The body needs insulin to regulate levels of sugar, or glucose, in the blood and to use this sugar to fuel the body's cells. Without insulin, the body cannot process glucose, which comes from carbohydrates in the diet.
When high levels of glucose collect in the blood, over time, these can damage the body's organs as the blood circulates. In addition, the body's cells will not have enough energy, because, without insulin, glucose cannot enter the cells.
Healthful eating is an important way of controlling blood sugar levels. A person with a new diagnosis of diabetes may have to reconsider their diet.
This can sound daunting, but, by making smart decisions, it is possible for those with diabetes to enjoy their favorite foods — including junk foods — from time to time and in moderation.
What is the link?
Junk food is high in calories and sugar but low in nutrients..
Junk food includes many types of fast food, processed foods, and premade snack foods.
People should eat these foods infrequently, especially if they have diabetes.
Fast food is often — but not always — junk food. Click here for some tips on healthful choices of fast food for people with diabetes.
Junk foods may contribute to diabetes in the following ways:
- Rapid effect on blood sugar levels: Highly processed foods that are high in calories and low in vitamins, minerals, and fiber break down quickly in the body and can cause a rapid rise in blood sugar levels.
- Poor portion control: Junk foods are usually not very filling and frequently come in large portion sizes. Both these factors may lead people to overeat junk foods. This can have a negative impact on diabetes, including blood sugar spikes and weight gain.
- Weight gain: Due to its poor nutritional qualities and ability to encourage overeating, people who eat junk food may gain weight. Excess weight and body fat are major risk factors for developing type 2 diabetes, which accounts for 90–95 percent of all cases of diabetes.
- High blood pressure. Junk food is usually very high in sodium (salt), which contributes to high blood pressure. High blood pressure is linked to an increased risk of type 2 diabetes.
- Triglyceride levels. Junk foods are high in trans and saturated fats, which can raise levels of triglycerides, a type of fat that is present in the blood. High levels of triglycerides increase the risk of developing type 2 diabetes.
According to a 2016 study published in Experimental Physiology, regularly eating junk foods can cause as much damage to the kidneys of people without diabetes as it does to those with the disease itself. Junk food also causes high blood sugar levels similar to those experienced by people with type 2 diabetes.
As people with diabetes are already at a higher risk of kidney disease, diets containing a lot of junk foods can be especially problematic.
Saturated and trans fats
Nuts, seeds, avocado, and olive oil are all healthful fats.
Saturated fat raises blood cholesterol levels and triglyceride levels. Health authorities recommend that less than 10 percent of a person's daily calorie intake comes from saturated fats.
For a person on an 1,800-calorie diet, this means they can consume 20 grams of saturated fat in a day. This can be difficult to do on a diet containing junk foods.
Sources of saturated fat include:
- chicken and turkey skin
- dairy products (butter, cheese, cream, ice cream, whole milk, sour cream)
- ground beef
- hot dogs
- palm oil
- pork, including sausage, bacon, ribs, and fatback pork
A review article published in 2016 suggested that trans fats could have a negative impact on insulin sensitivity and increase the risk of type 2 diabetes, but the study author notes that more research is necessary.
Sources of trans fats include:
- crackers and chips
- fast food items, including fries
- hydrogenated oil or partially hydrogenated oil
- muffins and cakes
When calculating amounts of trans fat in a product, remember that food producers can label their food as containing 0 grams (g) of trans fats if the product contains less than 0.5 g.
In 2015, the Food and Drug Administration determined that partially hydrogenated oils, a main source of trans fat, are not "Generally Recognized As Safe (GRAS)."
They have since banned the adding of partially hydrogenated oils to foods. All food companies have until January 1, 2020 to fully remove these oils from their current food manufacturing processes.
Understanding both quantity and type of carbohydrates is important in managing diabetes. Balancing insulin levels in the body with carbohydrate intake is key to managing blood glucose levels.
Heavily processed and junk foods often contain added sugar, a fast-acting carbohydrate that can quickly spike insulin levels.
They also tend to contain refined, rather than whole, grains and so lack the nutrients and fiber that slows down the body's breakdown of carbohydrates.
The quantity and types of carbohydrates that a person with diabetes should consume varies between individuals. It depends on a number of factors, including height, weight, activity level, and the use of medications. A doctor or dietitian will advise on a suitable amount for each person.
Learn more here about what foods to eat and what to avoid with diabetes.
It is important to read the nutritional content on store-bought food and understand per serving sizes.
Education and preparation are key to making the most healthful choices when eating out, or when choosing junk food.
Many restaurants, particularly large chain restaurants, publish the nutrition content of their food online.
It is a good idea to look at these websites prior to eating out, or to request nutritional information at the restaurant.
