Nearly 26 million Americans have diabetes, and it is estimated that 7 million people in the U.S. are unaware they have the disease.
The good news is that diabetes can be managed or prevented with a few lifestyle changes.
Whether you have been diagnosed with type-1, type-2 or gestational diabetes, to successfully manage the disease you need to understand how foods and nutrition affect your body.
Carbohydrates are always a focus for people with diabetes but also a source of confusion.
Everywhere you turn it seems like someone has an opinion about how carbohydrates interfere with your diabetes management.
Toby Smithson is a registered dietitian nutritionist and Spokesperson for the Academy of Nutrition and Dietetics. She joins Melanie Cole, MS, to share how you can sort fact from fiction when it comes to eating a healthy diet to manage your diabetes.
Melanie Cole (Host): Well, have you been confused about carbohydrates and its relation to diabetes? Because it can be quite confusing. My guest is registered dietician-nutritionist Toby Smithson. She’s also a certified diabetes educator and Academy of Nutrition and Dietetics spokesperson. Welcome to the show, Toby. Tell us a little bit about the confusion that surrounds carbohydrates when it comes to diabetes out there.
Toby Smithson (Guest): Well, carbohydrates seems to be the big word or the big elephant in the room when we’re talking about diabetes. There’s a couple of myths out there that people seem to get confused and hung up on. One of them is if you have diabetes, you need to avoid carbohydrates, especially with the emergence of all these low-carb fat diet that are out there. It’s always in the press and the media, right in front of people. But in fact, carbohydrates are needed by the body. It’s our best source of energy. So, if we avoid them, then we’re not going to have a lot of the energy that we need to all the fun things that we like to do.
Melanie: Well, Toby, it’s important to note that carbohydrates are what fuel our brain and spinal cord, and people don’t realize it. The word “carb” has gotten such a bad rep, and not just for diabetics, but really, for the world and population in general. So bust up another myth. One you just said was avoidance, that we need not avoid carbohydrates. Maybe separate them out a little bit for us so that people understand the difference between the goods and the bads.
Smithson: Many of the plant foods are carbohydrates sources, like our fruits, our grains and starchy vegetables like peas, corn, potatoes, and beans, which also serve as a really good, lean protein source too. Those are some examples of some carbohydrates, as well as milk and yogurt, which sometimes people don’t realize there’s a good source of protein and carbohydrate in those dairy products too. We need to have a balanced diet with a variety of foods. You hear that over and over again. If we avoided all of those food categories or types of foods, we wouldn’t have a variety of foods, and we will be missing out on a lot of important minerals and nutrients and vitamins.
Melanie: Now, Toby, in the world of foods, there’s, as you say, the plant-based and good foods for us. And then there’s also the processed foods and the things that come in a box with a long label and a name we can’t pronounce. There are some things we should avoid, especially when it comes to diabetes, some of the white foods. Explain that a little for us.
Smithson: Yes. A good rule of thumb is to think whole foods to start out with. Your best line of attack is to have the whole foods, the whole fruits, the whole grains when you’re eating green foods, so starting out from the whole food instead of the modified versions, the quick and easy packaging. One of the other myths that you were just touching on was about the white foods. A lot of people think that white foods in general should be avoided or are bad foods. But in fact, the focus for people with diabetes has an emphasis on carbohydrate. And a slice of white bread and a slice of wheat bread virtually have the same amount of carbohydrates. So I know that that’s going to be a big “What?”
Melanie: That’s a big shocker. People are absolutely doing that right now, Toby. They’re saying, “Really?” So if you’re a diabetic and you really want to have your white bread for some reason, then you’re saying that it’s not the worst thing that you can do.
Smithson: Right. All foods can fit. The wheat bread, if it was truly a whole wheat bread that was a whole grain is definitely better for you overall in health. But instead of people with diabetes beating themselves up about certain food choices, if you really, really like the white bread, then knowing that it’s the same 15 grams of carbohydrates. It doesn’t change it because it’s a whole grain, the amount of carbohydrate. The whole grain, though, does have more nutrients attached to it, so it is a better choice. But carbohydrate, side by side, it’s equal.
Melanie: Wow. So now, if you are a diabetic, what are some other things? Give us another myth, Toby.
Smithson: Carbohydrate’s the only nutrient they need to worry about. If it doesn’t have carbs, I can eat it. That’s a big myth out there because people with diabetes are in much higher risk for cardiovascular disease or heart disease. So we also need to be thinking about the types of fat in our diet as well for heart disease prevention.
Melanie: Okay, and the types of fat being ones that can contribute to that increased risk of coronary heart disease, or saturated fats. Tell us what some of those might be.
Smithson: Yes. The saturated fats and the trans fats tend to be the troublemakers. What I say about fats is that you want to pick them like you pick your friend. You want quality versus quantity when you’re choosing fats. The healthier fats are monounsaturated and polyunsaturated. So, the unsaturated fats, those you would find in nuts, in avocados, in vegetable oils, those are the top sources of those unsaturated fats. There’s also some in fish, too, those omega three fatty acids.
Melanie: Well, and that’s really what’s so important, Toby. People don’t always know where to find these nutrients that you’re talking about. So when you mentioned the poly and monounsaturates, avocados -- and you mentioned fish and nuts, legumes. Give us a little bit of a food list so that people know when they go to the grocery store really what to take with them and what to buy so that they can go home and start right away.
Smithson: Well, I always like to start in the produce section and start filling your cart there, so that when we get more from the produce -- and base your meals around the produce that you’re purchasing. It’s a really a good starting point, the fresh fruits and the fresh vegetables. And then go to the lean cuts of meat when you get to the meat aisle. And then the healthy fats would be what type of oil you’re having. I know a big question always is butter versus margarine and what the consensus is is that a tub of margarine is your better choice because of the amount of saturation of the fats. Let’s see. What else are we missing? Dried beans also, in one of the center aisles is where you’ll find that at the grocery store. So we’re loading our cart with some of the heart-healthy and diabetes-friendly foods. All foods can fit. We just need to really be paying attention to that portion.
Melanie: Now, you mentioned dried beans. So, canned foods, are they all right as well as canned beans, canned vegetables if somebody really is not adept at soaking their beans and doing all that? We don’t have a whole lot of time, but can we use canned foods for that as well?
Smithson: For canned, the only thing to be cautious about is the amount of sodium. So, for the canned vegetables or canned foods, get the no-added-salt version to lower the amount of sodium in those canned foods.
Melanie: That’s great. And Toby, if you would, in just the last minute give us your best advice for managing diabetes and all this confusion surrounding carbohydrates.
Smithson: I would say to eat a variety of foods and eat at least three meals a day. Don’t be skipping meals, and include a variety of all of the foods that you enjoy, and watch the portion sizes.
Melanie: That’s great advice. Carbohydrates are always a focus for people with diabetes, but they’re also a source of confusion which we have cleared up to day, and we’ve sorted the fact from the fiction when it comes to healthy eating and healthy diet to manage your diabetes. You’re listening to Eat Right Radio. For more information, you can go to eatright.org. That’s what we’re teaching right here on Eat Right and Radio MD is how to eat right. This is Melanie Cole. Thank you so much for listening, and stay well.