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Tuesday, June 30, 2015

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Tips for Smart Snacking With Diabetes

The right snacks can be beneficial to your diabetes plan. Learn how to choose healthy snacks for diabetes and when you might need them.

By Jennifer Warner

Medically reviewed by Niya Jones, MD, MPH

Knowing when and how to choose a healthy snack can help keep type 2 diabetes under control.

In fact, a healthy diabetic snack can help you maintain a stable blood sugar level and support your overalldiabetes diet and treatment plan. The key is to know what a healthy diabetic snack is and what it isn't. Try these five tips to help you snack strategically for diabetes:

1. Know how carbs affect your body. Smart snacking for diabetes starts with knowing how your body reacts to insulin and carbohydrates. Insulin is a hormone normally produced by the body to help regulate sugar (glucose) in the blood. If you have diabetes, your body can’t produce or process enough insulin to keep your blood sugar at healthy levels.

With diabetes, your body converts the carbohydrates in foods into glucose faster than it does protein and fat. You must be aware of the carbohydrates you're eating to avoid potentially dangerous spikes or drops in blood sugar. Typical high-carb foods include certain fruits, bread, pasta, rice, and cereal. Work with your doctor or a registered dietitian to develop an individualized diabetes eating plan for healthy meals and snacks based on your body’s reaction to carbohydrates and the status of your diabetes.

2. Snack only when you really need to. “If you're hungry, eat a snack. If you're not hungry, you don’t need a snack,” says Alison Evert, MS, RD, CDE, coordinator of diabetes care programs at the Diabetes Care Center at University of Washington Diabetes Care Center in Seattle. Because many people with type 2 diabetes are overweight and don’t need to make snacking a regular habit, Evert says, "the whole idea of three meals and three snacks a day is too many calories."

3. Plan ahead. Taking insulin or other diabetes medications that affect insulin production can cause dips in blood sugar after exercise or at night. To compensate, your doctor may recommend that you eat a snack before working out or going to bed. Always check your blood sugar before snacking, though, since a snack may not be needed.

“The idea that you need a snack if you’re exercising isn’t always true,” Evert says. Typically, if you take insulin or an insulin-producing drug that can lower blood sugar, you should check your blood sugar level before exercising and bring a snack in case you need it.

4. Keep snacks proportional. Portion control is essential to smart snacking for diabetes. Healthy diabetes snacks shouldn't add extra empty calories that can pack on the pounds. Instead, snacks intended to correct blood sugar should be proportional to blood glucose levels, says Helen W. Rodbard, MD, medical director of Endocrine and Metabolic Consultants in Rockville, Md., and past president of the American College of Endocrinology.

That means small dips in blood sugar should be managed with only a small, low-carbohydrate snack. Larger drops in blood sugar require a larger, faster-acting amount of carbohydrates. “If you’re having an episode of low blood sugar, you need juice or something that will raise your blood sugar rapidly,” Dr. Rodbard says.

5. Make snacking simple. Unless you’re experiencing low blood sugar, healthy snacks for diabetes should usually be low in carbohydrates and high in fiber or protein that won’t cause spikes in your blood sugar.

Again, portion size is key, Evert says. Most people should aim for snacks with some fiber, about 15 to 20 grams of carbohydrates, and no more than 150 calories. Fiber helps slow the absorption of carbohydrates and maintain healthy blood sugar levels. Some healthy snack ideas that fit the bill are an apple or orange, three cups of popcorn, or 15 almonds.

Evert says that most people with diabetes don’t need to worry about mixing food groups at snack time. This usually just adds extra calories you don’t need. “Many people have been told to add protein, and that’s a myth that we need to put to rest,” she says, because there's no evidence that it neutralizes the effect of carbohydrates. A study in "Metabolism" in 2012, for instance, showed that combining carbohydrates with protein does not improve the glucose response that naturally occurs in people with type 2 diabetes after eating carbohydrates.

