Diabetes Forecast

Carb-Conscious Meal Makeovers

By Joy Manning , , ,

Eric Hinders/Mittera

Do you hear your inner health cop shouting, “Drop that slice!” if you so much as consider making a sandwich with—gasp—bread? If so, you’re not alone. Many people with diabetes, aware that carbohydrate has the most impact on blood glucose levels, live with the sinking suspicion that carbs should be off-limits.

“Not only is that assumption not true, the opposite is true,” says Emily Weatherup, MS, RDN, CDE, program director of adult diabetes education at the University of Michigan. “I encourage patients to eat a variety of foods, including carbohydrates.” It’s even possible you don’t need to cut carbs at all. Review the number of carb grams you’re eating per day with your health care provider to learn if you need to cut back. You may find you simply need to reach for healthy vegetables, fruits, and whole grains instead of carb-rich foods high in refined flour, added sugar, and fat.

Think of all the benefits you get from certain carbohydrate-containing foods. “Whole grains are high in fiber,” says Lane Hobbs, RDN, CDE, a dietitian and diabetes educator with Virginia Mason Medical Center in Seattle. Grains such as brown rice, farro, and quinoa are especially rich in fiber, which can help reduce cholesterol, aid digestive health, and feed beneficial bacteria in your gut. Vegetables and fruits are low in calories yet high in vitamins, minerals, and fiber.

There’s also the matter of your brain. “Glucose is your body and brain’s preferred source of energy,” says Weatherup. The main source of glucose is food rich in carbohydrate. Energy, focus, and mood all tend to improve when carbohydrate, protein, and fat come from a mix of healthy foods.

Food with carbohydrate can be part of your eating plan, but it’s not a white flour free-for-all. “It’s important to eat the same amount of carbs at most meals, especially if you are on insulin,” says Weatherup. Moderation helps you manage blood glucose levels when eating carbs. To see how foods affect your blood glucose levels, experts recommend that every once in a while you check blood glucose before a meal and two hours after the first bite. Your glucose level is likely to be higher after eating than before, of course. If the after-meal number is much higher (especially if it is over 180 mg/dl), talk to your diabetes care provider about adjusting what you eat, the medication you take, and/or the exercise you do.

That said, just like everyone else, people with diabetes may want to occasionally splurge on special carb-rich treats. Talk to your health care provider about how to adjust your medication and physical activity when your carb intake varies. “It’s not all that hard to make an adjustment so you can have cake on your birthday,” says Hobbs. “Increasing your dose of insulin is exactly what your pancreas would do.” If you have type 2 and don’t use insulin, consider limiting carbs at other meals that day to fit in cake later on.

Another often-overlooked way to help bring blood glucose down after eating is to get moving. “Just a 10-minute walk can prevent a blood sugar spike. Even a five-minute walk helps,” says Weatherup. Of course, you need to be careful about exercise if you have injected insulin circulating in your bloodstream—talk these strategies through with your health care provider. You should always take your medications as directed.

For everyday eating, there are many ways to tweak your favorite meals to bring down the carb level so they fit in with your healthy eating plan. With some slight adjustments, it’s possible to prepare a meal that usually has 90 grams of carb so that it clocks in at 60 grams (a moderate carb amount for many men). Make another smart swap or two and you can bring it down to a lower level still—about 30 grams (a moderate carb amount for many women). Remember, these levels are a general guidance. Depending on your gender, activity level, desire to lose or maintain weight, and blood glucose management plan, you may need more or fewer carb grams per meal.

One way to lower the carb count of a meal that contains multiple sources of carbs is to eliminate the part you’ll miss the least, says Sacha Uelmen, RD, CDE, director of nutrition at the American Diabetes Association. Burritos are a perfect example: They typically include beans, rice, and a white flour tortilla. Losing the rice won’t impact flavor much, but it’ll cut down on the carb content.

Whatever your favorite meal, there are ways to dial back the carbs and still feel satisfied. “A good rule of thumb is to always load up half your plate with nonstarchy vegetables,” says Weatherup.

Keep reading for tips on how to modify four classic main dishes and sides to reduce the carb count.



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