Learn how to read the nutritional information on store-bought convenience and snack foods, paying particular attention to total calories, carbohydrates, fat, and salt content.
The list will show nutrition information per serving, so be sure to look at the serving size and understand portions based on this.
13 tips for healthier fast food choices
- Don't be afraid to make special requests. Ask servers to leave out certain items, or swap them for others. Request smaller portions and ask for sauces and dressings on the side, or do not have them at all. Consider ordering side salads to start and instead of a main course, or opt for an appetizer with some healthy sides.
- Avoid deluxe or super-sized portions in fast food restaurants. These may save money, but are higher in calories, fat, and sugar.
- Ask for meals without full-fat dressings or sauces, such as mayonnaise, ranch, or other creamy sauces. Mustard or fat-free dressings are more healthful choices. Ketchup often contains high fructose corn syrup, so people should be mindful of their intake of this condiment, as it can spike blood sugar.
- Choose a salad or veggie-based meal where possible, with grilled chicken, fish, tofu, or beans. Add a low-fat dressing on the side.
- Order burgers without cheese. Ask for extra salad toppings instead, if desired.
- Try an open-faced burger, with only half of a bun, or no bun. Or, opt for a lettuce wrap.
- Choose sides wisely. Instead of french fries or potato chips, opt for side salads, fresh fruit, or raw vegetables.
- Pizzas are more healthful if they have whole-wheat thin crusts, vegetable toppings, and light cheese, or no cheese at all. One tip is to consume a side salad before eating pizza, as this can help prevent overeating.
- It is best to avoid fried or breaded fish or poultry and choose grilled or broiled versions.
- When eating from salad bars, choose non-starchy vegetables, such as leafy greens, carrots, bell peppers, broccoli, and cucumber. Nuts, seeds, and avocado are healthy fat options. Avoid or limit cheese, bacon, and mayonnaise-based foods.
- Sodas, smoothies, and fruit juices can trigger blood sugar spikes. Plain or sparkling water or unsweetened tea are better choices.
- Restaurant portions tend to be oversized. Find out the rules about healthful portion sizes and follow them. For example, 3 ounces of cooked poultry or fish is the size of a deck of cards, 1 tablespoon of dressing is the size of an adult thumb, and a clenched fist equates to approximately 1 cup.
- Use the "plate method" and fill half the plate with non-starchy vegetables, one quarter with lean meat, fish, tofu, or beans, and one quarter with whole grains and starchy vegetables. Add a piece of fruit and a cup of low-fat milk or water. Be mindful of how large the plate it. These recommendations are for a 9-inch plate.
Eating breakfast on the go can lead to unhealthy food choices. It is best to start the day with a homemade meal.
If that is not possible, healthier options include:
- a whole-grain English muffin or bun, with toppings, such as egg, reduced-fat cream cheese, nut butter, or avocado
- an omelet with non-starchy vegetables
- a handful of granola, fat-free, or low-fat plain yogurt, a small handful of berries, and a sprinkling of nuts and seeds
- a cup of cooked oatmeal topped with cinnamon and nuts and a side of plain Greek yogurt with berries
- a side of fruit with the meal
- a black coffee or a skinny latte rather than a full-fat coffee, and without sugar or syrups
Wholegrains are good choices for breakfast, as they do not raise blood sugar levels excessively and they can leave a person feeling full for longer.
Find out more here about breakfast choices for people with diabetes.
The following menu items, from a selection of the most popular fast-food restaurants, represent some of the more healthful choices for people with diabetes.
- Burger King: A Whopper Jr. sandwich without mayonnaise, with apple slices.
- Chick-Fil-A: A grilled chicken sandwich without mayonnaise, with a large fruit cup.
- Chipotle: A chicken or tofu burrito bowl with black beans, fajita vegetables, tomato salsa, lettuce, and a half portion of guacamole.
- McDonald's: A quarter pounder without cheese, a side salad with low-fat balsamic vinaigrette and apple slices.
- Papa John's: 2 slices of a 14-inch custom thin pizza with olives, peppers, onions, tomatoes, mushrooms, light pizza sauce, and light cheese. Add a small side salad as an appetizer.
- Starbucks: For breakfast, the Berry Trio Yogurt or oatmeal with berries and mixed nuts and seeds. For lunch, the Zesty Chicken & Black Bean Salad Bowl. Drink options include unsweetened herbal teas, a Caffè Americano, or a plain, short, skinny latte with a drizzle of honey.
- Subway: The 6-inch Veggie Delite with lettuce, tomatoes, green peppers, cucumbers, onions, and a fat-free dressing.
- Taco Bell: The Breakfast Soft Taco with eggs and cheese, or the Chipotle Chicken Loaded Griller.
Which fast food options are most healthful? Get more information here.