Eating a healthful, balanced diet can help people with diabetes manage their condition and reduce their risk of health-related complications. It can also influence how well they feel and how much energy they have each day.
Having diabetes does not mean that a person has to stop eating the foods that they enjoy. People with diabetes can eat most foods, but they may need to eat some of them in smaller portions.
In this article, we take a look at the foods that people with diabetes should avoid and provide some tips on good dietary options.
Carbohydrates are an important source of energy, but a person with diabetes should be careful when choosing which carbs to eat and how to spread them evenly throughout the day.
There are three main types of carbohydrate in food:
Carbohydrates directly affect blood glucose levels more than other nutrients. The body breaks starches and sugars down into glucose.
The Dietary Guidelines for Americans 2015–2020 recommend that most adults consume 130 grams (g) of carbohydrate each day.
Of these, 22.4–33.6 g should be fiber, depending on the person's age and sex.
Carbs should make up 45–65% of an adult's daily calories, while added sugars should constitute less than 10% of their calorie intake.
In the past, there were specific recommendations about how many carbohydrates people with diabetes should eat.
Now, there are no set guidelines. A person can speak to a doctor or dietitian about their individual dietary needs, including how many carbohydrates to eat and when. Factors affecting these individual needs include height, weight, activity level, and medications.
A person with diabetes does not have to avoid carbs totally, but they need to be sure they are eating the right kind.
Carbs to avoid
Foods that consist of processed carbs and those that contain added sugars also provide energy, but they contain few nutrients. People should avoid these as far as possible.
- baked goods made with highly processed white flour
- sweets, candies, and any foods with added sugar
- white breads and cereals
The body does not break fiber down in the same way as other carbs, so it does not raise blood sugar levels as quickly. Fruits, vegetables, legumes, and whole grains provide healthful carbs. They provide energy, fiber, and nutrients, such as vitamins and minerals.
People with diabetes should limit their intake of unhealthful carbs and focus on healthful ones. They should also talk to their doctor about their carb intake, and keep track of how much they consume.
Monitoring the total carb intake per meal and during the day can help a person keep their glucose levels remain within the target range.
All grains contain starch, but whole grains can also contain essential vitamins, minerals, and fiber.
People with diabetes should limit or avoid:
- white bread, bagels, tortillas, cakes, muffins, and other baked goods containing white flour
- white rice
- white pasta
- cereals, crackers, and pretzels that contain added sugar and no whole grains
A 2012 study looked at the development of prediabetes and type 2 diabetes in people who consumed more than 59.1 g of whole grain a day compared with those eating less than 30.6 g. Those who consumed more whole grains had a 34% lower risk of their glucose tolerance becoming worse.
Another study found that eating two extra servings a day of whole grains reduced women's chances of developing type 2 diabetes by 21%.
Healthful grains to eat include:
- brown or wild rice
- high-fiber cereals that contain at least 5 g of fiber per serving
- whole-grain sprouted bread that contains at least 3 g of fiber per serving
The processing of refined carbs, such as white flour, partially breaks them down. As a result, the body absorbs the carbs and converts them to glucose quickly, which leads to an increase in blood sugar and leaves the person feeling hungry again soon after.
The body does not absorb all of the carbs from whole grains, and those that it does absorb will enter the bloodstream more slowly than processed carbs. For this reason, they are less likely to cause a blood sugar spike, and the person will feel full for longer.
Fiber is a healthful carb that people should eat every day. People with diabetes should limit the amount of sugar that they consume and pay careful attention to their intake of starch.
Protein helps the body build, maintain, and replace tissue. The body's organs, muscles, and immune system consist of protein. The body can also break protein down into sugar, but this process is less efficient than breaking down carbs.
As with carbs, a person should choose their protein sources with care, especially if they have diabetes.
Eating red meat, such as beef, pork, and lamb, may increase the risk of diabetes, even at low levels of consumption.
The authors of a review paper concluded that eating one 3.5-ounce serving per day of unprocessed red meat, such as beef, increased a person's risk of developing type 2 diabetes by 19%.