Best fruits for diabetics

Fruit does have a place in a healthy diabetes diet. Find out about the best fruits to eat and why whole fruits are better than fruit juice.

By Chris Iliades, MD

Medically reviewed by Niya Jones, MD, MPH

People with type 2 diabetes know that they need to limit the amount of sugar that they eat — even natural sugars. So how important is fruit for diabetes? Contrary to what you may have heard, it’s actually a crucial part of a good diabetes diet, according to a 2013 study published in theBritish Medical Journal that followed nearly 190,000 people over a number of years to see who would develop type 2 diabetes or not.

The study, which looked at the association between diabetes and eating fruit, found that eating whole fruits, especially blueberries, grapes, and apples, significantly reduces the risk for type 2 diabetes. On the flip side, drinking more fruit juices actually increases the risk for diabetes.

“If you have type 2 diabetes, you do need to watch your sugar," explains Katie Barbera, RD, CDE, a registered dietician and diabetes educator at North Shore-LIJ Health System in Great Neck, N.Y. "Both whole fruit and fruit juice have sugar, but a fruit is only equal to about 4 ounces of fruit juice. If you drink 12 ounces of fruit juice, you could be getting too much sugar,” she says. “And whole fruits have a lot of other advantages for a diabetes diet."

Understanding the Sugar in Fruit

Having type 2 diabetes means having to count your carbohydrates (carbs). Like vegetables and grains, fruits are carbs, and you need them. If you have diabetes, figuring out the best fruits for diabetes is about more than counting carbs. “Whole fruits are an excellent source of antioxidants," Barbera says. "They have a lot of fiber, so they make you feel fuller and satisfy your hunger. They also add a lot of flavor to a diabetes diet."

Antioxidants are important because they help prevent cell damage. “Antioxidants in a diabetes diet may help reduce inflammation caused by oxidative stress," Barbera says. Oxidative stress may contribute to complications of diabetes. "To get the most antioxidants, look for fruits with a variety of bright colors and full flavors," she says.

A 2013 study published in the National Journal of Integrated Research in Medicine compared people with type 2 diabetes who were on an oral diabetes medication alone to those on medication along with antioxidant supplements. After three months, people taking medication and antioxidants had less oxidative stress than the other group.

Unlike fruit juice, a whole fruit still has all of its fiber. That’s important for a diabetes diet because fiber isn’t digestible — it fills you up without raising your blood sugar. Including more fiber in your diet means better blood sugar control. To get the most fiber, eat your fruit with the skin or peel on it.

Counting Fruit Carbs and Other Diabetes Tips

“Most people with diabetes should get about 45 grams of carbs per meal," Barbera says, adding that it's important to balance fruit with proteins and other sources of healthy carbohydrates. "The key is to count the carbs and spread them out through the day to keep your blood sugar under control.” Your doctor and the feedback you get from monitoring your blood sugar can help you learn how.

A small piece of whole fruit has about 15 grams of carbohydrate. So does one-third cup of fruit juice or one-half cup of canned or frozen fruit (as long as there's no sugar added). Dried fruit is another good source of fiber and antioxidants, but it can have 15 grams of carbohydrate in just 2 tablespoons, so measure your portions carefully.

If you want to drink fruit juice, drink only 100 percent fruit juice without any added sugar. Also, try to limit your fruit juice to half a cup per serving. You might consider substituting a tasty vegetable juice that will allow you to drink a whole cup with only 10 grams of carbohydrates.

Best Fruits to Eat for Diabetes

Consider these high-antioxidant fruit choices as the best fruits to eat for a healthy diabetes diet:

Grapes
Apples
Berries
Citrus fruits
Pineapple
Mango
Papaya
Cantaloupe
Apricots

Colorful, flavorful fruits in all varieties have a healthy place in your diabetes diet. Just remember to count your carbs and eat fruit in moderation. Choose whole fruits instead of fruit juices because they're better for you, taste great, and fill you up faster and longer with fewer total carbs.