When it comes to using food to optimize blood sugars, what you eat is going to be one of the most important factors to take into consideration. Yes, there are certain tricks you can incorporate to help regulate this response, but at the end of the day, what we eat is likely going to play the largest role in your blood sugar control.
Carbohydrates, or carbs for short, are one of the three main classes of macronutrients (along with protein and fat). This category includes all foods that contain sugars and starches that the body can break down into glucose. It also includes fiber that the body can’t break down. Even though it can’t be broken down to provide energy, fiber offers some additional benefits. It can help aid in digestion, decrease cholesterol, promote satiety, and regulate blood sugar. It’s recommended that men get 38 grams of fiber per day while women should aim for 25 grams per day.
The type of carbs and the total amount that you eat will typically have the biggest impact on blood sugar levels. More carbs at one time often leads to higher blood sugar values.
Because carbs are the primary food drivers behind blood sugar spikes, they often get a bad rap. However, carbs provide our bodies with energy, and certain carbs can be excellent sources of vitamins, minerals, fiber, prebiotics, and other nutrients. Using a CGM, combined with a little bit of background information about carbs, can help you to figure out which carbs work best for you and your health goals. Here’s more information on the different sources of carbs:
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Fruits - Contain starches, fiber, and naturally occurring sugars and can be an excellent source of micronutrients. In addition to containing glucose, fruit also contains fructose. Fructose can be a concern as it bypasses the regular metabolic pathways that glucose goes through and goes straight to the liver. However, there doesn’t seem to be evidence to show that fructose from fruit has any detrimental effect on most people. A good rule of thumb is to stick to one to two servings per day and avoid massive amounts all at once from things like smoothies or fruit juices. While you can use a glycemic index chart, such as this one, to get a general idea of how you’ll respond to different fruits (and veggies), the best way to know what works for you is to test things out using a CGM.
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Starchy vegetables - Includes beans and other legumes, corn, peas, cassava, and potatoes, among others. These have a higher carb content than lower-carb vegetables (that will be discussed further on in this section). Just like with fruit, these can be an excellent source of energy, vitamins, and minerals (such as vitamin C, B vitamins, and potassium), but they will significantly impact glucose values. Because of this, it’s important to be mindful of serving sizes.
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Whole Grains - Consists of grain products made using 100% of the original grain kernel (bran, germ, and endosperm), meaning they keep the fiber and many of the other micronutrients naturally found in the grain product. This includes foods such as brown rice, oatmeal, quinoa, buckwheat, barley, whole-wheat bread, and pasta.
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Refined Carbohydrates - In contrast to whole grains, refined grains are those that have all but the starchy part of the grain removed during processing. This takes out much of the fiber and many of the vitamins and minerals inherent in the original grain itself, and removing these components means these refined grains will be much more quickly digested. This can rapidly increase blood sugar values. Opting for whole grains may have a more gentle impact on glucose levels as compared to refined grains.
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Added Sugars - Found in sweets, canned fruits/juices, soda, and other sugary drinks. These do provide energy but are lacking nutrients associated with naturally occurring sugars, such as vitamins, minerals, and fiber. You may see this listed on food labels as cane syrup, dextrose, sucrose, agave nectar, or honey. The American Heart Association recommends no more than 25 grams (6 teaspoons) of added sugar per day for most women and no more than 36 grams (9 teaspoons) for men. However, keeping these as low as possible can have a significant positive impact on your blood sugars.
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Non-starchy vegetables - This category consists of some of the most nutrient-dense options available. Non-starchy veggies are those that, unlike starchy veggies, are quite low in carbs and calories but high in vitamins, minerals, fiber, and phytochemicals. Non-starchy veggies are things like asparagus, greens, broccoli, tomatoes, cucumbers, onions, peppers, and green beans.
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Dairy - Milk and products made from dairy can provide an easy way to get adequate calcium, phosphorous, vitamin D, and other micronutrients in your diet, if you tolerate them and choose to include them. Dairy contains naturally occurring carbohydrates, so it is still important to be mindful of the total amount you are consuming at one time. Dairy products such as milk, fruited/flavored yogurt, and ice cream contain natural and/or added sugars, so it is important to be mindful of the total amount you are consuming at one time. Other dairy products such as cheese, cottage cheese, or plain Greek yogurt are lower glycemic index options and may result in a more desirable glucose response.
Protein
Protein is one of our three macronutrients, along with carbs and fat. This category includes animal-based products, such as seafood, eggs, meat, and wild game, dairy products like Greek yogurt and cottage cheese, poultry, and organ meats, as well as plant-based sources like tofu, tempeh, and seitan. Protein itself generally has a very small impact on glucose levels and can help to blunt the absorption of carbs into the bloodstream, leading to a smaller and more gradual glucose response.
In addition to helping minimize the impact of carbohydrates in a meal, protein is essential to provide satiety, stabilize energy, support weight loss, and promote lean body tissue. Many people do not eat enough protein, so it’s so it’s important to look at your personal needs.