A smaller serving of processed red meat, such as bacon, increased the risk by 51%.
The authors also noted that replacing red or processed red meat with other protein sources, such as poultry, fish, low-fat dairy, whole grains, or nuts, may cut the risk of diabetes by up to 35%.
Protein foods that are also high in fat are not healthful for many people with diabetes as they can lead to weight gain and high levels of cholesterol and triglycerides — a kind of fat — in the body.
Proteins to avoid or limit include:
- red meat, such as beef, pork, and lamb
- breaded, fried, and high-sodium meats
- processed meats, such as bacon, hot dogs, and deli meats
- ribs and other fatty cuts of meat
- poultry with the skin on
- deep-fried fish
Proteins to eat include:
- soy products
- poultry without the skin
What is protein and why do we need it? Click here to find out more.
Dairy foods provide calcium, protein, and vitamins. They also contain a sugar called lactose.
As long as they account for the carbs in their daily count, people with diabetes can consume dairy products, such as milk, yogurt, and cheese, every day.
Both type 1 and type 2 diabetes increase the risk of cardiovascular disease, and type 2 diabetes often occurs alongside obesity. For this reason, it is best to opt for low-fat dairy foods.
Full-fat foods can increase the levels of cholesterol in the blood and lead to a higher risk of heart disease than lower-fat options.
Dairy foods to avoid or limit include:
- whole milk
- full-fat yogurt
- full-fat cottage cheese
- full-fat cheese
- full-fat sour cream
- full-fat ice cream
- sweetened yogurts
- milk-based drinks with added sugar
Dairy products to eat include:
- reduced-fat or fat-free foods
- 1%, 2%, or skim milk
- low-fat plain yogurt
- low-fat cottage cheese
- low-fat sour cream
Dairy alternatives, such as soy or nut milk, can be a healthful choice, but some brands contain added sugar. People should check the label before buying or consuming these products.
Fruits and vegetables provide fiber, vitamins, and minerals. These foods can help a person manage their body weight and reduce their risk of stroke, heart disease, some cancers, and other chronic diseases.
Some fruits may cause blood sugar levels to rise, but the increase is less severe than it would be after eating a sugary snack, cake, or ice cream.
For this reason, whole fruits, in moderation, make a good dessert. They provide high-quality carbohydrates and contain fiber that may help slow down the body's absorption of glucose.
People with diabetes should take care when consuming the following:
Fruit juice: Even when people make it with fresh fruit, juice is more likely to cause a sugar spike than whole fruits, and it also provides less fiber. The reason for this is that juicing is a kind of processing that breaks down the fiber. Premade fruit juices often contain a lot of added sugar, so it is best to avoid these.
Dried fruit: This contains concentrated natural sugars, which may spike blood glucose levels.
Salt and sodium: People with high blood pressure should also be wary of the sodium, or salt, levels in foods. Many processed foods, including canned and pickled vegetables, may contain added sodium.
Being mindful of their sodium intake can help people avoid high blood pressure. The Centers for Disease Control and Prevention (CDC) advise people to limit their sodium intake to no more than 2,300 milligrams (mg) per day.
Fruit salads: Those that people make at home using whole fruits are usually more healthful than premade ones, which may contain syrup or added sugar. However, it is still easy to eat a lot of fruit in this way. A person with diabetes needs to account for the sugar content in the fruits and fruit products that they consume.
It is best to avoid or limit the following:
- dried fruit with added sugar
- canned fruit with sugar syrup
- jam, jelly, and other preserves with added sugar
- sweetened applesauce
- fruit drinks and fruit juices
- canned vegetables with added sodium
- pickles that contain sugar or salt
Fruits and vegetables to eat include:
- raw, steamed, roasted, or grilled fresh vegetables
- frozen vegetables
- canned unsalted or low sodium vegetables
- fresh, whole fruit
- frozen fruit with no added sugar
- canned fruit without added sugar
- unsweetened applesauce
Fat can provide essential fatty acids, such as omega-3, and it is an integral part of a healthful, balanced diet. Fat also helps the body absorb vitamins A, D, E, and K.
However, people need to choose the right types of fat, especially if they have diabetes.
Consuming unsaturated fats instead of saturated fats and trans fats can lower cholesterol and reduce the risk of heart disease.
Fats to avoid or limit include:
- certain oils, such as palm oil
- cream-based dressings or dips
- full-fat mayonnaise
- French fries
- breaded and battered foods
- potato chips
- many premade meals
- burgers and most fast foods
- many salad dressings
The following contain healthful fats, which makes them better options, but people should always consume fats in moderation.
- unsaturated oils, such as olive, sunflower, and canola oil
- reduced-fat dressings or dips
- salmon and other fatty fish
Manufacturers often add extra sugar or salt to premade, reduced-fat foods to improve the flavor. Therefore, it is important to check the nutritional information label before buying or consuming low-fat or "lite" foods.
Learn more here about healthful and unhealthful fats.
Sugary foods, sweets, and many desserts consist mostly of sugar and are low-quality carbohydrates. They often contain little to no nutritional value and can cause a sharp spike in blood glucose.
Sugar can also contribute to weight gain and the risk of heart disease and stroke.
Foods that are often high in sugar include:
- baked goods, such as croissants, breakfast pastries, cakes, and cookies
- pizza dough
- many sauces and condiments
- table sugar
- agave nectar and other sweeteners
- maple and other syrups
- desserts and candy bars
- premade fruit-flavored yogurts
- sweetened iced tea and lemonade
- flavored coffee drinks
- chocolate drinks
Some alcoholic beverages may contain carbohydrates and added sugars. People should limit their consumption of alcoholic beverages, especially:
- alcoholic fruit drinks
- dessert wines
- sweet mixers
More healthful options include:
- whole fruits for mixers, especially apples, oranges, pears, or berries
- unflavored, plain, or sparkling water
- flavored water without added sugar or artificial sweetener
- black coffee or coffee with low-fat milk
- fresh, frozen, or dried fruit as a sweetener
Artificial sweeteners are low in calories, but research has shown that they still have a negative effect on blood sugar by increasing insulin resistance. More studies are necessary to determine the extent of this effect.
Following the steps below may help a person eat healthfully and maintain their blood glucose levels:
- check blood sugar first thing in the morning and 2 hours after at least one meal a day
- spread food intake across three meals a day with two or three snacks
- eat a variety of foods
- eat a reasonable portion (around 1 cup or less) of starch at every meal
- only drink 1 cup of milk at a time to avoid blood sugar spikes
- limit fat and cholesterol if consuming a higher-carb diet
- always eat breakfast, and ensure that it contains whole grains, as these will help manage blood sugar and prevent overeating
- satisfy hunger cravings with low-fat dairy, lean protein, or nuts and seeds, which contain valuable nutrients
- avoid premade fruit juices that contain added sugar, and be mindful of the sugar content of 100% fruit juices
- limit candies and opt for fruit-based desserts
- use whole fruit as a sweetener instead of added sugar
- limit or avoid all products with added sugar, including syrups
- keep sodium and salt intake to a minimum
- limit alcohol, which adds calories and can disrupt glucose levels
- check the total carbohydrate content of foods
- minimize artificial sweeteners, which can negatively affect gut bacteria and insulin sensitivity
- take care with serving sizes, for example, by using a smaller plate
- eat a similar, small amount five times a day to help balance blood sugar
- keep a food record to monitor carbohydrate intake and blood sugar levels
The key to healthful eating for everyone, including people with diabetes, is to eat a variety of healthful foods from each of the food groups and to avoid highly processed foods that are high in sugar, salt, and fat.
Regardless of the types of food in a person's current diet, plenty of healthful alternatives are available to try. Once a person has adjusted to a new diet, they may not even miss the foods that they used to eat.
A diabetes educator or dietitian can help with developing a healthful eating plan. They can recommend what foods to eat, how much to eat, and when to have meals and snacks. They will base these recommendations on various factors, including weight, physical activity level, medicines, and blood glucose targets.