.

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