There are a few different ways to think about how much protein you should be getting each day. A general recommendation for many years has been to aim for 10-35% of your calories from protein. However current research suggests that aiming for 1.6-2.2 grams per kilogram of body weight or 1.2-2 grams per kilogram of ideal body weight may be more appropriate to maintain current muscle and also support new muscle growth. Another, more simplified way to think about this is to aim for 1 gram of protein per pound of body weight. Your NutriSense nutritionist or primary care team can help you to determine the most appropriate protein target for you.
Having some protein with each meal and snack can be an excellent strategy to maximize the benefits of protein intake and also help you to increase your total daily intake. For more on the benefits of protein, check out this article!
Fats
For many years, fat was blamed for being the root of all health problems, but in recent years, fat seems to be coming back into favor with the rise of things like the ketogenic or carnivore diet. So what’s going on here?
“Low fat” products do not automatically mean “healthy” products, and many times, more carbs are added in to counteract having to remove fat. Higher carb amounts often mean higher postprandial response. Including some fats in our diet can be essential for regulating appetite and hormone production, supporting brain health, and blunting the response from the carbohydrates in the meal the same way as protein does.
However, as you likely know, the type of dietary fat can play an important role here! The fats that we want to include more often are:
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Olives and olive oil
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Avocado and avocado oil
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Most nuts and seeds (almonds, pecans, walnuts, pistachios, Brazil nuts, chia, flax, pumpkin seeds)
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SMASH fish (Salmon, Mackerel, Anchovies, Sardines, and Herring) that are good sources of omega 3’s
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Dark chocolate
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Coconut
The fats that we want to try to limit are:
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Processed/cured meats like sausage and pepperoni
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Trans fats like margarine and partially hydrogenated oils (found in many packaged foods and nut butter)
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Refined oils like soybean, safflower, vegetable, corn, and rapeseed (canola) oils - these are high in pro-inflammatory compounds that can contribute to insulin resistance. If you’d like to read more about these compounds (known as omega 6’s), check out this article.
The choice to include higher saturated fat foods from animal products like beef, pork, eggs, and dairy can be a personal one. Animal proteins do contain some of the omega 6’s that we want to limit, but choosing pasture-raised products can help to lower this value. We do know that more saturated fat can contribute to higher cholesterol, but there isn’t great evidence to suggest that higher saturated fat intake is linked to heart disease. However, this can be very individualized, so talk with your healthcare provider and/or NutriSense nutrition coach to find out what approach may be best for you.
Hydration
While we may not initially think of fluid as an important part of glucose optimization, it can certainly play a role! If you become dehydrated, that means there’s less water circulating in your bloodstream, and this allows the glucose to become more concentrated. So while the amount of glucose in your bloodstream hasn’t changed, it can still lead to higher blood sugar levels as a result. Left untreated, severe dehydration can lead to diabetic ketoacidosis (refer to Chapter 2 - Section 3 for a review of DKA).
Water is also essential for so many other body functions, such as transporting oxygen and other nutrients throughout the body, producing hormones, having normal bowel movements, and regulating body temperature.
While the general recommendation is to aim for 6 to 8 glasses of water per day, you may need more than this depending on your energy levels, the temperature of your environment, if you are pregnant or breastfeeding, or if you take medications that increase how much you urinate. You may also need to limit your water intake if you have certain health conditions or take specific medications. Ask your primary care team if any of these special circumstances apply to you.
If you’re not someone who enjoys drinking water, it can be difficult to stay hydrated. Here are some ideas to encourage more water intake:
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Start your day off on the right foot by drinking a glass of water before eating or drinking anything else.
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Always carry a bottle of water around with you to make staying hydrated effortless.
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Set timers on your phone to remind you to drink water.
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Try sparkling water/club soda, herbal tea, lemon water, water flavored with sliced fruit, or broth - with any of these options, test these out on a CGM to make sure they don’t impact your blood sugars.
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Consider getting a water filter if you don’t enjoy the taste of your tap water or have concerns about its quality.
When it comes to hydration, it’s important to keep an eye out for sugar-sweetened beverages and steer clear of those. These often lead to bigger postprandial glucose values than any other type of food. This category includes things like regular soda, sports drinks, sugary coffee/tea beverages, sugary cocktails, and even fruit juice.
A Note on Food Quality
Leaning towards more whole foods whenever possible can help to support an overall healthy diet and can be helpful for blood sugars too. Maybe you’ve heard the term “whole foods” before but aren’t exactly sure what it means. Whole foods are those that are as close to their original form as possible. Some examples are a whole cut of meat versus sausage with lots of additives, or steel-cut oats versus more processed instant oats. Whole foods tend to be much more nutrient-dense than their processed counterparts, meaning they provide more vitamins, minerals, fiber, and other beneficial components. Some whole foods to try to eat more of include fruits and vegetables, animal-based protein foods (such as eggs, seafood, poultry, and red meat), organ meats (such as liver or heart), and fermented foods (such as good-quality sauerkraut, tempeh, or kefir).
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