Diabetes Meal Planning
Content by: Jamie Rinaldi, RD, MS in Applied Physiology & Nutrition
There are multiple approaches to planning an appropriate diet. Use this article and slideshow to educate others on the different options for meal planning and carbohydrate counting for patients with diabetes.
There are multiple approaches to planning an appropriate diet; however, all focus on carbohydrate intake, considering both the quality and quantity consumed. High quality carbohydrates are those found in high fiber, minimally processed foods.
The simplest nutritional plan to follow is the Diabetes Plate Method, which doesn’t involve any measuring, counting, or calculating. Half of a nine-inch round plate is packed with non-starchy vegetables, a quarter of it is filled with lean protein, and the remaining quarter contains high fiber carbohydrates.
Some versions of this method also include a serving of dairy and fruit with each meal, outside of the already allotted carbohydrate portion of the plate, and one to two servings of fat per meal. All that’s required to implement the Diabetes Plate Method is a simple visual guide and lists of preferred food choices for each food group. This is most appropriate for individuals with pre-diabetes and diabetes who do not take medication or inject insulin for blood sugar management, as it is not rigid.
Another method uses food exchange lists for meal planning. Different foods are categorized into lists by their predominant macronutrient and serving sizes are given for each food. As these foods are nutritionally similar, they can be exchanged for one another in a meal schedule that specifies how many servings from each list should be consumed at each meal and snack. The fruit list, for example, lists different fruits and juices in amounts that would contain approximately 60 calories and 15 grams of carbohydrate. A cup of strawberries could be exchanged for four fluid ounces of 100% fruit juice. The exchange system may be tedious, but it’s a great tool for anyone with type 2 diabetes.
Another older dietary strategy for attempting to manage diabetes is substituting sugar-free versions for “regular” versions of foods. This is often used in skilled nursing facilities as a simpler way of controlling carbohydrate intake, however it does not take into account total carbohydrate consumption. A food labeled sugar-free is not necessarily carbohydrate-free; it is typically just manufactured with the use of sugar substitutes instead of sugar. Although not an ideal approach to blood glucose management, it is widely acceptable for use with older individuals, as the consequences of strict diabetic diets outweigh the benefits.
✔️ A Popular Method:
Carbohydrate Counting is probably the most popular method for meal planning among those with diabetes, especially when insulin injections are required. Although some math is required, using one’s insulin-to-carbohydrate ratio to calculate how much carbohydrate can be consumed in a sitting and what amount of insulin will cover this is the most precise method of managing blood glucose levels. After some experimentation, individuals prescribed medications other than insulin can also determine approximately how much carbohydrate they need to consume, and when, to keep their blood glucose levels steady.
The amount of carbohydrate planned for each meal and snack is usually a multiple of 15, because a serving of food with 15 grams of carbohydrate comprises one carbohydrate (or “carb”) serving. Fiber is a type of carbohydrate not digested, therefore the number of fiber grams should be subtracted from the grams of total carbohydrate to determine a more accurate carbohydrate count. Food labels and exchange lists are among many resources for referencing portion sizes and nutritional content of foods. And until patients are seasoned carbohydrate counters, using food scales and measuring cups is advised for accuracy.
The glycemic index measures how fast a food raises one’s blood sugar. High glycemic index foods are digested and absorbed quickly for a quick boost of blood glucose, useful for a hypoglycemic episode. Foods with a low glycemic index are more slowly digested and absorbed, therefore producing a more gradual increase in blood glucose levels. Although the glycemic index seems like a scientifically sound tool for meal planning, it is complicated, as the way a food is prepared and the other ingredients or foods it is paired with changes the glycemic index of the whole meal or snack.
NOTE: No specific way of eating promises perfection with glycemic management, therefore the best one to choose is what is safe and appealing to each individual. One size does not fit all!
✔️ Quick Tips!
A journal detailing food consumption - including timing and portion sizes - and blood sugar readings can help clients establish an appropriate food plan over time. These logs must be specific!
✔️ Next Steps!
1. Decide what nutritional protocol is appropriate considering one’s lifestyle, preferences, and medical treatment.
2. Speak with a Professional who specializes in Diabetes Mellitus or a Certified Diabetes Educator for more personalized advice.
✔️ A few Great Resources!
*Health Professionals* Utilize the NCES Placemat for Diabetes as a teaching aid.
Food Exchange List:
Diabetes Plate, plus the Placement:
Count your Carbs:
Diabetes Glucose Wands,:
My Food Plan for Diabetes: