Food groups and diabetes
Eating with diabetes and be a confusing place. There are many different food groups to choose and therefore understanding their impact on your glucose levels can be tricky. I previously discussed carbohydrates and how these will increase your blood glucose levels. Carbohydrate is an umbrella term representing various different types of food. It includes starchy carbohydrates, processed sugars and natural sugars. All three are converted into glucose once entering the body and this is ultimately what pushes up your blood glucose levels.
This is not saying you need to cut these foods from your diet but rather have an appreciation regarding the types of foods effecting your blood glucose levels. Once you have this understanding you can make changes to your diet to help reduce your blood glucose levels.
There are 6 food groups we consume in our diet. Some of which will push up your blood glucose levels and some which will have minimal or zero effect on them. Each food group is made up of a combination of various energy providing nutrients, vitamins and minerals but their ultimate category is determined by their primary nutrient.
Each food group consists of 1 or a combination of the energy providing nutrients carbohydrate, fat and protein. Of these three, it is the carbohydrates which will increase your blood glucose levels. Fat and protein on the otherhand hand will have minimal to NO effect on your blood glucose levels.
This isn’t to say you should completely cut out the carbohydrates from your diet. Carbohydrate containing food comes with a number of benefits including fuelling the brain and central nervous system, contain fibre, have a variety of vitamins and minerals such as folic acid, vitamin C, iron, amongst many more benefits. Rather than no carbohydrates, it is good practice to eat a balanced diet based off some simple principles. In order to grasp these, we need to look at the food groups and how these will effect your blood glucose levels.
The Food Groups
The diagram below known as the ‘Eatwell Guide’ highlights the different food groups. This also details the general proportions each food group should make up in your diet. This is very generalistic and I would argue this could be tweaked slightly in diabetes patients looking for optimal dietary management.
The top right in yellow is the starchy carbohydrate group. These will increase your blood glucose levels and are primarily made up of carbohydrate.
Fruit and vegetables
Top left in green is your fruit and vegetables. Fruit being a natural sugar will increase your blood glucose whereas vegetables are very low calorie and therefore rarely make much difference to your blood glucose levels. In some instances, such as when carbohydrate counting, certain vegetables may need to be accounted for. However, this should have been explained during your carbohydrate counting course.
The bottom left category in pink is our protein foods. All foods in this category are there because they provide all the essential amino acids or proteins our body requires. Hence why beans, pulses, lentils all fall within this category, despite more commonly being associated as vegetables. These foods may have an effect on glucose levels if eating in large quantities. However, in practice we do not count these and therefore say these will not effect your blood glucose levels. Be careful though as sometimes protein containing foods can be contained within a sauce or made with flour for binding purposes as seen in foods such as some bacon or sausages.
The blue category is our dairy foods. These contain a combination of carbohydrate, fat and protein but get their own category because the major nutrient they provide is calcium. Calcium is good for bone health. Some of these foods may impact your blood glucose levels, however the effect will not be as significant compared with starchy carbohydrates or processed sugars unless eaten or drank in large quantities i.e. over a pint of milk at a time.
The final category within the plate is the purple category made up of oils and spreads. These are fats and fat will not impact your blood glucose levels.
Very high fat or processed sugar
Sat in the bottom left hand corner remains our high sugar and high fat foods and these foods are typically processed and very high calorie. As a general rule these foods will drastically increase your blood glucose levels. They are low nutrient and high energy, which is why they are not included within the plate but instead sit outside it. We do appreciate people enjoy a treat occasionally and to abstain from such foods forever is a big ask. We therefore recommend keeping these foods to a minimum, particularly if suffering from diabetes.
Two categories which do not effect blood glucose levels
Out of the 6, we have 3 food groups that do not effect your blood glucose levels or will have a very minimal effect. Fats (spreads and oils), protein based foods and vegetable based foods. Basing your meals around protein and vegetables is a good place to start in terms of managing your diabetes. I would suggest initially basing meals around vegetables as they have a very high nutritional value whilst being very low calorie.
I do appreciate not everyone is a big vegetable eater in which case protein foods are also a good starting point. Aim for leaner sources of protein such as steak, reduced fat mince, poultry, fish (with good fats) or bean, pulses or lentils.
Looking back at the eat well guide above you can start to play around with the proportions of each food group. Perhaps one could reduce the amount of starchy carbohydrates they are eating and replace these with more vegetables, protein foods or a combination of both.
This will particularly help in type 2 diabetes where it is difficult for many of the medical treatments to contend with high carbohydrate intakes. Secondly, because generally speaking type 2 diabetes is driven by insulin resistance (as in the body is no longer as sensitive to insulin as it once was and therefore the insulin does not work as well), which is mostly caused by carrying additional weight, increasing your vegetable intake will likely help you lose weight and thus improve your insulin sensitivity. However, those carbohydrate counting may also find it easier calculating insulin doses if eating smaller portions of carbohydrates.
Making dietary changes to help improve your diabetes does not have to be complicated. You know know from this blog and previous blogs the food groups which will increase your blood glucose levels. You also know the food groups that will have minimal or no effect on your blood glucose levels.
Therefore, if your practice nurse or GP tells you your diabetes control could be better or is uncontrolled, that is a sign you are eating too many carbohydrates for what your body can control. In this instance, reduce the carbohydrates and increase the vegetable and/or protein foods.
Alternatively, if you recognise you eat large portions already, merely reduce the carbohydrates at meal times.
If your practice tells you your diabetes is well controlled and you are happy with the medical management (i.e. you are only well controlled because you are taking various different medications to control the disease) then continue as you are doing.
In summary – poorly controlled = reduce carbohydrate intake.
Well controlled = continue as normal assuming the good control is not down to your medications masking your dietary intake.