The Diabetic Plate
By Avera Sacred Heart Hospital
Sara German, RD, LN
If you have diabetes or have a close family member or friend who does, you have probably heard a lot of “helpful advice” about the proper diet. Unfortunately, much of the information out there is inaccurate! This article will provide you with some of the basics of eating with diabetes. With a proper understanding of the principles, you can fit almost any food into a healthy meal plan. The diabetic plate method is one way to do this.
First, it’s important to know which foods affect blood sugars. After a meal, food goes from the stomach to the small intestine, where the nutrients are digested and absorbed. Carbohydrates, in the form of sugars and starches, are broken down into simple sugars. These sugars are absorbed into the blood stream and immediately raise the blood sugar. The body responds to higher blood sugars by producing insulin, which helps cells take in sugar to use as energy; once sugar goes into the cells, the blood sugar decreases. In most people, the body is able to regulate this process to keep blood sugars within the healthy range. In people with diabetes, the body is either unable to produce enough insulin, or cells aren’t as responsive to insulin, or a combination of both. As a result, after meals, blood sugars tend to go too high and stay high longer.
Not all foods raise blood sugars – only foods that contain carbohydrates. Limiting these foods and spreading them out throughout the day will help keep blood sugars under control. High carbohydrate foods include grains, fruit, milk and yogurt, legumes, starchy vegetables, and sugars/syrups. You may have heard that you will be ok if you simply avoid “white foods,” but ALL carbohydrate-containing foods raise blood sugars, including whole grains (such as whole wheat bread and oatmeal) and the orange sweet potato.
Foods that contain mostly protein and fat and are low in carbohydrates will not affect blood sugars. Low carbohydrate foods include meat, eggs, cheese, fats, nuts, and nonstarchy vegetables – any vegetable besides peas, potatoes, or corn. These foods contain energy, but they won’t significantly raise blood sugars in normal serving sizes.
As a general guideline, people with diabetes should try to eat every four to five hours, starting within an hour after waking up in the morning. This can help prevent overeating later on in the day, and will help keep your blood sugars more steady. It is important to eat some carbohydrates – sugar is the body’s main source of energy. The key is to eat only moderate amounts of carbohydrate at a time, which will give the body the energy it needs without making blood sugars go too high.
One way to help limit the amount of carbohydrates at each meal is the diabetic plate method. To create the diabetic plate, divide the plate in half, then into quarters. Half the plate should contain nonstarchy vegetables, and one quarter should contain protein (things like beef, chicken, eggs). These sections of the plate have very little effect on blood sugars. The last quarter is for starchy foods (things like grains – bread, pasta, rice – or starchy vegetables, like potatoes). “Sides” include a serving of fruit and a glass of milk. These three parts of the plate – the starchy foods, fruit, and milk – are the foods that will raise blood sugars. If one “plate” isn’t enough food, add more to the nonstarchy vegetable and protein sections.
The nice thing about the diabetic plate is its flexibility. What if you never drink milk with your meals? Then you can have bigger portion of your starchy food. Is dessert on the menu? Substitute a small piece of dessert for the fruit, or a medium sized piece for the starch. Here are a few examples of meals following the diabetic plate:
- A hamburger patty (no bun), a 3 oz sweet potato, 1-2 cups summer squash, 1 cup strawberries, 1 container light yogurt
- 4 oz tuna salad, two pieces of bread, a garden salad with Italian dressing, 3 Oreo cookies
- Marinara sauce with meatballs, 2/3 cup cooked spaghetti, 1 cup steamed broccoli, 1/2 cup fruit cocktail, 1/2 cup vanilla ice cream
Have more questions? Want to get more specifics? Talk with your doctor about getting a referral to see a registered dietitian. Medical nutrition therapy for diabetes is covered by Medicare and many other insurance companies.