Byline: Connie Kohler MS RDN, CDCES, Registered Dietitian/Nutritionist, Certified Diabetes Care and Education Specialist, Clinical Editor

    Patients who eat a healthy diet can prevent and manage certain types of diseases, including chronic conditions such as diabetes. When a person hears the dreaded diagnosis of diabetes, they are often confused about what they can eat. For good reason: there is a lot of confusion about what constitutes a healthy diet for someone with diabetes. Thank goodness much knowledge has been gained about nutrition and diet and the recommendations have evolved in recent years.

    Let’s start with macronutrients, the calorie providing nutrients: carbohydrates, protein, and fat. Carbohydrates impact blood sugar levels because they are broken down to glucose (sugar). For the person with diabetes, the more one consumes carbohydrates the more their blood sugar level rises. Carbohydrates are found in many types of foods including baked goods, bread, cereals, pasta, beans, nuts, dairy products, fruits, and vegetables. That’s why it is important to differentiate which type of carbohydrates one is consuming.

    There are primarily two different types: simple sugars and complex sugars. Simple sugars can be referred to as “refined” and an example is corn syrup, which is added to many processed foods (prepared foods/meals, baked goods) to make food taste sweeter. Refined carbohydrates, such as baked goods, are low in nutrient density, are caloric dense, provide no beneficial fibers, and are linked to causing obesity. Complex carbohydrates can include foods such as “whole grains” or legumes (beans). Whole grains and legumes are nutrient-dense, provide beneficial fiber, and are considered “anti-inflammatory.” Complex carbohydrates are are linked to preventing and managing chronic diseases. If confused about which grain foods are whole grain versus refined, the MyPlate website is a helpful resource.

    The recommendation is to include more complex carbohydrate foods, such as whole grains and legumes, into your diet as opposed to refined. Complex carbohydrates have less of an impact on blood glucose levels, provide essential nutrients to the microbiota within the intestinal tract that results in the release of beneficial substances such as glucagon-like peptide-1 (GLP-1), and aids in providing a protective barrier, mucin layer, that prevents leaky gut syndrome.

    GLP-1 is an intestinal hormone that stimulates insulin secretion and inhibits glucagon release, both are beneficial in blood glucose management. You want to avoid leaky gut syndrome because it allows toxic substances to enter the body’s circulatory system that puts the body into what is called a low-grade inflammatory state. This “low-grade inflammatory state” puts the body at risk for obesity, diabetes, and other chronic diseases such as cardiovascular disease. Other foods that contribute to building this mucosal protective barrier within the gastrointestinal tract are whole foods such as fruits, vegetables, legumes (beans), nuts, seeds, and yogurt.

    Diets that emphasize reducing carbohydrates (whole grains, legumes, fruits, vegetables, nuts, seeds) such as the ketogenic diet, high protein diet, or low glycemic index diet miss out on these added advantages. Diets that are plant-based, such as vegetarian diet, Mediterranean diet, or DASH diet, and that consist of complex carbohydrates, have all been proven to be beneficial not only with diabetes management but also the prevention of other diseases such as obesity or cardiovascular disease.

    As we continue to learn about how dietary intake impacts health, specifically the gastrointestinal tract, it is important to understand the science and the pathophysiology along with reviewing the scientific data and outcomes. While some of the aforementioned diets may reduce blood sugar response and calorie intake and lead to weight loss, there are other health-related factors to consider that are being overlooked.


    Connie Kohler

    Connie Kohler

    MS RDN, CDCES, Registered Dietician/Nutritionist, Certified Diabetes Care and Education Specialist, Clinical Editor at Elsevier

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