HealthNotes

Vegetarian, vegan, and Mediterranean-style eating patterns have the best evidence for benefiting people with pre-diabetes and type 2 diabetes. Vegetarians generally avoid meat, poultry, and pork, but many include dairy products and eggs, and some include fish. A vegan diet includes no animal foods. Both vegetarians and vegans typically eat lots of fruits and vegetables, nuts and seeds, and high-protein plant foods like soy and other legumes. The Mediterranean diet is also high in fruits and vegetables, is generous in olive oil, whole grains, and nuts, and includes modest amounts of fish and low-fat dairy foods like yogurt. While not strictly vegetarian, the Mediterranean diet is low in animal foods. These diets have a strong track record for preventing and treating diabetes as well as heart disease, kidney disease, non-alcoholic fatty liver disease, and obesity.

A low-glycemic load diet, which focuses on the amount and quality of carbohydrates in the diet, has also been found to be effective for improving blood glucose regulation in diabetics. The glycemic load of a food is determined by its carbohydrate content and its effect on blood glucose levels. Low-glycemic load foods include high-fiber, complex carbohydrate foods like whole grains and legumes, and low-carbohydrate foods like vegetables, fruits, nuts, seeds, dairy products, fish, and meats. Whether adherence to a low-glycemic load diet is effective at preventing the chronic conditions associated with diabetes is still unclear.

People with diabetes don’t necessarily need to fully embrace a strict vegetarian, vegan, Mediterranean, or low-glycemic load diet in order to benefit. Taking steps to eat more healthy foods and fewer unhealthy foods on a regular basis can have a dramatic affect on your long-term health. Here are some guidelines to keep in mind as you make decisions about what to eat every day:

Eat plenty of fruits and vegetables:

• Low fruit and vegetable consumption is linked to diabetes and all of the chronic diseases with which it is associated.
• Fruits and vegetables are rich in anti-inflammatory antioxidants, as well as vitamins, minerals, fiber, and numerous phytonutrients that may be important for good health.
• Vegetables and most fruits are low-glycemic load foods.

Include regular portions of soy foods, beans, and lentils:

• Legumes are low-glycemic load foods.
• Legumes are rich in soluble and insoluble fibers, which help control blood glucose levels and reduce cholesterol and triglygeride levels.
• Phytonutrients in legumes may also contribute to their health benefits.
• Legumes are good sources of plant proteins. When combined with grains, they provide all of the essential amino acids and can be used in place of animal proteins.

Enjoy nuts, seeds, avocados, and extra virgin olive oil:

• Studies show that the amount of fat you eat matters less than the quality.
• Nuts, seeds, avocados, and extra virgin olive oil are rich in mono- and polyunsaturated fats and are less inflammatory than animal fats.
• Nuts and seeds are high in fiber and minerals, and are low-glycemic load foods.
• Extra virgin olive oil is high in antioxidants and monounsaturated fats. It is stable under moderate heat and is a better choice than most refined vegetable oils for cooking.
• Eating these foods improves blood glucose control and is associated with better weight management and lower cardiovascular risk.

Eat a few servings of fish each week:

• The omega-3 polyunsaturated fats found in fish have anti-inflammatory effects and including them in the diet appears to protect against many chronic diseases.
• Fish is a low-glycemic load food and is a healthy alternative to animal proteins like beef, poultry, and pork.

Choose whole grains:

• Whole grains like brown rice, barley, oats, quinoa, and buckwheat provide high-quality carbohydrates, making them low- to moderate-glycemic load foods.
• Whole grains are high in fiber, which helps regulate blood glucose and lowers cholesterol and triglyceride levels.
• When choosing processed grains like bread, cereals, crackers, and pastas, choose those made with whole grain flour.

Limit portion size of meat to 3 to 4 ounces:

• When you do eat meat, choose lean meats like white skinless poultry, and round and loin cuts of beef, pork, and lamb.
• Animal foods have unhealthy saturated fats as well as an inflammatory type of omega-6 fat.
• Eating high amounts of animal foods is linked to many common chronic health problems including diabetes and its associated conditions.

Choose low-fat and non-fat dairy options:

• The evidence on dairy products and carbohydrate metabolism is mixed, but most nutrition experts agree that unsweetened cultured milk products like yogurt and kefir are good for general health and might reduce chronic inflammation and the diseases that commonly occur in diabetics.
• High-fat dairy foods like butter, cream, and most cheeses have high amounts of saturated fats, which might aggravate blood glucose dysregulation and increase the risk of heart disease.

If you choose to drink alcohol, don’t drink too much:

• Alcohol adds empty calories and may contribute to blood sugar instability, especially if you use insulin or other medications to manage your diabetes.
• People with type 1, type 2, and pre-diabetes should consult with a diabetes nutrition expert if they want to include alcohol in their diet, and should not exceed the general guidelines for maximum intake: one alcoholic drink per day for women and two for men.

Reduce your overall calorie intake:

• Weight loss has a profound positive effect on general health; extra fat in the body contributes to chronic inflammation, poor blood glucose control, and a high risk of chronic disease.
• Even moderate weight loss (7% of total body weight) can result in better blood sugar control, lower blood pressure, and lower levels of cholesterol and triglycerides.
• Avoid non-nutritious foods that add calories like soft drinks and sweets, and refined carbohydrates like bread, pasta, and crackers made with white flour.